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Elliott J, van Wyk P, Butler R, Giosa JL, Sims Gould J, Tong CE, Taabazuing MM, Johnson H, Coyne P, Mitchell F, Whate A, Callon A, Carson J, Stolee P. Developing an in-depth understanding of patient and caregiver engagement across care transitions from hospital: protocol for a qualitative study exploring experiences in Canada. BMJ Open 2023; 13:e077436. [PMID: 37479510 PMCID: PMC10364181 DOI: 10.1136/bmjopen-2023-077436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Patient and caregiver engagement is critical, and often compromised, at points of transition between care settings, which are more common, and more challenging, for patients with complex medical problems. The consequences of poor care transitions are well-documented, both for patients and caregivers, and for the healthcare system. With an ageing population, there is greater need to focus on care transition experiences of older adults, who are often more medically complex, and more likely to require care from multiple providers across settings. The overall goal of this study is to understand what factors facilitate or hinder patient and caregiver engagement through transitions in care, and how these current engagement practices align with a previously developed engagement framework (CHOICE Framework). This study also aims to co-develop resources needed to support engagement and identify how these resources and materials should be implemented in practice. METHODS AND ANALYSIS This study uses ethnographic approaches to explore the dynamics of patient and caregiver engagement, or lack thereof, during care transitions across three regions within Ontario. With the help of a front-line champion, patients (n=18-24), caregivers (n=18-24) and healthcare providers (n=36-54) are recruited from an acute care hospital unit (or similar) and followed through their care journey. Data are collected using in-depth semi-structured interviews. Workshops will be held to co-develop strategies and a plan for future implementation of resources and materials. Analysis of the data will use inductive and deductive coding techniques. ETHICS AND DISSEMINATION Ethics clearance was obtained through the Western University Research Ethics Board, University of Windsor Research Ethics Board and the University of Waterloo Office of Research Ethics. The findings from this study are intended to contribute valuable evidence to further bridge the knowledge to practice gap in patient and caregiver engagement through care transitions. Findings will be disseminated through publications, conference presentations and reports.
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Affiliation(s)
- Jacobi Elliott
- Lawson Health Research Institute, London, Ontario, Canada
- Specialized Geriatric Services, St. Joseph's Health Care London, London, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paula van Wyk
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Roy Butler
- Senior Leadership, St. Joseph's Health Care London, London, Ontario, Canada
| | - Justine L Giosa
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- SE Research Centre, Toronto, Ontario, Canada
| | | | - Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mary Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
| | - Helen Johnson
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paige Coyne
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
- Henry Ford Health System, Detroit, Michigan, USA
| | - Fallon Mitchell
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Alexandra Whate
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne Callon
- Patient and Caregiver Partner, London, Ontario, Canada
| | - Judith Carson
- Patient and Caregiver Partner, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Seligmann J, Fisher D, Brown L, Adams R, Graham J, Quirke P, Richman S, Butler R, Domingo E, Blake A, Braun M, Collinson F, Jones R, Brown E, De Winton E, Humphies T, Kaplan R, Wilson R, Seymour M, Maughan T. 382O Inhibition of WEE1 is effective in TP53 and RAS mutant metastatic colorectal cancer (mCRC): A randomised phase II trial (FOCUS4-C) comparing adavosertib (AZD1775) with active monitoring. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.904] [Citation(s) in RCA: 1] [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: 11/26/2022] Open
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Nowak J, Visnovsky SB, Cruz CD, Fletcher GC, van Vliet AHM, Hedderley D, Butler R, Flint S, Palmer J, Pitman AR. Inactivation of the gene encoding the cationic antimicrobial peptide resistance factor MprF increases biofilm formation but reduces invasiveness of Listeria monocytogenes. J Appl Microbiol 2020; 130:464-477. [PMID: 32687650 DOI: 10.1111/jam.14790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/18/2020] [Accepted: 07/14/2020] [Indexed: 11/27/2022]
Abstract
AIMS To understand the genetics involved in surface attachment and biofilm formation of Listeria monocytogenes. METHODS AND RESULTS An in vitro screen of a Himar1 transposon library of L. monocytogenes strain 15G01 identified three transposants that produced significantly different biofilm levels when compared to the wild-type strain; two mutants exhibited enhanced biofilm formation and one produced less biofilm biomass than the wild-type. The mutant 15G01 mprF::Himar1, which had a transposon insertion in the mprF gene, was selected for further analysis. The mutant produced a more densely populated biofilm on solid surfaces such as stainless steel and polystyrene, as determined using scanning electron and light microscopy. The 15G01 mprF::Himar1 mutant remained viable in biofilms, but showed an increase in sensitivity to the cationic antimicrobial gallidermin. The mutant also displayed reduced invasiveness in CaCo-2 intestinal cells, suggesting virulence properties are compromised by the inactivation of mprF. CONCLUSIONS Biofilm formation and gallidermin resistance of L. monocytogenes is influenced by mprF, but this trait is associated with a compromise in invasiveness. SIGNIFICANCE AND IMPACT OF THE STUDY The presence of pathogenic microorganisms in the food processing environment can cause a significant problem, especially when these microorganisms are established as biofilms. This study shows that the inactivation of the mprF gene results in enhanced biofilm formation and abiotic surface attachment of L. monocytogenes.
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Affiliation(s)
- J Nowak
- The New Zealand Institute for Plant & Food Research Limited, Auckland, New Zealand.,Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
| | - S B Visnovsky
- The New Zealand Institute for Plant & Food Research Limited, Lincoln, New Zealand
| | - C D Cruz
- Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - G C Fletcher
- The New Zealand Institute for Plant & Food Research Limited, Auckland, New Zealand
| | - A H M van Vliet
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - D Hedderley
- The New Zealand Institute for Plant & Food Research Limited, Palmerston North, New Zealand
| | - R Butler
- The New Zealand Institute for Plant & Food Research Limited, Lincoln, New Zealand
| | - S Flint
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
| | - J Palmer
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
| | - A R Pitman
- The Foundation for Arable Research, Christchurch, New Zealand
