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McMullen K, Gray A, Staggs T, Brown R, Banks J, Reisinger A, Searles T, Peters M. Development of infection prevention program standards for critical access hospitals. Am J Infect Control 2024; 52:365-367. [PMID: 38036177 DOI: 10.1016/j.ajic.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
Although critical access hospitals are small, the expected infection prevention activities remain extensive. Program standards, aligned with the Association for Professionals in Infection Control and Epidemiology infection prevention competency model domains, were developed and implemented in a midwestern health care system. Time estimates for completion of each activity were assigned and then extrapolated to offer guidance on necessary full-time equivalents for adequate staffing.
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Affiliation(s)
| | - Angela Gray
- St. Luke's Hospital of Duluth (formerly Mercy Hospitals Kingfisher, Logan County and Watonga, OK.), Duluth, MN
| | | | | | - Jessica Banks
- Mercy Hospitals Cassville and Aurora, Cassville and Aurora, MO
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2
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Bishr MK, Banks J, Abdelaziz MS, Badawi M, Crane PW, Donigiewicz UJ, Elkorety M, Girgis M, Humphreys A, Isherwood J, Kahan J, Keelan S, Lindqvist EK, Nixon I, Sackey H, Sars C, Soliman H, Touqan N, Remoundos DD, Ahmed M. Multidisciplinary Management of Phyllodes Tumours and Breast Sarcoma: A Cross-sectional Survey of Clinical Practice across the UK and Ireland. Clin Oncol (R Coll Radiol) 2024; 36:e31-e39. [PMID: 38294995 DOI: 10.1016/j.clon.2023.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 02/02/2024]
Abstract
AIMS Phyllodes tumours and breast sarcomas are uncommon tumours and their rarity poses significant challenges in diagnosis and management. This cross-sectional study was conducted to evaluate the multidisciplinary clinical practice for these tumours across the UK and Ireland, with the aim of identifying gaps in knowledge and providing direction for establishing national guidelines. MATERIALS AND METHODS An international survey was adapted and circulated to breast and/or sarcoma surgeons and oncologists in the UK and Ireland through national organisations. Multidisciplinary team (MDT) responses were analysed anonymously. RESULTS Twenty-eight MDTs participated in this study, predominately from high-volume units (85.5%). Although only 43% of the surveyed units were part of a trust that holds a sarcoma MDT, 68% of units managed malignant phyllodes and angiosarcoma, whereas 64.5% managed soft-tissue sarcoma of the breast. Across all subtypes, axillary surgery was recommended by 14-21% of the MDTs and the most recommended resection margins for breast surgery were 'no tumour on ink' in benign phyllodes (39%) and 10 mm in the remaining subtypes (25-29%). Immediate breast reconstruction was supported by 11-18% of MDTs for breast sarcoma subtypes, whereas 36% and 32% advocated this approach in benign and borderline phyllodes tumours, respectively. Adjuvant radiotherapy and chemotherapy were recommended by up to 29% and 11% of the MDTs, respectively. CONCLUSION The results of this study demonstrate a wide variation in clinical practice across the surveyed MDTs. As only 28 MDTs participated in our study, with under-representation from low-volume units, our results might be an underestimation of the variability in practice across the UK and Ireland. This multi-institutional study sheds light on controversial aspects in the management of phyllodes tumours and breast sarcoma, identifies the need for national guidelines to inform best practice, and calls for the centralisation of the management of breast sarcoma within specialist centres.
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Affiliation(s)
- M K Bishr
- The Royal Marsden NHS Foundation Trust, London, UK.
| | - J Banks
- The Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - M S Abdelaziz
- National Cancer Institute, Cairo University, Cairo, Egypt; University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Badawi
- East Sussex Healthcare Trust, Conquest Hospital, St Leonards-on-sea, UK
| | - P W Crane
- Queen Elizabeth II Hospital, Welwyn Garden City, UK
| | | | - M Elkorety
- West Hertfordshire Teaching Hospitals NHS Trust, Watford, UK
| | - M Girgis
- West Suffolk NHS Hospital, Bury St Edmunds, UK
| | - A Humphreys
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - J Isherwood
- Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - J Kahan
- Velindre Cancer Centre, Cardiff, UK
| | - S Keelan
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - E K Lindqvist
- Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
| | - I Nixon
- Management Science, Business School, Strathclyde University, Glasgow, UK; The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - H Sackey
- Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - C Sars
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - H Soliman
- Kings' College Hospital, Orpington, UK
| | - N Touqan
- Manchester University NHS Foundation Trust, North Manchester General Hospital, Manchester, UK
| | - D D Remoundos
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Ahmed
- University College London Hospitals NHS Foundation Trust, London, UK
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3
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Quddus R, Banks J, Morgan JL, Martin C, Reed MW, Walters S, Cheung KL, Todd A, Audisio R, Green T, Revell D, Gath J, Horgan K, Holcombe C, Parmeshwar R, Thompson A, Wyld L. Outcomes of complex oncoplastic breast surgery in older women. Analysis of data from the Age Gap cohort study. Eur J Surg Oncol 2023; 49:107075. [PMID: 37774649 DOI: 10.1016/j.ejso.2023.107075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
KEY WORDS Breast cancer, mastectomy, breast conserving surgery, post-mastectomy reconstruction, older women, quality of life.
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Affiliation(s)
- Ratul Quddus
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Jessica Banks
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Jenna L Morgan
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Charlene Martin
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | | | - Stephen Walters
- Clinical Trials Research Unit, School for Health and Related Research, University of Sheffield, UK
| | - Kwok Leung Cheung
- University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3DT, UK
| | - Annaliza Todd
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Riccardo Audisio
- University of Gothenberg, Sahlgrenska Universitetssjukhuset, 41345, Göteborg, Sweden
| | - Tracy Green
- Yorkshire and Humber Consumer Research Panel, UK
| | | | - Jacqui Gath
- Yorkshire and Humber Consumer Research Panel, UK
| | - Kieran Horgan
- Dept of Breast Surgery, Bexley Cancer Centre, St James's University Hospital, Leeds, LS9 7TF, UK
| | - Chris Holcombe
- Liverpool University Hospitals Foundation Trust, Prescott Street, Liverpool, L7 8 XP, UK
| | - Rishi Parmeshwar
- University Hospitals of Morecambe Bay, Royal Lancashire Infirmary Ashton Road, Lancaster, Lancashire, LA1 4RP, UK
| | - Alastair Thompson
- Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA
| | - L Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
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4
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Banks J, Shuttleworth P, Day N, Guy R. Small bowel obstruction caused by a fibrotic bow-string appendix: a consequence of non-operative management of acute appendicitis. Ann R Coll Surg Engl 2022; 104:e249-e251. [PMID: 35638901 PMCID: PMC9685988 DOI: 10.1308/rcsann.2022.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 10/03/2023] Open
Abstract
A 73-year-old woman presented with small bowel obstruction that failed to settle with conservative management. Over the previous 2 years she had presented twice with computed tomography scan-proven acute appendicitis with localised perforation of the appendix tip. In view of medical comorbidities, she was treated non-operatively with clinical and radiological resolution on each occasion, but on the third presentation laparoscopy was undertaken for non-resolving small bowel obstruction and the non-inflamed appendix itself was identified as a fibrous band causing compression of the distal ileum and complete small bowel obstruction. Following division and appendicectomy, the patient made an uneventful recovery. This case illustrates the potential consequence of repeated appendiceal inflammation and non-operative management and may be seen increasingly as this approach is widely adopted during the COVID-19 pandemic.
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Affiliation(s)
- J Banks
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - P Shuttleworth
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - N Day
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - R Guy
- Wirral University Teaching Hospital NHS Foundation Trust, UK
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5
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Banks J, Macadam R. TU8.10 Should patients with a predicted NELA mortality of 5–10% be managed on ICU? An audit of the management of high-risk laparotomies as per NELA Guidelines. Br J Surg 2022. [DOI: 10.1093/bjs/znac248.083] [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: 11/06/2022]
Abstract
Abstract
Aims
The National Emergency Laparotomy Audit (NELA) has been pivotal in improving the care of patients undergoing emergency laparotomy. One key recommendation is ‘high-risk’ patients are managed on ICU post-operatively. We aimed to identify if there was a difference in outcomes between ‘high-risk patients’ (predicated NELA mortality >5%) managed on ICU or a surgical ward post-operatively.
Methods
We retrospectively analysed all patients registered to our hospitals NELA database from January 2019-September 2021, assessing if ‘high-risk’ patients were managed on ICU or general surgery wards post-operatively and the difference in outcomes between these two groups.
Results
249 patients were included (138 Female). Over 80% of ‘high-risk’ patients were admitted to a ICU bed over the three-year period, as per NELA guidelines. 46 high-risk patients were managed on the ward post-operatively. Although there was no difference in age between the two groups, those admitted to ICU had a significantly higher predicated NELA mortality and higher mortality rate.
