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Cross J, Johansson U, Besley C, Protheroe R, Kulasekararaj A, Mehta P. Topic: AS04-MDS Biology and Pathogenesis/AS04b-Clonal diversity & evolution. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Robichaux J, Le X, Elamin Y, Nilsson M, Hu L, He J, Zhang F, Poteete A, Sun H, Rinsurongkawong W, Cross J, Heymach J. P1.14-08 Activity of Poziotinib and Other 2nd-Gen Quinazoline EGFR TKIs in Atypical Exon18 and Acquired Osimertinib Resistance Mutants. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fox C, Cross J, Penhale B, Hammond S, Backhouse T, Poland F, Shepstone L, Smith T, Sahota O, MacLullich A. 70PERI-OPERATIVE ENHANCED RECOVERY HIP FRACTURE CARE OF PATIENTS WITH DEMENTIA (PERFECTED): CLUSTER RANDOMISED CONTROL TRIAL. Age Ageing 2019. [DOI: 10.1093/ageing/afz059.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Fox
- School of Health Sciences, University of East Anglia
| | - J Cross
- School of Health Sciences, University of East Anglia
| | - B Penhale
- School of Health Sciences, University of East Anglia
| | - S Hammond
- Norwich Medical Scool, University of East Anglia
| | - T Backhouse
- School of Health Sciences, University of East Anglia
| | - F Poland
- School of Health Sciences, University of East Anglia
| | - L Shepstone
- Norwich Medical Scool, University of East Anglia
| | - T Smith
- Nuffield Centre, University of Oxford
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O'Doherty D, Cross J, Plaistow R, Fathi K, Thomas S. EP-1695 Determining the dose per pulse dependence of a commercial synthetic diamond detector. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Morocho P, Cai L, Rizzo A, Felsenstein M, Boas F, Erinjeri J, Yarmohammadi H, Cross J, Solomon S, Heaphy C, Reidy-Lagunes D, Ziv E. 04:03 PM Abstract No. 225 CRISPR-mediated loss of DAXX protein expression in BON1 cell lines results in ischemia resistance and ischemia-induced epithelial-mesenchymal transition. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.283] [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: 11/15/2022] Open
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White S, Griffiths R, Baxter M, Beanland T, Cross J, Dhesi J, Docherty AB, Foo I, Jolly G, Jones J, Moppett IK, Plunkett E, Sachdev K. Guidelines for the peri-operative care of people with dementia. Anaesthesia 2019; 74:357-372. [DOI: 10.1111/anae.14530] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 12/24/2022]
Affiliation(s)
- S. White
- Royal Sussex County Hospital; Co-Chair, Association of Anaesthetists Working Party; Brighton UK
| | - R. Griffiths
- Peterborough and Stamford Hospitals Foundation NHS Trust; Co-Chair, Association of Anaesthetists Working Party; Peterborough UK
| | - M. Baxter
- University Hospital Southampton; British Geriatrics Society; UK
| | | | - J. Cross
- Guy's and St. Thomas’ Hospitals NHS Trust; Royal College of Nursing; London UK
| | - J. Dhesi
- Guy's and St. Thomas’ Hospitals NHS Trust; British Geriatrics Society; London UK
| | - A. B. Docherty
- Department of Anaesthesia and Critical Care; University of Edinburgh; UK
| | - I. Foo
- Western General Hospital; Age Anaesthesia Association; Edinburgh UK
| | | | | | - I. K. Moppett
- Anaesthesia and Peri-operative Medicine; University of Nottingham; Royal College of Anaesthetists; UK
| | - E. Plunkett
- University Hospitals Birmingham; Association of Anaesthetists Trainees; UK
| | - K. Sachdev
- Homerton University Hospital NHS Foundation Trust; London UK
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Roberts NJ, Kidd L, Kirkwood K, Cross J, Partridge MR. A systematic review of the content and delivery of education in pulmonary rehabilitation programmes. Respir Med 2018; 145:161-181. [PMID: 30509706 DOI: 10.1016/j.rmed.2018.11.002] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Pulmonary rehabilitation (PR) is a core component of Chronic Obstructive Pulmonary Disease (COPD) management with well recognized benefits. While suggestions for educational content within pulmonary rehabilitation have been detailed in clinical guidance, it is unclear what educational content is delivered as part of pulmonary rehabilitation, who delivers it, and how it is delivered. METHODS A systematic review was conducted to identify what educational content is delivered as part of pulmonary rehabilitation, how is this delivered and who delivers it. Databases were searched from 1981 to 2017 using multiple search terms related to "pulmonary rehabilitation" and "education". RESULTS Fourteen studies were identified. This included 6 survey studies, 5 quasi-experimental studies and 3 RCTs. Five key topics that were consistently included within PR programmes were identified as: 1) Anxiety/depression and stress management. 2) Early recognition of signs of infection. 3) Dyspnea and symptom management. 4) Nutrition. 5) Techniques using inhalers and nebulizers. Broader topics such as welfare/benefits, sexuality, and advance care directives did not frequently feature. Only four studies used tools to measure knowledge or learning pre and post rehabilitation in an attempt to evaluate the effectiveness of the education delivered as part of PR. CONCLUSIONS The delivery of education in PR programmes is variable and does not follow suggested educational topics. Education needs to take a patient centered motivational approach to ensure effective delivery. Further research into appropriate educational outcome measures are needed, in order to evaluate the changes in behaviour associated with education.
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Affiliation(s)
- N J Roberts
- School of Health and Life Sciences, Glasgow Caledonian University, United kingdom.
| | - L Kidd
- School of Medicine, Dentistry and Nursing, University of Glasgow, United kingdom
| | - K Kirkwood
- Pulmonary Rehabilitation, NHS Greater Glasgow and Clyde, United kingdom
| | - J Cross
- School of Health Sciences, University of East Anglia, United kingdom
| | - M R Partridge
- National Heart and Lung Institute, Imperial College London, United kingdom
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Penhale B, Cross J, Poland F, Fox C, Hammond S, Backhouse T. DISRUPTIONS, DISCONTINUITIES & DISPERSIONS: AN ETHNOGRAPHY OF DISJUNCTURES IN ACUTE ORTHOPAEDIC WARDS. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - C Fox
- University of East Anglia
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Thompson D, Swystun T, Cross J, Cross R, Chartrand D, Edge C. Fine- and coarse-scale movements and habitat use by Wood Turtles (Glyptemys insculpta) based on probabilistic modeling of radiotelemetry and GPS-telemetry data. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Understanding animal movement and habitat use is critical for the delineation of habitat requiring protection for species at risk. Defining critical habitat requires studies with observations at a fine enough scale to reflect how animals use and move among habitats and include enough individuals to generalize findings to the population. We present results of a multiyear study on 48 adult Wood Turtles (Glyptemys insculpta (Le Conte, 1830)) from two different populations monitored with low-frequency radiotelemetry and high-frequency GPS telemetry. Results demonstrated the propensity for conventional radiotelemetry to underestimate cumulative distances moved and overestimate the amount of habitat used by Wood Turtles. Together the two data sets demonstrate the propensity for Wood Turtles to remain in close proximity to the river and that some differences in habitat use occur between the sexes; males tended to move parallel to the river, whereas females moved perpendicular to the river. The GPS-telemetry data provided a robust spatiotemporal data set that provided a better understanding of frequently used habitat types and features. Overall, study results suggest that currently delineated areas of protected habitat are likely to be effective in conserving these two populations and provides significantly improved, spatially explicit knowledge that can be used to inform further mitigation efforts if necessary.
