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2. Response to Mepolizumab Treatment in Patients with Severe Eosinophilic Asthma and Atopic Phenotypes

Author

Prazma CM, Idzko M, Douglass JA, Bourdin A, Mallett S, Albers FC, and Yancey SW

Subjects
allergens and epitopes, eosinophils, asthma, asthma treatments, biologics, Immunologic diseases. Allergy, RC581-607
Abstract

Charlene M Prazma,1 Marco Idzko,2,3 Jo Anne Douglass,4 Arnaud Bourdin,5,6 Stephen Mallett,7 Frank C Albers,8 Steven W Yancey1 1Respiratory Therapeutic Area, GSK, Research Triangle Park, NC, USA; 2Division of Pneumology, Medical University of Vienna, Vienna, Austria; 3Department of Pneumology, University Hospital Freiburg, Freiburg, Germany; 4The Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia; 5Departement de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, CHU Montpellier, Montpellier, France; 6PhyMedExp, University of Montpellier, Montpellier, France; 7Clinical Statistics, GSK, Uxbridge, Middlesex, UK; 8Respiratory Medical Franchise, GSK, Research Triangle Park, NC, USACorrespondence: Charlene M PrazmaRespiratory Therapeutic Area, GSK, 5 Moore Drive, PO Box 13398, Research Triangle Park, NC, 27709, USATel +1 919 483 9013Email charlene.m.prazma@gsk.comPurpose: Improved understanding of characteristics that may influence treatment response across phenotypes may help guide treatment decisions.Patients and Methods: This was a post hoc analysis of MENSA, a multicenter, randomized, double-blind, placebo-controlled trial (NCT01691521). Patients aged ≥ 12 years with severe eosinophilic asthma received mepolizumab (75 mg intravenously or 100 mg subcutaneously) or placebo, plus standard of care, every 4 weeks for 32 weeks. Outcomes assessed were the annualized rate of clinically significant exacerbations and change from baseline in Asthma Control Questionnaire (ACQ)-5 score. Subgroup analyses were performed by baseline blood eosinophil count (< 150, ≥ 150– 300, ≥ 300 cells/μL) within atopic subgroups (non-atopic [specific immunoglobulin E < 0.35 kU/L], atopic [≥ 0.35– 17.5 kU/L], strongly atopic [> 17.5 kU/L]), and by house dust mite (HDM) sensitivity.Results: Of 576 patients analyzed, 272 were non-atopic, 181 were atopic and 94 were strongly atopic; 29 had missing atopy data. In patients with blood eosinophil counts ≥ 300 cells/μL, mepolizumab versus placebo reduced clinically significant exacerbations by 74%, 43% and 25% in the non-atopic, atopic and strongly atopic subgroups. Similar reductions were observed in all atopic subgroups in other blood eosinophil count categories where there were sufficient patient numbers for analysis, except for non-atopic patients with baseline blood eosinophil counts of < 150 cells/μL. Improvements in ACQ-5 scores of – 0.75, – 0.73 and – 0.78 with mepolizumab versus placebo were observed in non-atopic, atopic and strongly atopic patients with blood eosinophil counts ≥ 300 cells/μL; consistent improvements in ACQ-5 were not observed in patients with blood eosinophil counts < 150 or ≥ 150– 300 cells/μL. Reductions in clinically significant exacerbations with mepolizumab versus placebo were also observed irrespective of sensitivity to HDMs.Conclusion: Mepolizumab was associated with a trend for reductions in clinically significant exacerbations and improved asthma control versus placebo in patients with severe eosinophilic asthma, irrespective of atopic status or HDM sensitivity.Keywords: allergens and epitopes, eosinophils, asthma, asthma treatments, biologics

Published
2021

8. Predictors of Close Family Relationships over One Year among Homeless Young People

Author

Milburn, N.G, Jane Rotheram-Borus, M., Batterham, P., Brumback, B., Rosenthal, D., and Mallett, S.

Abstract

Predictors of perceived family bonds were examined among homeless young people who initially left home one year earlier. Newly homeless young people aged 12-20 years who had recently left home were recruited in Los Angeles County, United States (n=201) and Melbourne, Australia (n=124) and followed longitudinally at 3, 6, and 12 months (follow-up rates ranging from 72% to 86% overall). These homeless young people varied substantially in their bonds to their families. Family bonds at one year were predicted in multivariate regression analyses by having significantly fewer problem behaviours when leaving home and decreasing rates of problem behaviours over the next year. Having more emotional support and more instrumental financial support were also significantly associated with greater family bonds one year later. These results suggest that efforts to reunite families may be a viable intervention strategy for newly homeless young people.

