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Murphy T, Stewart P, Nestor CC, Irwin MG. Handling injectable medications: mixing drugs. Anaesthesia 2024; 79:436-437. [PMID: 38306490 DOI: 10.1111/anae.16240] [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] [Accepted: 01/05/2024] [Indexed: 02/04/2024]
Affiliation(s)
- T Murphy
- University Hospital Tallaght, Dublin, Ireland
| | - P Stewart
- University Hospital Tallaght, Dublin, Ireland
| | - C C Nestor
- University Hospital Tallaght, Dublin, Ireland
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2
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McCready A, Quinn M, Francis P, Stortz R, Kuruvilla S, Stewart P, Palma D, Lang P, Read N, Sathya J, Venkatesan V, Nichols A, MacNeil D, Fung K, Mendez A, Carreau C, Hawkins S, Parker C, Warner L, Winquist E. Impact of a Head and Neck Cancer Chemoradiation (HNC CRT) Nurse Practitioner (NP) on Patient Outcomes. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.143] [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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3
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Malhotra G, Stewart P. Outcomes of Rotational Atherectomy in Three Large Queensland Centres Without Onsite Cardiac Surgical Backup in a Contemporary Patient Cohort – A 9-Year Experience. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.609] [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: 11/30/2022]
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4
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Faddy S, Stewart P, Savage L, Fletcher P. Prehospital Thrombolysis Program Reduces the Time to Reperfusion Therapy in Patients Suffering STEMI in Rural and Regional NSW. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.364] [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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5
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Palma D, Prisman E, Berthelet E, Tran E, Hamilton S, Wu J, Eskander A, Higgins K, Karam I, Poon I, Husain Z, Enepekides D, Hier M, Sultanem K, Richardson K, Mlynarek A, Johnson-Obaseki S, Eapen L, Odell M, Bayley A, Dowthwaite S, Jackson J, Dzienis M, O'Neil J, Chandarana S, Banerjee R, Hart R, Chung J, Tenenholz T, Krishnan S, Le H, Yoo J, Mendez A, Winquist E, Kuruvilla S, Stewart P, Warner A, Mitchell S, Chen J, Parker C, Wehrli B, Kwan K, Theurer J, Sathya J, Hammond J, Read N, Venkatesan V, MacNeil D, Fung K, Nichols A. A Randomized Trial of Radiotherapy vs. Trans-Oral Surgery for Treatment De-Escalation in HPV-Associated Oropharyngeal Squamous Cell Carcinoma (ORATOR2). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.09.013] [Citation(s) in RCA: 2] [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: 10/19/2022]
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6
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Faderani R, Mohamed A, Stewart P. 182 Improving Handovers from A Neurosurgical High Dependency Unit to Ward Teams. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.737] [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
Introduction
A good handover is fundamental in providing continuity of care within a multidisciplinary team, allowing for safe and effective management of patients.
Method
Handovers between the neurosurgical high dependency unit and the ward team were prospectively evaluated as patients were stepped down over a 6-week period. The handover rate and consequences of poor handovers (missed investigations, referrals, or delayed discharges) were documented. After 6-weeks, handover proforma was introduced and the rates were recalculated.
Results
In the initial 6-week period, 36 patients were transferred, with only 2(5.6%) appropriately handed-over. Consequently, 9(26%) patients had delayed scans, 5(15%) missed referrals, and 24(71%) delayed discharges. In the 6-week period following the introduction of the proforma, a total of 28 patients were transferred, with 19(67.8%) documented handovers. Consequently, 1(3.5%) patient had a scan delay, 0 missed referrals and only 2(7%) patients had delayed discharges.
Conclusions
By raising awareness of handovers and introducing a proforma, we improved documented handovers by 62.3% whilst reducing the rate of missed investigations, referrals, and delayed discharges by over 90%. This project highlights how small, simple, and easy to enforce changes can lead to significant improvements in the quality of care provided to patients.
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Affiliation(s)
- R Faderani
- Morriston Hospital, Swansea, United Kingdom
| | - A Mohamed
- University Hospital of Wales, Cardiff, United Kingdom
| | - P Stewart
- University Hospital of Wales, Cardiff, United Kingdom
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7
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Faderani R, Mohamed A, Stewart P. 248 Improving Handovers from A Neurosurgical High Dependency Unit to Ward Teams. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.391] [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
Introduction
A good handover is fundamental in providing continuity of care within a multidisciplinary team, allowing for safe and effective management of patients.
Method
Handovers between the neurosurgical high dependency unit and the ward team were prospectively evaluated as patients were stepped down over a 6-week period. The handover rate and consequences of poor handovers (missed investigations, referrals, or delayed discharges) were documented. After 6-weeks, handover proforma was introduced and the rates were recalculated.