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Rakieh C, Ho S, Butler R. SAT0445 TRABECULAR BONE SCORE IMPROVES FRACTURE RISK STRATIFICATION IN PATIENTS WITH REDUCED BONE MINERAL DENSITY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Trabecular bone score (TBS) is a textural index of bone microarchitecture and has been found to be related to 3D bone structure. A number of cohort studies have demonstrated the value of TBS as an independent fracture risk in clinical trials. Yet, very little is known about the performance and clinical value of TBS in real life practice.Objectives:To investigate the sensitivity and specificity of TBS in identifying prevalent fractures when compared with bone mineral density (BMD) measured by DXA. To evaluate the added value of TBS in fracture risk prediction above that obtained from DXA.Methods:Consecutive patients aged ≥ 18 with BMI 15-37 attnding a DXA plus TBS assessment were considered eligible. Sensitivity, specificity, and area under the curve (AUC) for prevalent major osteoporotic fracture (MOF) and clinical vertebral fractures (VF) were assessed for the following parameters: BMD lowest T-score ≤-2.5 (neck of femur, total hip, or spine), TBS T-score ≤-2.5, and either TBS or BMD T-score ≤-2.5. BMD categories (normal, osteopenia, and osteoporosis) were stratified by TBS T-score: normal (T-score ≥-1), moderate (-1≥T-score≥-2.5), and degraded TBS (T-score ≤-2.5) resulting in 9 risk groups. Odds ratios were calculated for all risk categories and fracture prevalence was compared between the best and worst TBS strata at each BMD level using chi-square test.Results:540 patients (87% females, 68.1 ± 11.6 years) were included. 238 (44%) had MOF including 81 (15%) clinical VF. For MOF, BMD had higher sensitivity (49.6% vs 30.7%), lower specificity (68.2% vs 82.1%), and similar AUC (0.59 vs 0.56) versus TBS. For VF, the sensitivity, specificity and AUC for BMD were 60%, 64%, and 0.62 respectively versus 42%, 79.7%, and 0.61 for TBS. Combining TBS and BMD (either T-score ≤ -2.5) increased the sensitivity to 63% for MOF and 75.3% for VF without affecting AUC (0.6 and 0.64 respectively). Patients with osteoporosis and degraded TBS had the highest OR of 2.65 for MOF and 3.8 for VF. The fracture risk increased at the same level of BMD when TBS was degraded. Numerically, the risk of MOF increased steadily from strata 1 to 9 and was statistically significant for osteoporosis with degraded TBS and osteoporosis with moderate TBS. When both TBS and BMD were normal, the risk of fracture was significantly reduced. In the osteopenia and osteoporosis BMD categories, patients with degraded TBS had significantly higher prevalence of fracture compared to those with normal TBS in the same BMD category.Conclusion:Fracture risk stratification can be improved when TBS is added to BMD. The sensitivity of predicting fracture may also improve when TBS and BMD are combined. Patients with both normal TBS and BMD have the lowest fracture risk, whereas those with degraded TBS and osteoporosis have the highest risk of fracture and should be targeted for early or more aggressive treatment.References:[1]Hans D et al. J Bone Miner Res. 2011;26(11).[2]McCloskey EV et al. Calcif Tissue Int. 2015;96(6).Table 1.Prevalence and risk of MOF and VF according to BMD stratified by TBS T-scorePatients within categoryNumber of MOFOR for MOFNumber of VFOR for VFNormal BMD & TBS497 (14.3%)0.19(0.08-0.43)*00.83(0.80-.87)*Normal BMD moderate TBS195 (26.3%)0.44(0.16-1.24)2 (10.5%)0.66(0.15-2.9)Normal BMD degraded TBS72 (28.6%)0.50(0.1-2.6)1 (14.3%)0.94(0.11-7.9)Osteopenia normal TBS9633 (34.4%)0.61(0.39-0.97)7 (7.3%)0.39(0.18-0.88)*Osteopenia moderate TBS9843 (43.9%)0.99(0.64-1.54)11 (11.2%)0.67(0.34-1.32)Osteopenia degraded TBS5730 (52.6%)1.47(.085-2.55)11 (19.3%)1.41(0.7-2.86)Osteoporosis normal TBS3918 (46.2%)1.1(0.57-2.1)6 (15.4%)1(0.42-2.6)Osteoporosis moderate TBS11259 (52.7%)1.55(1.02-2.35)*21 (18.8%)1.42(0.82-2.45)Osteoporosis degraded TBS6341 (65.1%)2.65(1.53-4.59)*22 (34.9%)3.8(2.12-6.83)*Total54023881Acknowledgments:Bone density team, Robert Jones and Agnes Hunt Orthopaedic HospitalDisclosure of Interests:None declared
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Rakieh C, Ho S, Butler R. SAT0479 IMPACT OF TRABECULAR BONE SCORE ON INTERVENTION THRESHOLD FOR BONE SPARING THERAPY IN PATIENTS REFERRED FOR BONE MINERAL DENSITY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Trabecular bone score (TBS) is an index of skeletal quality that has been validated as an independent risk factor for fracture and incorporated into fracture risk assessment (FRAX). TBS provides information on bone microarchitecture not captured from standard bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA). Nonetheless, the clinical implications of using TBS in routine practice are not yet fully understood and warrant further evaluation.Objectives:To determine whether lumbar TBS can have an impact on clinician’s treatment threshold derived from DXA and clinical risk factors: does the addition of TBS to DXA measurements make the clinician more or less likely to recommend bone sparing therapy?Methods:A cross-sectional study at a tertiary metabolic bone centre in the West Midlands region of England. Three expert metabolic bone physicians, two rheumatologists and one elderly care, assessed consecutive patients referred for a DXA scan ± clinic review and provided treatment recommendations with and without TBS. Patients ≥ 18 years old with BMI of 15-37 who were not on bone sparing therapy were considered eligible. TBS was defined according to T-score as normal (T-score ≥ -1), moderate (-1 > T-score ≥ -2.5) or degraded (T-score ≤ -2.5). TBS groups were stratified by BMD T-scores (normal, osteopenia, or osteoporosis) using minimum T-score of total hip, femoral neck, and spine to identify categories in which TBS may be of more clinical use. The main outcome measure was the proportion of change in clinician’s treatment threshold between BMD alone and BMD plus TBS. The difference was assessed for significance using Chi-square test. Additionally, the change in UK National Osteoporosis Guideline Group (NOGG) threshold was also assessed using TBS-adjusted FRAX scores. Correlations between BMD-TBS strata and the change in intervention threshold (yes/no) were carried out using Spearman test.Results:540 patients were analysed. The inclusion of TBS resulted in 8.2% change in clinician’s treatment threshold (p <0.001) shifting the outcome 6.5 % for and 1.7 % against treatment. More than half of the cases in which the clinical decision was changed were for patients with osteopenia and degraded TBS (significant correlation; P <0.001). NOGG intervention threshold was changed in 7.4% of the cases (P<0.001); 6.1% for and 1.3% against treatment. 37.5% of NOGG changed outcome was related to osteopenia with degraded TBS (p<0.001). Kappa agreement between the clinician and NOGG was fair at 0.42 (p<0.001).Conclusion:These results demonstrate that using TBS in routine clinical practice is most likely to impact treatment decision in patients with osteopenia who have compromised bone microarchitecture. Incorporating TBS in routine DXA scans may lead to a net increase in bone protective therapy of approximately 5%. It is unknown whether adopting such an approach universally can reduce future fracture risk, and prospective studies are needed to address this question.References:[1]Hans D et al. J Bone Miner Res. 2011;26(11):2762-9.[2]McCloskey EV et al. Calcif Tissue Int. 2015;96(6):500-9.Table 1.Demographic and baseline characteristics (n = 540)Female470 (87%)Age (years)68.1 ± 11.6Body mass index (BMI)26.2 ± 4.6Femoral neck T-score-1.80 ± 1.04Total hip T-score-1.32 ± 1.07Lumbar spine T-score-1.37 ± 1.42Lumbar spine TBS1.32 ± 0.13Major osteoporotic fractures238 (44%)Spinal fractures81 (15%)FRAX major osteoporotic fracture14.43 ± 9.03FRAX hip fracture4.60 ± 6.20TBS-adjusted FRAX major osteoporotic fracture13.82 ± 8.80TBS-adjusted FRAX hip fracture4.45 ± 5.73Figure 1.Distribution of changed clinical treatment threshold in normal, moderate, and degraded TBS according to BMD T-scoreAcknowledgments:Bone density unit &Rheumatology team, Robert Jones and Agnes Hunt Orthopaedic HospitalDisclosure of Interests:None declared
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Ragin C, Oliver JS, Cabral DN, Harlemon M, Louden D, Morrison-Blidgen BF, Alleyne-Mike K, Ashing K, Butler R, Gathere S, George S, Halliday D, Jackson M, Odero-Marah V, Roach V, Roberts R, Slewion S. African-Caribbean Cancer Consortium Scientific and Training Conference 2017. ACTA ACUST UNITED AC 2020; 26:e785-e790. [PMID: 31896949 DOI: 10.3747/co.26.5305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The sixth International African-Caribbean Cancer Consortium (AC3) Conference was held 6-9 October 2017 in Miami, Florida, U.S.A. The conference was open to all researchers, trainees, clinical and public health professionals, and community members, and served as an international hub for the United States, the Caribbean, and Africa. Sessions included AC3 collaboration meetings, cancer surveillance and research skills training workshops, and a community cancer prevention conference.