Published
2005
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11. Intraoperative transfusion practices in Europe

Author

Meier, J., Filipescu, D., Kozek-Langenecker, S., Llau Pitarch, J., Mallett, S., Martus, P., Matot, I., Accurso, Giuseppe, Ahrens, Norbert, Akan, Mert, Åkeröy, Kristin, Aksoy, Omur, Alanoğlu, Zekeriyye, Alfredo, Merten, Alkis, Neslihan, Almeida, Valentina, Alousi, Mohammed, Alves, Claudia, Amaral, Joana, Ambrosi, Xavier, Ana, Izquierdo, Anastase, Denisa, Andersson, Mona, Andreou, Antonis, Anthopoulos, Georgios, Apanaviciute, Daiva, Arbelaez, Alejandro, Arcade, Anne-Laure, Arion-Balescu, Carmen, Arun, Oguzhan, Azenha, Marta, Bacalbasa, Nicolae, Baeten, Wannes, Balandin, Alina, Barquero López, Marta, Barsan, Victoria, Bascuas, Begona, Basora, Misericordia, Baumann, Holger, Bayer, Andreas, Bell, Andrea, Belmonte Cuenca, Julio, Bengisun, Zuleyha Kazak, Bento, Carlos, Beran, Maud, Bermudez Lopez, Maria, Bernardino, Ana, Berthelsen, Kasper Gymoese, Bigat, Zekiye, Bilshiene, Diana, Bilska, Marcela, Bisbe Vives, Elvira, Biscioni, Tamara, Björn, Heyse, Blom, Tommi, Bogdan Prodan, Alexandru, Bogdanovic Dvorscak, Matea, Boisson, Matthieu, Bolten, Jens, Bona, Francesco, Borg, Francis, Boros, Cristian, Borys, Michał, Boveroux, Pierre, Boztug Uz, Neval, Brettner, Florian, Brisard, Laurent, Britta, De Waal, Browne, Gail, Budow, Kristin, Buerkle, Hartmut, Buggy, Donal, Cain, Alistair, Calancea, Esenia, Calarasu, Florenta, Calder, Verity, Camci, Ali Emre, Campiglia, Laura, Campos, Beatriz, Camps, Angela, Carlos, Delgado, Carreira, Claudia, Carrilho, Alexandre, Carvalho, Peter, Cassinello, Concepcion, Cattan, Anat, Cenni, Leonardo, Cerny, Vladimir, Ceyda Meço, Başak, Chesov, Ion, Chishti, Ahmed, Chupin, Anne-Marie, Cikova, Andrea, Cindea, Iulia, Cintula, Daniel, Ciobanasu, Roxana, Clements, Deborah, Cobiletchi, Serghei, Coburn, Mark, Coghlan, Liz, Collyer, Thomas, Copotoiu, Sanda Maria, Copotoiu, Ruxandra, Corneci, Dan, Cortegiani, Andrea, Coskunfirat, O.Koray, Costea, Dan, Czuczwar, Mirosław, Davies, Katy, De Baerdemaeker, Luc, De Hert, Stefan, Debernardi, Felicino, Decagny, Sylvie, Deger Coskunfirat, Nesil, Diana, Toma, Diana, Gómez Martinez, Dias, Sandra, Dickinson, Matthew, Dobisova, Anna, Dragan, Anca, Droc, Gabriela, Duarte, Sonia, Dunk, Nigel, Ekelund, Kim, Ekmekçi, Perihan, Elena, Ciobanu, Ellimah, Tracey, Espie, Laura, Everett, Lynn, Ferguson, Andrew, Fernandes, Melissa, Fernández, J.A., Ferner, Marion, Ferreira, Daniel, Ferrie, Rosemary, Filipescu, Daniela, Flassikova, Zora, Fleischer, Andreas, Font, A., Galkova, Katarina, Garcia, Irene, Garner, Matt, Gasenkampf, Andrey, Gelmanas, Arunas, Gherghina, Viorel, Gilsanz, Fernando, Giokas, George, Goebel, Ulrich, Gomes, Piedade, Gonçalves Aguiar, José Manuel, Gonzalez Monzon, Veronica, Gottschalk, André, Gouraud, Jean-Pierre, Gramigni, Elena, Grintescu, Ioana, Grynyuk, Andriy, Grytsan, Alexey, Guasch, Emilia, Gustin, Denis, Hans, Grégory, Harazim, Hana, Hervig, Tore, Hidalgo, Francisco, Higham, Charley, Hirschauer, Nicola, Hoeft, Andreas, Innerhofer, Petra, Innerhofer-Pompernigg, Nicole, Jacobs, Stefan, Jakobs, Nicolas, Jamaer, Luc, James, Sarah, Jawad, Monir, Jesus, Joana, Jhanji, Shaman, Jipa Lavina, Nicoleta, Jokinen, Johanna, Jovanovic, Gordana, Jubera, Maria Pilar, Kahn, David, Karjagin, Juri, Kasnik, Darja, Katsanoulas, Konstantinos, Kelle, Hened, Kelleher, Mortimer, Kessler, Florian, Kirigin, Borana, Kiskira, Olga, Kivik, Peeter, Klimi, Pelagia, Klučka, Jozef, Koers, Lena, Kontrimaviciut, Egle, Koopman-van Gemert, A.W.M.M., Korfiotis, Demetrios, Kosinová, Martina, Koursoumi, Eygenia, Kozek Langenecker, Sibylle, Kranke, Peter, Kresic, Marina, Krobot, Renatas, Kropman, Lucienne, Kulikov, Alexander, Kvolik, Slavica, Kvrgic, Ivana, Kyttari, Aikaterini, Lagarto, Filipa, Lance, Marcus