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Shah S, Morris H, Nicolaou N, MacInnes S, Haslam P, Shahane S, Ali F, Garcia J. The carbon footprint of arthroscopic procedures. Ann R Coll Surg Engl 2024; 106:256-261. [PMID: 37381779 PMCID: PMC10906500 DOI: 10.1308/rcsann.2023.0036] [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: 04/14/2023] [Indexed: 06/30/2023] Open
Abstract
INTRODUCTION The healthcare sector contributes the equivalent of 4.4% of global net emissions to the climate carbon footprint; between 20% and 70% of healthcare waste originates from a hospital's operating theatre and up to 90% of waste is sent for costly and unneeded hazardous waste processing. This study aimed to quantify the amount and type of waste produced during an arthroscopic anterior cruciate ligament reconstruction (ACLR) and an arthroscopic rotator cuff repair (RCR), calculate the carbon footprint and assess the cost of the waste disposal. METHODS The amount of waste generated from ACLR and RCR procedures was calculated across a range of hospital sites. The waste was separated primarily into clean and contaminated, paper or plastic. Both carbon footprint and cost of disposal across the hospital sites was subsequently calculated. RESULTS RCR generated 3.3-15.5kg of plastic waste and 0.9-2.3kg of paper waste. ACLR generated 2.4-9.6kg of plastic waste and 1.1-1.6kg of paper waste. The cost to process waste varies widely between hospital sites, waste disposal contractors and method of waste disposal. The annual burden of the included hospital sites for the arthroscopic procedures undertaken was 6.2 tonnes of carbon dioxide. CONCLUSIONS The data collected demonstrated a significant variability in waste production and cost for waste disposal between hospital sites. At a national level, consideration should be given to the procurement of appropriate products such that waste can be efficiently recycled or disposed of by environmentally sustainable methods.
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Affiliation(s)
| | - H Morris
- East Midlands North Training Rotation, UK
| | - N Nicolaou
- Sheffield Children’s NHS Foundation Trust, UK
| | - S MacInnes
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, UK
| | | | - S Shahane
- Chesterfield Royal Hospital NHS Foundation Trust, UK
| | - F Ali
- Chesterfield Royal Hospital NHS Foundation Trust, UK
| | - J Garcia
- Chesterfield Royal Hospital NHS Foundation Trust, UK
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Demetriou CA, Achilleos S, Quattrocchi A, Nicolaou N, Gabel J. Total, sex and age-specific excess mortality during 2020 in 20 countries part of the C-MOR consortium. Eur J Public Health 2022. [PMCID: PMC9594093 DOI: 10.1093/eurpub/ckac131.044] [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: 11/21/2022] Open
Abstract
Nationally published COVID-19 mortality estimates might underestimate the actual mortality burden attributed to COVID-19. Estimations of excess all-cause mortality can provide more accurate estimates of the toll of the pandemic. This study aims to estimate the overall, sex and age-specific excess all-cause mortality in 20 countries, during 2020. Total, sex and age-specific weekly all-cause death counts for 2015-2020 were extracted from national vital statistics databases. Percent excess mortality for 2020 was calculated by comparing average weekly 2020 mortality rates against average weekly mortality rates from the past five years (2015-2019). Comparisons were performed for the total population, per sex, and per age groups (<65 vs. 65+ or < 70 vs.70+) depending on data availability. Percent difference in average weekly mortality between 2020 and 2015-2019 ranged from negative for Australia and Norway, to < 5% for Denmark, Cyprus, Estonia, Israel, and Sweden, 5-10% for Georgia, Mauritius, Ukraine, Austria, France, Scotland and Northern Ireland, to ∼10-21% for England & Wales, Italy, Brazil, USA, Slovenia, and to 89% for Peru. The percent difference in average weekly mortality between 2020 and 2015-2019 for males was higher than for females except for Cyprus, Estonia, Slovenia and the USA. Lastly, in age specific analyses, for the majority of countries the % increase in average weekly mortality between 2020 and 2015-2019, was higher in the oldest age group investigated, however, for Peru and the USA (<65 vs. 65+ years) and for Cyprus and Mauritius (<70 vs. 70+ years), mortality increased similarly in both age groups. This study highlights that the excess mortality burden during the COVID-19 pandemic disproportionally affected specific countries, males, and in most, but not all countries, the oldest age groups. Strengthening of health resilience in the most affected countries, while targeting population groups impacted the most, is of paramount public health importance. Key messages • Excess mortality burden during the COVID-19 pandemic disproportionally affected specific countries, and even within countries specific sex and age groups. • Further investigation into the determinants of excess mortality is needed to suggest steps to strengthen health resilience in the countries and target population groups impacted the most.
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Affiliation(s)
- CA Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus
- C-MOR consortium
| | - S Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus
| | - A Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus
| | - N Nicolaou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School , Nicosia, Cyprus
| | - J Gabel
- University of Nicosia Medical School , Nicosia, Cyprus
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Campanini EH, Baker D, Arundel P, Bishop NJ, Offiah AC, Keigwin S, Cadden S, Dall'Ara E, Nicolaou N, Giles S, Fernandes JA, Balasubramanian M. High bone mass phenotype in a cohort of patients with Osteogenesis Imperfecta caused due to BMP1 and C-propeptide cleavage variants in COL1A1. Bone Rep 2021; 15:101102. [PMID: 34277895 PMCID: PMC8264105 DOI: 10.1016/j.bonr.2021.101102] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Osteogenesis Imperfecta (OI) is a heterogeneous condition mainly characterised by bone fragility; extra-skeletal features in OI include blue sclerae, dentinogenesis imperfecta, skin laxity and joint hyper-extensibility. Most patients with OI are thought to have a low bone mass but contrary to expectations there are certain forms of OI with high bone mass which this study explores in further detail. METHOD A cohort of n = 6 individuals with pathogenic variants in BMP1 and the C-propeptide cleavage variants in COL1A1 were included in this study. Detailed clinical and radiological phenotyping was done and correlated with genotype to identify patterns of clinical presentation and fracture history in this cohort of patients. This data was compared to previously reported literature in this group. RESULTS 2 patients with BMP1 and 4 patients with pathogenic variants in C-propeptide region in COL1A1 were deep-phenotyped as part of this study and 1 patient with C-propeptide variant in COL1A1, showed low bone mineral density. In those with an elevated bone mineral density, this became even more apparent on bisphosphonate therapy. Patients in this cohort had variable clinical presentation ranging from antenatal presentation to more of an insidious course resulting in later confirmation of genetic diagnosis up to 19 years of age. CONCLUSIONS Patients with pathogenic variants in the C-propeptide region of COL1A1/A2 and BMP1 appear to have a high bone mass phenotype with increased sensitivity to bisphosphonate therapy. It is important to closely monitor patients with these genotypes to assess their response to therapy and tailor their treatment regime accordingly.