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Affiliation(s)
- D.G. Thompson
- Canadian Forest Service – Natural Resources Canada, Great Lakes Forestry Centre, 1219 Queen Street East, Sault Ste. Marie, ON P6A 2E6, Canada
| | - T. Swystun
- Canadian Forest Service – Natural Resources Canada, Great Lakes Forestry Centre, 1219 Queen Street East, Sault Ste. Marie, ON P6A 2E6, Canada
| | - J. Cross
- Algoma Highlands Conservancy, 194 Pickard Road, Goulais River, ON P0S 1E0, Canada
| | - R. Cross
- Algoma Highlands Conservancy, 194 Pickard Road, Goulais River, ON P0S 1E0, Canada
| | - D. Chartrand
- Canadian Forest Service – Natural Resources Canada, Great Lakes Forestry Centre, 1219 Queen Street East, Sault Ste. Marie, ON P6A 2E6, Canada
| | - C.B. Edge
- Canadian Forest Service – Natural Resources Canada, Atlantic Forestry Centre, 1350 Regent Street South, Fredericton, NB E3B 5P7, Canada
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Biasutti SA, Dart AJ, Cross J, Dart CM, Uquillas E, Jeffcott LB. Imbrication of the medial retinaculum to repair a bilateral traumatic lateral patellar luxation in an alpaca (Vicugna pacos). N Z Vet J 2017; 66:48-49. [PMID: 28946822 DOI: 10.1080/00480169.2017.1385035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S A Biasutti
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
| | - A J Dart
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
| | - J Cross
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
| | - C M Dart
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
| | - E Uquillas
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
| | - L B Jeffcott
- a Research and Clinical Trials Unit Veterinary Teaching Hospital Camden University of Sydney Camden , NSW Australia
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Hamedi N, Antoniou S, Edwards F, Edwards F, Spratling L, Long G, Butt J, Anandan A, Cross J, Stebbings A, Cutting H, Lobban TCA, Williams H. 92Pan London ‘know your pulse’ awareness campaign during world heart rhythm week 2017. Europace 2017. [DOI: 10.1093/europace/eux283.087] [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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12
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Fox C, Penhale B, Cross J, Poland F, Smith T, Hammond S. CARING FOR PEOPLE WITH HIP FRACTURE AND COGNITIVE IMPAIRMENTS: FINDINGS FROM PERFECTED. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. Fox
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - B. Penhale
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - J. Cross
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - F. Poland
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - T. Smith
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - S.P. Hammond
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Cross J, Poland F, Hammond S, Backhouse T, Varley A, Penhale B, Lambert N, Fox C. DISRUPTIONS, DISCONTINUITIES, AND DISPERSIONS: AN ETHNOGRAPHY OF DISJUNCTURES IN ORTHOPAEDIC WARDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Cross
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - F. Poland
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - S.P. Hammond
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - T. Backhouse
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - A. Varley
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - B. Penhale
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - N. Lambert
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - C. Fox
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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14
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Varley A, Penhale B, Backhouse T, Lambert N, Poland F, Cross J, Hammond S, Fox C. “WORK IS LIKE A CONVEYOR BELT”: FINDINGS FROM AN ETHNOGRAPHIC STUDY OF ACUTE TRAUMA WARDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Varley
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom,
| | - B. Penhale
- School of Health Sciences, University of East Anglia, Norwich, Norwich, United Kingdom
| | - T. Backhouse
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom,
| | - N. Lambert
- School of Health Sciences, University of East Anglia, Norwich, Norwich, United Kingdom
| | - F. Poland
- School of Health Sciences, University of East Anglia, Norwich, Norwich, United Kingdom
| | - J. Cross
- School of Health Sciences, University of East Anglia, Norwich, Norwich, United Kingdom
| | - S.P. Hammond
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom,
| | - C. Fox
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom,
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15
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Cross J, Bhatnagar R, Martin FE, Dhesi JK. 10INTRODUCING NURSE-LED PROCEDURE CASE FINDING IN OLDER EMERGENCY GENERAL SURGICAL (EGS) PATIENTS. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.10] [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: 11/12/2022] Open
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16
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Sajjadi SA, Sheikh-Bahaei N, Cross J, Gillard JH, Scoffings D, Nestor PJ. Can MRI Visual Assessment Differentiate the Variants of Primary-Progressive Aphasia? AJNR Am J Neuroradiol 2017; 38:954-960. [PMID: 28341715 DOI: 10.3174/ajnr.a5126] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/02/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Primary-progressive aphasia is a clinically and pathologically heterogeneous condition. Nonfluent, semantic, and logopenic are the currently recognized clinical variants. The recommendations for the classification of primary-progressive aphasia have advocated variant-specific patterns of atrophy. The aims of the present study were to evaluate the sensitivity and specificity of the proposed imaging criteria and to assess the intra- and interrater reporting agreements. MATERIALS AND METHODS The cohort comprised 51 patients with a root diagnosis of primary-progressive aphasia, 25 patients with typical Alzheimer disease, and 26 matched control participants. Group-level analysis (voxel-based morphometry) confirmed the proposed atrophy patterns for the 3 syndromes. The individual T1-weighted anatomic images were reported by 3 senior neuroradiologists. RESULTS We observed a dichotomized pattern of high sensitivity (92%) and specificity (93%) for the proposed atrophy pattern of semantic-variant primary-progressive aphasia and low sensitivity (21% for nonfluent-variant primary-progressive aphasia and 43% for logopenic-variant primary-progressive aphasia) but high specificity (91% for nonfluent-variant primary-progressive aphasia and 95% for logopenic-variant primary-progressive aphasia) in other primary-progressive aphasia variants and Alzheimer disease (sensitivity 43%, specificity 92%). MR imaging was least sensitive for the diagnosis of nonfluent-variant primary-progressive aphasia. Intrarater agreement analysis showed mean κ values above the widely accepted threshold of 0.6 (mean, 0.63 ± 0.16). Pair-wise interobserver agreement outcomes, however, were well below this threshold in 5 of the 6 possible interrater contrasts (mean, 0.41 ± 0.09). CONCLUSIONS While the group-level results were in precise agreement with the recommendations, semantic-variant primary-progressive aphasia was the only subtype for which the proposed recommendations were both sensitive and specific at an individual level.