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Affiliation(s)
- C Ragin
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - J S Oliver
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - D N Cabral
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - M Harlemon
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - D Louden
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - B F Morrison-Blidgen
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - K Alleyne-Mike
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - K Ashing
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - R Butler
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - S Gathere
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Africa: Kenya Medical Research Institute, Nairobi, Kenya (Gathere); and Liberia National Cancer Registry, Monrovia, Liberia (Slewion)
| | - S George
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - D Halliday
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - M Jackson
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - V Odero-Marah
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George)
| | - V Roach
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - R Roberts
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Caribbean: Partnership for Public Engagement, The Valley, Anguilla (Louden); Department of Surgery, University of the West Indies, Mona, Kingston, Jamaica (Morrison-Blidgen); North West Regional Health Authority, Port-of-Spain, Trinidad and Tobago (Alleyne-Mike); School of Clinical Medicine and Research, University of the West Indies, Nassau, Bahamas (Butler, Halliday, Roberts); Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica (Jackson); African-Caribbean Cancer Consortium, Tobago, Trinidad and Tobago (Roach)
| | - S Slewion
- United States: Cancer Prevent ion and Control Program, Fox Chase Cancer Center, Philadelphia, PA (Ragin); African-Caribbean Cancer Consortium, Philadelphia, PA, (Alleyne-Mike, Ashing, Butler, Cabral, Gathere, George, Halliday, Harlemon, Jackson, Louden, Morrison-Blidgen, Odero-Marah, Oliver, Ragin, Roach, Roberts, Slewion); Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL (Oliver); California State University, Monterey Bay, Seaside, CA (Cabral); Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA (Harlemon, Odero-Marah); City of Hope Comprehensive Cancer Center, Duarte, CA (Ashing); Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL (George).,Africa: Kenya Medical Research Institute, Nairobi, Kenya (Gathere); and Liberia National Cancer Registry, Monrovia, Liberia (Slewion)
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Khan JN, Griffiths T, Sandhu K, Cabezon S, Kwok CS, Baig S, Naneishvili T, Lee VCK, Pasricha A, Robins E, Kanagala P, Butler R, Duckett S, Heatlie G. 1673 Accuracy and prognostic value of physiologist-led stress echocardiography for coronary disease. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
No funding sources
Background
Cardiac physiologist-led stress echocardiography (PLSE) services provide potential for expansion of SE services and increased productivity for cardiologists. There is no published data on the accuracy or prognostic value of PLSE.
Purpose
To assess and compare the accuracy and prognostic value of PLSE and cardiologist-led stress echocardiography (CLSE) for CAD assessment
Methods
Retrospective study of 898 subjects undergoing PLSE (n = 393) or CLSE (n = 505) for CAD assessment using exercise or dobutamine. For accuracy assessment, the primary outcome was the ability of stress echocardiography to identify significant CAD on invasive angiography (ICA). Incidence of 24-month non-fatal myocardial infarction (MI), total and cardiac mortality, revascularisation and combined major adverse cardiac events (MACE) were assessed.
Results
Demographics, comorbidities, CAD predictors and cardiac medications were matched between the PLSE and CLSE groups. PLSE had high sensitivity, specificity, positive and negative predictive value and accuracy (85%, 74%, 69%, 88%, 78% respectively). PLSE accuracy measures were similar and non-inferior to CLSE. There was a similar incidence of individual and combined outcomes in PLSE and CLSE subjects. Negative stress echocardiography conferred a low incidence of non-fatal MI (PLSE 1.4% vs. CLSE 0.9%, p = 0.464), cardiac mortality (0.6% vs. 0.0%, p = 0.277) and MACE (6.8% vs. 3.1%, p = 0.404).
Conclusion
This is the largest study of PLSE accuracy and first study of the prognostic value of PLSE. PLSE demonstrates high and non-inferior accuracy compared with CLSE for CAD assessment. Negative PLSE and CLSE confer a similarly very low incidence of cardiac outcomes, confirming for the first time the important prognostic value of PLSE.
Accuracy of PLSE and CLSE for CAD Marker of diagnostic test Total (n = 72) PLSE (n = 32) CLSE (n = 40) p Significant CAD present (n, %) 20 (27.8%) 12 (37.5%) 8 (20.0%) 0.167 * Single-vessel CAD 12 (60.0%) 7 (58.3%) 5 (62.5%) 0.325 * Multi-vessel CAD 8 (40.0%) 5 (41.7%) 3 (37.5%) 0.325 Sensitivity 76% (66-76%) 85% (73-97%) 63% (48-78%) Non-significant Specificity 73% (63-73%) 74% (59-89%) 72% (58-86%) Non-significant Positive predictive value (PPV) 53% (42-64%) 69% (53-85%) 29% (15-43%) Significant Negative predictive value (NPV) 88% (80-96%) 88% (77-99%) 88% (78-98%) Non-significant Overall accuracy 74% (64-84%) 78% (64-92%) 70% (56-84%) Non-significant Accuracy data expressed as value (95% confidence interval). CAD= coronary artery disease. Differences in values between PLSE and CLSE considered statistically significant if no crossover in 95% confidence intervals
Abstract 1673 Figure. Predicted coronary artery lesion from SE
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Affiliation(s)
- J N Khan
- University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom of Great Britain & Northern Ireland
| | - T Griffiths
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - K Sandhu
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - S Cabezon
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - C S Kwok
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - S Baig
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - T Naneishvili
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - V C K Lee
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - A Pasricha
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - E Robins
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - P Kanagala
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - R Butler
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - S Duckett
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
| | - G Heatlie
- Royal Stoke University Hospital, Cardiology, Stoke-on-Trent, United Kingdom of Great Britain & Northern Ireland
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Borovac JA, Kwok CS, Konopleva M, Kim PY, Palaskas NL, Zaman A, Butler R, Lopez-Mattei JC, Mamas MA. P676Percutaneous coronary intervention and clinical outcomes in patients with lymphoma: a 10-year period United States nationwide inpatient sample (NIS) analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0282] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Clinical outcomes and characteristics of patients with lymphoma undergoing percutaneous coronary intervention (PCI) are unknown.
Purpose
To describe clinical characteristics and procedural outcomes in patients that underwent PCI and had a concurrent diagnosis of Hodgkin (HL) or non-Hodgkin (NHL) lymphoma and compare risks of complications and in-hospital mortality in lymphoma subtypes to patients without lymphoma.
Methods
A total of 6,413,175 PCI procedures undertaken in the United States between 2004 and 2014 in the Nationwide Inpatient Sample were included in the analysis. Multivariable regression analysis was performed in order to examine the association between lymphoma diagnosis and clinical outcomes post-PCI including complications and in-hospital mortality.
Results
Patients with lymphoma generally had a significantly higher incidence of post-PCI complications and in-hospital mortality compared to patients without lymphoma (Figure 1). Patients with lymphoma were more likely to experience in-hospital mortality (OR 1.34, 95% CI 1.20–1.49), stroke or transient ischemic attack (TIA) (OR 1.59, 95% CI 1.47–1.73), and any in-hospital complication (OR 1.19, 95% CI 1.14–1.25), following PCI. In the lymphoma subtype-analysis, diagnosis of HL was associated with an increased likelihood of in-hospital death (OR 1.31, 95% CI 1.17–1.48), any in-hospital complication (OR 1.20, 95% CI 1.14–1,26), bleeding complications (OR 1.12 95% CI 1.05–1.19) and vascular complications (OR 1.10 95% CI 1.03–1.17) while these risks were not significantly associated with NHL diagnosis. Finally, both types of lymphoma were associated with an increased likelihood of stroke/TIA following PCI, with this effect being twice greater for HL than NHL diagnosis (OR 1.66, 95% CI 1.52–1.81 and OR 1.33, 95% CI 1.06–1.66, respectively) (Table 1).
Table 1. ORs for clinical outcomes Variable HL vs. No Lymphoma NHL vs. No Lymphoma Bleeding complications 1.12 (1.05–1.19) 1.07 (0.89–1.27) Vascular complications 1.10 (1.03–1.17) 1.13 (0.92–1.27) Cardiac complications 0.94 (0.85–1.03) 0.86 (0.68–1.11) Post-procedural stroke/TIA 1.66 (1.52–1.81) 1.33 (1.06–1.66) Any complication 1.20 (1.14–1.26) 1.04 (0.91–1.18) In-hospital mortality 1.31 (1.17–1.48) 0.89 (0.65–1.21) HL, Hodgkin's Lymphoma; NHL, non-Hodgkin's Lymphoma; TIA, Transient Ischemic Attack.