D., Laufenberg, Rita, Lauwick, Severine, Lecoq, Jean-Pierre, Leech, Leech, lidzborski, Lionel, Liliana, Henao, Linda, Filipe, Llau Pitarch, Juan Vicente, Lopes, Ana, Lopez, Luis, Lopez Alvarez, Alexo, Lorenzi, Irene, Lorre, Gilbert, Lucian, Horhota, Lupis, Tamara, Lupu, Mary Nicoleta, Macas, Andrius, Macedo, Ana, Maggi, Genaro, Mallett, Susan, Mallor, Thomas, Manoleli, Alexandra, Manolescu, Rely, Manrique, Susana, Maquoi, Isabelle, Marios-Konstantinos, Tasoulis, Markovic Bozic, Jasmina, Markus W., Hollmann, Marques, Margarida, Martinez, Raul, Martinez, Ever, Martínez, Esther, Martinho, Helder, Martins, Diogo, Martires, Emilia, Martus, Peter, Matias, Francisco, Matot, Idit, Mauff, Susanne, Meale, Paula, Meier, Jens, Merz, Hannah, Meybohm, Patrick, Militello, Maria Grazia, Mincu, Natalia, Miranda, Maria Lina, Mirea, Liliana, Moghildea, Victoria, Moise, Alida, Molano Diaz, Pablo, Moltó, Luís, Monedero, Pablo, Moral, Victoria, Moreira, Zélia, Moret, Enrique, Mulders, Freya, Munteanu, Anna Maria, Nadia Diana, Kinast, Nair, Ashok, Neskovic, Vojislava, Ninane, Vincent, Nitu, Denisa, Oberhofer, Dagmar, Odeberg-Wernerman, Suzanne, Oganjan, Juri, Omur, Dilek, Orallo Moran, Marian Angeles, Ozkardesler, Sevda, Pacasová, Rita, Paklar, Nataša, Pandazi, Ageliki, Papaspyros, Fotios, Paraskeuopoulos, Tilemachos, Parente, Suzana, Paunescu, Marilena Alina, Pavičić Šarić, Jadranka, Pereira, Filipa, Pereira, Elizabete, Pereira, Luciane, Perry, Chris, Petri, Attila, Petrovic, Uros, Pica, Silvia, Pinheiro, Filipe, Pinto, José, Pinto, Fernando, Piwowarczyk, Paweł, Platteau, Sofie, Poeira, Rita, Popescu, Ravzan, Popica, Georgian, Poredos, Peter, Prasser, Christopher, Preckel, Benedikt, Prospiech, Audrey, Pujol, Roger, Raimundo, Ana, Raineri, Santi Maurizio, Rakic, Dragana, Ramadan, Mohammed, Ramazanoğlu, Atilla, Rantis, Athanasios, Raquel, Ferrandis, Rätsep, Indrek, Real, Catia, Reikvam, Tore, Reis, Ligia, Rigal, Jean-Christophe, Rohner, Anne, Rokk, Alar, Roman Fernandez, Adriana, Rosenberger, Peter, Rossaint, Rolf, Rozec, Bertrand, Rudolph, Till, Saeed, Yousif, Safonov, Sergej, Saka, Esra, Samama, Charles Marc, Sánchez López, Óscar, Sanchez Perez, David, Sanchez Sanchez, Yvan Enrique, Sandeep, Varma, Sandu, Madalina Nina, Sanl, Suat, Saraiva, Alexandra, Scarlatescu, Ecaterina, Schiraldi, Renato, Schittek, Gregor, Schnitter, Bettina, Schuster, Michael, Seco, Carlos, Selvi, Onur, Senard, Marc, Serra, Sofia, Serrano, Helena, Shmigelsky, Alexander, Silva, Luisa, Simeson, Karen, Singh, Rita, Sipylaite, Jurate, Skitek, Kornel, Skok, Ira, Smékalová, Olga, Smirnova, Nadezda, Sofia, Machado, Soler Pedrola:, Maria, Söndergaard, Sören, Sõrmus, Alar, Sørvoll, Ingvild Hausberg, Soumelidis, Christos, Spindler Yesel, Alenka, Stefan, Mihai, Stevanovic, Ana, Stevikova, Jordana, Stivan, Sabina, Štourač, Petr, Striteska, Jana, Strys, Lydia, Suljevic, Ismet, Tania, Moreno, Tareco, Gloria, Tena, Beatriz, Theodoraki, Kassiani, Tifrea, Marius, Tikuisis, Renatas, Tolós, Raquel, Tomasi, Roland, Tomescu, Dana, Tomkute, Gabija, Tormos, Pilar, Trepenaitis, Darius, Troyan, Galina, Unic-Stojanovic, Dragana, Unterrainer, Axel, Uranjek, Jasna, Valsamidis, Dimitrios, van Dasselaar, Nick, Van Limmen, Jurgen, van Noord, Peter, van Poorten, J.F., Vanderlaenen, Margot, Varela Garcia, Olalla, Velasco, Ana, Veljovic, Milic, Vera Bella, Jorge, Vercauteren, Marcel, Verdouw, Bas, Verenkin, Vladimir, Veselovsky, Tomas, Vieira, Helena, Villar, Tania, Visnja, Ikic, Voje, Minca, von Dossow-Hanfstingl, Vera, Von Langen, Daniel, Vorotyntsev, Sergiy, Vujanovič, Vojislav, Vukovic, Rade, Watt, Philip, Werner, Eva, Wernerman, Jan, Wittmann, Maria, Wright, Margaret, Wunder, Christian, Wyffels, Piet, Yakymenko, Yevgen, Yldrm, Çiğdem, Ylmaz, Hakan, Zacharowski, Kai, Záhorec, Roman, Zarif, Maged, Zielinska-Skitek, Ewa, and Zsisku, Lajos