Results
In the initial 6-week period, 36 patients were transferred, with only 2(5.6%) appropriately handed-over. Consequently, 9(26%) patients had delayed scans, 5(15%) missed referrals, and 24(71%) delayed discharges. In the 6-week period following the introduction of the proforma, a total of 28 patients were transferred, with 19(67.8%) documented handovers. Consequently, 1(3.5%) patient had a scan delay, 0 missed referrals and only 2(7%) patients had delayed discharges.
Conclusions
By raising awareness of handovers and introducing a proforma, we improved documented handovers by 62.3% whilst reducing the rate of missed investigations, referrals, and delayed discharges by over 90%. This project highlights how small, simple, and easy to enforce changes can lead to significant improvements in the quality of care provided to patients.
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Affiliation(s)
- R Faderani
- University Hospital of Wales, Cardiff, United Kingdom
| | - A Mohamed
- University Hospital of Wales, Cardiff, United Kingdom
| | - P Stewart
- University Hospital of Wales, Cardiff, United Kingdom
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8
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Steenland K, Schubauer-Berigan M, Vermeulen R, Lunn R, Straif K, Zahm S, Stewart P, Arroyave W, Mehta S, Pearce N. Risk of Bias Assessments and Evidence Syntheses for Observational Epidemiologic Studies of Environmental and Occupational Exposures: Strengths and Limitations. Environ Health Perspect 2020; 128:95002. [PMID: 32924579 PMCID: PMC7489341 DOI: 10.1289/ehp6980] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Increasingly, risk of bias tools are used to evaluate epidemiologic studies as part of evidence synthesis (evidence integration), often involving meta-analyses. Some of these tools consider hypothetical randomized controlled trials (RCTs) as gold standards. METHODS We review the strengths and limitations of risk of bias assessments, in particular, for reviews of observational studies of environmental exposures, and we also comment more generally on methods of evidence synthesis. RESULTS Although RCTs may provide a useful starting point to think about bias, they do not provide a gold standard for environmental studies. Observational studies should not be considered inherently biased vs. a hypothetical RCT. Rather than a checklist approach when evaluating individual studies using risk of bias tools, we call for identifying and quantifying possible biases, their direction, and their impacts on parameter estimates. As is recognized in many guidelines, evidence synthesis requires a broader approach than simply evaluating risk of bias in individual studies followed by synthesis of studies judged unbiased, or with studies given more weight if judged less biased. It should include the use of classical considerations for judging causality in human studies, as well as triangulation and integration of animal and mechanistic data. CONCLUSIONS Bias assessments are important in evidence synthesis, but we argue they can and should be improved to address the concerns we raise here. Simplistic, mechanical approaches to risk of bias assessments, which may particularly occur when these tools are used by nonexperts, can result in erroneous conclusions and sometimes may be used to dismiss important evidence. Evidence synthesis requires a broad approach that goes beyond assessing bias in individual human studies and then including a narrow range of human studies judged to be unbiased in evidence synthesis. https://doi.org/10.1289/EHP6980.
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Affiliation(s)
- Kyle Steenland
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - R. Vermeulen
- Institute for Risk Assessment Science, University of Utrecht, Utrecht, Netherlands
| | - R.M. Lunn
- Division of the National Toxicology Program (NTP), NIEHS, Research Triangle Park, North Carolina, USA
| | - K. Straif
- Global Observatory on Pollution and Health, Boston College, Boston, Massachusetts, USA
- ISGlobal, Barcelona, Spain
| | - S. Zahm
- Shelia Zahm Consulting, Hermon, Maine, USA
| | - P. Stewart
- Stewart Exposure Assessments, LLC, Arlington, Virginia, USA
| | - W.D. Arroyave
- Integrated Laboratory Systems, Morrisville, North Carolina, USA
| | - S.S. Mehta
- Division of the National Toxicology Program (NTP), NIEHS, Research Triangle Park, North Carolina, USA
| | - N. Pearce
- London School of Hygiene and Tropical Medicine, London, UK
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9
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Newland RC, Chan C, Chapuis PH, Keshava A, Rickard MJFX, Stewart P, Suen M, Lee K, Dent OF. Relative effects of direct spread, lymph node metastasis and venous invasion in relation to blood borne distant metastasis present at the time of resection of colorectal cancer. Pathology 2020; 52:649-656. [PMID: 32782217 DOI: 10.1016/j.pathol.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 01/05/2023]
Abstract
Conventionally, lymphatic spread is regarded as the principal mechanism by which haematogenous metastasis occurs in colorectal cancer. The aim of this cross sectional study was to determine the relative strengths of direct tumour spread, the presence of lymph node metastasis and histologically demonstrated venous invasion as drivers of haematogenous metastasis diagnosed at the time of resection of colorectal cancer. The data were drawn from a hospital database of consecutive bowel cancer resections between 1995 and 2017 inclusive. The presence of haematogenous metastasis was determined at the time of surgery by imaging or other investigations or operative findings. Where possible, histological confirmation was obtained. Specimen dissection and reporting followed a standardised procedure. Tumour staging was according to the 7th edition of the UICC/AJCC pTNM system. Analysis was by multivariable logistic regression. After exclusions 3133 patients remained, among