Figure 1. Type of lymphoma and outcomes
Conclusions
While the incidence of lymphoma in the observed PCI cohort was low, a diagnosis of lymphoma was associated with an adverse prognosis following PCI, primarily in patients with a diagnosis of HL.
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Affiliation(s)
- J A Borovac
- Keele University, Keele Cardiovascular Research Group, Centre for Prognosis Research, Stoke-on-Trent, United Kingdom
| | - C S Kwok
- Keele University, Keele Cardiovascular Research Group, Centre for Prognosis Research, Stoke-on-Trent, United Kingdom
| | - M Konopleva
- University of Texas MD Anderson Cancer Center, Department of Leukaemia, Houston, United States of America
| | - P Y Kim
- University of Texas MD Anderson Cancer Center, Department of Cardiology, Division of Internal Medicine, Houston, United States of America
| | - N L Palaskas
- University of Texas MD Anderson Cancer Center, Department of Cardiology, Division of Internal Medicine, Houston, United States of America
| | - A Zaman
- Newcastle University, Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle upon Tyne, United Kingdom
| | - R Butler
- Royal Stoke Hospital, University Hospital North Midlands, Department of Cardiology, Stoke-on-Trent, United Kingdom
| | - J C Lopez-Mattei
- University of Texas MD Anderson Cancer Center, Department of Cardiology, Division of Internal Medicine, Houston, United States of America
| | - M A Mamas
- Keele University, Keele Cardiovascular Research Group, Centre for Prognosis Research, Stoke-on-Trent, United Kingdom
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Howell SJ, Waters S, Twelves C, Joffe J, Moon S, Bale C, Venkitaraman R, Bezecny P, Casbard A, Wilhelm-Benartzi C, Carucci M, Butler R, Alchami F, Jones R. Abstract PD1-07: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd1-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Howell SJ, Waters S, Twelves C, Joffe J, Moon S, Bale C, Venkitaraman R, Bezecny P, Casbard A, Wilhelm-Benartzi C, Carucci M, Butler R, Alchami F, Jones R. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD1-07.
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Affiliation(s)
- SJ Howell
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - S Waters
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Twelves
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - J Joffe
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - S Moon
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Bale
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Venkitaraman
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - P Bezecny
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - A Casbard
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Wilhelm-Benartzi
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - M Carucci
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Butler
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - F Alchami
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Jones
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
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Welch L, Butler R, Taniere P, Thompson L, Oniscu A, Clarke C, Burghel G, Collins N, Timm L. Evidence-based best practices for EGFR and EGFR T790M mutation testing in non-small cell lung cancer (NSCLC) in the UK. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30076-5] [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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Butler R, Shore S, Hilbmann A, Mazurek J, Justice C, Wald J, Atluri P, Goldberg L, Rame J, Birati E. Prognostic Significance of Red Cell Distribution Width in Patients with Left Ventricular Assist Devices. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.943] [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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Palackdharry S, Gillison M, Worden F, Old M, O'brien P, Dunlap N, Cohen E, Casper K, Mierzwa M, Morris J, Sadraei NH, Huth B, Takiar V, Butler R, Mark J, Patil Y, Wilson K, Janssen E, Conforti L, Yaniv B, Wise-Draper T. Neoadjuvant Pembrolizumab is Active in Surgically Resected Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.150] [Citation(s) in RCA: 1] [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: 11/25/2022]
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Grobmyer SR, Butler R, Neuschler EI, Stavros AT, Aitchison RD, Lavin PT, Tucker FL. Abstract P5-02-04: Opto-acoustic imaging of breast masses: Correlation with breast biopsy prognostic indicators. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-02-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The Imagio™ OA/US breast imaging system, a diagnostic opto-acoustic (OA) imaging device bearing the CE Mark, is in the U.S. FDA Premarket Approval process. OA/US provides both functional (relative oxygenation/de-oxygenation) and anatomic (angiogenesis) information that is co-registered and temporally interleaved in real time with gray-scale ultrasound that may improve discrimination between benign and malignant masses. We recently reported correlation studies demonstrating tumor-zone specific OA attributes in histopathologic grade I versus grade III malignancies. The relationship between OA attributes (individual feature scores or summed feature results) and pathologically-determined prognostic markers (PDPM) in malignant lesions is the subject of this report.
Materials and Methods: In this HIPAA-compliant, IRB-approved prospective multi-center trial across 16 U.S clinical sites; 1,808 masses in 1,739 subjects assessed as BI-RADS 3, 4 or 5 were imaged with OA/US. Of these, 655 were invasive malignancies and the subject of this analysis. Each mass was scored by 8 blinded readers on 3 internal zone features of the tumor nidus and 2 external features (0-5, 6) of the tumor boundary and peripheral zones (OA attributes). Pathologic diagnoses were confirmed by an experienced central breast pathologist blinded to the OA assessment. Tumor histologic classification and grading was performed in all subjects.Evaluation of tumor estrogen receptor (ER) and progesterone receptor (PR) were performed at each site by immunohistochemistry (IHC) and was reported as percent of tumor cells expressing the receptor or, as positive if greater than 1%. Tumor HER2-neu expression was reported by IHC as 0, 1+ (negative, not over-expressed), 2+ (indeterminate) and 3+ (over-expressed). All 2+ results reflexed to fluorescence in-situ hybridization (FISH) and reported as over-expressed or not over-expressed. Tumor Ki-67 expression was evaluated with IHC and reported as percent of tumor cells positive for the antigen.
Statistical analysis of categorical measures of PDPM is in process and will be performed using a two-way Analysis of Variance (ANOVA) and Tukey HSD (honest significant difference) test for pairwise comparisons. This ANOVA will be repeated for each PDPM to test which specific PDPM sub-categories are related to OA attributes. Correlation coefficients will be generated for PDPM that are continuous, not categorical. All statistical testing will be done at a 5% significance level.
Results: A total of 655 invasive and 22 DCIS were scored for internal (nidus) and external (boundary and periphery) OA attributes and compared with PSBC as defined by ER, PR, Her2 and Ki-67 expression. Of these, 108 were Luminal-A (LA), 153 Luminal-B (LB), 80 Triple-negative (TN), 23 Her2-enriched (HER2) and 314 unclassified (including 22 DCIS). OA attributes differentiated LA (99%CI 2.8,3.1) from TN (99%CI 3.1,3.4), p=0.027 and HER2 (99%CI 3.1,3.6), p=0.036. OA features strongly suggested LA vs. LB (99%CI 3.1,3.3) subtype, p=0.060. LB vs.TN(p=0.59) and HER2(p=0.41) were non-significant. TNBC vs. HER2 was p=0.62.
Citation Format: Grobmyer SR, Butler R, Neuschler EI, Stavros AT, Aitchison RD, Lavin PT, Tucker FL. Opto-acoustic imaging of breast masses: Correlation with breast biopsy prognostic indicators [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-02-04.