Published
2016
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26. Bystander cardiopulmonary resuscitation for paediatric out-of-hospital cardiac arrest in England: An observational registry cohort study.

Author

Albargi, H., Mallett, S., Berhane, S., Booth, S., Hawkes, C., Perkins, G.D., Norton, M., Foster, T., and Scholefield, B.

Subjects
*BYSTANDER CPR, *CARDIAC arrest, *COHORT analysis, *PEDIATRICS, *CHILD patients, *EMERGENCY medical services, *SURVIVAL analysis (Biometry), *HOSPITAL statistics
Abstract

Introduction: Bystander cardiopulmonary resuscitation (BCPR) is strongly advocated by resuscitation councils for paediatric out-of-hospital cardiac arrests (OHCAs). However, there are limited reports on rates of BCPR in children and its relationship with return of spontaneous circulation (ROSC) or survival outcomes.Objective: We describe the rate of BCPR and its association with any ROSC and survival- to- hospital-discharge.Methods: We conducted retrospective analysis of prospectively collected paediatric (<18 years of age) OHCA cases in England; we included specialist registry patients treated by emergency medical services (EMS) with known BCPR status and outcome between January 2014 and November 2018. Data included patient demographics, aetiology, witness status, initial rhythm, EMS, season, time of day and bystander status. Associations between BCPR, and any ROSC and survival-to-hospital-discharge outcomes were explored using multivariable logistic regression.Results: There were 2363 paediatric OHCAs treated across 11 EMS regions. BCPR was performed in 69.6% (1646/2363) of the cases overall (range 57.7% (206/367) to 83.7% (139/166) across EMS regions). Only 34.9% (550/1572) of BCPR cases were witnessed. Overall, any ROSC was achieved in 22.8% (523/2289) and survival to hospital discharge in 10.8% (225/2066). Adjusted odds ratio (aOR) for any ROSC was significantly improved following BCPR compared to no BCPR (aOR 1.37, 95% CI 1.03-1.81), but adjusted odds ratio for survival-to-hospital-discharge were similar (aOR 1.01, 95% CI 0.66-1.55).Conclusions: BCPR was associated with improved rates of any ROSC but not survival-to-hospital-discharge. Variations in EMS BCPR rates may indicate opportunities for regional targeted increase in public BCPR education. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Sixteenth sir peter freyer memorial lecture and surgical symposium September 13th & 14th, 1991 Session I