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Affiliation(s)
- S A Sajjadi
- From the Department of Neurology (S.A.S.), University of California, Irvine, Irvine, California
| | - N Sheikh-Bahaei
- Department of Radiology (N.S.-B., J.H.G.), University of Cambridge, Cambridge, UK
- Department of Radiology (N.S.-.B., J.C., J.H.G., D.S.), Cambridge University Hospitals, Cambridge, UK
| | - J Cross
- Department of Radiology (N.S.-.B., J.C., J.H.G., D.S.), Cambridge University Hospitals, Cambridge, UK
| | - J H Gillard
- Department of Radiology (N.S.-B., J.H.G.), University of Cambridge, Cambridge, UK
- Department of Radiology (N.S.-.B., J.C., J.H.G., D.S.), Cambridge University Hospitals, Cambridge, UK
| | - D Scoffings
- Department of Radiology (N.S.-.B., J.C., J.H.G., D.S.), Cambridge University Hospitals, Cambridge, UK
| | - P J Nestor
- German Center for Neurodegenerative Diseases (P.J.N.), Magdeburg, Germany
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Hart MG, Housden CR, Suckling J, Tait R, Young A, Müller U, Newcombe VFJ, Jalloh I, Pearson B, Cross J, Trivedi RA, Pickard JD, Sahakian BJ, Hutchinson PJ. Advanced magnetic resonance imaging and neuropsychological assessment for detecting brain injury in a prospective cohort of university amateur boxers. Neuroimage Clin 2017; 15:194-199. [PMID: 28529875 PMCID: PMC5429235 DOI: 10.1016/j.nicl.2017.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 04/22/2017] [Accepted: 04/25/2017] [Indexed: 10/25/2022]
Abstract
BACKGROUND/AIM The safety of amateur and professional boxing is a contentious issue. We hypothesised that advanced magnetic resonance imaging and neuropsychological testing could provide evidence of acute and early brain injury in amateur boxers. METHODS We recruited 30 participants from a university amateur boxing club in a prospective cohort study. Magnetic resonance imaging (MRI) and neuropsychological testing was performed at three time points: prior to starting training; within 48 h following a first major competition to detect acute brain injury; and one year follow-up. A single MRI acquisition was made from control participants. Imaging analysis included cortical thickness measurements with Advanced Normalization Tools (ANTS) and FreeSurfer, voxel based morphometry (VBM), and Tract Based Spatial Statistics (TBSS). A computerized battery of neuropsychological tests was performed assessing attention, learning, memory and impulsivity. RESULTS During the study period, one boxer developed seizures controlled with medication while another developed a chronic subdural hematoma requiring neurosurgical drainage. A total of 10 boxers contributed data at to the longitudinal assessment protocol. Reasons for withdrawal were: logistics (10), stopping boxing (7), withdrawal of consent (2), and development of a chronic subdural hematoma (1). No significant changes were detected using VBM, TBSS, cortical thickness measured with FreeSurfer or ANTS, either cross-sectionally at baseline, or longitudinally. Neuropsychological assessment of boxers found attention/concentration improved over time while planning and problem solving ability latency decreased after a bout but recovered after one year. CONCLUSION While this neuroimaging and neuropsychological assessment protocol could not detect any evidence of brain injury, one boxer developed seizures and another developed a chronic sub-dural haematoma.
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Affiliation(s)
- M G Hart
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom.
| | - C R Housden
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - J Suckling
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - R Tait
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - A Young
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - U Müller
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom; Adult ADHD Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge Road, Fulbourn, Cambridge CB21 5HH, United Kingdom
| | - V F J Newcombe
- Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; University Division of Anaesthesia, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - I Jalloh
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - B Pearson
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - J Cross
- Department of Radiology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - R A Trivedi
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - J D Pickard
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - B J Sahakian
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - P J Hutchinson
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
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Smith TO, Cooper A, Peryer G, Griffiths R, Fox C, Cross J. Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. Int J Geriatr Psychiatry 2017; 32:386-396. [PMID: 28093812 DOI: 10.1002/gps.4655] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/01/2016] [Accepted: 12/06/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery. Pooled odds ratio (OR) and mean difference of those who experienced delirium compared to those who did not were calculated for each variable. Evidence was assessed using the Downs and Black appraisal tool and interpreted using the GRADE approach. RESULTS A total of 6704 people (2090 people with post-operative delirium) from 32 studies were analysed. There was moderate evidence of nearly a two-times greater probability of post-operative delirium for those aged 80 years and over (OR: 1.77; 95% CI: 1.09, 2.87), whether patients lived in a care institution pre-admission (OR: 2.65; 95% CI: 1.79, 3.92), and a six-times greater probability of developing post-operative delirium with a pre-admission diagnosis of dementia (OR: 6.07, 95% CI: 4.84, 7.62). There was no association with intra-operative variables and probability of delirium. CONCLUSION Clinicians treating people with a hip fracture should be vigilant towards post-operative delirium if their patients are older, have pre-existing cognitive impairment and poorer overall general health. This is also the case for those who experience post-operative complications such as pneumonia or a urinary tract infection. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- T O Smith
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - A Cooper
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - G Peryer
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - R Griffiths
- Department of Anaesthesia, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, UK
| | - C Fox
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J Cross
- School of Health Sciences, University of East Anglia, Norwich, UK
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Yu HA, Sima C, Feldman D, Liu LL, Vaitheesvaran B, Cross J, Rudin CM, Kris MG, Pao W, Michor F, Riely GJ. Phase 1 study of twice weekly pulse dose and daily low-dose erlotinib as initial treatment for patients with EGFR-mutant lung cancers. Ann Oncol 2017; 28:278-284. [PMID: 28073786 PMCID: PMC5834093 DOI: 10.1093/annonc/mdw556] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Patients with EGFR-mutant lung cancers treated with EGFR tyrosine kinase inhibitors (TKIs) develop clinical resistance, most commonly with acquisition of EGFR T790M. Evolutionary modeling suggests that a schedule of twice weekly pulse and daily low-dose erlotinib may delay emergence of EGFR T790M. Pulse dose erlotinib has superior central nervous system (CNS) penetration and may result in superior CNS disease control. Methods We evaluated toxicity, pharmacokinetics, and efficacy of twice weekly pulse and daily low-dose erlotinib. We assessed six escalating pulse doses of erlotinib. Results We enrolled 34 patients; 11 patients (32%) had brain metastases at study entry. We observed 3 dose-limiting toxicities in dose escalation: transaminitis, mucositis, and rash. The MTD was erlotinib 1200 mg days 1-2 and 50 mg days 3-7 weekly. The most frequent toxicities (any grade) were rash, diarrhea, nausea, fatigue, and mucositis. 1 complete and 24 partial responses were observed (74%, 95% CI 60-84%). Median progression-free survival was 9.9 months (95% CI 5.8-15.4 months). No patient had progression of an untreated CNS metastasis or developed a new CNS lesion while on study (0%, 95% CI 0-13%). Of the 18 patients with biopsies at progression, EGFR T790M was identified in 78% (95% CI 54-91%). Conclusion This is the first clinical implementation of an anti-cancer TKI regimen combining pulse and daily low-dose administration. This evolutionary modeling-based dosing schedule was well-tolerated but did not improve progression-free survival or prevent emergence of EGFR T790M, likely due to insufficient peak serum concentrations of erlotinib. This dosing schedule prevented progression of untreated or any new central nervous system metastases in all patients.