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Affiliation(s)
- SR Grobmyer
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - R Butler
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - EI Neuschler
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - AT Stavros
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - RD Aitchison
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - PT Lavin
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
| | - FL Tucker
- Cleveland Clinic, Cleveland, OH; Virginia Biomedical Laboratory, LLC, Wirtz, VA; Yale-New Haven Hospital/ Smilow Cancer Hospital, New Haven, CT; Northwestern Medicine/Prentice Hospital, Chicago, IL; Seno Medical Instruments, Inc., San Antonio, TX; Boston Biostatistics Research Foundation, Framingham, MA
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Subramaniam S, Cerone M, McBride D, Rehal P, Rettino A, Bell J, Roberts H, Macdonald M, Butler R, MacMahon S, Thompson L, Middleton C, Sharpe R, Walker I, Johnson P. Use of NGS for stratification of patients with advanced NSCLC within the NHS using FFPE-extracted DNA from diagnostic biopsies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.020] [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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15
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O'Connor P, Jankovic D, Muscat M, Ben-Mamou M, Reef S, Papania M, Singh S, Kaloumenos T, Butler R, Datta S. Measles and rubella elimination in the WHO Region for Europe: progress and challenges. Clin Microbiol Infect 2017; 23:504-510. [PMID: 28111293 PMCID: PMC6434680 DOI: 10.1016/j.cmi.2017.01.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/02/2017] [Accepted: 01/04/2017] [Indexed: 11/17/2022]
Abstract
Globally measles remains one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. The World Health Organization (WHO) European Region has seen a decline in measles and rubella cases in recent years. The recent outbreaks have primarily affected adolescents and young adults with no vaccination or an incomplete vaccination history. Eliminating measles and rubella is one of the top immunization priorities of the European Region as outlined in the European Vaccine Action Plan 2015-2020. Following the 2010 decision by the Member States in the Region to initiate the process of verifying elimination, the European Regional Verification Commission for Measles and Rubella Elimination (RVC) was established in 2011. The RVC meets every year to evaluate the status of measles and rubella elimination in the Region based on documentation submitted by each country's National Verification Committees. The verification process was however modified in late 2014 to assess the elimination status at the individual country level instead of at regional level. The WHO European Region has made substantial progress towards measles and rubella elimination over the past 5 years. The RVC's conclusion in 2016 that 70% and 66% of the 53 Member States in the Region had interrupted the endemic transmission of measles and rubella, respectively, by 2015 is a testament to this progress. Nevertheless, where measles and rubella remain endemic, challenges in vaccination service delivery and disease surveillance will need to be addressed through focused technical assistance from WHO and development partners.
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Affiliation(s)
- P O'Connor
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - D Jankovic
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - M Muscat
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - M Ben-Mamou
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - S Reef
- Centres for Disease Control and Prevention, Global Immunization Division, USA
| | - M Papania
- Centres for Disease Control and Prevention, Global Immunization Division, USA
| | - S Singh
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - T Kaloumenos
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - R Butler
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
| | - S Datta
- World Health Organization Regional Office for Europe, Vaccine-preventable Diseases and Immunization, Denmark
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16
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Williams A, Nelmes D, Roberts H, Butler R. 31: A new NHS diagnostic service to detect EGFR ctDNA mutations in non-small cell lung cancer patients. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30081-8] [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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17
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Lester J, Rees T, Parry D, Davies H, Rowe K, Everson R, Dickinson M, Butler R, Jewitt K. 29: The NHS Wales–Novartis joint working project on lung cancer. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30079-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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18
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Adams R, Brown E, Brown L, Butler R, Falk S, Fisher D, Kaplan R, Quirke P, Richman S, Samuel L, Seligmann J, Seymour M, Shiu K, Wasan H, Wilson R, Maughan T. FOCUS4-D: Results from a randomised, placebo controlled trial (RCT) of AZD8931 (an inhibitor of signalling by HER1, 2, and 3) in patients (pts) with advanced or metastatic colorectal cancer (aCRC) in tumours that are wildtype (wt) for BRAF, PIK3CA, KRAS & NRAS. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.57] [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: 11/14/2022] Open
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19
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Wise-Draper T, hashemi Sadraei N, Sendilnathan A, Pease N, Qualtieri J, Butler R, Casper K, Mierzwa M, Morris J, Patil Y, Wilson K, Mark J, Privette Vinnedge L. The DEK Oncogene Can Be Detected in the Plasma of Head and Neck Cancer Patients and May Be Correlated With Tumor Immune Response and Prognosis. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.267] [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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20
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Deeb A, Beck J, Schuetz E, Nwizu T, Romick-Rosendale L, Lucas F, Butler R, Wise-Draper T, Mirezwa M, Morris J, Casper K, Adelstein D, Grandis J, Bahassi E, Urnovitz H, hashemi Sadraei N. Genomic Instability in Larynx Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.263] [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: 10/22/2022]
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21
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Haralambos K, Whatley S, Edwards R, Gingell R, Townsend D, Holmans P, Clarke A, Datta D, Butler R, Palmer-Smith S, Wood M, McDowell I. GENETIC VARIANTS OF UNCERTAIN SIGNIFICANCE (VUS) IN FAMILIAL HYPERCHOLESTEROLAEMIA (FH) IN WALES: YEAR 2 UPDATE. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2015.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Nelmes D, Williams A, Button M, Lester J, Butler R, Chester J. 2 Detecting and monitoring somatic mutations in circulating cell free tumour DNA in patients with lung cancer. Lung Cancer 2016. [DOI: 10.1016/s0169-5002(16)30019-8] [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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23
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Muscat M, Shefer A, Ben Mamou M, Spataru R, Jankovic D, Deshevoy S, Butler R, Pfeifer D. Corrigendum to ‘The state of measles and rubella in the WHO European Region, 2013’ [Clin Microbiol Infect 20 (Suppl. 5) (2014), pp. 12–18]. Clin Microbiol Infect 2015. [DOI: 10.1016/j.cmi.2014.12.003] [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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24
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Trottier M, Lunn J, Butler R, Curling D, Turnquest T, Francis W, Halliday D, Royer R, Zhang S, Li S, Thompson I, Donenberg T, Hurley J, Akbari MR, Narod SA. Prevalence of founder mutations in the BRCA1 and BRCA2 genes among unaffected women from the Bahamas. Clin Genet 2015; 89:328-31. [PMID: 25920394 DOI: 10.1111/cge.12602] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 03/16/2015] [Revised: 04/16/2015] [Accepted: 04/23/2015] [Indexed: 01/17/2023]
Abstract
Population-based testing for BRCA1/2 mutations detects a high proportion of carriers not identified by cancer family history-based testing. We sought to determine whether population-based testing is an effective approach to genetic testing in the Bahamas, where 23% of women with breast cancer carry one of seven founder mutations in the BRCA1 or BRCA2 gene. We determined the prevalence of founder BRCA mutations in 1847 Bahamian women without a personal history of breast or ovarian cancer, unselected for age or family history. We found that 2.8% (20/705) of unaffected women with a family history of breast/ovarian cancer and 0.09% (1/1089) of unaffected women without a family history carry a BRCA mutation. A total of 38% of unaffected women with a known mutation in the family were found to carry the familial mutation. We previously suggested that all Bahamian women with breast or ovarian cancer be offered genetic testing. These current data suggest that additionally all unaffected Bahamian women with a family history of breast/ovarian cancer should be offered genetic testing for the founder BRCA mutations.