whom 380 (12.1%) had one or more haematogenous metastases. In bivariate analyses, the frequency of haematogenous metastasis was directly associated with increasing T status (p<0.001), increasing N status (p<0.001) and increasing extent of venous invasion (p<0.001) and with some other patient and tumour features. In a multivariable model, after adjustment for other features, associations with the occurrence of haematogenous metastasis were as follows: T3 odds ratio (OR) 4.41 (95% confidence interval 2.40-8.10), p<0.001; T4a OR 6.29 (3.27-12.10), p<0.001; T4b OR 5.50 (2.71-11.15), p<0.001; N1 OR 3.39 (2.47-4.64), p<0.001; N2 OR 4.59 (3.21-6.54), p<0.001; mural venous invasion OR 2.18 (1.14-4.16), p=0.018; extramural venous invasion OR 2.91 (2.21-3.83), p<0.001. Only three other features had significant, though weak effects in the model. These results led to the conclusion that venous invasion, demonstrated histologically and also inferred independently by the extent of direct tumour spread, made a greater contribution to the occurrence of haematogenous metastasis than did spread through lymphatics. Our approach and findings may have implications for other cancer sites apart from colorectal cancer.
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Affiliation(s)
- R C Newland
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - C Chan
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Division of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - P H Chapuis
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia
| | - A Keshava
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia
| | - M J F X Rickard
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia
| | - P Stewart
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia
| | - M Suen
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia
| | - K Lee
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Division of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - O F Dent
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Discipline of Surgery, Sydney Medical School, Sydney, NSW, Australia.
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10
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Dent OF, Ripley JE, Chan C, Rickard MJFX, Keshava A, Stewart P, Chapuis PH. Competing risks analysis of the association between perioperative blood transfusion and long-term outcomes after resection of colorectal cancer. Colorectal Dis 2020; 22:871-884. [PMID: 31960549 DOI: 10.1111/codi.14970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/24/2019] [Accepted: 12/15/2019] [Indexed: 02/08/2023]
Abstract
AIM Despite numerous reports over three decades, the association between perioperative blood transfusion and long-term outcomes after resection of colorectal cancer remains controversial. This cohort study used competing risks statistical methods to examine the association between transfusion and recurrence and colorectal cancer-specific death after potentially curative and noncurative resection. METHOD A hospital database provided prospectively recorded clinical, operative and follow-up information. All surviving patients were followed for at least 5 years. Data were analysed by multivariable competing risks regression. RESULTS From 2575 patients in the period 1995-2010 inclusive, after exclusions, 2334 remained for analysis. Among 1941 who had a potentially curative resection and 393 who had a noncurative resection the transfusion rates were 24.9% and 33.6%, respectively. After potentially curative resection there was no significant bivariate association between transfusion and recurrence (HR 0.93, CI 0.74-1.16, P = 0.499) or between transfusion and colorectal cancer-specific death (HR 1.04, CI 0.82-1.33, P = 0.753). After noncurative resection there was no significant association between transfusion and cancer-specific death (HR 0.93, CI 0.73-1.19, P = 0.560). Multivariable models showed no material effect of potential confounder variables on these results. CONCLUSION The competing risks findings in this study showed no significant association between perioperative transfusion and recurrence or colorectal cancer-specific death.
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Affiliation(s)
- O F Dent
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - J E Ripley
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - C Chan
- Division of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - M J F X Rickard
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - A Keshava
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - P Stewart
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - P H Chapuis
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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11
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Mc Connell L, Houghton O, Catherwood M, Gazdova J, Stewart P, Oniscu A, Groenen P, Kroeze L, Taniere P, Flanagan A, Stobl A, Salto-Tellez M, De Castro DG. Clinical validation of a novel assay for the detection of diagnostic alterations in sarcomas. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.050] [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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12
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Stewart P, Swartz J, Tapscott B, Davis B. C-36 Montreal Cognitive Assessment for Dementia Severity Rating in a Diagnostically Heterogeneous Clinical Cohort. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The Mini Mental State Exam (MMSE) has enjoyed widespread use as a dementia severity staging instrument (Perneczky et al., 2006). More recently, the Montreal Cognitive Assessment (MoCA; Nasreddine, 2005) has been advanced as a potentially superior measure with enhanced sensitivity to Mild Cognitive Impairment (MCI). To the authors’ knowledge, there are no published guidelines for staging dementia severity with the MoCA. The aim of this study was to evaluate the utility of the MoCA for dementia severity staging.