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Affiliation(s)
- H. A. Yu
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - C. Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - D. Feldman
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - L. L. Liu
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - B. Vaitheesvaran
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Sloan Kettering Institute, Sloan Kettering Cancer Center, New York
| | - J. Cross
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Sloan Kettering Institute, Sloan Kettering Cancer Center, New York
| | - C. M. Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - M. G. Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - W. Pao
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - F. Michor
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - G. J. Riely
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
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Wright DC, Adayapalam N, Bain N, Bain SM, Brown A, Buzzacott N, Carey L, Cross J, Dun K, Joy C, McCarthy C, Moore S, Murch AR, O'Malley F, Parker E, Watt J, Wilkin H, Fagan K, Pertile MD, Peters GB. Chromosome microarray proficiency testing and analysis of quality metric data trends through an external quality assessment program for Australasian laboratories. Pathology 2016; 48:586-96. [PMID: 27575971 DOI: 10.1016/j.pathol.2016.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/19/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
Chromosome microarrays are an essential tool for investigation of copy number changes in children with congenital anomalies and intellectual deficit. Attempts to standardise microarray testing have focused on establishing technical and clinical quality criteria, however external quality assessment programs are still needed. We report on a microarray proficiency testing program for Australasian laboratories. Quality metrics evaluated included analytical accuracy, result interpretation, report completeness, and laboratory performance data: sample numbers, success and abnormality rate and reporting times. Between 2009 and 2014 nine samples were dispatched with variable results for analytical accuracy (30-100%), correct interpretation (32-96%), and report completeness (30-92%). Laboratory performance data (2007-2014) showed an overall mean success rate of 99.2% and abnormality rate of 23.6%. Reporting times decreased from >90 days to <30 days for normal results and from >102 days to <35 days for abnormal results. Data trends showed a positive correlation with improvement for all these quality metrics, however only 'report completeness' and reporting times reached statistical significance. Whether the overall improvement in laboratory performance was due to participation in this program, or from accumulated laboratory experience over time, is not clear. Either way, the outcome is likely to assist referring clinicians and improve patient care.
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Affiliation(s)
- D C Wright
- The Children's Hospital at Westmead, Westmead, NSW, Australia.
| | - N Adayapalam
- Royal Brisbane Hospital, Brisbane, Qld, Australia
| | - N Bain
- Hunter Area Pathology, Newcastle, NSW, Australia
| | - S M Bain
- SA Pathology, Adelaide, SA, Australia
| | - A Brown
- Wellington Hospital, Wellington, New Zealand
| | - N Buzzacott
- Western Genome Diagnostics, Perth, WA, Australia
| | - L Carey
- The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - J Cross
- The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - K Dun
- Royal Hobart Hospital, Hobart, Tas, Australia
| | - C Joy
- Mater Hospital, Brisbane, Qld, Australia
| | - C McCarthy
- Queensland Fertility Group, Brisbane, Qld, Australia
| | - S Moore
- SA Pathology, Adelaide, SA, Australia
| | - A R Murch
- Retired, formerly at Pathwest Laboratory Medicine WA, QEII Medical Centre, Nedlands, WA, Australia
| | - F O'Malley
- St Vincents Hospital, Melbourne, Vic, Australia
| | - E Parker
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - J Watt
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - H Wilkin
- Monash Medical Centre, Melbourne, Vic, Australia
| | - K Fagan
- Retired, formerly at Hunter Area Pathology Service, John Hunter Hospital, Newcastle, NSW, Australia
| | - M D Pertile
- Murdoch Children's Research Institute, Melbourne, Vic, Australia
| | - G B Peters
- The Children's Hospital at Westmead, Westmead, NSW, Australia
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Abstract
Objective: To assess the effect of a slider shoe on the gait speed and energy efficiency of hemiplegic gait. Design: A–B–A single-case design to compare walking with and without the slider shoe. Results were assessed graphically using the 2SD method. Setting: Stroke unit of an NHS general hospital in the UK. Subjects: Four acute stroke patients undergoing gait rehabilitation. Intervention: Walking practice with and without a slider shoe worn over the real shoe of the weak leg. Main outcome measures: Gait speed (10-m walk test) and energy efficiency (Physiological Cost Index). Results: All subjects showed an improvement in speed and efficiency when wearing the slider shoe compared with the baseline phase (A1). Three subjects showed a sustained improvement in efficiency and two showed a sustained improvement in speed in the second baseline phase (A2). Conclusion: A slider shoe may improve the speed and efficiency of hemiplegic gait for people in the early stages of gait rehabilitation. Further investigation is warranted.
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Affiliation(s)
- J Cross
- Tameside General Hospital, Uxbridge, Middlesex, UK
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22
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Hall SL, Cross J, Selix NW, Patterson C, Segre L, Chuffo-Siewert R, Geller PA, Martin ML. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol 2015; 35 Suppl 1:S29-36. [PMID: 26597803 PMCID: PMC4660046 DOI: 10.1038/jp.2015.147] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/23/2015] [Indexed: 12/25/2022]
Abstract
Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents' functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby.
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Affiliation(s)
- S L Hall
- Division of Neonatology, St John's Regional Medical Center, Oxnard, CA, USA
| | - J Cross
- Department of Social Work, Widener University, Chester, PA, USA
| | - N W Selix
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - C Patterson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L Segre
- College of Nursing and Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - R Chuffo-Siewert
- Department of Nursing, University of Iowa Children's Hospital, Iowa City, IA, USA
| | - P A Geller
- Departments of Psychology, Obstetrics/Gynecology and Public Health, Drexel University, Philadelphia, PA, USA
| | - M L Martin
- Department of Nursing, McLeod Regional Medical Center, Florence, SC, USA
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Sakel M, Boukouvalas A, Buono R, Moten M, Mirza F, Chan WY, Maidment I, Cross J, Smith TO, Myint PK, Fox C. Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay? Brain Inj 2015; 29:1426-30. [PMID: 26287759 DOI: 10.3109/02699052.2015.1060358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. RESEARCH DESIGN A retrospective case note review assessed total rehabilitation unit admission. METHODS AND PROCEDURES Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge. MAIN OUTCOMES AND RESULTS A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = -6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36-68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002-0.35). CONCLUSIONS There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort.