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Affiliation(s)
- E H Campanini
- Medical School, University of Sheffield, Sheffield, UK
| | - D Baker
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - P Arundel
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - N J Bishop
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | - A C Offiah
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | - S Keigwin
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - S Cadden
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - E Dall'Ara
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | - N Nicolaou
- Department of Orthopaedic Surgery, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - S Giles
- Department of Orthopaedic Surgery, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - J A Fernandes
- Department of Orthopaedic Surgery, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - M Balasubramanian
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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Achilleos S, Pagola Ugarte M, Quattrocchi A, Gabel J, Kolokotroni O, Constantinou C, Nicolaou N, Rodriguez-Llanes JM, Demetriou CA. Potential life years lost to COVID-19 in 17 countries during the pandemic period, up to August 2020. Eur J Public Health 2021. [PMCID: PMC8574565 DOI: 10.1093/eurpub/ckab164.550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background COVID-19 pandemic is affecting populations and regions in different ways. In this study, we assess the Potential Years of Life Lost (PYLL) to COVID-19 across different regions. Methods We used age-group and sex-specific weekly COVID-19 deaths (from January to August 2020) from national primary sources of 17 countries from the C-MOR consortium (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States). PYLL were calculated by summing up the numbers of deaths in each age group multiplied by the remaining years of life up to age 80. Age-standardized PYLL rates (per 100,000 population), using the World (WHO 2000-2025) Standard population as the reference population, were estimated to facilitate comparison across countries. Results Countries in South America displayed the highest PYLL rates (567-1,377 PYLL/100,000). Countries in Asia & Middle East (besides Kazakhstan), Australia, and some European countries (Georgia, Norway, and Slovenia) observed <50 PYLL/100,000. Furthermore, the male to female PYLL rate ratio was above one in all countries [1.3 (Ukraine) - 14.4 (Cyprus)], besides Georgia (ratio = 0.5). Conclusions South America, and males were found to be the most affected by COVID-19. Ongoing monitoring of the COVID-19 mortality impact is essential in order to assess health system performances, control measures, and identify vulnerable populations. Differences in mortality burden among populations will help public health officials in their efforts to minimize the COVID-19 mortality burden on a local, and on a global level. Key messages Up to August 2020, COVID-19 was a cause of premature mortality in all the participating countries, with South America and males to be more affected. The timing of the pandemic, seasonal trends, the control measures enforced, and underlying social conditions are probable explanations for the differences observed among countries.
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Affiliation(s)
- S Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - A Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - J Gabel
- University of Nicosia Medical School, Nicosia, Cyprus
| | - O Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - C Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - N Nicolaou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - CA Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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Demetriou CA, Achilleos S, Quattrocchi A, Gabel J, Heraclides A, Kolokotroni O, Constantinou C, Pagola Ugarte M, Nicolaou N, Rodriguez-Llanes JM. Excess all-cause mortality from January to August 2020: a temporal analysis in 20 countries. Eur J Public Health 2021. [PMCID: PMC8574564 DOI: 10.1093/eurpub/ckab164.553] [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: 11/19/2022] Open
Abstract
Analysis of all-cause mortality is an important tool to investigate the impact of the COVID-19 pandemic. This study aims to investigate the magnitude and potential determinants of excess all-cause mortality, from January until August 2020, using national mortality databases from 20 countries part of the C-MOR consortium. Excess weekly mortality for 2020 was calculated by comparing observed against expected weekly number of deaths for 2020. Expected 2020 weekly mortality was estimated using 2015-19 data based on a time series model adjusting for time trend and seasonality. The excess mortality was visualized against a stringency index (SI), based on nine government response indicators, downloaded from the Oxford COVID-19 Government Response Tracker. Brazil, Cyprus, France, Ireland, Italy, countries of the UK, Spain and the USA showed a substantial increase in the observed mortality during 2020, which lasted from 1 (Cyprus) to 7 (England and Wales, Scotland) weeks. Australia, Denmark and Georgia observed fewer than expected deaths, whereas in Austria, Estonia, Israel, Norway, Slovenia and Ukraine 2020 mortality was as expected. Italy, Spain, UK and Brazil enforced high SI measures at least after 3 weeks from the first COVID-19 death. Sweden and the USA did not apply high SI measures for the duration of this study. In Austria, Estonia, Israel, Norway, Cyprus, Georgia, Slovenia and Ukraine, measures of high SI were implemented within 2 weeks of the first COVID-19 death. The decreased mortality in Australia is probably attributed to different seasonality patterns coupled with strict control measures. Several but not all countries showed excess all-cause mortality. Excess mortality was shown to be influenced by the seasonality patterns of each country, as well as the promptness of governments to apply high SI control measures. As the pandemic continues, the lessons learned from the first months of the pandemic can prove useful to minimize increases in all-cause mortality. Key messages Some countries showed excess all-cause mortality between January and August 2020, whereas others displayed either negligible excess mortality or even a decrease in all-cause mortality. Excess mortality may be partly attributed to delayed application of strict control measures whereas lack of excess mortality may be due to seasonality and/or strict control measures.