Method
Participants (N = 162) were drawn from a diagnostically heterogeneous retrospective sample of referrals to a multidisciplinary memory clinic. Participants were categorized as MCI, mild dementia, or moderate dementia using the Quick Dementia Rating System (QDRS) sum of boxes score. Receiver operating characteristics of the MoCA were calculated using MATLAB and optimal cutpoints were determined using Youden’s Index.
Results
The MoCA demonstrated some utility in differentiating MCI from all severity dementia as defined by the QDRS, with an optimal cutpoint of 17 (AUC = .75). Cut points of 17 and 14 best separated MCI from mild dementia (AUC = .72) and mild from moderate dementia (AUC = .66), respectively. These cutpoints were associated with modest sensitivity (.50 - .53) and reasonable specificity (.76 - .87). Average diagnostic accuracy was 69.5%.
Conclusions
This study suggests that the MoCA has some utility for dementia severity staging. Future work should replicate these findings in other clinical cohorts. The use of the QDRS (an informant report measure) as the severity criterion is a significant limitation of the present study.
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13
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O’Sullivan D, Stone G, Mahomed H, O’Reilly P, Stewart P, Noonan H, Murphy AM. Bereavement Counselling for Healthcare Workers in the Aftermath of Child Death. Ir Med J 2019; 112:931. [PMID: 31411013] [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: 06/10/2023]
Affiliation(s)
- D O’Sullivan
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - G Stone
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - H Mahomed
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - P O’Reilly
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - P Stewart
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - H Noonan
- Department of Paediatrics, University Hospital Limerick (UHL)
| | - A M Murphy
- Department of Paediatrics, University Hospital Limerick (UHL)
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14
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Chapuis PH, Bokey E, Chan C, Keshava A, Rickard MJFX, Stewart P, Young CJ, Dent OF. Recurrence and cancer-specific death after adjuvant chemotherapy for Stage III colon cancer. Colorectal Dis 2019; 21:164-173. [PMID: 30253025 DOI: 10.1111/codi.14434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 03/28/2018] [Accepted: 09/12/2018] [Indexed: 12/14/2022]
Abstract
AIM The recommended standard of care for patients after resection of Stage III colon cancer is adjuvant 5-fluorouracil based chemotherapy - FOLFOX (fluorouracil, leucovorin with oxaliplatin) - or CAPOX (capecitabine, oxaliplatin). This may be modified in older patients or depending on comorbidity. This has been challenged recently as the apparent benefit of adjuvant chemotherapy may arise from improvements in surgery or preoperative imaging or pathology staging. This study compares recurrence and colon-cancer-specific death between patients who received postoperative adjuvant chemotherapy and those who did not. METHOD Prospectively recorded data from 363 consecutive patients who had a resection for Stage III colonic adenocarcinoma between 1995 and 2010 inclusive were analysed. Surviving patients were followed for at least 5 years. The suitability of patients for chemotherapy was discussed routinely at multidisciplinary team meetings. The incidence of recurrence and colon-cancer-specific death was evaluated by competing risk methods. RESULTS After adjustment for the competing risk of non-colorectal cancer death, there was no significant difference in recurrence between the 204 patients who received chemotherapy and the 159 who did not [hazard ratio (HR) 0.94, 95% CI 0.66-1.32, P = 0.700) and no significant difference in colon-cancer-specific death (HR 0.73, 95% CI 0.50-1.04, P = 0.084; HR 0.88, 95% CI 0.57-1.36, P = 0.577 after adjustment for relevant covariates). CONCLUSION These findings question the routine use of chemotherapy after complete mesocolic excision for Stage III colon cancer. Recurrence and cancer-specific death, assessed by competing risk methods, should be the standard outcomes for evaluating the effectiveness of adjuvant chemotherapy after potentially curative resection.
