Medicine and Health Sciences Commons^™

Nothing To Sneeze At! A Study Into Intra-Operative Contamination, David Graham, Benjamin Parkinson, Meghan Evans, Gerben Keijzers, Petra Derrington

Gerben Keijzers

Purpose: We performed a prospective study of sneezes from orthopaedic registrars to assess the potential for intra-operative contamination from a masked surgeon, and to determine if head position can alter the potential for contamination. Type of Study: Prospective controlled trial. Methods: Four orthopaedic registrars from the Gold Coast Hospital each inhaled pepper to precipitate a sneeze. Cultures were taken with and without standard Smith & Nephew™ surgical masks, in positions directly in front and to the sides of a masked registrar. The process was repeated three times for each registrar. A control plate was left exposed to the atmosphere. A …

Trajectories Of Ptsd And Substance Use Disorders In A Longitudinal Study Of Personality Disorders, Meghan E. Mcdevitt-Murphy, Gilbert R. Parra, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Andrew E. Skodol, John C. Markowitz

Charles A. Sanislow, Ph.D.

Organ Donation: An Integrated Approach To Saving Lives, Christopher Michetti

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.

Is Extended Volume Of External Beam Irradiation Beneficial In Post-Esophagectomy High Risk Patients Receiving Combined Chemoradiation Therapy?, E. Yu, A. R. Dar, R. Ash, G. Videtic, P. Truong, L. Stitt, A. Tomiak, M. Vincent, R. Malthaner, I. Craig, E. Brecevic, W. Kocha, R. Inculet, M. Lefcoe

Edward Yu

OBJECTIVE: To assess the value of extended volume irradiation with anastomotic coverage in high risk resected esophageal cancer patients. METHOD: A retrospective study was undertaken at LRCC from 1989-1999 for high risk resected esophageal cancer patients. Adjuvant treatments consisted of 4 cycles of chemotherapy (epirubicin/fluorouracil/cisplatin or cisplatin/fluorouracil), and local regional irradiation with or without coverage of the anastomotic site. Radiation dose ranged from 45-60Gy at 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage) or small (without anastomotic coverage) field followed by oblique fields for boost. RESULT: One hundred eighty-eight charts were reviewed. Seventy-two patients were …

Robot Assisted Ultrasound Imaged Guided Interstitial Lung Brachytherapy In A Porcine Model, Richard A. Malthaner, Edward Yu, Jerry J. Battista, Chris Blake, Donal Downey, Aaron Fenster

Edward Yu

We set out to see if permanent interstitial brachytherapy seeds could be safely and reproducibly inserted thoracoscopicaly with the ZEUS Robotic system and intraoperative ultrasound into in-vivo porcine lungs.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Edward Yu

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy. Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function. Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity. We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …

Extended Vs. Small Field Irradiation In High Risk Post Esophagectomy Patients Receiving Combined Chemoradiation Therapy: A Decade Experience In Treatment Of Esophageal Cancer, Edward Yu, Patricia Tai, George Rodrigues, Robert Ash, Larry Stitt, Rashid A. Dar, Pauline Truong, Gregory M. Videtic, Richard Malthaner, Richard Inculet, Anna Tomiak, Jawaid Younus, Brian Dingle, Walter Kocha, Mark Vincent

Edward Yu

OBJECTIVE: To assess the impact of extended field irradiation with anastomotic coverage on local recurrence in high risk resected esophageal cancerpatients. METHODS: From 1989-1999, high risk resected esophageal cancer cases receiving post-resection chemoradiation were reviewed. Adjuvant chemotherapy consisted of four cycles of fluorouracil-based regimens. Loco-regional irradiation with or without coverage of anastomotic site had radiation a dose range from 45-60 Gyat 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage), or small (without anastomotic coverage) field followed by oblique fields for boost. RESULTS: One hundred eighty-eight charts were reviewed. Seventy-two patients were eligible for post-resection chemoradiation. …

Evaluation Of Intra-And Inter-Fraction Motion In Breast Radiotherapy Using Electronic Portal Imaging Cine Loops, Chrison Lee, Edward Yu, Tomas Kron

Edward Yu

Parallel tangent breast irradiation is commonly used postbreast conservation surgery for early breast cancer patient without lymph node involvement to improve local disease control. Intra-fractional and inter-fractional variabilities are often presented in daily treatment setup. The present pilot study used Electronic Portal Imaging (EPI) to evaluate intra-and inter-fraction motion in patients undergoing simple breast tangent radiotherapy.