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Affiliation(s)
- CA Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Contact:
| | - S Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - A Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - J Gabel
- University of Nicosia Medical School, Nicosia, Cyprus
| | - A Heraclides
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - O Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - C Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - N Nicolaou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
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Perry DC, Wright JG, Cooke S, Roposch A, Gaston MS, Nicolaou N, Theologis T. A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom. Bone Joint J 2018; 100-B:680-684. [PMID: 29701090 DOI: 10.1302/0301-620x.100b5.bjj-2018-0051] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.
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Affiliation(s)
- D C Perry
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK and University of Oxford, Oxford, UK
| | - J G Wright
- University of Oxford, Botnar Research Centre, Oxford, UK
| | - S Cooke
- University Hospital Coventry and Warwick, Coventry, UK
| | - A Roposch
- UCL GOS Institute of Child Health, University College London, London, UK
| | - M S Gaston
- Royal Hospital for Sick Children, Edinburgh, UK
| | - N Nicolaou
- Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - T Theologis
- University of Oxford, Botnar Research Centre, Oxford, UK
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Nicolaou N, Du Plessis A. Squamous carcinoma arising from a true tracheal bronchus: Management and case report. Int J Surg Case Rep 2014; 6C:256-8. [PMID: 25549955 PMCID: PMC4334959 DOI: 10.1016/j.ijscr.2014.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 12/05/2014] [Accepted: 12/05/2014] [Indexed: 12/01/2022] Open
Abstract
A case of a squamous carcinoma arising in a "True" tracheal bronchus is described. The presentation and management of this case is discussed.
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Affiliation(s)
- N Nicolaou
- Division of Cardiothoracic Surgery, Flora Clinic, 2nd floor, South East Block, Johannesburg, South Africa.
| | - A Du Plessis
- Division of Radiology, Flora Clinic, Johannesburg, South Africa
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Nicolaou N, Georgiou J. Spatial Analytic Phase Difference of EEG activity during anesthetic-induced unconsciousness. Clin Neurophysiol 2014; 125:2122-31. [PMID: 24631010 DOI: 10.1016/j.clinph.2014.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 10/23/2013] [Revised: 01/17/2014] [Accepted: 02/09/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A number of studies provide supporting evidence for changes in synchronization during anesthetic-induced unconsciousness. This study investigates how anesthetic administration affects the widespread patterns of phase synchrony. METHODS The recently introduced method of Spatial Analytic Phase Difference (SAPD) was used to measure changes in synchrony in the electroencephalogram (EEG) activity of 29 patients undergoing routine surgery. Analysis was performed over 9 frequency bands: (i) δ (1.5-3.5Hz); (ii) θ (3.5-7.5Hz); (iii) α1 (8-10Hz); (iv) α2 (10.5-12Hz); (v) β1 (12.5-18Hz); (vi) β2 (18.5-21Hz); (vii) β3 (21.5-30Hz); (viii) γ1 (30.5-40Hz); and (ix) γ2 (60-80Hz). RESULTS Anesthesia was characterized by (a) large and localized synchrony increases in mid-frequency bands (8-12Hz), (b) smaller and widespread synchrony increases in higher frequency bands (30.5-40Hz, 60-80Hz), and (c) both increase and decrease of synchrony in low frequency bands (1.5-7.5Hz). CONCLUSIONS This study supports anesthetic-induced changes in synchrony, with the inducement of persistent and reversible widespread γ synchrony being most prominent. SIGNIFICANCE Our findings have implications in the study of consciousness, support existing literature in the field and contribute towards the theoretical understanding of the mechanisms behind loss of consciousness. Future investigations could result in a synchrony-based measure for monitoring the level of hypnosis of patients during surgery.
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Affiliation(s)
- N Nicolaou
- Holistic Electronics Research Lab, Department of Electrical and Computer Engineering, University of Cyprus, Cyprus; KIOS Research Centre, University of Cyprus, Kallipoleos 75, 1678 Nicosia, Cyprus.
| | - J Georgiou
- Holistic Electronics Research Lab, Department of Electrical and Computer Engineering, University of Cyprus, Cyprus; KIOS Research Centre, University of Cyprus, Kallipoleos 75, 1678 Nicosia, Cyprus
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Dawson SE, Gibreel T, Nicolaou N, AlRabiah H, Xu Y, Goodacre R, Upton M. Implementation of Fourier transform infrared spectroscopy for the rapid typing of uropathogenic Escherichia coli. Eur J Clin Microbiol Infect Dis 2014; 33:983-8. [DOI: 10.1007/s10096-013-2036-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 12/10/2013] [Indexed: 10/25/2022]
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Abstract
BACKGROUND Anaesthetic agents may disrupt consciousness by inhibiting long-range synchronization of brain activity. In the current study, the patterns of widespread and spatially localized synchrony during anaesthesia are investigated using a measure called global field synchrony (GFS). METHODS The EEG obtained during routine surgery in 29 patients was analysed with GFS over the following frequency bands: δ (1.5-3.5 Hz), θ (3.5-7.5 Hz), α1 (8-10 Hz), α2 (10.5-12 Hz), β1 (12.5-18 Hz), β2 (18.5-21 Hz), β3 (21.5-30 Hz), γ1 (30.5-40 Hz), and γ2 (60-80 Hz). In addition, localized GFS estimations over aggregate brain areas were performed. GFS was estimated over 2 s non-overlapping windows. The differences in GFS values between 'wakefulness' and 'anaesthesia' were assessed with the two-sided Wilcoxon rank-sum tests (α=0.05). RESULTS Anaesthetic administration caused significant GFS changes in all frequency ranges and electrode combinations studied: (i) widespread synchrony increased in the α2 and β1 ranges and decreased in all other ranges, with the exception of α1 and β2, where no specific pattern was identified; and (ii) localized synchrony decreased in all areas in the δ and γ2 ranges, while location-specific changes were observed in the remaining frequency ranges. The most consistent findings were statistically significant decreases over all areas in the γ2 range, with GFS decrease over the central-right temporal being the most consistent change. CONCLUSIONS Significant frequency- and location-dependent changes in GFS were induced by anaesthetic administration, with more robust changes identified in the γ range. GFS can act as an aid for further and more detailed analysis regarding the particular combinations of frequency ranges and spatial locations that are most informative for the study of anaesthetic-induced unconsciousness.
