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Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma

World Journal of Gastrointestinal Oncology 2014年第5期6卷 139-144页

作者： Omar S Al-Taan Amar Eltweri David Sharpe Peter M Rodgers Sukhbir S Ubhi David J Bowrey Departments of Surgery University Hospitals of Leicester Departments of Radiology University Hospitals of Leicester

AIM: To evaluate the influence of baseline maximum standardized uptake value(SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography(PET-CT) scan for esophageal carcinoma. METHODS: The pre-treatment SUVmax numeric reading was determined in patients with confirmed esophageal or junctional cancer having PET-CT scan during the time period 1st January 2007 until 31 st July 2012. A minimum follow up of 12 mo was required. Patients were subdivided into quartiles according to SUVmax value and the influence of SUVmax on survival was assessed using univariate and multivariate analysis. The following pre-treatment factors were investigated: patient characteristics, tumor characteristics and planned treatment. RESULTS: The study population was 271 patients(191male) with esophageal or junctional carcinoma. The median age was 65 years(range 40-85) and histologic subtype was adenocarcinoma in 197 patients and squamous carcinoma in 74 patients. The treatment intent was radical in 182 and palliative in 89 patients. SUVmax was linked to histologic subtype(P = 0.008), tumor site(P = 0.01) and Union for International Cancer Control(UICC) stage(P < 0.001). On univariate analysis, prognosis was significantly associated with SUVmax(P = 0.001), T-stage(P < 0.001) and UICC stage(P < 0.001). On multivariate analysis, only T-stage and UICC stage remained significant. CONCLUSION: Pretreatment SUVmax was not a useful marker in isolation for determining prognosis of patients with esophageal carcinoma.

关键词： Esophageal neoplasms Fluorodeoxyglucose F18 Positron emission tomography Positron emission tomography-computed tomography Prognosis

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Should pyridoxine be given to breastfed infants whose mothers are on isoniazid?

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Asian Pacific Journal of Tropical Medicine 2019年第10期12卷 435-437页

作者： Khuen Foong Ng Srini Bandi leicester Royal Infirmary University Hospitals of Leicester NHS TrustLeicesterUK

A mother was recently started on isoniazid and rifampicin for latent tuberculosis *** was breastfeeding her 1-monthold *** was no indication to treat the child with antituberculous *** isoniazid can be present in breast milk,question was raised whether the baby should receive pyridoxine supplementation to prevent peripheral neuropathy or *** were variable views in the management approach due to uncertainties of evidence in this topic.

关键词： isoniazid pyridoxine latent

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When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer？

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Asian Journal of Andrology 2008年第6期10卷 890-895页

作者： Raj P. Pal Thivyaan Thiruudaian Masood A. Khan Department of Urology University Hospitals of Leicester NHS Trust Leicester General Hospital Leicester LE5 4WP UK

Aims： To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. Methods： Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen （PSA） cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. Results： Only 1/61 men （1.6%） with a serum PSA 〈 20 ng/mL had a positive bone scan. However, 2/38 men （4.7%） with a serum PSA 20.1-40.0 ng/mL, 3/20 men （15%） with a serum PSA 40.1-60.0 ng/mL, 7/19 men （36.8%） with a serum PSA 60.1-100.0 ng/mL and 19/38 men （50%） with a serum PSA 〉 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. Conclusion： Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA 〈 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.

关键词： prostate cancer bone scan asymptomatic prostate-specific antigen

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Duration of treatment with 5-aminosalicylic acid compounds

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World Journal of Gastroenterology 2007年第32期13卷 4310-4315页

作者： T Moshkovska JF Mayberry leicester General Hospital University Hospitals of Leicester NHS TrustGwendolen RoadLeicester LE5 4PWUnited Kingdom

The development of 5-aminosalicylic acid (5-ASA) therapy as a life long treatment for ulcerative colitis is reviewed from its origins in the 1940s to the present day. The drug was designed to treat rheumatoid arthritis,but was found helpful in the management of nine patients with ulcerative colitis. This discovery preceded the emergence of the clinical trial as a tool for assessing a new drug's efficacy; as a result it lacked scientific rigour and was selective in its presentation of results. Nevertheless it identified the future cornerstone of therapy in ulcerative colitis. In 1962,the first double blind controlled trial of sulphasalazine was conducted on 40 patients. Outcome measures were subjective and included symptoms and an assessment of the rectal mucosa. In 1973,the first two papers on the role of sulphasalazine in maintenance of remission were published. Both used placebo controls and had a stratified design. Outcomes were measured using "an intention to treat" approach. The British study of 64 patients used both subjective and objective criteria to assess outcomes. Patients on placebo had a relapse rate four times patients on active treatment and this founded the basis for a life long approach to therapy with 5-ASA compounds in ulcerative colitis. However,in 1985,a small "on demand" study of 32 patients suggested this approach might be as effective as continuous treatment. Some support for this view came from an Italian study which showed no benefit to continued treatment for those in remission for two years or more. The central problem these studies identify is that of adherence to treatment in the long-term. Few studies have considered patients' attitudes to continuous therapy and it is an area that needs further investigation.