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Affiliation(s)
- P H Chapuis
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - E Bokey
- Departments of Colorectal Surgery and Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - C Chan
- Division of Anatomical Pathology, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Pathology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - A Keshava
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - M J F X Rickard
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - P Stewart
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - C J Young
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - O F Dent
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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15
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Wrigley P, Wood P, Stewart P, Hall R, Robertson D. Module layout optimization using a genetic algorithm in light water modular nuclear reactor power plants. Nuclear Engineering and Design 2019. [DOI: 10.1016/j.nucengdes.2018.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Dixit C, LeBlanc S, Buchanan L, Aldred L, Behlen L, Stewart P. WHEN EDEMA ISN'T ANGIOEDEMA: SUPERIOR VENA CAVA SYNDROME AS A CONFOUNDER IN HEREDITARY ANGIOEDEMA. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.284] [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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17
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Power BD, Stewart P, Stone G, O’Reilly P, Costigan C, O’Gorman C, Murphy AM. Coming of Age in Ireland: the Twilight Zone! Ir Med J 2018; 111:819. [PMID: 30556667] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aim To describe the healthcare needs of adolescent patients inhabiting the ‘seventh age of childhood’ in our region with a view towards future workforce and infrastructure planning. Methods This is a retrospective descriptive study of patients aged between 14 and 16 years presenting to each of the six hospitals in our hospital group over a 10 year period (01.07.2006-1.07.2016) using electronic databases. Results There were 10,992 hospital admissions, 41,456 outpatient appointments and an average of 1,847 attendances per year at our Emergency Department in this age group. Seventeen percent (n=1,873) of patients were admitted to age appropriate wards. Only 11.3% (n=1,242) of our cohort were admitted under the care of a Paediatrician. Conclusion The Irish healthcare agenda needs to be advanced to ensure the optimal health for this valuable, yet vulnerable generation. Further investment will help shape the fledgling discipline of ‘adolescent health’ in Ireland.
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Affiliation(s)
- B D Power
- Department of Paediatrics, University Hospital Limerick, Ireland
| | - P Stewart
- Department of Paediatrics, University Hospital Limerick, Ireland
| | - G Stone
- Department of Paediatrics, University Hospital Limerick, Ireland
| | - P O’Reilly
- Department of Paediatrics, University Hospital Limerick, Ireland
| | - C Costigan
- Department of Paediatrics, University Hospital Limerick, Ireland
| | - C O’Gorman
- Department of Paediatrics, University Hospital Limerick, Ireland
- Department of Paediatrics, Graduate Entry Medical School, University of Limerick
| | - A M Murphy
- Department of Paediatrics, University Hospital Limerick, Ireland
- Department of Paediatrics, Graduate Entry Medical School, University of Limerick
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18
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Junod A, Childs K, Stewart P. A - 28The Quick Dementia Rating System and Ecological Validity in a Memory Disorders Cohort. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.28] [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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19
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Tomlinson S, Jayasuria T, Hayman S, Stewart P. A Bleeding Heart. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.056] [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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20
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O'Sullivan P, Stewart P. Sudden Cardiac Death and Mitral Valve Prolapse: Three Interesting Cases. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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McCarthy K, Stewart P, Sigman J, Read M, Keith JC, Brinkhous KM, Nichols TC, Schaub RG. Pharmacokinetics of Recombinant Factor IX after Intravenous and Subcutaneous Administration in Dogs and Cynomolgus Monkeys. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613091] [Citation(s) in RCA: 18] [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: 10/17/2022]
Abstract
SummaryHemophilia B therapy requires intravenous (IV) infusions of large volumes of factor IX due to the low concentration of factor IX in concentrates (∼100 IU/mL). High concentration recombinant factor IX (rFIX) could be a significant advance since it would reduce the large volumes necessary for IV dosing and allow for low-volume subcutaneous (SC) administration. To evaluate high concentration factor IX, we produced formulations with either 2,000 or 4,000 IU/mL and studied the SC bioavailability in beagle dogs, cynomolgus monkeys and hemophilia B dogs along with efficacy in hemophilia B dogs. Beagle dog SC bioavailability was 86.4% using a 2000 IU/mL formulation and 77.0% using a 4000 IU/mL formulation. Monkey bioavailability of a 4000 IU/mL formulation of rFIX was 34.8%. A single SC administration of 200 IU/kg (4000 IU/mL) of rFIX to hemophilia B dogs, produced factor IX clotting activity above 5% for 5 days with a bioavailability of 48.6%. High concentration SC rFIX has an acceptable pharmacokinetic profile in monkeys and dogs, and produces a sustained FIX activity in hemophilic dogs.