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Affiliation(s)
- N Nicolaou
- KIOS Research Centre, and Holistic Electronics Research Lab, Department of Electrical and Computer Engineering, University of Cyprus, Kallipoleos 75, CY-1678 Nicosia, Cyprus
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Nicolaou N, Ghassemi A, Hill RA. Congenital pseudarthrosis of the tibia: the results of an evolving protocol of management. J Child Orthop 2013; 7:269-76. [PMID: 24432086 PMCID: PMC3799925 DOI: 10.1007/s11832-013-0499-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 09/18/2012] [Accepted: 05/13/2013] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This retrospective cohort study assesses the outcomes of a protocol of management, based on the recommendations of the European Paediatric Orthopaedic Society (EPOS) multi-centre study, for the management of congenital pseudarthrosis of the tibia. METHODS Utilising an incremental protocol of bracing, intramedullary rods and circular frame fixation with or without bone morphogenetic protein-2 (BMP-2), 11 patients had reached skeletal maturity or had follow up of 5 years from radiological union of the pseudarthrosis. Demographic data, deformity parameters before and after treatment, and functional outcome scores were recorded. RESULTS Ten of the 11 patients successfully healed and two sustained a refracture. All deformity parameters improved and a mean leg length discrepancy of 2.5 cm (range 0-7.5 cm) existed at the time of the last follow up. Some pseudarthroses healed with deformity correction and rod insertion alone. Six of the 11 patients had a confirmed diagnosis of neurofibromatosis and nine had sustained a fracture before 4 years of age. Refracture was associated with malalignment after healing. CONCLUSION This method of treatment provides a successful stepwise protocol for the management of this complex disorder, avoiding the use of aggressive limb reconstruction techniques at a young age in some cases. Level of evidenceCase series Level IV.
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Affiliation(s)
- N. Nicolaou
- />Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent UK
| | - A. Ghassemi
- />Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - R. A. Hill
- />Great Ormond Street Hospital for Children NHS Trust, London, UK
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Keller MF, Saad M, Bras J, Bettella F, Nicolaou N, Simon-Sanchez J, Mittag F, chel FB, Sharma M, Gibbs JR, Schulte C, Moskvina V, Durr A, Holmans P, Kilarski LL, Guerreiro R, Hernandez DG, Brice A, Ylikotila P, Stefansson H, Majamaa K, Morris HR, Williams N, Gasser T, Heutink P, Wood NW, Hardy J, Martinez M, Singleton AB, Nalls MA. Using genome-wide complex trait analysis to quantify 'missing heritability' in Parkinson's disease. Hum Mol Genet 2013. [DOI: 10.1093/hmg/ddt199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Keller MF, Saad M, Bras J, Bettella F, Nicolaou N, Simon-Sanchez J, Mittag F, Buchel F, Sharma M, Gibbs JR, Schulte C, Moskvina V, Durr A, Holmans P, Kilarski LL, Guerreiro R, Hernandez DG, Brice A, Ylikotila P, Stefansson H, Majamaa K, Morris HR, Williams N, Gasser T, Heutink P, Wood NW, Hardy J, Martinez M, Singleton AB, Nalls MA. Using genome-wide complex trait analysis to quantify 'missing heritability' in Parkinson's disease. Hum Mol Genet 2013. [DOI: 10.1093/hmg/ddt030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nicolaou N, Becker A, Mc Michael G, Nicolaou V. Giant atrial thrombus presenting as a tumor. Int J Surg Case Rep 2012; 4:62-4. [PMID: 23123416 DOI: 10.1016/j.ijscr.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/12/2012] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Right Atrial masses may represent tumors or thrombi of the heart and are potentially fatal if left untreated. PRESENTATION OF CASE A 45-year-old woman with a previous history of breast cancer who was found to have a right atrial mass diagnosed as a tumor by Echocardiography and Computed Tomography which ultimately proved to be a giant organized thrombus at surgery. DISCUSSION Metastatic tumors of the heart are 20 times more common than primary tumors and malignancies that often involve the heart include breast, lung, lymphoma, melanoma and sarcomas. Myxomas remain the most common cause of atrial tumors and are classically described arising on the left but a significant amount do occur on the right side. Presenting features with masses in the right atrium are similar to patients with tricuspid stenosis which may present with tiredeness, swelling of the feet, hepatomegaly and ascites. The clinical presentation and history may be of help in the diagnosis especially if the patient has a confirmed tumour. CONCLUSION Despite our current state of the art equipment these "masses" still pose a diagnostic challenge in distinguishing between solid thrombus and tumour as to determine the appropriate therapeutic approach. Surgical removal of Giant Atrial Thrombi appears to be the procedure of Choice.
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Affiliation(s)
- N Nicolaou
- Division of Cardiothoracic Surgery, Flora Clinic, Johannesburg, South Africa.
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Nicolaou N, Houris S, Alexandrou P, Georgiou J. Entropy measures for discrimination of 'awake' Vs 'anaesthetized' state in recovery from general anesthesia. Annu Int Conf IEEE Eng Med Biol Soc 2012; 2011:2598-601. [PMID: 22254873 DOI: 10.1109/iembs.2011.6090717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Approximate Entropy (ApEn) and Permutation Entropy (PE) have been recently introduced for assessment of anesthetic depth. Both measures have previously been shown to track changes in the electrical brain activity related to the administration of anesthetic agents. In this paper ApEn and PE are compared for the automatic classification of 'awake' and 'anesthetized' state using a Support Vector Machine to assess their robustness for potential use in a device for monitoring awareness during general anesthesia. It was found that both measures provide linearly separable features and we are able to discriminate between the two states with accuracy greater than 96% using either of the two entropy measures.