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Affiliation(s)
- M Sakel
- a East Kent University NHS Hospitals , Canterbury , UK
| | | | - R Buono
- c University of Aberdeen , Aberdeen , UK
| | - M Moten
- d Imperial College , London , UK
| | - F Mirza
- a East Kent University NHS Hospitals , Canterbury , UK
| | - W-Y Chan
- e Norfolk and Norwich University Hospital , Norwich , UK , and
| | | | - J Cross
- f University of East Anglia , Norwich , UK
| | - T O Smith
- f University of East Anglia , Norwich , UK
| | - P K Myint
- c University of Aberdeen , Aberdeen , UK
| | - C Fox
- f University of East Anglia , Norwich , UK
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24
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Affiliation(s)
- Sophia Varadkar
- Epilepsy Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and UCL Institute of Child Health, London, United Kingdom
| | - J. Cross
- Department of Clinical Neurosciences, UCL-Institute of Child Health, Great Ormond Street for Children NHS Foundation Trust, London and Young Epilepsy, Lingfield, United Kingdom
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25
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Venneti S, Dunphy M, Zhang H, Pitter K, Campos C, Carlin S, Lyashchenko S, Ploessl C, Rohle D, Omuro A, Cross J, Brennan C, Weber W, Holland E, Mellinghoff I, Kung H, Lewis J, Thompson C. TM-15 * GLUTAMINE BASED PET IMAGING FACILITATES ENHANCED METABOLIC DETECTION OF GLIOMAS IN VIVO. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou278.14] [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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26
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Dhesi J, Partridge J, Shipway D, Cross J. SS4.01: Perioperative medicine for older people. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70061-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fontsere N, Mestres G, Burrel M, Barrufet M, Montana X, Arias M, Ojeda R, Maduell F, Campistol JM, Nagaraja P, Rees D, Husein T, Chess J, Lin CC, Yang WC, Khosravi M, Kandil H, Cross J, Hopkins S, Collier S, Lopes D, Pereira S, Gomes AM, Ventura A, Martins V, Seabra J, Rothuizen TC, Damanik F, Visser MJT, Lavrijsen T, Cox MAJ, Moroni L, Rabelink TJ, Rotmans JI, Fontsere N, Cardozo C, Donate J, Soriano A, Muros M, Pons M, Mensa J, Campistol JM, Navarro-Gonzalez JF, Maduell F, Wijewardane A, Murley A, Powers S, Allen C, Baharani J, Wilmink T, Esenturk M, Zengin M, Dal M, Tahtal N, Shibata K, Shinzato T, Satta H, Nishihara M, Koguchi N, Kuji T, Kawata S, Kaneda T, Yasuda G, Scrivano J, Pettorini L, Rutigliano T, Ciavarella GM, De Biase L, Punzo G, Mene P, Pirozzi N, El Haggan W, Belazrague K, Ehoussou S, Foucher V, El Salhy M, Ouellet G, Davis J, Caron P, Leblanc M, Pettorini L, Romitelli F, Fazzari L, Scrivano J, Ortu G, Di Stasio E, Punzo G, Mene P, Pirozzi N, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Letachowicz K, Go biowski T, Kusztal M, Letachowicz W, Weyde W, Klinger M, Murley A, Wijewardane A, Powers S, Allen C, Hollingsworth L, Wilmink T, Baharani J, Roca-Tey R, Samon R, Ibrik O, Roda A, Gonzalez-Oliva JC, Martinez-Cercos R, Viladoms J, Renaud CJ, Lim EK, Seow TY, Teh HS, Tosic J, Jankovic A, Djuric P, Radovic Maslarevic V, Popovic J, Dimkovic N, Kazantzi A, Trigka K, Buono F, Laurino S, Toriello G, Di Luccio R, Galise A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Asano M, Oguchi K, Saito A, Onishi Y, Yamamoto Y, Fukuhara S, Akiba T, Akizawa T, Kurokawa K, Guedes Marques M, Ibeas J, Maia P, Ponce P, Chang KY, Park HS, Kim HW, Choi BS, Park CW, Yang CW, Jin DC, Likaj E, Seferi S, Caco G, Petrela E, Barbullushi M, Idrizi A, Thereska N, Lomonte C, Casucci F, Libutti P, Lisi P, Basile C, Ancarani P, Valsuani G, Cavallo L, Parodi D, Lorusso C, Renaud C, Lai BC, Tho S, Yeoh L, Guedes Marques M, Botelho C, Maia P, Ponce P, Yankovoy A, Alexandr S, Smoliacov A, Stepanov V, Rees D, Parker C, Davies P, Taylor S, Mikhail A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Gubensek J, Persic V, Vajdic B, Ponikvar R, Buturovic-Ponikvar J, Hadimeri U, Warme AV, Stegmayr B, Jankovic A, Suvakov S, Tosic J, Damjanovic T, Djuric P, Bajcetic S, Radovic-Maslarevic V, Popovic J, Simic T, Dimkovic N, Likaj E, Seferi S, Petrela E, Idrizi A, Rroji M, Barbullushi M, Thereska N, Chua HL, Kanda H, See SL, Liew NC, Tsuchida K, Tomo T, Fukasawa M, Kawashima S, Minakuchi J, Thanaraj V, Dhaygude A, Ikeda K, Forneris G, Cecere P, Pozzato M, Trogolo M, Vallero A, Mesiano P, Roccatello D, Esenturk M, Zengin M, Keskin L, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Casey JR, Hanson CS, Winkelmayer WC, Craig J, Palmer S, Strippoli G, Tong A, Ferrara D, Scamarda S, Bernardino L, Amico L, Lorito MC, Incalcaterra F, Visconti L, Visconti G, Valenza F, D'Amato F, Di Napoli A, Tazza L, Chicca S, Lapucci E, Silvestri P, Di Lallo D, Michelozzi P, Davoli M. DIALYSIS VASCULAR ACCESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu156] [Citation(s) in RCA: 2] [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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Abstract
INTRODUCTION The aim of this study is to establish the current practice of aneurysm management, to assess the introduction of fenestrated endovascular aneurysm repair (FEVAR) and to establish the criteria for its use and its role in the UK. METHODS All UK centres performing FEVAR and centres with an established interest in infra-renal endovascular aneurysm repair (EVAR) were invited to respond to an open-ended questionnaire about abdominal aortic aneurysm (AAA) management. RESULTS A response was obtained from over 90% of UK FEVAR centres. Results showed marked regional differences in aneurysm management, in particular with regard to indications for complex aneurysm management. CONCLUSION The trend in the UK is towards endovascular repair. However, there are still variations in unit policies, indicating regional differences in patient management.
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Affiliation(s)
- J Cross
- University College Hospital, London, UK.