关键词： Ulcerative colitis 5-aminosalicylic acid compounds Sulphasalazine mesalazine adherance trials

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Communication after cancellations in orthopaedics: The patient perspective

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World Journal of Orthopedics 2014年第1期5卷 45-50页

作者： Saurabh S Mehta David J Bryson Jitendra Mangwani Lucy Cutler Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester General Hospital Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester Royal Infirmary

AIM: To examine patients' perceptions on communication surrounding the cancellation of orthopaedic operations and to identify areas for improvement in ***: A prospective survey was undertaken at a university teaching hospital within the department of Trauma and Orthopaedics. Patients admitted to an acute orthopaedic unit, whose operations were cancelled, were surveyed to assess patient satisfaction and preferences for notification of cancellation of their operations. Patients with an abbreviated mental test score of < 9, patients unable to complete the survey independently, those under 16 years of age, and any patient notified of the cancellation by any of the authors were excluded from this study. Patients were surveyed themorning after their operation had been cancelled thus ensuring that every opportunity was given for the medical staff to discuss the cancellation with the patient. The survey included questions on whether or not patients were notified of the cancellation of their surgery, the qualifications of the person discussing the cancellation, and patient preferences on the process. Satisfaction was assessed via 5-point Likert scale ***: Sixty-five consecutive patients had their operations cancelled on 75 occasions. Fifty-four point seven percent of the patients who had cancellations were notified by a nurse and 32% by a doctor. No formal communication occurred for 13.3% cancellations and no explanation was provided for a further 16%. Patients reported that they were dissatisfied with the explanation provided for 36 of the 75(48%) cancellations. Of those patients who were dissatisfied, 25(69.4%) were notified by a nurse. Twenty-three of the 24(96%) patients notified by a doctor were satisfied with the explanation and that communication. Of those patients who were notified by a nurse 83% patients reported that they would have preferred it if a doctor had discussed the cancellation with them. There was a significant difference

关键词： Communication Patient satisfaction Orthopaedic surgery Cancellation

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Chondroitinase ABC combined with Schwann cell transplantation enhances restoration of neural connection and functional recovery following acute and chronic spinal cord injury

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Neural Regeneration Research 2025年第5期20卷 1467-1482页

作者： Wenrui Qu Xiangbing Wu Wei Wu Ying Wang Yan Sun Lingxiao Deng Melissa Walker Chen Chen Heqiao Dai Qi Han Ying Ding Yongzhi Xia George Smith Rui Li Nai-Kui Liu Xiao-Ming Xu Spinal Cord and Brain Injury Research Group Stark Neurosciences Research InstituteDepartment of Neurological SurgeryIndiana University School of MedicineIndianapolisINUSA Department of Hand Surgery the Second Hospital of Jilin UniversityChangchunJilin ProvinceChina Shriners hospitals Pediatric Research Center Temple University School of MedicinePhiladelphiaPAUSA Department of Anatomy&Cell Biology Indiana University School of MedicineIndianapolisINUSA

Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal *** we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord *** report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal *** Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder ***,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord *** findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.

关键词： axonal regrowth bladder function chondroitinase ABC functional recovery glial scar lentivirus migration Schwann cell spinal cord injury transplantation

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Pioneering the future of robotic liver surgery

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 721-723页

作者： Mohamed Elshaer Department of Hepatobiliary and Pancreatic Surgery University Hospitals of LeicesterGlenfieldUK

Hepatocellular carcinoma(HCC)is the sixth most commonly diagnosed cancer worldwide and represents the predominant form of primary liver cancer,accounting for approximately 90%of cases(1).Predictions indicate a significant rise in the incidence of liver cancer over the next two *** emphasises the urgent imperative for cutting-edge research to enhance patient outcomes and optimise surgical resection strategies for HCC(2).

关键词： Robotic surgery liver resections cost effectiveness

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Registry report on prediction by Pocock cardiovascular score of cerebral microemboli acutely following carotid endarterectomy

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Stroke & Vascular Neurology 2018年第3期3卷 147-152页