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Affiliation(s)
- N Nicolaou
- KIOS Research Centre and Holistic Electronics Research Lab, Dept. of Electrical and Computer Engineering, University of Cyprus, Kallipoleos 75, 1678 Nicosia, Cyprus.
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Inazu T, Kawahara T, Endou H, Anzai N, Sebesta I, Stiburkova B, Ichida K, Hosoyamada M, Testa A, Testa A, Leonardis D, Catalano F, Pisano A, Mafrica A, Spoto B, Sanguedolce MC, Parlongo RM, Tripepi G, Postorino M, Enia G, Zoccali C, Mallamaci F, Working Group* M, Luque de Pablos A, Garcia-Nieto V, Lopez-Menchero JC, Ramos-Trujillo E, Gonzalez-Acosta H, Claverie-Martin F, Arsali M, Demosthenous P, Papazachariou L, Athanasiou Y, Voskarides K, Deltas C, Pierides A, Lee S, Jeong KH, Ihm C, Lee TW, Lee SH, Moon JY, Wi JG, Lee HJ, Kim EY, Rogacev K, Friedrich A, Hummel B, Berg J, Zawada A, Fliser D, Geisel J, Heine GH, Brabcova I, Brabcova I, Dusilova-Sulkova S, Dusilova-Sulkova S, Krejcik Z, Stranecky V, Lipar K, Marada T, Stepankova J, Viklicky O, Buraczynska M, Zukowski P, Zaluska W, Kuczmaszewska A, Ksiazek A, Gaggl M, Weidner S, Hofer M, Kleinert J, Fauler G, Wallner M, Kotanko P, Sunder-Plassmann G, Paschke E, Heguilen R, Heguilen R, Albarracin L, Politei J, Liste AA, Bernasconi A, Kusano E, Russo R, Pisani A, Messalli G, Imbriaco M, Prikhodina L, Ryzhkova O, Polyakov V, Lipkowska K, Ostalska-Nowicka D, Smiech M, Jaroniec M, Zaorska K, Szaflarski W, Nowicki M, Zachwieja J, Spoto B, Spoto B, Testa A, Sanguedolce MC, D'arrigo G, Parlongo RM, Pisano A, Tripepi G, Zoccali C, Mallamaci F, Moskowitz J, Piret S, Tashman A, Velez E, Lhotta K, Thakker R, Kotanko P, Cox J, Kingswood J, Mbundi J, Attard G, Patel U, Saggar A, Elmslie F, Doyle T, Jansen A, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin M, Korf B, Flamini R, Kohrman M, Sparagana S, Wu J, Ford J, Shah G, Franz D, Zonnenberg B, Cheung W, Urva S, Wang J, Frost M, Kingswood C, Budde K, Kofman T, Narjoz C, Raimbourg Q, Roland M, Loriot MA, Karras A, Hill GS, Jacquot C, Nochy D, Thervet E, Jagodzinski P, Mostowska M, Oko A, Nicolaou N, Kevelam S, Lilien M, Oosterveld M, Goldschmeding R, Van Eerde A, Pfundt R, Sonnenberg A, Ter Hal P, Knoers N, Renkema K, Storm T, Nielsen R, Christensen E, Frykholm C, Tranebjaerg L, Birn H, Verroust P, Neveus T, Sundelin B, Hertz JM, Holmstrom G, Ericson K, Fabris A, Cremasco D, Zambon A, Muraro E, Alessi M, D'angelo A, Anglani F, Del Prete D, Alkmim Teixeira A, Quinto BM, Jose Rodrigues C, Beltrame Ribeiro A, Batista M, Kerti A, Kerti A, Csohany R, Szabo A, Arkossy O, Sallai P, Moriniere V, Vega-Warner V, Lakatos O, Szabo T, Reusz G, Tory K, Addis M, Anglani F, Tosetto E, Meloni C, Ceol M, Cristofaro R, Melis MA, Vercelloni P, D'angelo A, Marra G, Kaniuka S, Nagel M, Wolyniec W, Obolonczyk L, Swiatkowska-Stodulska R, Sworczak K, Rutkowski B, Chen C, Jiang L, Chen L, Fang L, Mozes M. M, Boosi M, Rosivall L, Kokeny G, Diana R, Gross O, Johanna T, Rainer G, Ayse C, Henrik H, Gerhard-Anton M, Nabil M, Intissar E, Belge H, Belge H, Bloch J, Dahan K, Pirson Y, Vanhille P, Demoulin N. Genetic diseases. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Turaka A, Murphy C, Fang Z, Farma J, Lango M, Wu H, Engstrom P, Nicolaou N, Perlis C. Merkel Cell Carcinoma and Sentinel Lymph Node Evaluation: Outcomes from a Single Institution. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nicolaou N, Xu Y, Goodacre R. Fourier transform infrared spectroscopy and multivariate analysis for the detection and quantification of different milk species. J Dairy Sci 2011; 93:5651-60. [PMID: 21094736 DOI: 10.3168/jds.2010-3619] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 09/02/2010] [Indexed: 11/19/2022]
Abstract
The authenticity of milk and milk products is important and has extended health, cultural, and financial implications. Current analytical methods for the detection of milk adulteration are slow, laborious, and therefore impractical for use in routine milk screening by the dairy industry. Fourier transform infrared (FT-IR) spectroscopy is a rapid biochemical fingerprinting technique that could be used to reduce this sample analysis period significantly. To test this hypothesis we investigated 3 types of milk: cow, goat, and sheep milk. From these, 4 mixtures were prepared. The first 3 were binary mixtures of sheep and cow milk, goat and cow milk, or sheep and goat milk; in all mixtures the mixtures contained between 0 and 100% of each milk in increments of 5%. The fourth combination was a tertiary mixture containing sheep, cow, and goat milk also in increments of 5%. Analysis by FT-IR spectroscopy in combination with multivariate statistical methods, including partial least squares (PLS) regression and nonlinear kernel partial least squares (KPLS) regression, were used for multivariate calibration to quantify the different levels of adulterated milk. The FT-IR spectra showed a reasonably good predictive value for the binary mixtures, with an error level of 6.5 to 8% when analyzed using PLS. The results improved and excellent predictions were achieved (only 4-6% error) when KPLS was employed. Excellent predictions were achieved by both PLS and KPLS with errors of 3.4 to 4.9% and 3.9 to 6.4%, respectively, when the tertiary mixtures were analyzed. We believe that these results show that FT-IR spectroscopy has excellent potential for use in the dairy industry as a rapid method of detection and quantification in milk adulteration.