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29
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Ambler G, Boyle J, Cousins C, Hayes P, Metha T, See T, Varty K, Winterbottom A, Adam D, Bradbury A, Clarke M, Jackson R, Rose J, Sharif A, Wealleans V, Williams R, Wilson L, Wyatt M, Ahmed I, Bell R, Carrell T, Gkoutzios P, Sabharwal T, Salter R, Waltham M, Bicknell C, Bourke P, Cheshire N, Franklin I, James A, Jenkins M, Tyrrell M, Wilkins C, Bown M, Choke E, McCarthy M, Sayers R, Tamberaja A, Farquharson F, Serracino-Inglott F, Davis M, Hamilton G, Brennan J, Canavati R, Fisher R, McWilliams R, Naik J, Vallabhaneni S, Hardman J, Black S, Hinchliffe R, Holt P, Loftus I, Loosemore T, Morgan R, Thompson M, Agu O, Bishop C, Boardley D, Cross J, Hague J, Harris P, Ivancev K, Raja J, Richards T, Simring D, Fisher A, Smith D, Copeland G. Early Results of Fenestrated Endovascular Repair of Juxtarenal Aortic Aneurysms in the United Kingdom. Circulation 2012; 125:2707-15. [PMID: 22665884 DOI: 10.1161/circulationaha.111.070334] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - T. Metha
- Addenbrooke's Hospital, Cambridge
| | - T.C. See
- Addenbrooke's Hospital, Cambridge
| | - K. Varty
- Addenbrooke's Hospital, Cambridge
| | | | - D.J. Adam
- Birmingham Heartlands Hospital, Birmingham
| | | | | | | | - J.D. Rose
- Freeman Hospital, Newcastle upon Tyne
| | - A. Sharif
- Freeman Hospital, Newcastle upon Tyne
| | | | | | - L. Wilson
- Freeman Hospital, Newcastle upon Tyne
| | | | - I. Ahmed
- Guy's & St. Thomas' Hospital, London
| | - R.E. Bell
- Guy's & St. Thomas' Hospital, London
| | | | | | | | - R. Salter
- Guy's & St. Thomas' Hospital, London
| | | | | | | | | | | | - A. James
- Imperial College Hospitals, London
| | | | | | | | - M. Bown
- Leicester Royal Infirmary, Leicester
| | - E. Choke
- Leicester Royal Infirmary, Leicester
| | | | - R. Sayers
- Leicester Royal Infirmary, Leicester
| | | | | | | | | | | | | | - R. Canavati
- Royal Liverpool University Hospital, Liverpool
| | - R.K. Fisher
- Royal Liverpool University Hospital, Liverpool
| | | | - J.B. Naik
- Royal Liverpool University Hospital, Liverpool
| | | | | | | | | | - P. Holt
- St. George's Hospital, London
| | | | | | | | | | - O. Agu
- University College London Hospital, London
| | - C. Bishop
- University College London Hospital, London
| | | | - J. Cross
- University College London Hospital, London
| | - J. Hague
- University College London Hospital, London
| | | | - K. Ivancev
- University College London Hospital, London
| | - J. Raja
- University College London Hospital, London
| | | | - D. Simring
- University College London Hospital, London
| | - A.C. Fisher
- Globalstar on-line database IT support, University of Liverpool, Liverpool
| | - D. Smith
- Globalstar on-line database IT support, University of Liverpool, Liverpool
| | - G.P. Copeland
- POSSUM advice, Warrington General Hospital, Warrington
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30
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Abstract
Abstract
Background
Endovascular technology has advanced rapidly in the development of fenestrated endovascular aneurysm repair (FEVAR). Current evidence for endovascular aneurysm repair is limited to infra-renal aortic aneurysms. With increased costs and complexity of FEVAR, its current role is unclear. A national multicentre, cross-disciplinary consensus model was developed to propose indications for FEVAR.
Methods
All UK FEVAR centres and a wide selection of high-volume aneurysm treatment centres were invited to participate. The RAND appropriateness methodology was used. Five key steps were undertaken: meta-analysis of current literature; survey of current UK practice; nominal group establishment and definition of key clinical attributes; round 1—online survey of case vignettes; and round 2—nominal group consensus meeting.
Results
More than 90 per cent of UK FEVAR centres participated. Literature review showed heterogeneous case series with no clear indications for use of FEVAR. Survey of current practice showed wide variations in aneurysm management. Consensus agreement on the role of FEVAR was achieved in 68·8 per cent of cases. Consensus for FEVAR was agreed in areas of moderate risk from open repair and need for suprarenal clamping, but it was less likely to be indicated in patients aged 85 years or more with 5·5–6-cm aneurysms, or short-necked infrarenal aortic aneurysms.
Conclusion
These data record areas of agreement and define the grey area of equipoise. Consequently, guidelines and recommendations can be developed on the indications for FEVAR to inform clinicians, commissioners and health economists.
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Affiliation(s)
- J Cross
- Multidisciplinary Endovascular Team, University College London Hospitals, London, UK
| | - R Raine
- Epidemiology & Public Health, University College London, London, UK
| | - P Harris
- Multidisciplinary Endovascular Team, University College London Hospitals, London, UK
| | - T Richards
- Multidisciplinary Endovascular Team, University College London Hospitals, London, UK
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31
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Cross J, Gurusamy K, Gadhvi V, Simring D, Harris P, Ivancev K, Richards T. Fenestrated endovascular aneurysm repair. Br J Surg 2011; 99:152-9. [PMID: 22183704 DOI: 10.1002/bjs.7804] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2011] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Fenestrated endovascular aneurysm repair (FEVAR) is a technically challenging operation. The duration, blood loss, and risk of limb ischaemia, contrast-induced nephropathy and reperfusion injury are likely to be higher than after standard endovascular aneurysm repair (EVAR). Benefits of FEVAR over open repair may be less than those seen with standard infrarenal EVAR. This paper is a meta-analysis of observational studies of all published data for FEVAR, with the aim to highlight current issues around the evidence for the potential benefit of FEVAR.
Methods
A search was performed for studies describing FEVAR for juxtarenal abdominal aortic aneurysms. Small series of fewer than ten procedures and studies describing predominantly branched endografts or FEVAR for aortic dissection were excluded. Authors of included papers were contacted to eliminate patient duplication.
Results
Eleven studies were identified describing a total of 660 procedures. Definitions of aneurysm morphology were variable, and clear inclusion and exclusion criteria were not always documented. Double fenestrations were more common than triple or quadruple fenestrations. Target vessel perfusion rates ranged from 90·5 to 100 per cent. Eleven deaths occurred within 30 days, giving a 30-day proportional mortality rate of 2·0 per cent. Morbidity was poorly reported.
Conclusion
FEVAR for repair of suprarenal and juxtarenal aneurysms is a viable alternative to open repair. However, there is no level 1 evidence for FEVAR, and current evidence is weak with many unanswered questions.
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Affiliation(s)
- J Cross
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
| | - K Gurusamy
- Department of Surgery, University College London, London, UK
| | - V Gadhvi
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
| | - D Simring
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
| | - P Harris
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
| | - K Ivancev
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
| | - T Richards
- Multidisciplinary Endovascular Team, University College Hospital, London, UK
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Colgan L, Cross J, Morrison J, Wales C, Markose G, Currie W, Hislop W. An audit of visual acuity recording in mid-face trauma. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shah AJ, Breen DP, Thomas D, Cross J, Coles A, Molyneux P. An evolving case of headaches and strokes. Pract Neurol 2011; 11:113-7. [DOI: 10.1136/jnnp.2011.242206] [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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Cross J, Amiri N, Fung C, Simring D, Ivancev K, Harris P, Richards T. Endovascular repair of abdominal aortic aneurysms (AAA) outside manufacturers instructions for use: Infra-renal sealing is not a safe option. Int J Surg 2011. [DOI: 10.1016/j.ijsu.2011.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cross J, Elender F, Barton G, Clark A, Shepstone L, Blyth A, Bachmann M, Harvey I. A randomised controlled equivalence trial to determine the effectiveness and cost-utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX). Health Technol Assess 2010; 14:1-147, iii-iv. [PMID: 20487638 DOI: 10.3310/hta14230] [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: 11/22/2022] Open
Abstract