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22
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Fiscaletti M, Stewart P, Munns CF. The importance of vitamin D in maternal and child health: a global perspective. Public Health Rev 2017; 38:19. [PMID: 29450091 PMCID: PMC5809824 DOI: 10.1186/s40985-017-0066-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 04/10/2017] [Accepted: 08/21/2017] [Indexed: 12/12/2022] Open
Abstract
Vitamin D and calcium are important nutrients for skeletal growth and bone health. Children and pregnant women are particularly vulnerable to 25-hydroxy vitamin D deficiency (VDD). VDD, with or without dietary calcium deficiency, can lead to nutritional rickets (NR), osteomalacia, and disturbances in calcium homeostasis. Multiple studies have linked VDD to adverse health outcomes in both children and pregnant women that extend beyond bone health. VDD remains an important global public health concern, and an important differentiation must be made between the impact of VDD on children and adults. Reports of increased incidence of NR continue to emerge. NR is an entirely preventable condition, which could be eradicated in infants and children worldwide with adequate vitamin D and calcium supplementation. The desire and necessity to put in place systems for preventing this potentially devastating pediatric disease should not elicit dispute. VDD and NR are global public health issues that require a collaborative, multi-level approach for the implementation of feasible preventative strategies. This review highlights the history, risk factors, and controversies related to VDD during pregnancy and childhood with a particular focus on global NR prevention.
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Affiliation(s)
- M Fiscaletti
- Institute of Endocrinology, The Children’s Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW 2145 Australia
| | - P Stewart
- Institute of Endocrinology, The Children’s Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW 2145 Australia
| | - CF Munns
- Institute of Endocrinology, The Children’s Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Locked Bag 4001, Westmead, NSW 2145 Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia
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Wulff J, Santner T, Storb R, Banaji M, Buckner C, Clift R, Stewart P, Sanders J, Slichter S, Thomas E. Transfusion Requirements after HLA-Identical Marrow
Transplantation in 82 Patients with Aplastic Anemia. Vox Sang 2017. [DOI: 10.1159/000465334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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24
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Kuenzi B, Remsing Rix L, Stewart P, Fang B, Kinose F, Bryant A, Boyle T, Koomen J, Haura E, Rix U. Repurposing Ceritinib Using Systems Polypharmacology. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.06.046] [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: 11/17/2022]
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25
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Masuodi S, Blackwell J, Stewart P, Egan T. Cytokine Levels in Steen Solution Perfusate Increase During Ex-Vivo Lung Perfusion (EVLP) of Lungs from Conventional Donors (Conv) and Uncontrolled Donation After Circulatory Determination of Death Donors (uDCDDs). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1508] [Citation(s) in RCA: 2] [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: 11/16/2022] Open
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26
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27
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Phillips S, Stewart P, Liang S. Response to letter to editor. Anaesth Intensive Care 2017; 45:128. [PMID: 28072949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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28
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Cranford C, Caldwell M, Stewart P. P310 Idiopathic hypereosinophilic syndrome as a cause of pulmonary-renal syndrome. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.324] [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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29
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Fizazi K, Hotte S, Saad F, Alekseev B, Matveev V, Flechon A, Gravis G, Joly F, Chi K, Malik Z, Stewart P, Jacobs C, Beer T. genitourinary tumours, prostate Final overall survival (OS) from the AFFINITY phase 3 trial of custirsen and cabazitaxel/prednisone in men with previously treated metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.20] [Citation(s) in RCA: 2] [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: 11/14/2022] Open
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30
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Khan A, Savage L, Stewart P, Williams T, Bhagwandeen R, Fletcher P, Boyle A. Pre-Hospital ECG and Triage Strategy Improves Survival in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.131] [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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31
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Khan A, Williams T, Savage L, Stewart P, Bhagwandeen R, Fletcher P, Boyle A. Pre-Hospital Thrombolysis and Transfer Achieves Optimal. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.132] [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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32
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Bokey L, Chapuis PH, Chan C, Stewart P, Rickard MJFX, Keshava A, Dent OF. Long-term results following an anatomically based surgical technique for resection of colon cancer: a comparison with results from complete mesocolic excision. Colorectal Dis 2016; 18:676-83. [PMID: 26476136 DOI: 10.1111/codi.13159] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 04/28/2015] [Accepted: 09/05/2015] [Indexed: 02/08/2023]
Abstract
AIM Complete mesocolic excision (CME) has been advocated as likely to improve the long-term oncological outcome of colon cancer resection, although there is a paucity of long-term results in the literature. The aim of this study was to supplement our previously published results on colon cancer resection based on a standardized technique of precise dissection along anatomical planes with high vascular ligation and to compare our long-term results with those of recent European studies of CME. METHOD Data were drawn from a prospective hospital registry of consecutive resections for colon cancer between 1996 and 2007, including follow-up to the end of 2012. The principal outcomes from potentially curative resections were 5-year Kaplan-Meier rates of local recurrence, systemic recurrence, overall survival and cancer-specific survival. Secondary outcomes for all resections were postoperative complications, number of lymph nodes retrieved and R0 status. RESULTS For 779 potentially curative resections the local recurrence rate was 2.1% (95% CI 1.3-3.4), the systemic recurrence rate was 10.2% (95% CI 8.1-12.7), the 5-year overall survival rate was 76.2% (95% CI 73.0-79.0) and the cancer-specific survival rate was 89.8% (95% CI 87.3-91.9). For all 905 resections, rates of 14 surgical complications were low and not dissimilar to those in a comparable study. The median lymph node count was 15 (range 0-113). R0 status was confirmed in 883/905 patients (97.6%; 95% CI 96.4-98.5). CONCLUSION For colon cancer, meticulous dissection along anatomical planes together with high vascular ligation results in few complications, a high R0 rate, low recurrence and high survival.