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Affiliation(s)
- N Nicolaou
- School of Chemistry and Manchester Interdisciplinary Biocentre, The University of Manchester, 131 Princess Street, Manchester, M1 7DN United Kingdom
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Nicolaou N, Flint N, Nicolaou V, Isaacs M. Coarctation After Endograft Repair for Traumatic Rupture of the Aorta. Eur J Vasc Endovasc Surg 2011. [DOI: 10.1016/j.ejvs.2010.11.032] [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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Abstract
This work proposes the use of Permutation Entropy (PE), a measure of time-series complexity, to characterize electroencephalogram (EEG) signals recorded during sleep. Such a measure could provide information concerning the different sleep stages and, thus, be utilized as an additional aid to obtain sleep staging information. PE has been estimated for artifact-free 30s segments from more than 80 hours of EEG records obtained from 16 subjects during all-night recordings, from which the mean PE for each sleep stage was obtained. It was found that different sleep stages are characterized by significantly different PE values, which track the physiological changes in the complexity of the EEG signals observed at the different sleep stages. This finding encourages the use of PE as an additional aide to either visual or automated sleep staging.
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Affiliation(s)
- N Nicolaou
- Department of Electrical and Computer Engineering, University of Cyprus, Kallipoleos 75, Nicosia 1678, Cyprus.
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Borghaei H, Turaka A, Li T, Smith M, Schilder R, Nicolaou N. Curative Radiation Therapy for Primary Ocular Lymphomas: Demonstration of Dose Response. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Richard C, Turaka A, Li T, Nicolaou N, Horwitz E, Lango M, Burtness B, Ridge J, Feigenberg S. Intensity Modulated Radiation Therapy (IMRT) for the Para-nasal Sinus (PNS) Malignancies. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mehra R, Cai KQ, Zhu F, Weaver J, Nicolaou N, Cohen RB, Lango M, Ridge JA, Godwin AK, Burtness B. Analysis of ERCC1 (excision repair cross complementing group 1) in squamous cell carcinoma of the head and neck (SCCHN) by quantitative immunohistochemistry (IHC) using FL297. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Turaka A, Li T, Lubbe W, Smith MR, Millenson MM, Schilder RJ, Borghaei H, Cohen AD, Al-Saleem TI, Nicolaou N. Curative radiation therapy for primary ocular lymphomas: Demonstration of dose response. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e18503] [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: 11/20/2022] Open
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Murphy C, Li T, Anderson P, Nicolaou N, Freedman G. The Impact of a Boost on Outcomes after Breast-conserving Surgery and Radiation. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Turaka A, Li T, Nicolaou N, Lango M, Burtness B, Horwitz E, Ridge J, Feigenberg S. The use of a Low Neck Field (LNF) and Intensity-Modulated Radiation Therapy (IMRT): No Clinical Detriment of IMRT to an Anterior LNF during the Treatment of Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rusthoven K, Feigenberg S, Raben D, Kane M, Song J, Nicolaou N, Mehra R, Burtness B, Swing R, Chen C. Initial Results of a Phase I Dose Escalation Trial of Concurrent and Maintenance Erlotinib and Re-irradiation for Recurrent and New Primary Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.935] [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: 11/28/2022]
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Bhatia M, Singh B, Nicolaou N, Ravikumar KJ. Correlation between rotator cuff tears and repeated subacromial steroid injections: a case-controlled study. Ann R Coll Surg Engl 2009; 91:414-6. [PMID: 19409148 DOI: 10.1308/003588409x428261] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Concern exists regarding potential damage to the rotator cuff from repeated corticosteroid injections into the subacromial space. PATIENTS AND METHODS In this retrospective, case-controlled study, 230 consecutive patients presenting to three orthopaedic units with subacromial impingement and investigated as an end-point with magnetic resonance imaging (MRI) of the shoulder were divided into groups having received less than three or three or more subacromial injections of corticosteroids. RESULTS With no significant difference in age and sex distribution, analysis by MRI showed no significant difference between the two groups in the incidence of rotator cuff tear (P < 1.0). CONCLUSIONS This suggests that corticosteroid use in patients with subacromial impingement should not be considered a causative factor in rotator cuff tears.
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Affiliation(s)
- M Bhatia
- Department of Trauma and Orthopaedics, Maidstone District General Hospital, Maidstone, UK.