Plantar Cutaneous Sensory Stimulation Improves Single-Limb Support Time, And Emg Activation Patterns Among Individuals With Parkinson's Disease, M. Jenkins, Q. Almeida, S. Spaulding, R. Van Oostveen, J. Holmes, Andrew Johnson, S. Perry

Andrew M. Johnson

Parkinson's disease is a chronic neurological disorder that results in gait and posture impairment. There is increasing evidence that these motor impairments may be partially due to deficits within the sensory system. In this study, the effects of a facilitatory insole that provides increased plantar sensory stimulation, was evaluated during gait, in a group of individuals with Parkinson's disease in comparison with healthy age-matched controls. Spatial-temporal parameters of gait were evaluated using an instrumented carpet, and muscle activation patterns were evaluated using surface EMG. All participants were tested with both a facilitatory (ribbed) insole and a conventional (flat) insole while …

Effect Of Interval To Definitive Breast Surgery On Clinical Presentation And Survival In Early-Stage Invasive Breast Cancer, Olga Vujovic, Edward Yu, Anil Cherian, Francisco Perera, A. Dar, Larry Stitt, A. Hammond

Edward Yu

Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined …

Role Of Non-Group A Streptococci In Acute Pharyngitis, Jeffrey Tiemstra, R L. Miranda

Jeffrey Tiemstra, MD, FAAFP

The Stability Of Personality Traits In Individuals With Borderline Personality Disorder, Christopher J. Hopwood, Daniel A. Newman, M. Brent Donnellan, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, Emily B. Ansell, M. Tracie Shea, Andrew E. Skodol, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Although stability and pervasive inflexibility are general criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994) personality disorders (PDs), borderline PD (BPD) is characterized by instability in several domains, including interpersonal behavior, affect, and identity. The authors hypothesized that such inconsistencies notable in BPD may relate to instability at the level of the basic personality traits that are associated with this disorder. Five types of personality trait stability across 4 assessments over 6 years were compared for BPD patients (N = 130 at first interval) and patients with other PDs (N = 302). Structural …

Indications For Resection Of Metastatic Liver Lesions, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.

Pancreatic Cancer: Define Unresectable, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.

Four Centuries Of Military Surgery In Canada, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.

Accelerated Fractionation In Inoperable Non-Small Cell Lung Cancer. A Phase I/Ii Study, Edward Yu, Luis Souhami, Julio Guerra, Brenda Clark, Carole Gingras, Palma Fava

Edward Yu

Background: A prospective, single-treatment-arm, Phase I/II trial was performed to determine the tumor response to an accelerated regimen and assess the feasibility and toxic effects of this approach in patients with inoperable non-small cell lung cancer (NSCLC). Methods: Thirty-seven previously untreated patients with inoperable NSCLC who had no evidence of metastatic disease entered the study. All patients were able to walk and had disease that was measurable or assessable. Patients with palpable supraclavicular disease and weight loss were also eligible. Radiation therapy consisted of an altered fractionation regimen with a concomitant boost technique. The original lung volume received a dose …

Decarboxylation Of L-Dopa And 5-Hydroxytryptophan In Dispersed Rat Pancreas Acinar Cells, E. Yu, L. Stern, A. Tenenhouse

Edward Yu

Amino acid decarboxylation activity in dispersed rat pancreas acinar cells and fractions derived by differential centrifugation of homogenate of these cells was studied. The rate of decarboxylation was measured by determining the rate of production of the [3H]-amine from [3H]-amino acid or the rate of production of 14CO2 from the [14C]-carboxy-labelled amino acid. Only the hydroxylated amino acids L-dopa and 5-hydroxytryptophan are decarboxylated by intact dispersed pancreas acinar cells or cell homogenates at all pH values and amino acid concentrations tested. The decarboxylase activity is located exclusively in the cell cytosol. Each substrate competitively inhibits the decarboxylation of the other …