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Affiliation(s)
- L Bokey
- Department of Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.,School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia
| | - P H Chapuis
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - C Chan
- Division of Anatomical Pathology, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - P Stewart
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - M J F X Rickard
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - A Keshava
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - O F Dent
- Department of Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.,School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia.,Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Affiliation(s)
- L Kang
- Sydney Medical School, University of Sydney, Australia
| | - P Stewart
- Sydney Adventist Hospital, Sydney, Australia
| | - S Phillips
- Sydney Adventist Hospital, Sydney, Australia.
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Goldmann W, Marier E, Stewart P, Konold T, Street S, Langeveld J, Windl O, Ortiz-Pelaez A. Prion protein genotype survey confirms low frequency of scrapie-resistant K222 allele in British goat herds. Vet Rec 2016; 178:168. [PMID: 26755614 PMCID: PMC4789823 DOI: 10.1136/vr.103521] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Subscribe] [Scholar Register] [Accepted: 12/11/2015] [Indexed: 11/03/2022]
Abstract
Scrapie in goats is a transmissible, fatal prion disease, which is endemic in the British goat population. The recent success in defining caprine PRNP gene variants that provide resistance to experimental and natural classical scrapie has prompted the authors to conduct a survey of PRNP genotypes in 10 goat breeds and 52 herds to find goats with the resistant K222 allele. They report here the frequencies in 1236 tested animals of the resistance-associated K222 and several other alleles by breed and herd. Eight animals were found to be heterozygous QK222 goats (0.64 per cent genotype frequency, 95 per cent CI 0.28 to 1.27 per cent) but no homozygous KK222 goats were detected. The K222 allele was found in Saanen, Toggenburg and Anglo-Nubian goats. The fact that only a few goats with the K222 allele have been identified does not preclude the possibility to design and implement successful breeding programmes at national level.
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Affiliation(s)
- W Goldmann
- The Roslin Institute and R(D)SVS University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK
| | - E Marier
- Animal and Plant Health Agency Weybridge, Woodham Lane, Addlestone, Surrey KT15 3NB, UK
| | - P Stewart
- The Roslin Institute and R(D)SVS University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK
| | - T Konold
- Animal and Plant Health Agency Weybridge, Woodham Lane, Addlestone, Surrey KT15 3NB, UK
| | - S Street
- Animal and Plant Health Agency Weybridge, Woodham Lane, Addlestone, Surrey KT15 3NB, UK
| | - J Langeveld
- Central Veterinary Institute part of Wageningen UR (CVI) Department of Infection Biology, P.O. Box 65, 8200 AB Lelystad, The Netherlands
| | - O Windl
- Animal and Plant Health Agency Weybridge, Woodham Lane, Addlestone, Surrey KT15 3NB, UK
| | - A Ortiz-Pelaez
- Animal and Plant Health Agency Weybridge, Woodham Lane, Addlestone, Surrey KT15 3NB, UK
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Stewart P, Fulton R, Wilson B. C-47Psychometric Criteria for Detecting Impairment: Concordance between Abbreviated and Full Versions of the Neuropsychological Assessment Battery (NAB) Memory Module. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.249] [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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36
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Petrylak D, Eigl B, Senkus E, Loriot Y, Twardowski P, Castellano D, Blais N, Sridhar S, Sternberg C, Retz M, Blumenstein B, Jacobs C, Stewart P, Bellmunt J. 2637 Baseline circulating tumor cells (CTC) and serum heat shock protein 27 (Hsp27) levels are increased in advanced bladder cancer (BC) patients with poor prognostic factors: Results from the randomized phase 2 Borealis-1™ trial of first-line gemcitabine/cisplatin plus apatorsen or placebo. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31454-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Egan T, Dong B, Blackwell J, Birchard K, Stewart P, Funkhouser W, Simmons W, Jernigan E, Venkataraman A, Reddy S, Haithcock B. Assessing Human Lungs Unsuitable for Transplant By Ex-Vivo Lung Perfusion (EVLP) and Ex-Vivo CT Scan: Does EVLP Cause Inflammation? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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38
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Faddy S, McMullen M, Stewart P. Epidemiological analysis of a cohort of rural and remote STEMI patients in NSW. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Kyranis S, Dooris M, Katahanas G, Stewart P. The safety of rotational atherectomy at a PCI capable centre with no on-site cardiac surgery. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Peverill W, Hayman S, Brazzale A, Puchalski R, Stewart P, Dooris M. Percutaneous coronary intervention in the very elderly. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.421] [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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41