Conclusions
NELA predicted mortality helps to guide which patients may need a higher level of post-operative care. However, this study indicates that for some patients with a predicted mortality of 5–10%, ward-based care may be appropriate. In the context of increasingly stretched ICU resources, we believe further research is needed to identify whether some patients with a NELA mortality over 5% would be appropriate for ward management.
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6
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Sinnott J, Banks J, Park B. Optimal timing of fundamentals of laparoscopic surgery (fls) in obstetrics & gynecology residency. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.103] [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: 11/01/2022]
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Issa M, Nair D, David B, Banks J, Lewis E, Monk C, Griffin A, Guy R. 127 Optimum Treatment for Sigmoid Volvulus Remains Elusive but Surgery May Provide Considerable Benefit: Results of a 5-Year Audit. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.071] [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]
Abstract
Abstract
Background
Sigmoid volvulus is a surgical emergency and patients are often elderly with significant comorbidities. Whilst endoscopic decompression is easy and effective in the short-term, recurrence and repeated admissions are common with surgery generally being reserved for non-resolution or complications. Consensus an optimum management is lacking.
Method
A retrospective audit of all patients admitted with sigmoid volvulus to a DGH General Surgery service between 01/01/2015-20/10/2020 was undertaken. Patient demographics, comorbidities, clinical findings, investigations, and treatment were recorded.
Results
Sixty-three patients were identified (median age 71.5 years; 58.7% male]. Some 50.8% had more than one previous presentation (range 1–6), 19% presented after 3 days of symptoms and 3.2% presented with perforation. Plain radiography and CT scanning was undertaken in 90.5% and 54%, respectively.
Endoscopic detorsion was performed in 77.77% and repeated in the same admission for 33.3% of cases. Flatus tubes and rigid sigmoidoscopy was used in 47.6% with a 59.6% success rate. Seventeen patients (27%) underwent sigmoid resection, 14 having open surgery and 3 laparoscopic. Primary anastomosis was undertaken in 64.7% (11 patients), with only one anastomotic leak; the remaining 6 patients had a colostomy. The re-admission rate was 30.1% (19% non-operated patients, 11.1% operated patients).
Conclusions
Most patients with sigmoid volvulus are managed non-operatively with endoscopic detorsion which may be associated with a considerable healthcare burden and high readmission rates. Selective resection can be associated with low morbidity and good outcomes. Clinicians could reasonably adopt a lower threshold for surgical intervention, particularly for recurrent volvulus.
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Affiliation(s)
- M. Issa
- Prince Charles Hospital, Myrther Tydfil, United Kingdom
| | - D. Nair
- Arrowe Park Hospital, Wirral, United Kingdom
| | - B. David
- Arrowe Park Hospital, Wirral, United Kingdom
| | - J. Banks
- Arrowe Park Hospital, Wirral, United Kingdom
| | - E. Lewis
- Arrowe Park Hospital, Wirral, United Kingdom
| | - C. Monk
- Arrowe Park Hospital, Wirral, United Kingdom
| | - A. Griffin
- Arrowe Park Hospital, Wirral, United Kingdom
| | - R. Guy
- Arrowe Park Hospital, Wirral, United Kingdom
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8
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Banks J, Doherty CP. CoVID Tracker Ireland: What is its Function? Ir Med J 2022; 115:513. [PMID: 35279047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- J Banks
- Academic Unit of Neurology, Trinity College Dublin
| | - C P Doherty
- Academic Unit of Neurology, Trinity College Dublin
- FutureNeuro, Science Foundation Ireland Centre for Chronic and Rare Neurological Disease Research
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9
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Banks J, Aiynattu S, Ishak R. EP.FRI.468 A review of the management of malignant bowel obstruction at an NHS teaching hospital. Br J Surg 2021. [DOI: 10.1093/bjs/znab312.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Patients presenting with malignant bowel obstruction (MBO) due to peritoneal metastasis present a clinical dilemma for surgeons: although palliative surgery is beneficial, post-operative complications and mortality are as high as 30%. A personalised and multi-disciplinary approach is paramount when treating these patients.
Aims
This study aimed to review the management (surgical versus conservative) of patients presenting with MBO; ascertain if a multi-disciplinary approach was adopted; and compare clinical outcomes including length-of-stay, readmission rates and mortality.
Methods
All patients admitted with MBO secondary to peritoneal metastasis between January 2019 – January 2021 were identified.
Results
29 patients; 14 females, were identified with a median age 72. The median length of stay was 16 days.
All patients had a CT scan and 76% were performed within 24 hours of admission. 25/29 patients were referred to palliative care.
Conclusions
Overall mortality and morbidity in our cohort, regardless of surgical or conservative management, is consistent with existing literature. Palliative care input was sought for the majority of patients.
Management decisions should be individualised and focus on ensuring the best quality of life for the patient. All decisions should be made with multi-disciplinary input.
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10
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Nair D, Banks J, Guy R. EP.FRI.337 Active management of the open abdomen in non-trauma catastrophes, including use of negative pressure wound therapy, is associated with high primary fascial closure rates. Br J Surg 2021. [DOI: 10.1093/bjs/znab312.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aims
Deliberate use of the open abdomen (OA) following emergency laparotomy (EL) may be life-saving in the non-trauma abdominal catastrophe (NTAC) and damage control surgery (DCS) can reduce the risk of abdominal compartment syndrome in compromised patients. Controversy exists over optimum management of the abdominal wall. An audit was undertaken of negative pressure wound therapy (NPWT) in OA patients.
Methods
All patients who underwent OA management of NTAC from 1st Jan 2019 to 31st Dec 2020 were identified. Data on patient demographics, indication for OA and clinical outcomes were analysed.
Results
Eighteen patients (median age 65.5 years; M:F9 each) underwent OA following EL. The indications were: bowel ischaemia (8), intra-abdominal sepsis (5), grossly distended bowel (3) and intra-abdominal haemorrhage (2). In all cases, ABTHERATM dressings (KCI/Acelity) were used. Mean ICU stay was 7.4 days (range 1-15) and mean hospital stay 33 days (range 2-61). Four patients died, 3 within 24 hours of initial EL. Relook laparotomy was performed within 48 hours in the remaining 15 patients; 3 patients required 2 relooks and 1 patient had three. Primary fascial closure (PFC) was achieved within five days in 13/14 (93%) survivors. Eight patients had SSIs with 2 intra-abdominal collections and all were treated conservatively. One patient developed an enterocutaneous fistula.
Conclusions
The use of commercially-available NPWT dressings in OA management is associated with high PFC rates within one week of initial EL. This practice is consistent with World Society of Emergency Surgery guidance recommending planned re-look laparotomy within 48 hours.
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Affiliation(s)
- Dheepa Nair
- Emergency Surgery Department. Arrowe Park Hospital
| | | | - Richard Guy
- Emergency Surgery Department. Arrowe Park Hospital
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11
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Banks J, Nair D, Guy R. TP10.1.3SARS-Cov-2 and Colitis: A Case Series. Br J Surg 2021. [PMCID: PMC8574391 DOI: 10.1093/bjs/znab362.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Up to a third of patients with COVID-19 infection present with gastrointestinal (GI) symptoms. The Sars-Cov-2 virus enters enterocytes through a novel mechanism via ACE- 2 receptors, which are expressed throughout the GI tract, especially in the mid-gut. Small bowel and colonic inflammation and alteration of the gut microbiome (“altered inflammasome”) have been observed. Aims We report a cluster of cases during the first and second wave UK pandemics involving young patients with unexplained segmental CT-proven colitis. Methods All patients diagnosed with CT proven colitis with no history of IBD, ischaemic colitis or significant medical comorbidities were included. Results Fifteen patients (median age 33 years; 8 females) were admitted under Emergency General Surgery between Mar 2020 & Jan 2021. All patients were previously well with no history of IBD, ischaemic colitis or significant medical comorbidities. Thirteen patients underwent CT imaging, showing evidence of colitis in 12, with changes affecting the right colon predominating. Campylobacter jejuni was identified in 4 of 7 stool cultures but only 1 patient had a positive PCR nasal swab and another had COVID antibodies detected in serum. Endoscopic and histological appearances of those undergoing colonoscopy were non-specific. Conclusion These cases may represent Covid-19 involvement of the gut. Nasal swabs are not validated for use in the GI tract and detection of SARS-Cov-2 virus requires faecal or mucosal sampling. Disruption of the microbiome permits emergence of pathogenic species such as Campylobacter. More work is required in this important area to further define and elucidate COVID-19 GI involvement.