Letter To The Editors: Early Enteral Nutrition Within 24 H Of Intestinal Surgery Versus Later Commencement Of Feeding: A Systematic Review And Meta-Analysis, Emma Osland, Rossita Yunus, Shahjahan Khan, Muhammed Memon

Muhammed Ashraf Memon

Extract:

Dear Dr Lewis, Andersen, and Thomas:
It was with great interest that we read your most recent systematic review and meta-analysis addressing the important issue of early versus later commencement of enteral feeding in gastrointestinal surgery patients.¹ While your 2006 Cochrane review² has clear merit in that it expands on the number of studies and thus the power of your earlier analysis,³ we feel that the present study is essentially a duplication of your Cochrane effort, although with slightly different conclusions.

¹ ² ³ See notes in article.

Splenic Rupture After Colonoscopy: A Case Report, Anthony Kiosoglous, Raphael Varghese, Muhammed Memon

Muhammed Ashraf Memon

Iatrogenic splenic tear after a colonoscopy is a rare complication. Conditions predisposing to splenocolic adhesions such as previous abdominal surgery, pancreatitis, or inflammatory bowel disease may increase the risk of this injury after colonoscopy. We present a case of a 47-year-old woman with an iatrogenic splenic tear after a routine colonoscopy, who had several of these predisposing factors and required an urgent splenectomy.

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, Patricia Tai, Richard Malthaner, Larry Stitt, George Rodrigues, Rashid Dar, Brian Yaremko, Jawaid Younus, Michael Sanatani, Mark Vincent, Brian Dingle, Dalilah Fortin, Richard Inculet

Edward Yu

Management of patients who have disease relapse after completion of surgery and adjuvant chemo-radiation (CRT) is controversial. Some oncologists would advocate intensive therapeutic intervention due to promising experience on treatment for recurrence disease while others would recommend palliative support due to the concerns for poor patient outcome post disease recurrence. In Addition, it is not clear if patient outcome is improved post adjuvant CRT when patients at risk have resection margin involvement and if time interval to recurrence can affect patient survival post relapse. The present study was conducted to determine what factors will affect patient outcome at relapse after …

The Convergent And Discriminant Validity Of Five-Factor Traits: Current And Prospective Social, Work, And Recreational Dysfunction, Christopher J. Hopwood, Leslie C. Morey, Emily B. Ansell, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John C. Markowitz, John G. Gunderson, Shirley Yen, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

The convergent and discriminant validity of Five Factor Model (FFM) personality traits with concurrent and prospective social, work, and recreational dysfunction was assessed in a large, longitudinal clinical sample. Consistent with five factor theoretical expectations, neuroticism is broadly related to dysfunction across domains; extraversion is primarily related to social and recreational dysfunction; openness to recreational dysfunction; agreeableness to social dysfunction; and conscientiousness to work dysfunction. Findings support five factor theory and the clinical assessment of normative personality traits.

Outcome Of Palliative Esophageal Stenting For Malignant Dysphagia: A Retrospective Analysis, M. Burstow, T. Kelly, S. Panchani, M. Khan, D. Meek, Breda Memon, Muhammed Memon

Muhammed Ashraf Memon

Greater than 50% of patients with esophageal carcinoma are found to be incurable at the time of diagnosis, leaving only palliative options. Self-expanding metal stents (SEMs) are effective for relieving symptoms and complications associated with esophageal carcinoma and improving quality of life. We undertook a retrospective analysis to evaluate the experience of palliative esophageal stenting for symptomatic malignant dysphagia in our institution over a period of 7 years. Between January 1999 and January 2006, 126 patients who received SEMs for malignant dysphagia were identified using an upper gastrointestinal specialist nurse clinician database. Data were obtained from patient case notes, endoscopy, …

Pillows For Pain, Michael Lock

Michael Lock

No abstract provided.