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Stewart P, Yankaskas J, Egan T. The Growing Impact of Lung Transplant (LTX) on Survival for Patients with Cystic Fibrosis (CF). J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.591] [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] Open
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42
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Egan T, Blackwell J, Forrest L, Gazda S, Requard III J, Haithcock B, Birchard K, Stewart P, Randell S, Venkataraman A, Beamer S, Reddy S, Myers B, Bachman M, Casey N, Niedfeldt D. Evaluation of Human Lungs from Uncontrolled Donation After Cardiac Death Donors (uDCDDs) with Ex-vivo Lung Perfusion (EVLP). J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Egan T, Haithcock B, Long J, Noone P, Blackwell J, Forrest L, Gazda S, Reddy S, Davis R, Birchard K, Stewart P. Preliminary Results of a Phase II Trial Comparing Outcomes of Patients Transplanted with Lungs from Uncontrolled Donation After Cardiac Death Donors (uDCDDs) Assessed with Ex-vivo Lung Perfusion (EVLP) to Lungs from Conventional Brain-Dead Donors. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.073] [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] Open
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44
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Egan T, Gazda S, Stewart P. If I Had a Million Lungs: Impact of Uncontrolled Donation After Cardiac Death Donors (uDCDDs) on the Number of Potential Lung Donors in the U.S. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.156] [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: 11/27/2022] Open
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45
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Puchalski R, Peverill W, Brazzale A, Hayman S, Dooris M, Stewart P. Outcomes of Percutaneous Coronary Intervention in a Nonagenarian Population. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.108] [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: 10/26/2022]
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46
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Dooris M, Carr L, Camuglia A, Stewart P, Prasad S. Predicting Pre-A Wave LVEDP in Biomarker Positive Acute Coronary Syndrome using Lateral E/E′ and Tei Index. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.455] [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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47
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Lax S, Wilson MR, Takata M, Stewart P, Thickett D. S54 The Role of Pre-Receptor Glucocorticoid Metabolism in Regulating the Severity and Persistence of Murine Lung Injury. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
This study aimed to explore women's experiences of chronic pelvic pain (CPP). Twenty-one interviews with women 12 to 18 months after a negative laparoscopy were conducted. A predominantly qualitative methodology was adopted. The majority of women were still experiencing pain at this time, yet few were in receipt of continuing medical care. Women's accounts suggested that their pain continued to affect many areas of their lives, and issues including uncertainty, anxiety, and a sense of not being believed emerged. In provision of care, ways in which health professionals related to women were viewed as important, and had an impact in terms of whether or not they felt their pain had been validated. Dissatisfaction with the quality and quantity of information offered by professionals was a common finding. Based on women's accounts, implications for improving the quality of care for women with CPP are provided.
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Stewart P, Stewart R. Home visits: why do rates vary so much? Ir Med J 2012; 105:83-84. [PMID: 22558815] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Data including information on patient age, gender, who initiated the visit and call classification was collected during office hours from 12 G.P. rural teaching practices with a combined GMS patient population of 24,720, over a 2 month period. There were a total of 603 home visits, giving an annual visiting rate of 143/1000. Visiting rates varied between practices from 45 to 305/1000 per year. When high visiting practices (>210/1000/year) were compared to low visiting rate practices (>90/1000/year), patients tended to be older (79.7 v. 74.5 years) and calls were 12 times more likely to be doctor initiated (16.6% v. 1.4%) or classified as routine( 50.7% v. 44.9%). The variation between practices was related in part to patient age but appears largely due to differences in doctor home visiting behaviour. There are no recent figures on home visiting in Ireland.
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Affiliation(s)
- P Stewart
- Donegal Specialist Training Programme in General Practice, Education Centre, St. Conals, Letterkenny, Co Donegal.
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Jetmalani K, Young PM, Smith T, Stewart P, Traini D. Micronized drug powders in binary mixtures and the effect of physical properties on aerosolization from combination drug dry powder inhalers. Drug Dev Ind Pharm 2012; 38:1504-11. [DOI: 10.3109/03639045.2012.654793] [Citation(s) in RCA: 3] [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: 11/13/2022]
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