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Cohen R, Freedman G, Li T, Brennan C, Li L, Anderson P, Nicolaou N, Schmidt D, Fowble B. Effect of Bra use during Radiotherapy for Large Breasted Women: Acute Toxicity and Treated Heart and Lung Volume. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Turaka A, Freedman G, Li T, Bleicher R, Swaby R, Nicolaou N, Goldstein L, Sigurdson E, Anderson P. Young Age is not Associated with Increased Local Recurrence for DCIS Treated by Breast-conserving Surgery and Radiation. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sharma N, Ruth K, Konski A, Buyyounouski M, Nicolaou N, Lally B, Yu J, Langer C, Movsas B, Feigenberg S. Low Morbidity and Excellent Local Control using Image Guided Stereotactic Body Radiotherapy (IGSBRT) for Lung Tumors. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Morgan P, Kuritzky N, Price R, Nicolaou N, Ross E, Li S, Miyamoto C, Micaily B, Feigenberg S. A Simple Method to Significantly Reduce Treatment Time for Head and Neck IMRT. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Li L, Li T, Cohen R, Anderson P, Nicolaou N, Freedman G. Which Patients are Appropriate Candidates for Salvage Partial Breast Irradiation if Previously Treated with Whole Breast Irradiation? Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Freedman G, Anderson P, Li T, Nicolaou N, Konski A. Health States of Women up to 15 years after Breast Conserving Surgery and Radiation for Breast Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ma C, Li J, Jin L, ElDib A, Fan J, Price R, Freedman G, Anderson P, Nicolaou N. Advanced Mixed Beam Treatment Techniques for Breast and Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Freedman G, Li T, Nicolaou N, Anderson P. Breast IMRT Reduces Time Spent With Acute Dermatitis for Women of all Breast Sizes During Radiation. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Movsas B, Moughan J, Langer C, Werner-Wasik M, Nicolaou N, Komaki R, Machtay M, Smith C, Axelrod R, Byhardt R. Randomized trial of amifostine in locally advanced non-small cell lung cancer (NSCLC) patients receiving chemotherapy and hyperfractionated radiation (HRT): Long-term survival results of Radiation Therapy Oncology Group (RTOG) 9801. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7529] [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: 11/20/2022] Open
Abstract
7529 Purpose: This analysis was conducted to address the potential antitumor effect of amifostine (AM) in NSCLC patients enrolled on RTOG-9801. The long-term survival results of RTOG-9801 are presented here. Methods: 243 patients (pts) with stage II/IIIAB NSCLC received induction paclitaxel (P) 225 mg/m2IV days 1, 22 and carboplatin (C) AUC 6 days 1, 22 and then concurrent weekly P (50 mg/m2) and C (AUC 2) and HRT (69.6 Gy at 1.2 Gy BID). Pts were randomly assigned to AM 500 mg IV 4x/week or no-AM during chemoradiation. Treatment differences for overall and disease-free survival (OS & DFS) were analyzed with the log-rank test; Gray's test was used for time to progression (TTP). Results: 118 pts were randomly assigned to receive AM and 121 to no-AM (4 pts were ineligible). The median follow-up for pts still alive is 52.3 months (mo) for the AM-arm and 58.3 mo for the no-AM arm (16.6 vs 17.9 for all pts). There are no significant differences in OS, DFS or TTP between arms. The median survival, 3-yr, and 5-yr OS are 17.1 mo, 27% and 17% (AM-arm) vs 18.4 mo, 28% and 16% (no-AM arm) (p=0.97). Grade 3/4/5 late-RT toxicities are similar (11%/3%/2% AM-arm vs 14%/4%/2% no-AM arm). Conclusion: While an earlier publication reported that amifostine did not reduce objective measures of severe esophagitis in RTOG-9801, patient-reported outcome analyses suggested a possible advantage to AM with decreased pain and swallowing symptoms (J Clin Oncol 23:2145–2154, 2005). This long-term follow-up analysis on survival shows no evidence of tumor radioprotection due to amifostine. The promising 5-yr OS suggests that induction paclitaxel/carboplatin (P/C) followed by concurrent RT and weekly low-dose P/C is comparable to other regimens using cisplatin doublets at higher dosages every 3–4 weeks. Research supported by NCI and Medimmune Oncology. No significant financial relationships to disclose.
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Affiliation(s)
- B. Movsas
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - J. Moughan
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - C. Langer
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - M. Werner-Wasik
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - N. Nicolaou
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - R. Komaki
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - M. Machtay
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - C. Smith
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - R. Axelrod
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
| | - R. Byhardt
- Henry Ford Health System, Detroit, MI; RTOG, Philadelphia, PA; Fox Chase Cancer Center, Philadelphia, PA; Thomas Jefferson U, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; Tom Baker Cancer Ctr, Calgary, AB, Canada; Med College of Wisconsin, Milwaukee, WI
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Nicolaou N, Nasuto SJ. Robustness of mutual information to inter-subject variability for automatic artefact removal from EEG. Conf Proc IEEE Eng Med Biol Soc 2007; 2005:5991-4. [PMID: 17281626 DOI: 10.1109/iembs.2005.1615856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The externally recorded electroencephalogram (EEG) is contaminated with signals that do not originate from the brain, collectively known as artefacts. Thus, EEG signals must be cleaned prior to any further analysis. In particular, if the EEG is to be used in online applications such as Brain- Computer Interfaces (BCIs) the removal of artefacts must be performed in an automatic manner. This paper investigates the robustness of Mutual Information based features to inter-subject variability for use in an automatic artefact removal system. The system is based on the separation of EEG recordings into independent components using a temporal ICA method, RADICAL, and the utilisation of a Support Vector Machine for classification of the components into EEG and artefact signals. High accuracy and robustness to inter-subject variability is achieved.
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Affiliation(s)
- N Nicolaou
- CIRG, Department of Cybernetics, University of Reading, Whiteknights, RG6 6AY, U.K
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Sarna L, Swann S, Langer C, Werner-Wasik M, Nicolaou N, Komaki R, Machtay M, Smith C, Axelrod R, Movsas B. 2595. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Feigenberg S, Hanlon A, Langer C, Goldberg M, Nicolaou N, Millenson M, Coia L, Lanciano R, Movsas B. 114. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.145] [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: 11/28/2022]
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Nicolaou N, Nasuto SJ. Comment on "Performance of different synchronization measures in real data: a case study on electroencephalographic signals". Phys Rev E Stat Nonlin Soft Matter Phys 2005; 72:063901; author reply 063902. [PMID: 16485993 DOI: 10.1103/physreve.72.063901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Indexed: 05/06/2023]
Abstract
We agree with Duckrow and Albano [Phys. Rev. E 67, 063901 (2003)] and Quian Quiroga [Phys. Rev. E 67, 063902 (2003)] that mutual information (MI) is a useful measure of dependence for electroencephalogram (EEG) data, but we show that the improvement seen in the performance of MI on extracting dependence trends from EEG is more dependent on the type of MI estimator rather than any embedding technique used. In an independent study we conducted in search for an optimal MI estimator, and in particular for EEG applications, we examined the performance of a number of MI estimators on the data set used by Quian Quiroga in their original study, where the performance of different dependence measures on real data was investigated [Phys. Rev. E 65, 041903 (2002)]. We show that for EEG applications the best performance among the investigated estimators is achieved by -nearest neighbors, which supports the conjecture by Quian Quiroga in Phys. Rev. E 67, 063902 (2003) that the nearest neighbor estimator is the most precise method for estimating MI.