Personality Traits As Prospective Predictors Of Suicide Attempts, Shirley Yen, M. Tracie Shea, Charles A. Sanislow, Andrew E. Skodol, Carlos M. Grilo, Maria O. Edelen, Robert L. Stout, Leslie C. Morey, Mary C. Zanarini, John C. Markowitz, Thomas H. Mcglashan, Maria T. Daversa, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine higher order personality factors of negative affectivity (NA) and disinhibition (DIS), as well as lower order facets of impulsivity, as prospective predictors of suicide attempts in a predominantly personality disordered sample.

METHOD: Data were analyzed from 701 participants of the Collaborative Longitudinal Personality Disorders Study with available follow-up data for up to 7 years. Cox proportional hazards regression analyses was used to examine NA and DIS, and facets of impulsivity (e.g. urgency, lack of perseverance, lack of premeditation and sensation seeking), as prospective predictors of suicide attempts.

RESULTS: NA, DIS and all facets of impulsivity except for …

Postulated Role Of Vasoactive Neuropeptide-Related Immunopathology Of The Blood Brain Barrier And Virchow-Robin Spaces In The Aetiology Of Neurological-Related Conditions, Donald R. Staines, Ekua W. Brenu, Sonya Marshall-Gradisnik

Sonya Marshall-Gradisnik

Vasoactive neuropeptides (VNs) such as pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) have critical roles as neurotransmitters, vasodilators including perfusion and hypoxia regulators, as well as immune and nociception modulators. They have key roles in blood vessels in the central nervous system (CNS) including maintaining functional integrity of the blood brain barrier (BBB) and blood spinal barrier (BSB). VNs are potent activators of adenylate cyclase and thus also have a key role in cyclic AMP production affecting regulatory T cell and other immune functions. Virchow-Robin spaces (VRSs) are perivascular compartments surrounding small vessels within the CNS and …

Factors Impacting On The Lives Of Terminally Ill Older People, And Requests For Euthanasia, Phd Thesis, University Of Queensland, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

Leaders, Leadership And Future Primary Care Clinical Research, John Furler, Jennifer Cleland, Chris Del Mar, Barbara Hanratty, Umesh Kadam, Daniel Lasserson, Colin Mccowan, Parker Magin, Caroline Mitchell, Nadeem Qureshi, Greta Rait, Nick Steel, Mieke Van Driel, Alison Ward

Christopher Del Mar

Background: A strong and self confident primary care workforce can deliver the highest quality care and outcomes equitably and cost effectively. To meet the increasing demands being made of it, primary care needs its own thriving research culture and knowledge base. Methods: Review of recent developments supporting primary care clinical research. Results: Primary care research has benefited from a small group of passionate leaders and significant investment in recent decades in some countries. Emerging from this has been innovation in research design and focus, although less is known of the effect on research output. Conclusion: Primary care research is now …

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders., Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

This reprinted article originally appeared in Psychological Assessment, 2005, Vol. 17, (No. 4), 492–496. (The following abstract of the original article appeared in record 2005-16347-014.) The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive–compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and …

Ten-Year Stability And Latent Structure Of The Dsm-Iv Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorders, Charles A. Sanislow, Todd D. Little, Carlos M. Grilo, Maria Daversa, John C. Markowitz, Anthony Pinto, M. Tracie Shea, Shirley Yen, Andrew E. Skodol, Leslie C. Morey, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Evaluation of the validity of personality disorder (PD) diagnostic constructs is important for the impending revision of the Diagnostic and Statistical Manual of Mental Disorders. Prior factor analytic studies have tested these constructs in cross-sectional studies, and models have been replicated longitudinally, but no study has tested a constrained longitudinal model. The authors examined 4 PDs in the Collaborative Longitudinal Personality Disorders study (schizotypal, borderline, avoidant, and obsessive-compulsive) over 7 time points (baseline, 6 months, 1 year, 2 years, 4 years, 6 years, and 10 years). Data for 2-, 4-, 6- and 10-year assessments were obtained in semistructured interviews by …

Switching And Selecting Atypical Antipsychotic Drugs: Quetiapine, Amresh Srivastava

Amresh Srivastava

No abstract provided.