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12
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Banks J, George J, Potter S, Gardiner MD, Ives C, Shaaban AM, Singh J, Sherriff J, Hallissey MT, Horgan K, Harnett A, Desai A, Ferguson DJ, Tillett R, Izadi D, Sadideen H, Jain A, Gerrand C, Holcombe C, Hayes A, Teoh V, Wyld L. Breast Angiosarcoma Surveillance Study: UK national audit of management and outcomes of angiosarcoma of the breast and chest wall. Br J Surg 2021; 108:388-394. [PMID: 33749771 DOI: 10.1093/bjs/znaa128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/15/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort. METHODS Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres. RESULTS The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent ) recurrences in patients with primary and 80 of 124 (64.5 per cent ) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0-16) years for patients with primary and 5 (0-15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort. CONCLUSION A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study.
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Affiliation(s)
- J Banks
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - J George
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK.,Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S Potter
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - M D Gardiner
- Department of Plastic Surgery, Frimley Health Foundation NHS Trust, Frimley, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Ives
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - A M Shaaban
- Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, UK.,Department of Cellular Pathology, University of Birmingham, Birmingham, UK
| | - J Singh
- Department of Breast Surgery, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - J Sherriff
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M T Hallissey
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - K Horgan
- Department of General Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Harnett
- Department of Oncology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - A Desai
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - D J Ferguson
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - R Tillett
- Department of Plastic Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - D Izadi
- Department of Plastic Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - H Sadideen
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Plastic and Reconstructive surgery, Imperial College Healthcare NHS Trust, London, UK
| | - C Gerrand
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - C Holcombe
- British Association of Plastic, Reconstructive and Aesthetic Surgeons, London, UK.,Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust, Liverpool, UK
| | - A Hayes
- Sarcoma and Melanoma Unit, Department of Academic Surgery, Royal Marsden Hospital, London, UK
| | - V Teoh
- Sarcoma and Melanoma Unit, Department of Academic Surgery, Royal Marsden Hospital, London, UK
| | - L Wyld
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
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13
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Banks J, Abouelazayem M, Kaur V, Mcglone E, Fiorani C, Reddy M, Khan O. Routine Intra-gastric Balloon Insertion in the Management of 'Super-Super-Obese' Patients: an Obituary? Obes Surg 2021; 31:2319-2323. [PMID: 33151519 DOI: 10.1007/s11695-020-05102-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To prospectively evaluate the feasibility of single-stage bariatric surgery in patients with super-super obesity and compare their outcomes with patients undergoing intra-gastric balloon insertion as a bridging device prior to definitive surgery. MATERIALS AND METHODS Data from 42 patients with BMI 60-75 kg/m2 who underwent either intra-gastric balloon insertion followed by sleeve gastrectomy (two-stage group); or attempted bariatric surgery as a single-stage procedure were compared. RESULTS All patients in the single-stage group underwent successful bariatric surgery. Length of hospital stay after definitive bariatric surgery (3.3 ± 1.9 vs 2.2 ± 0.6 days, p = 0.005) and overall complication rates were significantly higher in the two-stage group. CONCLUSIONS Routine use of an intra-gastric balloon in super-super obese patients is not required and may be associated with poorer peri-operative outcomes and delayed weight loss.
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Affiliation(s)
| | | | | | | | | | | | - Omar Khan
- St George's Hospital London, London, UK
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14
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Banks J, Ferdock M, Nagle J. 502 Adapting to COVID19: Can Virtual Burn Camp be as Impactful as Last Year’s In-person Camp? J Burn Care Res 2021. [PMCID: PMC8083703 DOI: 10.1093/jbcr/irab032.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Skin is not the only casualty following a burn accident. Many children suffer long term, debilitating emotional effects from their burn injury (Abdullah et al. 1994; Kornhaber et al. 2018). Armstrong-James et al. (2018) and Maslow and Lobato (2010) found that summer camps explicitly designed for burn survivor children can positively impact children’s adaptability to stares and comments and improve their sense of self-esteem. Camp Susquehanna has been a summer camp for burn survivors for the past 25+ years. When the COVID19 pandemic closed many businesses, we decided to transition our in-person camp to 100% online. Researchers demonstrated the positive effects of summer camp for burn survivors (Maslow & Lobato, 2010; Bakker et al. 2011). However, the effects of a 100% online camp are not known. Our concern was, are we able to transition and be as impactful as it is face to face at camp? What will the schedule and activities look like in this new format? How will we ensure all children participating will have access to online and the supplies necessary?
Methods
We opted to select a three-week format with two sessions a day divided into two age groups. We ensured every child had internet access then mailed out a “camp in the box.” It contained all the things needed for each planned activity. The critical question remained, however, will we be as impactful? The current research looks at quantitative and qualitative measures of self-esteem, happiness, and satisfaction following participation in a three-week summer program held in July 2020. We make comparisons to previous years’ results. The authors expected that self-esteem, happiness, and satisfaction levels matched or exceeded last years’ levels.
Results
We collected data from 42 campers and 22 volunteer camp counselors. Results show that campers were able to receive the support they needed, not only from the staff but also from their peers.
Conclusions
The delivery method was indeed different this year, but the positive effect on our campers remained the same.
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Affiliation(s)
- Jessica Banks
- Burn Prevention Network, Allentown, Pennsylvania; Navitas Data Sciences, Zionsville, Pennsylvania; Lehigh Valley Hospital, Macungie, Pennsylvania
| | - Matt Ferdock
- Burn Prevention Network, Allentown, Pennsylvania; Navitas Data Sciences, Zionsville, Pennsylvania; Lehigh Valley Hospital, Macungie, Pennsylvania
| | - Jennifer Nagle
- Burn Prevention Network, Allentown, Pennsylvania; Navitas Data Sciences, Zionsville, Pennsylvania; Lehigh Valley Hospital, Macungie, Pennsylvania
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Affiliation(s)
- D Bodansky
- Alder Hey Children’s NHS Foundation Trust, UK
| | - L Thornton
- Liverpool University Hospitals NHS Foundation Trust, UK
| | - N Sargazi
- Mid Cheshire Hospitals NHS Foundation Trust, UK
| | - M Philpott
- Alder Hey Children’s NHS Foundation Trust, UK
| | - R Davies
- Manchester University NHS Foundation Trust, UK
| | - J Banks
- Liverpool University Hospitals NHS Foundation Trust, UK
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Woo J, Santasusagna S, Banks J, Pastor-Lopez S, Yadav K, Carceles-Cordon M, Dominguez-Andres A, Den RB, Languino LR, Pippa R, Lallas CD, Lu-Yao G, Kelly WK, Knudsen KE, Rodriguez-Bravo V, Tewari AK, Prats JM, Leiby BE, Gomella LG, Domingo-Domenech J. Urine Extracellular Vesicle GATA2 mRNA Discriminates Biopsy Result in Men with Suspicion of Prostate Cancer. J Urol 2020; 204:691-700. [PMID: 32250729 PMCID: PMC7483587 DOI: 10.1097/ju.0000000000001066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Prostate specific antigen has limited performance in detecting prostate cancer. The transcription factor GATA2 is expressed in aggressive prostate cancer. We analyzed the predictive value of urine extracellular vesicle GATA2 mRNA alone and in combination with a multigene panel to improve detection of prostate cancer and high risk disease. MATERIALS AND METHODS GATA2 mRNA was analyzed in matched extracellular vesicles isolated from urines before and after prostatectomy (16) and paired urine and tissue prostatectomy samples (19). Extracellular vesicle GATA2 mRNA performance to distinguish prostate cancer and high grade disease was tested in training (52) and validation (165) cohorts. The predictive value of a multigene score including GATA2, PCA3 and TMPRSS2-ERG (GAPT-E) was tested in both cohorts. RESULTS Confirming its prostate origin, urine extracellular vesicle GATA2 mRNA levels decreased significantly after prostatectomy and correlated with prostate cancer tissue GATA2 mRNA levels. In the training and validation cohort GATA2 discriminated prostate cancer (AUC 0.74 and 0.66) and high grade disease (AUC 0.78 and 0.65), respectively. Notably, the GAPT-E score improved discrimination of prostate cancer (AUC 0.84 and 0.72) and high grade cancer (AUC 0.85 and 0.71) in both cohorts when compared with each biomarker alone and PT-E (PCA3 and TMPRSS2-ERG). A GAPT-E score for high grade prostate cancer would avoid 92.1% of unnecessary prostate biopsies, compared to 61.9% when a PT-E score is used. CONCLUSIONS Urine extracellular vesicle GATA2 mRNA analysis improves the detection of high risk prostate cancer and may reduce the number of unnecessary biopsies.