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Affiliation(s)
- M Trottier
- Bahamas Breast Cancer Initiative Foundation, Nassau, Bahamas
| | - J Lunn
- Department of Hematology and Oncology, Doctors Hospital, Nassau, Bahamas
| | - R Butler
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas.,Department of Obstetrics and Gynecology, Princess Margaret Hospital, Nassau, Bahamas
| | - D Curling
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas
| | - T Turnquest
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas
| | - W Francis
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas
| | - D Halliday
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas.,Department of Obstetrics and Gynecology, Princess Margaret Hospital, Nassau, Bahamas
| | - R Royer
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - S Zhang
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - S Li
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - I Thompson
- Bahamas Breast Cancer Initiative Foundation, Nassau, Bahamas
| | - T Donenberg
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - J Hurley
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - M R Akbari
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - S A Narod
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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25
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Davies R, Bowden C, Nelmes D, Butler R, Lester J. 73: Oligo-recurrence on tyrosine kinase inhibitors: is radiotherapy an option? Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50072-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: 10/24/2022]
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26
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Davies R, Nelmes D, Butler R, Lester J. 9: EGFR mutations: are exon 19 deletions and L858R different in the real world setting? Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50009-3] [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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27
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Davies R, Smith C, Butler R, Parry D, Lester J. 70: Molecular analysis in advanced NSCLC are we doing the best we can? Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50069-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: 10/24/2022]
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28
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Muscat M, Shefer A, Ben Mamou M, Spataru R, Jankovic D, Deshevoy S, Butler R, Pfeifer D. The state of measles and rubella in the WHO European Region, 2013. Clin Microbiol Infect 2014; 20 Suppl 5:12-8. [PMID: 24520948 DOI: 10.1111/1469-0691.12584] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Measles and rubella persist in the World Health Organization European Region despite long-standing and widespread use of vaccines against them. Our aim was to review the epidemiology of measles and rubella in relation to the goal of eliminating these diseases from the Region by 2015. We report on the number of measles and rubella cases by country in 2012 and present an analysis of preliminary measles and rubella surveillance data for 2013. We analysed data of these diseases for 2013 by age group, diagnosis confirmation (clinical, laboratory-confirmed and epidemiologically linked), and vaccination, hospitalization and importation status. We also report on measles-related deaths. For 2012, there were 26,785 [corrected] measles cases and 29,601 rubella cases reported in the Region. For 2013, these figures were 31,520 and 39,367 respectively. Most measles cases in 2013 (96%; n = 30,178) were reported by nine countries: Georgia (7830), Germany (1773), Italy (2216), the Netherlands (2499), Romania (1074), the Russian Federation (2174), Turkey (7404), Ukraine (3308) and the United Kingdom (1900). In 2013, most measles cases were among unvaccinated persons and over one in three patients were aged 20 years and older. For 2013, almost all rubella cases were reported by Poland (n = 38,585; 98%). High population immunity and high-quality surveillance are the cornerstones to eliminate measles and rubella. Without sustained political commitment and accelerated action by Member States and partners, the elimination of measles and rubella in the WHO European Region may not be achieved.
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Affiliation(s)
- M Muscat
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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29
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Weller JM, Henning M, Butler R, Thompson A. The Impact of the Australian and New Zealand College of Anaesthetists’ Specialist Examinations on Trainee Learning and Wellbeing: A Qualitative Study. Anaesth Intensive Care 2014; 42:736-44. [DOI: 10.1177/0310057x1404200609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Assessment is an essential component of any medical specialist training program and should motivate trainees to acquire and retain the knowledge and skills essential for specialist practice, and to develop effective approaches to learning, essential for continuous professional development. Ideally, this should be achieved without creating an unreasonable burden of assessment. In this qualitative study we sought to investigate the underlying processes involved in trainees’ preparation for Australian and New Zealand College of Anaesthetists’ examinations, focusing on how the examinations helped trainees to learn the Australian and New Zealand College of Anaesthetists’ curriculum, and to identify any potential areas for improvement. We also explored the effect the examinations had on trainees’ lives, to identify if the examinations were a potential threat to their wellbeing. Using a phenomenological approach and purposive sampling, we conducted semi-structured interviews with post-fellowship trainees (n=20) selected from three different regions, with sampling continuing to achieve data saturation. We undertook a thematic analysis of the transcribed interview data utilising a general inductive approach. Our preliminary data suggest that, while the examinations are an important extrinsic motivator to learn and important for professional development, interviewees described many test-driven learning strategies, including rote learning and memorising past examination questions. A strong theme was the considerable impact on participants’ relationships and social activities for prolonged periods. Our findings support further research in this area and, in particular, into alternative testing strategies that might increase the proportion of time spent in useful study while decreasing less useful study time.
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Affiliation(s)
- J. M. Weller
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Medical and Health Sciences Education, University of Auckland and Specialist Anaesthetist, Auckland City Hospital. Auckland, New Zealand
| | - M. Henning
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - R. Butler
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Academic Consulting Ltd, Ground Floor, 17 Great South Road, Newmarket, Auckland, New Zealand
| | - A. Thompson
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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30
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31
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Trottier M, Lunn J, Butler R, Curling D, Turnquest T, Royer R, Akbari MR, Donenberg T, Hurley J, Narod SA. Strategies for recruitment of relatives of BRCA mutation carriers to a genetic testing program in the Bahamas. Clin Genet 2014; 88:182-6. [PMID: 25060751 DOI: 10.1111/cge.12468] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/15/2014] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
Abstract
The prevalence of BRCA1 and BRCA2 mutations among unselected breast cancer patients in the Bahamas is 23%. It is beneficial to advise relatives of mutation carriers that they are candidates for genetic testing. Women who test positive are then eligible for preventive interventions, such as oophorectomy. It is not clear how often relatives of women with a mutation in the Bahamas wish to undergo genetic testing for the family mutation. Furthermore, it is not clear how best to communicate this sensitive information to relatives in order to maximize patient compliance. We offered genetic testing to 202 first-degree relatives of 58 mutation carriers. Of 159 women who were contacted by the proband or other family member, only 14 made an appointment for genetic testing (9%). In contrast, among 32 relatives who were contacted directly by the genetic counselor, 27 came for an appointment (84%). This study suggests that for recruitment of relatives in the Bahamas, direct contact by counselor is preferable to using the proband as an intermediary.
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Affiliation(s)
- M Trottier
- Bahamas Breast Cancer Initiative Foundation, Nassau, Bahamas
| | - J Lunn
- Department of Hematology and Oncology, Doctors Hospital, Nassau, Bahamas
| | - R Butler
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas.,Department of Obstetrics and Gynecology, Princess Margaret Hospital, Nassau, Bahamas
| | - D Curling
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas
| | - T Turnquest
- Department of Oncology, Princess Margaret Hospital, Nassau, Bahamas
| | - R Royer
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - M R Akbari
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - T Donenberg
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - J Hurley
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - S A Narod
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Peyretaillade E, Boucher D, Parisot N, Gasc C, Butler R, Pombert JF, Lerat E, Peyret P. Exploiting the architecture and the features of the microsporidian genomes to investigate diversity and impact of these parasites on ecosystems. Heredity (Edinb) 2014; 114:441-9. [PMID: 25182222 DOI: 10.1038/hdy.2014.78] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 07/16/2014] [Accepted: 07/21/2014] [Indexed: 12/16/2022] Open
Abstract
Fungal species play extremely important roles in ecosystems. Clustered at the base of the fungal kingdom are Microsporidia, a group of obligate intracellular eukaryotes infecting multiple animal lineages. Because of their large host spectrum and their implications in host population regulation, they influence food webs, and accordingly, ecosystem structure and function. Unfortunately, their ecological role is not well understood. Present also as highly resistant spores in the environment, their characterisation requires special attention. Different techniques based on direct isolation and/or molecular approaches can be considered to elucidate their role in the ecosystems, but integrating environmental and genomic data (for example, genome architecture, core genome, transcriptional and translational signals) is crucial to better understand the diversity and adaptive capacities of Microsporidia. Here, we review the current status of Microsporidia in trophic networks; the various genomics tools that could be used to ensure identification and evaluate diversity and abundance of these organisms; and how these tools could be used to explore the microsporidian life cycle in different environments. Our understanding of the evolution of these widespread parasites is currently impaired by limited sampling, and we have no doubt witnessed but a small subset of their diversity.