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Bleiker TO, Nicolaou N, Traulsen J, Hutchinson PE. 'Atrophic telogen effluvium' from cytotoxic drugs and a randomized controlled trial to investigate the possible protective effect of pretreatment with a topical vitamin D3 analogue in humans. Br J Dermatol 2005; 153:103-12. [PMID: 16029334 DOI: 10.1111/j.1365-2133.2005.06608.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hair loss from cytotoxic drugs is classically ascribed to the loss of fractured hairs (anagen effluvium). Telogen hair loss has also been described but some authors have denied any effect on the hair cycle. There are conflicting reports on a protective effect of pretreatment with a vitamin D analogue on cytotoxic drug-induced hair loss in rodents. OBJECTIVES To investigate the process of cytotoxic hair loss and any protective effect on the hair of pretreatment with topical calcipotriol. METHODS Breast cancer patients who were about to receive cycles of chemotherapy with cyclophosphamide 600 mg m(-2), methotrexate 40 mg m(-2) and 5-fluorouracil 600 mg m(-2) were recruited and randomized to receive calcipotriol scalp solution 50 microg mL(-1) or vehicle. The solution was applied twice daily from 4 days prior to chemotherapy and continued for 14 days in each treatment cycle. Shed, plucked and cut hairs were sampled. Absolute shed rates, the proportion of major hair types, the presence of proximal hair shaft changes, regrowth (using the new anagen hair count) and hair density were assessed. RESULTS Ten patients receiving calcipotriol and 14 receiving vehicle completed three treatment cycles and nine from both groups completed six cycles. There was no detectable effect of calcipotriol on the proportion of patients experiencing minimal hair loss from chemotherapy, shed rates, plucked telogen and fractured hair counts, the morphology of shed and plucked hair, hair regrowth or hair density. Combining results of the treatment groups, there was a large variation in the impact of chemotherapy on hair loss, from total loss in five patients to no obvious loss in five. Excluding the latter, during chemotherapy shed telogen hairs (mean 81% of shed hairs) predominated over fractured (12%) and anagen hairs (6%) (P = 0.0002). The major pathological change was proximal hair shaft tapering, baseline mean 3% of shed hairs rising to 48% (P = 0.0005) during treatment, and there was a consequent decrease in normal telogen hairs, baseline mean 98% of all telogen hairs falling to 55% (P = 0.0005) during treatment. The pathological tapered telogen hairs had normal or small, sometimes diminutive, bulbs. Fracturing of hairs with diminutive bulbs produced typical 'exclamation mark' hairs. CONCLUSIONS The cardinal effects of cytotoxic drugs found in this study were tapering of the proximal hair shaft and premature entry of the follicle into telogen, conflicting with the conventional view that affected hair follicles continue in anagen. There was a resulting effluvium of a mixture of tapering telogen hairs and fractured hairs. As entry into telogen is an integral part of the process, cytotoxic hair loss may be regarded as a variant of the conventional 'telogen effluvium' and we propose the term 'atrophic telogen effluvium'. There was no obvious protective effect on the hair loss of prior treatment with topical calcipotriol.
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Affiliation(s)
- T O Bleiker
- Department of Dermatology, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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Horwitz EM, Harris J, Langer CJ, Nicolaou N, Kies M, Curran W, Wong SJ, Ang K. Concurrent split course hyperfractionated radiotherapy (Hfx RT), cisplatin (DDP) and paclitaxel (P) in patients with recurrent, previously irradiated squamous cell carcinoma of the head and neck (SCCHN): Update of RTOG 9911. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5577] [Citation(s) in RCA: 7] [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: 11/20/2022] Open
Affiliation(s)
- E. M. Horwitz
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - J. Harris
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - C. J. Langer
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - N. Nicolaou
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - M. Kies
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - W. Curran
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - S. J. Wong
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
| | - K. Ang
- Fox Chase Cancer Ctr, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; MD Anderson, Houston, TX; Thomas Jefferson Univ Hosp, Philadelphia, PA; MD Anderson Cancer Ctr, Houston, TX; MD Anderson Cancer Ctr, Houston, TX
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Snyder-Dougherty L, Sherman E, Riordan D, Nicolaou N, Feigenberg S, Lango M, Cohen RB, Horwitz EM, Langer CJ, Ridge JA. Cost effectiveness of amifostine for prevention of radiation-induced xerostomia. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L. Snyder-Dougherty
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - E. Sherman
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - D. Riordan
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - N. Nicolaou
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - S. Feigenberg
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - M. Lango
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - R. B. Cohen
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - E. M. Horwitz
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - C. J. Langer
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
| | - J. A. Ridge
- Fox Chase Cancer Ctr (FCCC), Philadelphia, PA; Fox Chase Cancer Ctr, Philadelphia, PA
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Nicolaou N, Yiallouros P, Pipis S, Ioannou P, Simpson A, Custovic A. Relationship between allergen and endotoxin exposure and allergic sensitization in Cyprus. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.393] [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: 10/25/2022]
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Kramer N, Anderson P, Freedman G, Hanlon A, Eisenberg D, Nicolaou N. Mastectomy scar boosts and dose escalation to the chest wall are not needed to achieve excellent local control in patients with locally advanced and inflammatory breast cancer. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Freedman G, Anderson P, Hanlon A, Eisenberg D, Nicolaou N, Li J. Intensity modulated radiation therapy (IMRT) decreases the acute skin toxicity for large-breasted women receiving radiation therapy for breast cancer. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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