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Affiliation(s)
- J Woo
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - S Santasusagna
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - J Banks
- Division of Biostatistics and Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - S Pastor-Lopez
- Urology Department, Hospital Sant Jaume Calella, Barcelona, Spain
| | - K Yadav
- Urology Department, Icahn School of Medicine at Mount Sinai, New York, New York
| | - M Carceles-Cordon
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - A Dominguez-Andres
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - R B Den
- Radiation Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
- Cancer Biology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - L R Languino
- Cancer Biology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - R Pippa
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - C D Lallas
- Urology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - G Lu-Yao
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - W K Kelly
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - K E Knudsen
- Cancer Biology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - V Rodriguez-Bravo
- Cancer Biology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - A K Tewari
- Urology Department, Icahn School of Medicine at Mount Sinai, New York, New York
| | - J M Prats
- Urology Department, Hospital Sant Jaume Calella, Barcelona, Spain
| | - B E Leiby
- Division of Biostatistics and Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - L G Gomella
- Urology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Josep Domingo-Domenech
- Medical Oncology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
- Cancer Biology Department, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
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Woo J, Santasusagna S, Banks J, Dominguez-Andres A, Yadav K, Pippa R, Carceles-Cordon M, Lallas C, Luyao G, Rodriguez-Bravo V, Tewari A, Pastor-Lopez S, Kelly W, Leiby B, Prats J, Gomella L, Domingo-Domenech J. Urine extracellular vesicle GATA2 mRNA alone and in a multigene test predicts initial prostate biopsy result. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lewis EG, Banks J, Paddick SM, Duinmaijer A, Tucker L, Kisoli A, Cletus J, Lissu C, Kilonzo K, Cosker G, Mukaetova-Ladinska EB, Dotchin C, Gray W, Walker R, Urasa S. Risk Factors for Delirium in Older Medical Inpatients in Tanzania. Dement Geriatr Cogn Disord 2018; 44:160-170. [PMID: 28869952 DOI: 10.1159/000479058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/27/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The risk factors for prevalent delirium in older hospitalised adults in Sub-Saharan Africa (SSA) remain poorly characterised. METHODS A total of 510 consecutive admissions of adults aged ≥60 years to acute medical wards of Kilimanjaro Christian Medical Centre in northern Tanzania were recruited. Patients were assessed within 24 h of admission with a risk factor questionnaire, physiological observations, neurocognitive assessment, and informant interview. Delirium and dementia diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) and DSM IV respectively, by an expert panel. RESULTS Being male, current alcohol use, dementia, and physiological markers of illness severity were significant independent risk factors for delirium on multivariable analysis. CONCLUSIONS The risk factors for prevalent delirium in older medical inpatients in SSA include pre-existing dementia, and are similar to those identified in high-income countries. Our data could help inform the development of a delirium risk stratification tool for older adults in SSA.
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Affiliation(s)
- Emma Grace Lewis
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin, Berlin, Germany
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Hayes A, Banks J, Shah H, Luong T, Navalkissoor S, Grossman A, Mandair D, Toumpanakis C, Caplin M. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) in patients with pulmonary carcinoid tumours: Prevalence and prognosis of an under-recognised disease. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy293.016] [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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Seekings AH, Slomka MJ, Russell C, Howard WA, Choudhury B, Nuñéz A, Löndt BZ, Cox W, Ceeraz V, Thorén P, Irvine RM, Manvell RJ, Banks J, Brown IH. Direct evidence of H7N7 avian influenza virus mutation from low to high virulence on a single poultry premises during an outbreak in free range chickens in the UK, 2008. Infect Genet Evol 2018; 64:13-31. [PMID: 29883773 DOI: 10.1016/j.meegid.2018.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/24/2018] [Accepted: 06/03/2018] [Indexed: 11/30/2022]
Abstract
H5 and H7 subtypes of low pathogenicity avian influenza viruses (LPAIVs) have the potential to evolve into highly pathogenic avian influenza viruses (HPAIVs), causing high mortality in galliforme poultry with substantial economic losses for the poultry industry. This study provides direct evidence of H7N7 LPAIV mutation to HPAIV on a single poultry premises during an outbreak that occurred in June 2008 in free range laying hens in Oxfordshire, UK. We report the first detection of a rare di-basic cleavage site (CS) motif (PEIPKKRGLF), unique to galliformes, that has previously been associated with a LPAIV phenotype. Three distinct HPAIV CS sequences (PEIPKRKKRGLF, PEIPKKKKRGLF and PEIPKKKKKKRGLF) were identified in the infected sheds suggesting molecular evolution at the outbreak premises. Further evidence for H7N7 LPAIV preceding mutation to HPAIV was derived by examining clinical signs, epidemiological descriptions and analysing laboratory results on the timing and proportions of seroconversion and virus shedding at each infected shed on the premises. In addition to describing how the outbreak was diagnosed and managed via statutory laboratory testing, phylogenetic analysis revealed reassortant events during 2006-2008 that suggested likely incursion of a wild bird origin LPAIV precursor to the H7N7 HPAIV outbreak. Identifying a precursor LPAIV is important for understanding the molecular changes and mechanisms involved in the emergence of HPAIV. This information can lead to understanding how and why only some H7 LPAIVs appear to readily mutate to HPAIV.
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Affiliation(s)
- A H Seekings
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom.
| | - M J Slomka
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - C Russell
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - W A Howard
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - B Choudhury
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - A Nuñéz
- Pathology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - B Z Löndt
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - W Cox
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - V Ceeraz
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - P Thorén
- Swedish Agricultural University (SLU), Uppsala, Sweden
| | - R M Irvine
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - R J Manvell
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - J Banks
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
| | - I H Brown
- Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey KT15 3NB, United Kingdom
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Paddick SM, Lewis EG, Duinmaijer A, Banks J, Urasa S, Tucker L, Kisoli A, Cletus J, Lissu C, Kissima J, Dotchin C, Gray WK, Muaketova-Ladinska E, Cosker G, Walker RW. Identification of delirium and dementia in older medical inpatients in Tanzania: A comparison of screening and diagnostic methods. J Neurol Sci 2017; 385:156-163. [PMID: 29406898 DOI: 10.1016/j.jns.2017.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND In sub-Saharan Africa, there are no validated screening tools for delirium in older adults. This study assesses clinical utility of two instruments, the IDEA cognitive screen and the Confusion Assessment Method (CAM) for identification of delirium in older adults admitted to medical wards of a tertiary referral hospital in Tanzania. METHOD The IDEA cognitive screen and CAM were administered to a consecutive cohort of older individuals on admission to Kilimanjaro Christian Medical Centre using a blinded protocol. Consensus diagnosis for delirium was established against DSM-5 criteria and dementia by DSM-IV criteria. RESULTS Of 507 admission assessments, 95 (18.7%) had DSM-5 delirium and 95 (18.7%) had DSM-IV dementia (33 (6.5%) delirium superimposed on dementia). The CAM and IDEA cognitive screen had very good diagnostic accuracy for delirium (AUROC curve 0.94 and 0.87 respectively). However, a number of participants (10.5% and 16.4% respectively) were unable to complete these screening assessments due to reduced consciousness, or other causes of reduced verbal response and were excluded from this analysis; many of whom met DSM-5 criteria for delirium. Secondary analysis suggests that selected cognitive and observational items from the CAM and IDEA cognitive screen may be as effective as the full screening tools in identifying delirium even in unresponsive patients. CONCLUSION Both instruments appeared useful for delirium screening in this inpatient setting, but had significant limitations. The combination of assessment items identified may form the basis of a brief, simple delirium screening tool suitable for use by non-specialist clinicians. Further development work is needed.
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Affiliation(s)
- S M Paddick
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
| | - E G Lewis
- Charité - Universitätsmedizin Berlin, CVK: Campus Virchow-Klinikum, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - A Duinmaijer
- Haydom Lutheran Hospital, Mbulu, Manyara, Tanzania
| | - J Banks
- The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - S Urasa
- Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania
| | - L Tucker
- The London School of Hygiene & Tropical Medicine, London, UK
| | - A Kisoli
- Hai District Hospital, Boman'gombe, Kilimanjaro, Tanzania
| | - J Cletus
- Hai District Hospital, Boman'gombe, Kilimanjaro, Tanzania
| | - C Lissu
- Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania
| | - J Kissima
- Hai District Hospital, Boman'gombe, Kilimanjaro, Tanzania
| | - C Dotchin
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - W K Gray
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - E Muaketova-Ladinska
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Institute of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK and Leicestershire Partnership NHS Trust, Leicester, UK
| | - G Cosker
- Institute of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK and Leicestershire Partnership NHS Trust, Leicester, UK
| | - R W Walker
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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Paddick S, Lewis E, Duinmaijer A, Banks J, Tucker L, Kisoli A, Cletus J, Urasa S, Lissu C, Kissima J, Dotchin C, Gray W, Mukaetova-Ladinska E, Cosker G, Walker R. Identification of delirium and dementia in older medical inpatients in Tanzania: A comparison of screening and diagnostic methods. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2395] [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: 10/18/2022]
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Poole J, Reid M, Banks J, Liew Y, Addy J, Longster G. Serological and Immunochemical Specificity of a
Human Autoanti-Gerbich-Like Antibody. Vox Sang 2017. [DOI: 10.1159/000461136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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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Pengas IP, Nash W, Khan W, Assiotis A, Banks J, McNicholas MJ. Coronal Knee Alignment 40 Years after Total Meniscectomy in Adolescents: A Prospective Cohort Study. Open Orthop J 2017; 11:424-431. [PMID: 28660000 PMCID: PMC5470071 DOI: 10.2174/1874325001711010424] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/06/2017] [Accepted: 04/21/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction: Meniscectomies result in altered knee biomechanics and increase contact forces on the operated knee joint. Methods: We assessed coronal knee alignment in relation to radiological osteoarthritis grading, clinical range of movement and patient reported outcome measures 40 years after total open meniscectomies in adolescence. Thirty eight knees (30 patients) that underwent total open meniscectomy were assessed on standardised weight-bearing anteroposterior radiographs for deviation from ‘physiological valgus angle’ in either direction (magnitude of malalignment). These values were analysed as per site of meniscectomy for correlations with radiographic scoring systems, range of motion and patient reported outcome measures. Results: Tibiofemoral angle was significantly more varus, and the magnitude of malalignment was significantly higher for the medial meniscectomy patients. The range of flexion was lower for those patients who underwent medial and lateral meniscectomies of the same knee. The patients who underwent meniscectomies of both knees had worse scores for IKDC and KOOS quality of life. Tibiofemoral angle, magnitude of malalignment and range of flexion strongly correlated with Ahlback, and Kellgren and Laurence scores, but patient reported that outcome measures did not correlate. Conclusion: Meniscectomy induced malalignment corresponds to the site of meniscectomy and the radiographic degree of osteoarthritis. While malalignment and reduced range of movement correlate well with worsening radiographic signs of arthritis, patient reported outcome measures do not correlate.