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Affiliation(s)
- E Peyretaillade
- Genomics, Clermont Université, Université d'Auvergne, EA 4678 CIDAM, Clermont-Ferrand, France
| | - D Boucher
- Genomics, Clermont Université, Université d'Auvergne, EA 4678 CIDAM, Clermont-Ferrand, France
| | - N Parisot
- 1] Genomics, Clermont Université, Université d'Auvergne, EA 4678 CIDAM, Clermont-Ferrand, France [2] CNRS, UMR 6023, LMGE, Aubière, France
| | - C Gasc
- Genomics, Clermont Université, Université d'Auvergne, EA 4678 CIDAM, Clermont-Ferrand, France
| | - R Butler
- Illinois Institute of Technology, BCHS Biology Division, Chicago, IL, USA
| | - J-F Pombert
- Illinois Institute of Technology, BCHS Biology Division, Chicago, IL, USA
| | - E Lerat
- Université de Lyon, Lyon, Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Villeurbanne, France
| | - P Peyret
- Genomics, Clermont Université, Université d'Auvergne, EA 4678 CIDAM, Clermont-Ferrand, France
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Walsh K, Wallace WA, Butler R, Mackean MJ, Harrison DJ, Stirling D, Oniscu A. A cautionary lesson on the use of targeted methods for EGFR mutation analysis: a case report. J Clin Pathol 2014; 67:734-5. [PMID: 24811487 DOI: 10.1136/jclinpath-2014-202313] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Epidermal growth factor receptor (EGFR) mutation analysis is recommended for lung cancer patients prior to the prescription of first-line EGFR tyrosine kinase inhibitors in order to predict response to treatment. There are many methods available to identify mutations in the EGFR gene; a large number of clinical laboratories use the therascreen EGFR RGQ PCR kit (Qiagen). We report a case where this kit detected an exon 19 deletion, predicting sensitivity to tyrosine kinase inhibitors (TKIs), which on further analysis was found to be a 2 bp indel (c.2239_2240delinsCC, p.(Leu747Pro)). Two of four published cases with this mutation were found to be associated with resistance to EGFR TKI. The sample was also tested using two other commercial kits, one of which indicated a deletion. This is a rare mutation making the erroneous detection of a deletion unlikely; however, it is important that clinical laboratories are aware of the potential failings of two commercial kits for EGFR mutation analysis.
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Affiliation(s)
- K Walsh
- Department of Molecular Pathology, NHS Lothian, Edinburgh, UK
| | - W A Wallace
- Department of Pathology, NHS Lothian, Edinburgh, UK
| | - R Butler
- Department of Molecular Genetics, Institute of Medical Genetics, Cardiff, UK
| | - M J Mackean
- Department of Clinical Oncology, NHS Lothian, Edinburgh, UK
| | - D J Harrison
- Department of Pathology, NHS Lothian, Edinburgh, UK
| | - D Stirling
- Department of Haematology, NHS Lothan, Edinburgh, UK
| | - A Oniscu
- Department of Molecular Pathology, NHS Lothian, Edinburgh, UK
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Maughan TS, Meade AM, Adams RA, Richman SD, Butler R, Fisher D, Wilson RH, Jasani B, Taylor GR, Williams GT, Sampson JR, Seymour MT, Nichols LL, Kenny SL, Nelson A, Sampson CM, Hodgkinson E, Bridgewater JA, Furniss DL, Roy R, Pope MJ, Pope JK, Parmar M, Quirke P, Kaplan R. A feasibility study testing four hypotheses with phase II outcomes in advanced colorectal cancer (MRC FOCUS3): a model for randomised controlled trials in the era of personalised medicine? Br J Cancer 2014; 110:2178-86. [PMID: 24743706 PMCID: PMC4007241 DOI: 10.1038/bjc.2014.182] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [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] [Received: 11/21/2013] [Revised: 02/27/2014] [Accepted: 03/13/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Molecular characteristics of cancer vary between individuals. In future, most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The MRC FOCUS3 trial is a feasibility study to assess key elements in the planning of such studies. PATIENTS AND METHODS Patients with advanced colorectal cancer were registered from 24 centres between February 2010 and April 2011. With their consent, patients' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase 1 (topo-1) immunohistochemistry. Patients were then classified into one of four molecular strata; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm (FOLFIRI chemotherapy). A 4-stage suite of patient information sheets (PISs) was developed to avoid patient overload. RESULTS A total of 332 patients were registered, 244 randomised. Among randomised patients, biomarker results were provided within 10 working days (w.d.) in 71%, 15 w.d. in 91% and 20 w.d. in 99%. DNA mutation analysis was 100% concordant between two laboratories. Over 90% of participants reported excellent understanding of all aspects of the trial. In this randomised phase II setting, omission of irinotecan in the low topo-1 group was associated with increased response rate and addition of cetuximab in the KRAS, BRAF wild-type cohort was associated with longer progression-free survival. CONCLUSIONS Patient samples can be collected and analysed within workable time frames and with reproducible mutation results. Complex multi-arm designs are acceptable to patients with good PIS. Randomisation within each cohort provides outcome data that can inform clinical practice.
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Affiliation(s)
- T S Maughan
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - A M Meade
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - R A Adams
- Cardiff University and Velindre Cancer Centre, Cardiff, UK
| | - S D Richman
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - R Butler
- University Hospital of Wales, Cardiff CF14 4XW, UK
| | - D Fisher
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - R H Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast BT9 7AE, UK
| | - B Jasani
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - G R Taylor
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - G T Williams
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - J R Sampson
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - M T Seymour
- St James's Institute of Oncology, University of Leeds, Leeds LS9 7TF, UK
| | - L L Nichols
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - S L Kenny
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - A Nelson
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - C M Sampson
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - E Hodgkinson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK
| | | | - D L Furniss
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK
| | - R Roy
- Department of Oncology, Castle Hill Hospital, East Riding of Yorkshire HU16 5JQ, UK
| | - M J Pope
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - J K Pope
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - M Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - P Quirke
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - R Kaplan
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
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Bolton-Maggs P, Butler R, Mountford R, Gailani D. Eleven novel mutations in non-Jewish factor XI deficient kindreds detected by SSCP with heteroduplex analysis followed by sequencing. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2003.tb05452.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sullivan L, Sekeres M, Shrestha N, Maciejewski J, Tiu R, Butler R, Mossad S. Epidemiology and risk factors for infections in myelodysplastic syndromes. Transpl Infect Dis 2013; 15:652-7. [DOI: 10.1111/tid.12130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/09/2013] [Accepted: 03/12/2013] [Indexed: 12/22/2022]
Affiliation(s)
- L.R. Sullivan
- Department of Infectious Disease; Medicine Institute; Cleveland Clinic; Cleveland Ohio USA
| | - M.A. Sekeres
- Leukemia Program; Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute; Cleveland Clinic; Cleveland Ohio USA
| | - N.K. Shrestha
- Department of Infectious Disease; Medicine Institute; Cleveland Clinic; Cleveland Ohio USA
| | - J.P. Maciejewski
- Leukemia Program; Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute; Cleveland Clinic; Cleveland Ohio USA
| | - R.V. Tiu
- Leukemia Program; Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute; Cleveland Clinic; Cleveland Ohio USA
| | - R. Butler
- Department of Quantitative Health Sciences; Cleveland Clinic; Cleveland Ohio USA
| | - S.B. Mossad
- Department of Infectious Disease; Medicine Institute; Cleveland Clinic; Cleveland Ohio USA
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Muscat M, Jankovic D, Goel A, Butler R, Pfeifer D. [Progress in the elimination of measles and rubella in the WHO European Region]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:1225-30. [PMID: 23990083 DOI: 10.1007/s00103-013-1797-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Substantial progress has been made in the World Health Organization (WHO) European Region toward reaching the goal of measles and rubella elimination. We analyzed the surveillance data of 2012 on measles and rubella for age-group, diagnosis confirmation status (clinical, laboratory-confirmed and epidemiologically linked), vaccination status, and measles-related deaths. For 2012, there were 23,871 measles cases and 29,361 rubella cases reported in the region, mostly among unvaccinated persons. Almost one in three patients with measles and one in five patients with rubella were aged 20 years and older. In a few countries, widespread outbreaks or indigenous transmission of measles persisted in 2012. While most countries in the region have controlled rubella, a small number still reported a high incidence and several outbreaks. Therefore, more efforts are required to achieve the goal of eliminating measles and rubella in the WHO European Region by 2015, particularly in high-incidence countries. The WHO measles and rubella elimination plan stipulates that all countries should achieve and maintain the required high vaccination coverage while conducting high-quality surveillance.
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Affiliation(s)
- M Muscat
- WHO Regional Office for Europe, UN City, Marmorvej 51, 2100, Copenhagen Ø, Dänemark.