作者： Mahmud Saedon Athanasios Saratzis Rachel W S Lee Charles E Hutchinson Christopher H E Imray Donald R J Singer Nottingham university hospitals NHS Trust NottinghamUK university hospitals Coventry and Warwickshire NHS Trust CoventryUK leicester Royal Infirmary LeicesterUK Yale School of Medicine New HavenConnecticutUSA Fellowship of Postgraduate Medicine LondonUK

background Cerebral microemboli may lead to ischaemic neurological complications after carotid endarterectomy(CEA).The association between classical cardiovascular risk factors and acute cerebral microemboli following carotid surgery has not been *** aim of this study was to explore whether an established cardiovascular risk score(Pocock score)predicts the presence of cerebral microemboli acutely after *** and methods Pocock scores were assessed for the 670 patients from the Carotid Surgery Registry(age 71±1(SEM)years,474(71%)male,652(97%)Caucasian)managed from January 2002 to December 2012 in the Regional Vascular Centre at university hospitals Coventry and Warwickshire NHS Trust,which serves a population of *** was undertaken in 474(71%)patients for symptomatic carotid stenosis and in 196(25%)asymptomatic patients during the same period.74% of patients were hypertensive,71%were smokers and 49% had *** A high Pocock score(≥2.3%)was significantly associated with evidence of cerebral microemboli acutely following CEA(P=0.039,Mann-Whitney(MW)test).A Pocock score(≥2.3%)did not predict patients who required additional antiplatelet therapy(microemboli signal(MES)rate>50 hour-1:P=0.164,MW test).Receiver operating characteristic analysis also showed that the Pocock score predicts acute postoperative microemboli(area under the curve(AUC)0.546,95%CI 0.502 to 0.590,P=0.039)but not a high rate of postoperative microemboli(MES>50 hour−1:AUC 0.546,95% CI 0.482 to 0.610,P=0.164).A Pocock score≥2.3% showed a sensitivity of 74% for the presence of acute postoperative cerebral microemboli.A Pocock score≥2.3% also showed a sensitivity of 77% and a negative predictive value of 90% for patients who developed a high microembolic rate>50 hour−1 after carotid *** These findings demonstrate that the Pocock score could be used as a clinical tool to identify patients at high risk of developing acute postoperative microemboli.

关键词： cerebral Surgery Registry

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Vitreous haemorrhage as the first presentation of undiagnosed Waldenstrom macroglobulinemia

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International Journal of Ophthalmology(English edition) 2021年第10期14卷 1639-1641页

作者： Christina S Lim Huzaifa Malick Somnath Banerjee Department of Ophthalmology University Hospitals of Leicester NHS TrustInfirmary SquareLeicester LE15WWUnited Kingdom

Dear Editor, Waldenstrom macroglobulinemia(WM) is a rare type of non-Hodgkin’s lymphoma, commonly associated with hyperviscosity syndrome. Unlike non-Hodgkin’s lymphoma, its ocular manifestations are less well described in the literature. Here we present the first case of undiagnosed WM presenting with dense vitreous haemorrhage. The study was conducted in accordance with the principles of the Declaration of Helsinki. The informed consent was obtained from the subject.

关键词： globulin lymphoma Waldenstr

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Risk factors for hepatocellular carcinoma associated with hepatitis C genotype 3 infection:A systematic review

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1596-1612页

作者： Hamzah Z Farooq Michael James Jane Abbott Patrick Oyibo Pip Divall Naheed Choudhry Graham R Foster Blizard Institute Queen Mary University of LondonLondon E12ATUnited Kingdom School of Health and Psychological Sciences University of LondonLondon EC1V 0HBUnited Kingdom university hospitals of leicester Library University Hospitals of Leicester NHS TrustLeicester LE39QPUnited Kingdom

BACKGROUND Hepatitis C virus(HCV)is a blood-borne virus which globally affects around 79 million people and is associated with high morbidity and *** infection leads to cirrhosis in a large proportion of patients and often causes hepatocellular carcinoma(HCC)in people with *** the 6 HCV genotypes(G1-G6),genotype-3 accounts for 17.9%of *** genotype-3 responds least well to directly-acting antivirals and patients with genotype-3 infection are at increased risk of HCC even if they do not have *** To systematically review and critically appraise all risk factors for HCC secondary to HCV-G3 in all ***,we studied possible risk factors for HCC due to HCV-G3 in the literature from 1946 to *** This systematic review aimed to synthesise existing and published studies of risk factors for HCC secondary to HCV genotype-3 and evaluate their strengths and *** searched Web of Science,Medline,EMBASE,and CENTRAL for publications reporting risk factors for HCC due to HCV genotype-3 in all settings,*** Four thousand one hundred and forty-four records were identified from the four databases with 260 records removed as *** thousand eight hundred and eighty-four records were screened with 3514 *** hundred and seventy-one full-texts were assessed for eligibility with seven studies included for *** the seven studies,three studies were retrospective case-control trials,two retrospective cohort studies,one a prospective cohort study and one a cross-sectional study *** were based in hospital settings with four in Pakistan,two in South Korea and one in the United *** total number of participants were 9621 of which 167 developed HCC(1.7%).All seven studies found cirrhosis to be a risk factor for HCC secondary to HCV genotype-3 followed by higher age(five-studies),with two studies each showing male sex,high alpha feto-protein,directly-acting antivirals trea

关键词： Hepatocellular carcinoma Hepatitis C Genotype 3 Systematic review Blood-borne viruses Liver cancer

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