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Affiliation(s)
- I P Pengas
- University Hospitals of Coventry & Warwickshire, Clifford Bridge Road, Coventry, West Midlands, CV2 2DX, UK
| | - W Nash
- Queen Elizabeth Hospital, Stadium Road, Woolwich, London, SE18 4QH, UK
| | - Wasim Khan
- Cardiff and Vale Orthopaedic Centre, Llandough Hospital, University Hospital Wales Health Board, Cardiff, CF64 2XX, UK
| | - A Assiotis
- Hillingdon Hospital, Pield Heath Road, Uxbridge. UB8 3NN, UK
| | - J Banks
- University Hospital Aintree Teaching Hospital NHS Foundation Trust, Longmoor Lane, Liverpool, L9 7AL, UK
| | - M J McNicholas
- University Hospital Aintree Teaching Hospital NHS Foundation Trust, Longmoor Lane, Liverpool, L9 7AL, UK
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Worth LBC, Pearce RJH, Bruce J, Banks J, Scales S. Development of a Novel Contamination Resistant Ion Chamber for Process Tritium Measurement and Use in the JET First Trace Tritium Experiment. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- L. B. C. Worth
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB UK
| | - R. J. H. Pearce
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB UK
| | - J. Bruce
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB UK
| | - J. Banks
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB UK
| | - S. Scales
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB UK
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Vidaña A, Seekings A, Núñez A, Slomka M, Howard W, Banks J, Brookes S, Brown I. Consecutive Challenges with Geneticaly Modified H7N7 LPAIV and H7N7 HPAIV in layer hens. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.087] [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: 11/29/2022]
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Lewis E, Paddick SM, Banks J, Duinmaijer A, Tucker L, Kisoli A, Cletus J, Lissu C, Dotchin C, Gray W, Walker R, Urasa S. Prevalence of Delirium in Older Medical Inpatients in Tanzania. J Am Geriatr Soc 2016; 64:e28-9. [DOI: 10.1111/jgs.14278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Emma Lewis
- Charite-Universitatsmedizin Berlin; Berlin Germany
| | - Stella-Maria Paddick
- Newcastle University; Newcastle upon Tyne UK
- Northumbria Healthcare National Health Service Foundation Trust; North Tyneside General Hospital; North Shields UK
| | | | | | - Laura Tucker
- London School of Hygiene and Tropical Medicine; London UK
| | - Aloyce Kisoli
- Kilimanjaro Christian Medical University College; Moshi United Republic of Tanzania
| | - Jane Cletus
- Hai District Hospital; Boman'gombe United Republic of Tanzania
| | - Carolyn Lissu
- Kilimanjaro Christian Medical University College; Moshi United Republic of Tanzania
| | - Catherine Dotchin
- Newcastle University; Newcastle upon Tyne UK
- Northumbria Healthcare National Health Service Foundation Trust; North Tyneside General Hospital; North Shields UK
| | - William Gray
- Northumbria Healthcare National Health Service Foundation Trust; North Tyneside General Hospital; North Shields UK
| | - Richard Walker
- Newcastle University; Newcastle upon Tyne UK
- Northumbria Healthcare National Health Service Foundation Trust; North Tyneside General Hospital; North Shields UK
| | - Sarah Urasa
- Kilimanjaro Christian Medical University College; Moshi United Republic of Tanzania
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Heal CF, Charles D, Hardy A, Delpachitra M, Banks J, Wohlfahrt M, Saednia S, Buettner P. Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial. BMJ Open 2016; 6:e011604. [PMID: 27388361 PMCID: PMC4947720 DOI: 10.1136/bmjopen-2016-011604] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions. METHODS AND ANALYSIS The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance. ETHICS AND DISSEMINATION The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media. DISCUSSION RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence. TRIAL REGISTRATION NUMBER ACTRN12615001045505; Pre-results.
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Affiliation(s)
- C F Heal
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - D Charles
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - A Hardy
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - M Delpachitra
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | | | - M Wohlfahrt
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Sabine Saednia
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - P Buettner
- Discipline of General Practice and Rural Medicine, Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia Tropical Health Solutions, Townsville, Queensland, Australia Queensland Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia
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Paddick SM, Lewis EG, Duinmaijer AT, Banks J, Urasa S, Tucker L, Kisoli A, Cletus J, Lissu C, Kisima J, Dotchin C, Gray WK, Mushi D, Walker R. O4‐12‐04: EVALUATION OF THE IDEA (IDENTIFICATION AND INTERVENTIONS FOR DEMENTIA IN ELDERLY AFRICANS) BRIEF COGNITIVE SCREENING TOOL FOR IDENTIFICATION OF DELIRIUM IN OLDER HOSPITALISED ADULTS IN TANZANIA. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Stella-Maria Paddick
- Newcastle UniversityNewcastle Upon Tyne United Kingdom
- Northumbria Healthcare NHS Foundation TrustNorth ShieldsUnited Kingdom
| | | | | | - Jessica Banks
- Newcastle UniversityNewcastle upon Tyne United Kingdom
| | - Sarah Urasa
- Kilimanjaro Christian Medical CollegeMoshiUnited Kingdom
| | - Laura Tucker
- The London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | | | - Jane Cletus
- Hai District Medical OfficeBoma'ngombeTanzania
| | - Carolyn Lissu
- Kilimanjaro Christian Medical CollegeMoshiUnited Kingdom
| | - John Kisima
- Hai District Medical OfficeBoma'ngombeTanzania
| | - Catherine Dotchin
- Northumbria Healthcare NHS Foundation TrustNorth ShieldsUnited Kingdom
| | | | | | - Richard Walker
- Newcastle UniversityNewcastle Upon Tyne United Kingdom
- Northumbria Healthcare NHS TrustNorth ShieldsUnited Kingdom
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Alexander DJ, Manvell RJ, Banks J, Collins MS, Parsons G, Cox B, Frost KM, Speidel EC, Ashman S, Aldous EW. Experimental assessment of the pathogenicity of the Newcastle disease viruses from outbreaks in Great Britain in 1997 for chickens and turkeys, and the protection afforded by vaccination. Avian Pathol 2016; 28:501-11. [PMID: 26911606 DOI: 10.1080/03079459994542] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The Newcastle disease virus isolated from healthy turkeys in outbreak GB 97/6 was used to challenge 4-week-old turkeys and chickens, which were either not vaccinated or had received a single dose of Hitchner B1 live vaccine 14 days earlier, by one of the intramuscular, intranasal or contact routes. Similar experiments were done in 38-day-old turkeys and chickens using virus isolated from severely sick chickens in outbreak GB 97/1. All vaccinated chickens showed low but measurable immune responses 14 days after vaccination, but only three of the turkeys had detectable antibodies. No vaccinated turkey or chicken showed any clinical sign after challenge with either virus. The virus from healthy turkeys in outbreak GB 97/6 induced clinical signs in 12/30 unvaccinated turkeys after challenge and 7/30 died. In unvaccinated chickens, challenge with this virus produced clinical signs in 25/30 birds and 21/30 died. In challenge experiments with the virus from outbreak GB 97/1 in chickens, 3/30 unvaccinated turkeys showed clinical signs and all three subsequently died. In contrast, 30/30 unvaccinated chickens challenged with this virus showed clinical signs and died. Vaccination did not prevent infection and excretion of either challenge virus. However, when compared with unvaccinated birds, vaccination reduced significantly the length of time virus was excreted and the overall proportion of swabs that were positive.