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Ingram JR, Wood M, John B, Butler R, Anstey AV. Absence of pathogenic γ-secretase mutations in a South Wales cohort of familial and sporadic hidradenitis suppurativa (acne inversa). Br J Dermatol 2013; 168:874-6. [PMID: 23013355 DOI: 10.1111/bjd.12048] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mielcarek M, Landles C, Weiss A, Bradaia A, Seredenina T, Inuabasi L, Wadel K, Touller C, Butler R, Robertson J, Franklin SA, Smith DL, Park L, Marks PA, Wanker EE, Olson EN, Luthi-Carter R, van der Putten H, Beaumont V, Bates GP. A12 HDAC4 interacts with huntington and HDAC4 reduction decreases cytoplamsic aggregation and rescues synaptic dysfunction in HD mouse models. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alwan S, Yee IM, Dybalski M, Guimond C, Dwosh E, Greenwood TM, Butler R, Sadovnick AD. Reproductive decision making after the diagnosis of multiple sclerosis (MS). Mult Scler 2012; 19:351-8. [PMID: 22760102 DOI: 10.1177/1352458512452920] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to determine reproductive practices and attitudes of North Americans diagnosed with multiple sclerosis (MS) and the reasons for their reproductive decision making. METHODS A self-administered questionnaire on reproductive practices was mailed to 13,312 registrants of the North American Research Committee on Multiple Sclerosis (NARCOMS) database who met inclusion criteria for the study. Completed questionnaires were then returned to the authors in an anonymous format for analysis. RESULTS Among 5949 participants, the majority of respondents (79.1%) did not become pregnant following diagnosis of MS. Of these, 34.5% cited MS-related reasons for this decision. The most common MS-related reasons were symptoms interfering with parenting (71.2%), followed by concerns of burdening partner (50.7%) and of children inheriting MS (34.7%). The most common reason unrelated to MS for not having children was that they already have a "completed family" (55.6%). Of the 20.9% of participants who decided to become pregnant (or father a pregnancy) following a diagnosis of MS, 49.5% had two or more pregnancies. CONCLUSION This study indicates that an MS diagnosis does not completely deter the consideration of childbearing in MS patients of both genders.
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Affiliation(s)
- S Alwan
- Faculty of Medicine, Division of Neurology, University of British Columbia, Canada
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Staggs J, Crewe R, Butler R. A theoretical and experimental investigation of intumescent behaviour in protective coatings for structural steel. Chem Eng Sci 2012. [DOI: 10.1016/j.ces.2011.12.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [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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Lukenbill J, Mossad S, Butler R, Sobecks R, Andresen S, Copelan E, Dean R, Duong H, Kalaycio M, Hill B, Pohlman B, Sweetenham J, Bolwell B. Immunogenicity of Polysaccharide Pneumococcal Vaccination in Autologous Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.099] [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: 10/14/2022]
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Kiesel K, Plisky P, Butler R. Functional movement test scores improve following a standardized off-season intervention program in professional football players. Scand J Med Sci Sports 2011; 21:287-92. [PMID: 20030782 DOI: 10.1111/j.1600-0838.2009.01038.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to determine if an off-season intervention program was effective in improving Functional Movement Screen(™) (FMS) scores in professional American football players. Pre- and post-intervention FMS scores were obtained on 62 subjects who completed a 7-week off-season intervention program. A repeated measures ANOVA was conducted to determine the effectiveness of the training program on FMS scores. A chi-square was performed to determine if there were a greater number of players who met the injury threshold and if asymmetries were reduced following intervention. Logistic regression was used to predict what factors were associated with failure (post-test score of <14). There was a positive main effect for time (P<0.01) and a greater number of individuals with a score >14 following the intervention. At post-test, 41 players were free of asymmetry as compared with 31 at the pre-test. The strongest predictor of program failure was a low squat score at pre-test. This study demonstrated that fundamental movement characteristics do change with a standardized intervention. Further research is required to determine if injury risk is reduced when a player's score improves beyond the established cut-off of 14 and/or asymmetry is resolved.
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Affiliation(s)
- K Kiesel
- Department of Physical Therapy, University of Evansville, Evansville, Indiana 47722, USA.
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Maughan T, Wilson RH, Williams GT, Seymour MT, Richman S, Quirke P, Pope M, Pope J, Parmar M, Nelson A, Meade AM, Kenny SL, Jasani B, Hodgkinson E, Fisher D, Butler R, Bridgewater JA, Adams RA, Kaplan RS. Developing a biomarker-stratified trial design in advanced colorectal cancer: The MRC FOCUS 3 feasibility study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps165] [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: 11/20/2022] Open
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Currie S, Butler R, Tanguay J, Button M, Brewster A, Stevens R, Lester J. 37 Experiences in epidermal growth factor receptor tyrosine kinase mutation testing in South East Wales. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70037-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: 10/18/2022]
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Butler R, Clark C, Deans Z, Durkie M, Gonzalez D, Taniere P, Wallace A. 35 The first 12 months of UK diagnostic services for EGFR gene mutations in NSCLC patients. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70035-6] [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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Butler R, Williams A, Walker G, Marsh N. 36 Twelve months' experience of EGFR mutation testing in the UK. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70036-8] [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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Sargeant LA, Simmons RK, Barling RS, Butler R, Williams KM, Prevost AT, Kinmonth AL, Wareham NJ, Griffin SJ. Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study. Diabet Med 2010; 27:995-1003. [PMID: 20722672 PMCID: PMC3428846 DOI: 10.1111/j.1464-5491.2010.03056.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS One of the factors influencing the cost-effectiveness of population screening for Type 2 diabetes may be uptake. We examined attendance and practice- and individual-level factors influencing uptake at each stage of a diabetes screening programme in general practice. METHODS A stepwise screening programme was undertaken among 135, 825 people aged 40-69 years without known diabetes in 49 general practices in East England. The programme included a score based on routinely available data (age, sex, body mass index and prescribed medication) to identify those at high risk, who were offered random capillary blood glucose (RBG) and glycosylated haemoglobin tests. Those screening positive were offered fasting capillary blood glucose (FBG) and confirmatory oral glucose tolerance tests (OGTT). RESULTS There were 33 539 high-risk individuals invited for a RBG screening test; 24 654 (74%) attended. Ninety-four per cent attended the follow-up FBG test and 82% the diagnostic OGTT. Seventy per cent of individuals completed the screening programme. Practices with higher general practitioner staff complements and those located in more deprived areas had lower uptake for RBG and FBG tests. Male sex and a higher body mass index were associated with lower attendance for RBG testing. Older age, prescription of antihypertensive medication and a higher risk score were associated with higher attendance for FBG and RBG tests. CONCLUSIONS High attendance rates can be achieved by targeted stepwise screening of individuals assessed as high risk by data routinely available in general practice. Different strategies may be required to increase initial attendance, ensure completion of the screening programme, and reduce the risk that screening increases health inequalities.
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Seiber C, Bawa S, Ritchie D, Mukherjee S, Ostridge K, Spinks K, Wong E, Edwards M, Ledingham J, Wijesooriya CS, Bharadwaj AN, Anilkumar A, Gendi NS, Evans SJ, Bevan M, Adams KR, Hunter R, Craddock L, Ali C, Ng N, Colaco R, Ali E, Colaco CB, Rao VK, Butler R, Matschke V, Jones JG, Lemmey AB, Maddison PJ, Thom JM, Haroon M, Eltahir A, Harney S, Moorthy A, Tripathi M, Hirsch G, Pace A, Yau WH, Cohen H, McCabe C, Mo N, O'Sullivan M, Williams E, Ledingham J, Gwynne C, Hale S, Negi A, Humphreys E, Nash J, Malipeddi AS, Neame R, Bharadwaj A, Gendi N, Abdulla A, Ginawi A, Malaviya AP, Dasgupta B, Das S, Tan AL, Miles S, Hordon L, Sivaramakrishhan N. Case Reports [3-24]: 3. An Unusal Case of Focal Myositis. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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