OBJECTIVES To estimate the effect, if any, of manual chest physiotherapy (MCP) administered to patients hospitalised with chronic obstructive pulmonary disease (COPD) exacerbation on both disease-specific and generic health-related quality of life. To compare the health service costs for those receiving and not receiving MCP. DESIGN A pragmatic, randomised controlled trial powered for equivalence. It was not possible to blind participants, clinicians or research staff to study arm allocation during the intervention. SETTING Four UK hospitals in Norwich, Great Yarmouth, King's Lynn and Liverpool. PARTICIPANTS 526 participants aged 34-91 years were recruited between November 2005 and April 2008; of these, 372 provided evaluable data for the primary outcome. All persons hospitalised with COPD exacerbation and evidence of sputum production on examination were eligible for the trial providing there were no contraindications to performing MCP. INTERVENTIONS Participants were allocated to either MCP or no MCP on an intention-to-treat (ITT) basis. However, active cycle of breathing techniques (ACBT) was used in both arms. Participants allocated to the intervention were guided to perform ACBT while the physiotherapist delivered MCP. Participants allocated to the control arm received instruction on ACBT only. MAIN OUTCOME MEASURES The primary outcome was COPD-specific quality of life, measured using the St George's Respiratory Questionnaire (SGRQ) at 6 months post randomisation. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to calculate the quality-adjusted life-year (QALY) gain associated with MCP compared with no MCP. Secondary physiological outcome measures were also used. RESULTS Of the 526 participants, 261 were allocated to MCP and 264 to control, with 186 participants evaluable in each arm. ITT analyses indicated no significant difference at 6 months post randomisation in total SGRQ score [adjusted effect size (no MCP - MCP) 0.03 (95% confidence interval, CI -0.14 to 0.19)], SGRQ symptom score [adjusted effect size 0.04 (95% CI -0.15 to 0.23)], SGRQ activity score [adjusted effect size -0.02 (95% CI -0.20 to 0.16)] or SGRQ impact score [adjusted effect size 0.02 (95% CI -0.15 to 0.18)]. The imputed ITT and per-protocol results were similar. No significant differences were observed in any of the outcome measures or subgroup analyses. Compared with no MCP, employing MCP was associated with a slight loss in quality of life (0.001 QALY loss) but lower health service costs (cost saving of 410.79 pounds). Based on these estimates, at a cost-effectiveness threshold of lambda = 20,000 pounds per QALY, MCP would constitute a cost-effective use of resources (net benefit = 376.14 pounds). There was, however, a high level of uncertainty associated with these results and it is possible that the lower health service costs could have been due to other factors. CONCLUSIONS In terms of longer-term quality of life the use of MCP did not appear to affect outcome. However, this does not mean that MCP is of no therapeutic value to patients with COPD in specific circumstances. Although the cost-effectiveness analysis suggested that its use was cost-effective, much uncertainty was associated with this finding and it would be difficult to justify providing MCP therapy on the basis of cost-effectiveness alone. Future research should include evaluation of MCP for patients with COPD producing high volumes of sputum, and an evaluation of the effectiveness of ACBT in COPD exacerbation. TRIAL REGISTRATION Current Controlled Trials ISRCTN13825248.
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Affiliation(s)
- J Cross
- School of Allied Health Professions, University of East Anglia, Norwich, UK
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Bleicher K, Orosz A, Cross J, Markó V. Survey of leafhoppers, planthoppers and froghoppers (Auchenorrhyncha) in apple orchards in South-East England. ACTA ACUST UNITED AC 2010. [DOI: 10.1556/aphyt.45.2010.1.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Berg A, Berkovic S, Brodie M, Buchhalter J, Cross J, van Emde Boas W, Engel Jr J, French J, Glauser T, Mathern G, Moshé S, Nordli D, Plouin P, Scheffer I. Revidierte Terminologie und Konzepte zur Einteilung von epileptischen Anfällen und Epilepsien: Bericht der Klassifikations- und Terminologiekommission der Internationalen Liga gegen Epilepsie, 2005–2009. Akt Neurol 2010. [DOI: 10.1055/s-0030-1248426] [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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Pohl U, Dean AF, Ichimura K, Liu L, Nicholson J, Cross J, Collins VP. Genomic analysis of chromosome 22 in synchronous and histologically distinct intracranial tumours in a child. Neuropathol Appl Neurobiol 2010; 36:359-63. [PMID: 20345646 DOI: 10.1111/j.1365-2990.2010.01085.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saundankar J, Cross J, Ramsay J, Andrew B, Kothari D. Impact and Benefits of a Dedicated Paediatric Cardiology Murmur Clinic. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.610] [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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Affiliation(s)
- J H Gillard
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
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Sauerzapf V, Jones AP, Cross J. Environmental factors and hospitalisation for chronic obstructive pulmonary disease in a rural county of England. J Epidemiol Community Health 2009; 63:324-8. [PMID: 19208692 DOI: 10.1136/jech.2008.077024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a major global cause of morbidity and mortality. Studies in urban areas have shown associations between air pollutants and hospital admissions for COPD. Whether temporal variations in air quality are associated with hospital admissions for COPD in a rural region with lower concentrations of air pollutants than previously studied was investigated. METHODS Daily COPD admissions were recorded for patients attending three hospitals in the county of Norfolk, UK, between January 2006 and February 2007. Records were combined with daily information on concentrations of six air pollutants (carbon monoxide, nitric oxide, nitrogen dioxide, oxides of nitrogen, ozone and fine particulates), airborne pollens, temperature and influenza incidence. A case-crossover analysis was used to examine the association between air pollution and daily admissions. RESULTS There were 1050 admissions for COPD over the study period. After adjustment for temperature, pollen and respiratory infections, each 10 microg/m(3) increase in CO was associated with a 2% increase in the odds of admission. Values of 17%, 22% and 9% were observed for NO, NO(2) and oxides of nitrogen respectively. No associations were observed with O(3) or particulates. CONCLUSION Among a population of a less urbanised area than previously investigated, this study found evidence that ambient pollutant concentrations were still associated with the risks of hospital admission for COPD.
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Affiliation(s)
- V Sauerzapf
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, UK
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Coco BJ, Bagg J, Cross LJ, Jose A, Cross J, Ramage G. MixedCandida albicansandCandida glabratapopulations associated with the pathogenesis of denture stomatitis. ACTA ACUST UNITED AC 2008; 23:377-83. [DOI: 10.1111/j.1399-302x.2008.00439.x] [Citation(s) in RCA: 180] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tanguay JS, Ford DR, Sadler G, Buckley L, Uppal H, Cross J, Holmes N, Fortes Mayer K, Fernando I. Selective axillary node sampling and radiotherapy to the axilla in the management of breast cancer. Clin Oncol (R Coll Radiol) 2008; 20:677-82. [PMID: 18722758 DOI: 10.1016/j.clon.2008.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2008] [Revised: 06/13/2008] [Accepted: 06/16/2008] [Indexed: 10/21/2022]
Abstract
AIMS Axillary treatment for patients with early-stage breast cancer can be associated with considerable morbidity. Techniques, such as axillary node sampling (ANS) and, more recently, sentinel node biopsy, in combination with radiotherapy have the potential to reduce toxicity. A retrospective review of axillary treatment in patients with early-stage breast cancer treated at our institution between 1997 and 2003 was carried out to assess the outcome and morbidity of ANS in combination with radiotherapy. MATERIALS AND METHODS The treatment policy was to carry out four-node, Edinburgh-style ANS except in those cases with either palpably enlarged nodes or cytological confirmation of involvement or with clinically obvious node involvement at surgery when level 2 axillary node clearance (ANC) was carried out. Patients with involved nodes after ANS received postoperative axillary radiotherapy. RESULTS In total, 381 patients were included, 331 received ANS and 50 received ANC. The median follow-up was 6.5 years and overall survival at 5 years was 84%. Pathologically involved nodes were found in 152/331 (50%) ANS patients and 43/50 (86%) ANC patients. The rate of local recurrence (breast or chest wall) at 5 years was 4% (95% confidence interval 1-17%) in the ANC group and 2% (95% confidence interval 1-4%) in the ANS group. The nodal recurrence rate of those undergoing ANS was 3% (11/331) compared with 6% (3/50) for those treated by ANC. The rate of clinically significant lymphoedema at 5 years was significantly higher (P=0.01) in the ANC arm: 18% (95% confidence interval 9-32%) compared with 5% (95% confidence interval 3-8%) in those treated by ANS. Thirty-one cases received additional supraclavicular fossa irradiation because of the involvement of more than four nodes on ANS, which may not have been available with sentinel node biopsy and has implications for current practice. CONCLUSIONS Selective ANS with the removal of a minimum of four nodes guides optimal locoregional treatment with good local control rates, low overall morbidity and may obviate the need for a second surgical procedure.