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Hall N, Birt L, Banks J, Emery J, Mills K, Johnson M, Rubin GP, Hamilton W, Walter FM. Symptom appraisal and healthcare-seeking for symptoms suggestive of colorectal cancer: a qualitative study. BMJ Open 2015; 5:e008448. [PMID: 26453591 PMCID: PMC4606388 DOI: 10.1136/bmjopen-2015-008448] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Timely diagnosis of colorectal cancer is important to improve survival. This study explored symptom appraisal and help-seeking among patients referred to specialist services with symptoms of colorectal cancer. DESIGN Qualitative in-depth interview study. SETTING AND PARTICIPANTS Participants were recruited on referral to gastroenterology clinics (North East and East of England); interviews were conducted soon after referral. We purposively sampled participants to ensure a range of accounts in terms of age, sex, diagnosis and geographical location. METHODS Data collection and analysis were underpinned by the Model of Pathways to Treatment. Framework analysis was used to explore the data within and across cases, focusing on patient beliefs and experiences, disease factors and healthcare influences. RESULTS 40 participants were interviewed (aged 43-87 years, 17 women, 18 diagnosed with colorectal cancer). Patients diagnosed with and without colorectal cancer had similar symptom pathways. We found a range of interacting and often competing biopsychosocial, contextual and cultural influences on the way in which people recognised, interpreted and acted on their symptoms. People attempted to 'maintain normality' through finding benign explanations for their symptoms. Bodily changes were appraised within the context of usual bowel patterns, comorbidities and life events, and decisions to seek help were made in relation to expectations about the course of symptoms. The 'private nature' of colorectal cancer symptoms could affect both their identification and discussions with others including healthcare professionals. Within the context of the National Health Service, people needed to legitimise appropriate use of healthcare services and avoid being thought of as wasting doctors' time. CONCLUSIONS Findings provide guidance for awareness campaigns on reducing stigma around appraising and discussing bowel movements, and the importance of intermittent and non-specific symptoms. Altering perceptions about the appropriate use of health services could have a beneficial effect on time to presentation.
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Affiliation(s)
- N Hall
- School of Medicine, Pharmacy and Health, Durham University, Durham, UK
| | - L Birt
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - J Banks
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - J Emery
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
| | - K Mills
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | | | - G P Rubin
- School of Medicine, Pharmacy and Health, Durham University, Durham, UK
| | - W Hamilton
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - F M Walter
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
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Parker CD, Irvine RM, Slomka MJ, Pavlidis T, Hesterberg U, Essen S, Cox B, Ceeraz V, Alexander DJ, Manvell R, Banks J, Brown IH. Outbreak of Eurasian lineage H5N1 highly pathogenic avian influenza in turkeys in Great Britain in November 2007. Vet Rec 2014; 175:282. [DOI: 10.1136/vr.102350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- C. D. Parker
- Slatehall Veterinary Practice; Unit 10 Moorlands Trading Estate, Moor Lane Metheringham Lincolnshire LN10 6YY UK
| | - R. M. Irvine
- Technical Adviser Epidemiology, Emergency Centre for Transboundary Animal Diseases (ECTAD) FAO; Indonesia
| | - M. J. Slomka
- Technical Adviser Epidemiology, Emergency Centre for Transboundary Animal Diseases (ECTAD) FAO; Indonesia
| | - T. Pavlidis
- Technical Adviser Epidemiology, Emergency Centre for Transboundary Animal Diseases (ECTAD) FAO; Indonesia
| | - U. Hesterberg
- Technical Adviser Epidemiology, Emergency Centre for Transboundary Animal Diseases (ECTAD) FAO; Indonesia
| | - S. Essen
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - B. Cox
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - V. Ceeraz
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - D. J. Alexander
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - R. Manvell
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - J. Banks
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
| | - I. H. Brown
- EU/OIE/FAO International Reference Laboratory for Avian Influenza and Newcastle Disease; Animal Health and Veterinary Laboratories Agency (AHVLA); Weybridge, New Haw Addlestone Surrey KT15 3NB UK
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Freidl GS, Meijer A, de Bruin E, de Nardi M, Munoz O, Capua I, Breed AC, Harris K, Hill A, Kosmider R, Banks J, von Dobschuetz S, Stark K, Wieland B, Stevens K, van der Werf S, Enouf V, van der Meulen K, Van Reeth K, Dauphin G, Koopmans M, FLURISK Consortium. Influenza at the animal–human interface: a review of the literature for virological evidence of human infection with swine or avian influenza viruses other than A(H5N1). Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.18.20793] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Factors that trigger human infection with animal influenza virus progressing into a pandemic are poorly understood. Within a project developing an evidence-based risk assessment framework for influenza viruses in animals, we conducted a review of the literature for evidence of human infection with animal influenza viruses by diagnostic methods used. The review covering Medline, Embase, SciSearch and CabAbstracts yielded 6,955 articles, of which we retained 89; for influenza A(H5N1) and A(H7N9), the official case counts of the World Health Organization were used. An additional 30 studies were included by scanning the reference lists. Here, we present the findings for confirmed infections with virological evidence. We found reports of 1,419 naturally infected human cases, of which 648 were associated with avian influenza virus (AIV) A(H5N1), 375 with other AIV subtypes, and 396 with swine influenza virus (SIV). Human cases naturally infected with AIV spanned haemagglutinin subtypes H5, H6, H7, H9 and H10. SIV cases were associated with endemic SIV of H1 and H3 subtype descending from North American and Eurasian SIV lineages and various reassortants thereof. Direct exposure to birds or swine was the most likely source of infection for the cases with available information on exposure.
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Affiliation(s)
- G S Freidl
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - A Meijer
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands
| | - E de Bruin
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands
| | - M de Nardi
- Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human–Animal Interface, Padova, Italy
| | - O Munoz
- Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human–Animal Interface, Padova, Italy
| | - I Capua
- Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human–Animal Interface, Padova, Italy
| | - A C Breed
- Animal Health and Veterinary Agency (AHVLA), Surrey, United Kingdom
| | - K Harris
- Animal Health and Veterinary Agency (AHVLA), Surrey, United Kingdom
| | - A Hill
- Animal Health and Veterinary Agency (AHVLA), Surrey, United Kingdom
- Royal Veterinary College (RVC), London, United Kingdom
| | - R Kosmider
- Animal Health and Veterinary Agency (AHVLA), Surrey, United Kingdom
| | - J Banks
- Animal Health and Veterinary Agency (AHVLA), Surrey, United Kingdom
| | - S von Dobschuetz
- United Nations Food and Agricultural Organization (FAO), Rome, Italy
- Royal Veterinary College (RVC), London, United Kingdom
| | - K Stark
- Royal Veterinary College (RVC), London, United Kingdom
| | - B Wieland
- Royal Veterinary College (RVC), London, United Kingdom
| | - K Stevens
- Royal Veterinary College (RVC), London, United Kingdom
| | | | - V Enouf
- Institut Pasteur, Paris, France
| | | | | | - G Dauphin
- United Nations Food and Agricultural Organization (FAO), Rome, Italy
| | - M Koopmans
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Bilthoven, the Netherlands
| | - FLURISK Consortium
- http://www.izsvenezie.it/index.php?option=com_content&view=article&id=1203&Itemid=629
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De Nardi M, Hill A, von Dobschuetz S, Munoz O, Kosmider R, Dewe T, Harris K, Freidl G, Stevens K, van der Meulen K, Stäerk K, Breed A, Meijer A, Koopmans M, Havelaar A, van der Werf S, Banks J, Wieland B, van Reeth K, Dauphin G, Capua I. Development of a risk assessment methodological framework for potentially pandemic influenza strains (FLURISK). ACTA ACUST UNITED AC 2014. [DOI: 10.2903/sp.efsa.2014.en-571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- M. De Nardi
- Istituto Zooprofilattico Sperimentale delle Venezie (Project Coordinator) Italy
| | - A. Hill
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - S. von Dobschuetz
- Royal Veterinary College (RVC) United Kingdom
- Food and Agricultural Organization of the United Nations (FAO) Italy
| | - O. Munoz
- Istituto Zooprofilattico Sperimentale delle Venezie (Project Coordinator) Italy
| | - R. Kosmider
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - T. Dewe
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - K. Harris
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - G. Freidl
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases Research, Diagnostics and Screening (IDS) the Netherlands
| | - K. Stevens
- Royal Veterinary College (RVC) United Kingdom
| | - K. van der Meulen
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University Belgium
| | | | - A. Breed
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - A. Meijer
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases Research, Diagnostics and Screening (IDS) the Netherlands
| | - M. Koopmans
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases Research, Diagnostics and Screening (IDS) the Netherlands
| | - A. Havelaar
- National Institute for Public Health and the Environment (RIVM), Laboratory for Infectious Diseases Research, Diagnostics and Screening (IDS) the Netherlands
| | | | - J. Banks
- Animal Health and Veterinary Agency (AHVLA) United Kingdom
| | - B. Wieland
- Royal Veterinary College (RVC) United Kingdom
| | - K. van Reeth
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University Belgium
| | - G. Dauphin
- Food and Agricultural Organization of the United Nations (FAO) Italy
| | - I. Capua
- Istituto Zooprofilattico Sperimentale delle Venezie (Project Coordinator) Italy
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Hollinghurst S, Hunt LP, Banks J, Sharp DJ, Shield JP. Cost and effectiveness of treatment options for childhood obesity. Pediatr Obes 2014; 9:e26-34. [PMID: 23505002 DOI: 10.1111/j.2047-6310.2013.00150.x] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 01/22/2013] [Accepted: 01/30/2013] [Indexed: 11/28/2022]
Abstract
UNLABELLED What is already known about this subject Approximately one-fifth of children in the UK are obese. There are currently few, effective interventions available in the UK. There are very little data on relative cost-effectiveness of childhood obesity interventions, which hampers the commissioning of future services. What this study adds Simple multi-component obesity interventions can be provided at relatively low cost per 0.1 body mass index standard deviation score (BMI SDS) improvement. More intensive and effective interventions incur greater cost per 0.1 BMI SDS reduction but this may be justified given the improved overall BMI SDS reduction attained. OBJECTIVE To describe the costs and outcomes of three models of care for childhood obesity previously evaluated in two 2-arm pilot randomized trials in England. The treatments were (i) a hospital clinic (control in both trials), comprising a multidisciplinary team of consultant, dietitian and exercise specialist; (ii) a nurse-led primary care clinic replicating the service provided by the hospital and (iii) an intensive intervention using Mandometer®, a behaviour modification tool aimed at encouraging slower eating and better recognition of satiety. METHOD Patient-level data on resources used to deliver each intervention were collected during the trials. Apart from the cost of the Mandometer® the majority of cost was staff time, dependent on discipline and grade. Outcome for both trials was body mass index standard deviation score (BMI SDS) measured at 12 months. RESULTS Cost and outcome data were available for 143 children in total. Cost per child was £1749 (SD £243) in the Mandometer® group, £301 (£76) in the primary care group, and £263 (£88) and £209 (£81) in the hospital groups. Mean reduction in BMI SDS was 0.40 (0.35), 0.17 (0.26), 0.15 (0.25) and 0.14 (0.32), respectively. CONCLUSION Intensive management using Mandometer® was effective but costly (£432 per 0.1 reduction in BMI SDS) compared to conventional care (range £153-£173). A total of 26% children receiving conventional care achieved a clinically meaningful reduction in BMI SDS; however, use of Mandometer® training may be justified in children not responding to conventional lifestyle interventions.
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Affiliation(s)
- S Hollinghurst
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
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Whale J, Banks J, Foley E, Patel R. Summary and highlights of the scientific tracks at the STI & AIDS World Congress 2013, Vienna. Int J STD AIDS 2013; 25:405-9. [PMID: 24256694 DOI: 10.1177/0956462413512810] [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: 11/16/2022]
Abstract
The joint meeting of International Society for Sexually Transmitted Diseases Research (ISSTDR) and International Union against Sexually Transmitted Infections (IUSTI) was held in July 2013 in Vienna, Austria. The conference had attracted over 1300 submissions and was divided into six tracks. The track chairs reviewed all presentations and identified key themes and data that delegates should be aware of. In a conference summary session, each track chair presented these highlights. This conference report details and expands on this summary.
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Affiliation(s)
- J Whale
- University of Southampton, School of Medicine, Southampton, UK
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Brooks B, Banks J, Ison C, Laar MVD, Moi H, Radcliffe K, Unemo M, Ross J, White J, Patel R. P3.292 The 2013 IUSTI European Collaborative Clinical Group (ECCG) Report on the Diagnosis and Management of Chlamydial Infections in Europe. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0747] [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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Abstract
We continued a prospective longitudinal follow-up study of 53 remaining patients who underwent open total meniscectomy as adolescents and who at that time had no other intra-articular pathology of the knee. Their clinical, radiological and patient-reported outcomes are described at a mean follow-up of 40 years (33 to 50). The cohort of patients who had undergone radiological evaluation previously after 30 years were invited for clinical examination, radiological evaluation and review using two patient-reported outcome measures. A total of seven patients (13.2%) had already undergone total knee replacement at the time of follow-up. A significant difference was observed between the operated and non-operated knee in terms of range of movement and osteoarthritis of the tibiofemoral joint, indicating a greater than fourfold relative risk of osteoarthritis at 40 years post-operatively. All patients were symptomatic as defined by the Knee Injury and Osteoarthritis Outcome Score. This study represents the longest follow-up to date and it can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.
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Affiliation(s)
- I P Pengas
- Percivall Pott Rotation, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
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40
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Slomka MJ, Hanna A, Mahmood S, Govil J, Krill D, Manvell RJ, Shell W, Arnold ME, Banks J, Brown IH. Phylogenetic and molecular characteristics of Eurasian H9 avian influenza viruses and their detection by two different H9-specific RealTime reverse transcriptase polymerase chain reaction tests. Vet Microbiol 2012; 162:530-542. [PMID: 23228620 DOI: 10.1016/j.vetmic.2012.11.013] [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: 07/09/2012] [Revised: 10/25/2012] [Accepted: 11/07/2012] [Indexed: 11/30/2022]
Abstract
Avian influenza viruses (AIVs) of the H9 haemagglutinin subtype are endemic in many Asian and Middle-East countries, causing mortality and morbidity in poultry. Consequently there is a need for accurate and sensitive detection of Eurasian H9 subtype viruses. Two H9 RealTime reverse transcriptase polymerase chain reaction (RRT-PCR) tests, developed by Monne et al. (2008) and Ben Shabat et al. (2010), were originally validated with a limited number of H9 specimens. In the present study, the two tests have been assessed using 66 diverse H9 isolates and 139 clinical specimens from six H9 poultry outbreaks in four geographically disparate Eurasian countries. The Monne et al. (2008) test was modified and successfully detected all H9 viruses from all three Eurasian H9 lineages. Bayesian analysis of the clinical specimens' results revealed this test to be more sensitive (97%) than the Ben Shabat et al. (2010) test (31%). The latter test detected most H9 isolates of the G1 lineage, but no isolates from other H9 lineages. Mismatches in the primer/probe binding sequences accounted for sensitivity differences between the two H9 RRT-PCRs. Genetic analysis of 34 sequenced H9 haemagglutinin genes showed the South Asian and Middle-East H9 isolates to belong to the H9 G1 lineage, and possessed residues that appear to preferably bind alpha 2,6-linked sialic acid receptors which indicate a potential for human infection. European H9s clustered phylogenetically in a broader geographical group that includes recent North American H9 wild bird isolates and contemporary Asian viruses in the Y439 H9 lineage.
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Affiliation(s)
- M J Slomka
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom.
| | - A Hanna
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - S Mahmood
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - J Govil
- Cranfield University, Cranfield Health, Milton Keynes, MK45 4DT, United Kingdom
| | - D Krill
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - R J Manvell
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - W Shell
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - M E Arnold
- AHVLA Sutton Bonington, The Elms, College Road, Sutton Bonington, Loughborough, LE12 5RB, United Kingdom
| | - J Banks
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - I H Brown
- Avian Virology, OIE, FAO & EU Avian Influenza Reference Laboratory, Animal Health & Veterinary Laboratories Agency (AHVLA-Weybridge), Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
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Wood GW, Banks J, Strong I, Parsons G, Alexander DJ. An avian influenza virus of H10 subtype that is highly pathogenic for chickens, but lacks multiple basic amino acids at the haemagglutinin cleavage site. Avian Pathol 2012; 25:799-806. [PMID: 18645899 DOI: 10.1080/03079459608419182] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Avian influenza virus isolate A/mandarin duck/Singapore/805/F-72/7/93 was found to be consistently highly pathogenic by recognised in vivo testing procedures although it was of a subtype (H10) not usually associated with high pathogenicity. The virus was also not typical of highly pathogenic influenza viruses in that it was not pathogenic when administered intra-nasally, did not possess a haemagglutinin cleavage site with multiple basic amino acids and did not replicate in the brains of chickens after intravenous inoculation. A re-examination of the earlier H10 isolate A/turkey/England/384/79 suggested that it was similarly pathogenic. The pathogenicity may have been associated with replication in the kidney.