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Affiliation(s)
- J S Tanguay
- University Hospital Birmingham, Birmingham, UK.
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Cross J, Steinberg M, Yassi A, Astrakianakis G, Lu J, Rodriguez-Acosta RL, Schoenfisch AL, Richardson DB, Lipscomb HJ, Dement JM, Alamgir H, Yu S, Quinn MM, Markkanen P, Galligan C, Chalupka S, Kim H, Sama S, Gore R, Kriebel D, Bello A, Davis L, Laramie A, Firsova N. Health care workers. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Morrish DW, Kudo Y, Caniggia I, Cross J, Evain-Brion D, Gasperowicz M, Kokozidou M, Leisser C, Takahashi K, Yoshimatsu J. Growth Factors and Trophoblast Differentiation – Workshop Report. Placenta 2007; 28 Suppl A:S121-4. [PMID: 17379301 DOI: 10.1016/j.placenta.2007.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 01/31/2007] [Accepted: 02/01/2007] [Indexed: 11/17/2022]
Affiliation(s)
- D W Morrish
- Department of Medicine, University of Alberta, 362 Heritage Medical Research Centre, Edmonton, Alberta T6G 2S2, Canada.
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Cross J. Paediatric brain and spine. An atlas of MRI and spectroscopy. Br J Neurosurg 2006. [DOI: 10.1080/02688690600601309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dishmon DA, Khouzam RN, Hajjar A, Cross J, Khan M, Chishti W, Nasser W, Weber KT, Carbone LD. 263 HIP FRACTURES IN MALE VETERANS WITH CONGESTIVE HEART FAILURE. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.262] [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: 11/18/2022]
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Cetin I, Foidart JM, Miozzo M, Raun T, Jansson T, Tsatsaris V, Reik W, Cross J, Hauguel-de-Mouzon S, Illsley N, Kingdom J, Huppertz B. Fetal growth restriction: a workshop report. Placenta 2005. [PMID: 15450396 DOI: 10.1016/j.placenta.2004.02.004s014340040400058x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Intrauterine growth restriction (IUGR) is associated with significantly increased perinatal morbidity and mortality as well as cardiovascular disease and glucose intolerance in adult life. A number of disorders from genetic to metabolic, vascular, coagulative, autoimmune, as well as infectious, can influence fetal growth by damaging the placenta, leading to IUGR as a result of many possible fetal, placental and maternal disorders. Strict definitions of IUGR and of its severity are needed in order to eventually distinguish among different phenotypes, such as gestational age at onset, degree of growth restriction and presence of hypoxia. This report explores and reviews some of the most recent developments in both clinical and basic research on intrauterine growth restriction, by seeking mechanisms that involve genetic factors, utero-placental nutrient availability and vascular growth factors. New exciting findings on the genomic imprinting defects potentially associated with IUGR, and the placental anomalies associated with the decreased nutrient transport are summarized. Moreover, recent data on angiogenic growth factors as well as new information arising from application of gene chip technologies are discussed.
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Affiliation(s)
- I Cetin
- Institute of Obstetrics and Gynecology L. Mangiagalli, University of Milano School of Medicine, via della Commenda 12, 20122 Milano, Italy.
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Cetin I, Foidart JM, Miozzo M, Raun T, Jansson T, Tsatsaris V, Reik W, Cross J, Hauguel-de-Mouzon S, Illsley N, Kingdom J, Huppertz B. Fetal growth restriction: a workshop report. Placenta 2005; 25:753-7. [PMID: 15450396 DOI: 10.1016/j.placenta.2004.02.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [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] [Accepted: 02/09/2004] [Indexed: 01/12/2023]
Abstract
Intrauterine growth restriction (IUGR) is associated with significantly increased perinatal morbidity and mortality as well as cardiovascular disease and glucose intolerance in adult life. A number of disorders from genetic to metabolic, vascular, coagulative, autoimmune, as well as infectious, can influence fetal growth by damaging the placenta, leading to IUGR as a result of many possible fetal, placental and maternal disorders. Strict definitions of IUGR and of its severity are needed in order to eventually distinguish among different phenotypes, such as gestational age at onset, degree of growth restriction and presence of hypoxia. This report explores and reviews some of the most recent developments in both clinical and basic research on intrauterine growth restriction, by seeking mechanisms that involve genetic factors, utero-placental nutrient availability and vascular growth factors. New exciting findings on the genomic imprinting defects potentially associated with IUGR, and the placental anomalies associated with the decreased nutrient transport are summarized. Moreover, recent data on angiogenic growth factors as well as new information arising from application of gene chip technologies are discussed.
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Affiliation(s)
- I Cetin
- Institute of Obstetrics and Gynecology L. Mangiagalli, University of Milano School of Medicine, via della Commenda 12, 20122 Milano, Italy.
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Evans J, Baraitser P, Cross J, Bacon L, Piper J. Managing genital infection in community family planning clinics: an alternative approach to holistic sexual health service provision. Sex Transm Infect 2004; 80:142-4. [PMID: 15054180 PMCID: PMC1744821 DOI: 10.1136/sti.2003.004382] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 11/04/2022] Open
Abstract
OBJECTIVE To pilot and evaluate sexually transmitted infection (STI) management in community family planning clinics (FPCs). METHODS Number of STI tests taken, positive results, infections treated, contacts traced/treated, referrals to specialist services and time from testing to treatment were documented as well as age and sex of the population tested. RESULTS STI tests taken increased from 233 to 308/month and male clients seen increased from 114 to 147/month across all clinics. Chlamydia prevalence rates in one large clinic increased from 6.7% to 11.9%. 82% of those with STIs in this clinic were treated. Of 44 clients treated for chlamydia, 84% had partner notification performed, 0.43 contacts were treated for every client with chlamydia and referrals to specialist services decreased. 70% of STIs were detected in clinic users under the age of 25 and 45.5% of clients tested under the age of 16 had an STI. Before STI treatment was available at FP clinics 52% of clients with STIs attended specialist services after referral and time from testing to treatment was 19 days. Managing STIs in the community increased treatment rates to 82% with a testing to treatment time of 10 days. CONCLUSIONS The management of uncomplicated genital infection in community FPCs working in partnership with specialist services is a feasible and effective approach to holistic sexual health service provision.
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Affiliation(s)
- J Evans
- The Department of Family Planning and Reproductive Health Care, Lewisham Primary Care Trust, St Giles Hospital, St Giles Road, London SE5 7RN, UK.
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