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Affiliation(s)
- G W Wood
- Central Veterinary Laboratory, New Haw, Addlestone, Surrey, UK
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Jørgensen PH, Nielsen OL, Hansen HC, Manvell RJ, Banks J, Alexander DJ. Isolation of influenza a virus, subtype H5N2, and avian paramyxovirus type 1 from a flock of ostriches in Europe. Avian Pathol 2012; 27:15-20. [PMID: 18483960 PMCID: PMC7154298 DOI: 10.1080/03079459808419269] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A total of 146 of 506 ostriches (Struthio camelus) introduced into a quarantine in Denmark died within the first 23 days. The majority of deaths were in young birds up to 10 kg body weight. Avian influenza A viruses (AIVs) were isolated from 14 pools of organ tissues representing seven groups each of three or four ostriches, which died over the first 3 weeks. The AIVs were detected in respiratory tissues, kidneys and intestines. All were subtype H5N2. The intravenous pathogenicity index of each isolate for chickens was 0.0 and the four isolates examined each had the amino acid sequence -P-Q-R-E-T-R*G-L-F- at the cleavage site of the haemagglutinin protein, typical of non-pathogenic AIVs. In addition, an avirulent avian paramyxovirus type 1 virus was isolated from one pool of kidney tissues. Bacteriological examination gave no significant results. The most characteristic pathological findings were impaction of the proventriculus and gizzard, enteritis with stasis and multi-focal necrotic hepatitis.
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Wood GW, Banks J, Brown IH, Strong I, Alexander DJ. The nucleotide sequence of the HA1 of the haemagglutinin of an HI avian influenza virus isolate from turkeys in Germany provides additional evidence suggesting recent transmission from pigs. Avian Pathol 2012; 26:347-55. [PMID: 18483911 DOI: 10.1080/03079459708419217] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The nucleotide sequence encoding the HA1 portion of the haemagglutinin gene of the influenza virus A/turkey/Germany/2482/90j isolated from birds kept in an area of many pig farms, was determined and compared with those of recent avian and swine influenza isolates. It was found to be closest to the 'avian-like' swine H1N1 influenza viruses that have been reported in Europe since the early 1980s and may represent good evidence for transmission of these viruses back to birds after they have become established in pigs.
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Affiliation(s)
- G W Wood
- Central Veterinary Laboratory, New Haw, Addlestone, Surrey, UK
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Abstract
A 380 nucleotide region (bases 613 to 992) of the HA1 part of the haemagglutinin (H) gene was obtained for 35 influenza viruses of H9 subtype isolated from around the world over the past 33 years. These were analyzed phylogenetically and compared with sequences from 19 H9 subtype viruses available in the Genbank database. These viruses do not show such clear geographical lineages as other subtypes (i.e. H5 or H7) and there is a high degree of variation at the cleavage site of the haemagglutinin. Genetically distinct lineages of H9 viruses have circulated contemporaneously in different locations. Thus, it is likely that the numerous infections of poultry and other birds with H9 subtype influenza viruses during the 1990s originate from separate introductions from feral birds. The observed heterogeneity of these viruses may reflect the gene pool for H9 viruses, which is maintained in shorebirds and gulls (Charadriiformes).
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Affiliation(s)
- J Banks
- Avian Virology, Veterinary Laboratories Agency Weybridge, Addlestone, Surrey KT15 3NB, UK
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Reid SM, Shell WM, Barboi G, Onita I, Turcitu M, Cioranu R, Marinova-Petkova A, Goujgoulova G, Webby RJ, Webster RG, Russell C, Slomka MJ, Hanna A, Banks J, Alton B, Barrass L, Irvine RM, Brown IH. First reported incursion of highly pathogenic notifiable avian influenza A H5N1 viruses from clade 2.3.2 into European poultry. Transbound Emerg Dis 2010; 58:76-8. [PMID: 21054819 DOI: 10.1111/j.1865-1682.2010.01175.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study reports the first incursion into European poultry of H5N1 highly pathogenic notifiable avian influenza A (HPNAI) viruses from clade 2.3.2 that affected domestic poultry and wild birds in Romania and Bulgaria, respectively. Previous occurrences in Europe of HPNAI H5N1 in these avian populations have involved exclusively viruses from clade 2.2. This represents the most westerly spread of clade 2.3.2 viruses, which have shown an apparently expanding range of geographical dispersal since mid-2009 following confirmation of infections in wild waterfowl species in Mongolia and Eastern Russia. During March 2010, AI infection was suspected at post-mortem examination of two hens from two backyard flocks in Tulcea Country, Romania. HPNAI of H5N1 subtype was confirmed by reverse transcription polymerase chain reaction (RT-PCR). A second outbreak was confirmed 2 weeks later by RT-PCR, affecting all hens from another flock located 55 km east of the first cluster. On the same day, an H5N1 HPNAI virus was detected from a pooled tissue sample collected from a dead Common Buzzard found on the Black Sea coast in Bulgaria. Detailed genetic characterization of the haemagglutinin gene revealed the cleavage site of the isolates to be consistent with viruses of high pathogenicity belonging to clade 2.3.2 of the contemporary Eurasian H5N1 lineage. Viruses from a clade other than 2.2 have apparently spread to wild birds, with potential maintenance and spread through such populations. Whilst the scale of threat posed by the apparent westward spread of the clade 2.3.2 viruses remains uncertain, ongoing vigilance for clinical signs of disease as part of existing passive surveillance frameworks for AI, and the prompt reporting of suspect cases in poultry is advised.
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Affiliation(s)
- S M Reid
- OIE, FAO, Veterinary Laboratories Agency-Weybridge, Addlestone, Surrey, UK.
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Abstract
Chlamydiae were found capable of producing plaques in several cell lines. Mouse fibroblast cells, L-929, proved the most sensitive to infection and yielded plaques of the highest clarity. Assay of chlamydial infectivity by plaque titration was at least as sensitive as egg ld(50) determination. Among chlamydial isolates of avian, mammalian, and human origin, only slow-growing trachoma-inclusion-conjunctivitis agents did not produce plaques. The plaque assay is highly sensitive, reproducible, and offers a potential tool for investigations requiring accurate measurement of small changes in chlamydial infectivity.
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Affiliation(s)
- J Banks
- The G. W. Hooper Foundation, University of California San Francisco Medical Center, San Francisco, California 94122
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Banks J, Eddie B, Sung M, Sugg N, Schachter J, Meyer KF. Plaque reduction technique for demonstrating neutralizing antibodies for Chlamydia. Infect Immun 2010; 2:443-7. [PMID: 16557859 PMCID: PMC416030 DOI: 10.1128/iai.2.4.443-447.1970] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Some members of the genus Chlamydia (Bedsonia or psittacosis-lymphogranuloma venereum-trachoma-inclusion conjunctivitis group of microorganisms) produce plaques in monolayers of mouse fibroblast (L-929) cells. Hyperimmune chicken antisera may be capable of specifically reducing plaque counts. When the test was applied to chlamydiae isolated from avian species, the results indicated that different isolates with a common source had similar antigenic reactivity. The plaque reduction test is a potentially useful method for serotyping chlamydiae. The difficult aspect of the method appears to be a readily reproducible means of producing neutralizing antiserum.
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Affiliation(s)
- J Banks
- The G. W. Hooper Foundation, University of California, San Francisco, San Francisco, California 94122
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Abstract
Batches of whole wheat contaminated with ochratoxin A were produced by inoculation with Penicillium verrucosum under controlled conditions in the laboratory. The fate of ochratoxin was followed through initial cleaning, abrasive scouring of the outer grain coat, milling into wholemeal wheat or into 10 milled fractions. Bread was baked from both wholemeal flour and straight-run white flour. Concentrations of ochratoxin A in the cleanings, scourings, and the bran and offal fractions were increased, but reduced in the white flour. Scouring removed up to 44% of the ochratoxin A present, but only a small further loss occurred in the bread-making process. An overall reduction of about 75% could be achieved in white bread using a combination of cleaning scouring and removal of the bran and offal fractions. Maximum overall reduction in producing wholemeal bread was about 40%. The reduction in ochratoxin A that can be achieved must be considered in relation to economic constraints concerning the disposal of wasted grain. Appropriate strategies for the use or disposal of potentially highly contaminated cleanings, scourings, bran or offal must be established.
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Slomka MJ, Irvine RM, Pavlidis T, Banks J, Brown IH. Role of Real-Time RT-PCR Platform Technology in the Diagnosis and Management of Notifiable Avian Influenza Outbreaks: Experiences in Great Britain. Avian Dis 2010; 54:591-6. [DOI: 10.1637/8947-052909-reg.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jenkins PA, Campbell IA, Banks J, Gelder CM, Prescott RJ, Smith AP. Clarithromycin vs ciprofloxacin as adjuncts to rifampicin and ethambutol in treating opportunist mycobacterial lung diseases and an assessment of Mycobacterium vaccae immunotherapy. Thorax 2008; 63:627-34. [DOI: 10.1136/thx.2007.087999] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [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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