Author

Coulter, J., Molloy, R. G., Moran, K. T., Waldron, R., Kirwan, W. O., O’Suilleabhain, C., Horgan, A., Mealy, K., Burke, P., Hyland, J., Horgan, A. F., Sheehan, M., Browne, R. M., Austin, O., Clery, A. P., Deasy, J. M., Sulaiman-Shoaib S., Soeda, J., O’Briain, D. S., Puri, P., Coveney, E. C., McAllister, V., McDermott, E. W. M., O’Higgins, N. J., Maher, M., Caldwell, M. T. P., Murchan, P., Beesley, W., Feeley, T. M., Tanner, W. A., Keane, F. B. V., Abbasakoor, F., Attwood, S. E. A., McGrath, L P., Stephens, R. B., O’Broin, E., Davies, M. G., McGinley, J., Mannion, C., Gupta, S., Shine, M. F., Lennon, F., Ninan, G., Fitzgerald, R. J., Guiney, E. J., O’Donnell, B., O’Donnell, A. F., Luke, D., Wood, A. E., Murphy, P. G., Walsh, T. N., Hill, A. D. K., Li, H., Hennessy, T. P. J., Noonan, N., Breslin, B., Keeling, P. W. N., Curran, A. J., Gough, D. B., Davidson, I. R., Keeling, P., O’Leary, D. P., Smythe, A., Bird, N. C., Johnson, A. G., Nicholson, P., Traynor, O., Dawson, K., Aitken, J., Cooke, B. A., Parbhoo, S. P., N.Williams, N., Daly, J. M., Herlyn, M., Bouchier-Hayes, D., Stuart, R. C., Allen, M. J., Thompson, W. D., Peel, A. L. G., Hehir, D. T., Cronin, K., McCann, A., Dervan, P. A., Heffernan, S. J., Hederman, W. P., Galea, M. H., Dilks, B., Gilmour, A., Ellis, L. O., Elston, C. W., Blarney, R. W., O’Rourke, S., Mookens, A., Carter, R., Parkin, D., Couse, N. F., Delaney, C. P., Horgan, P. G., Fitzpatrick, J. M., Gorey, T. F., O’Byrne, J. M., McCabe, J. P., Stephens, M., McManus, F., L.Mangan, J., Barr, D. A., Mulvenna, G. J., Maginn, P., Kernohan, W. G., Mollan, R. A. B., O’Flanagan, S. J., Stack, J. P., Dervan, P., Hurson, B., Tierney, S., Fitzgerald, P., O’Sullivan, T., Grace, P., Wyatt, J. P., Evans, R. J., Cusack, S. P., McGowan, S., McGovem, E., Schwaitzberg, S. D., Connolly, R. J., Sullivan, R. P., Mortimer, G., Geraghty, J. G., O’Dwyer, P. J., McGlone, B. S., O’Brien, D. P., Younis, H. A., Given, H. F., Phelan, C., Byrne, J., Barry, K., Gough, D., Hanrahan, L., Given, F., Sweeney, J. P., Korebrits, A. M., Reynolds, J. V, Gorey, T. F, O’Hanlon, D. M., Stokes, M. A., Redmond, H. P., McCarthy, J., Daly, J. M., Losty, P., Murphy, M., Butler, P. E. M., Grace, P. G., Novell, J. R., Hobbs, S. K., Smith, O., Hazlehurst, G., Brozovic, B., Rolles, K., Burroughs, A., Mallett, S., Mehta, A., Buckley, D., Waldron, D., O’Brien, D., Curran, C., Given, F., Grey, L., Leahy, A., Darzi, A., Leader, D., Broe, P., Geoghegan, J. G., Cheng, C. A., Lawson, D. C., Pappas, T. N., O’Sullivan, D., Lieber, M. M., Colby, T. V, Barrett, D. M., Rogers, E., Greally, J., Bredin, H. C., Corcoran, M. O., Kenny, M., Horgan, P., Headon, D., Grace, A., Grace, P. A., Bouchier-Hayes, D., Cross, S., Hehir, D., O’Briain, S., Hartigan, P., Colgan, M. P., Moore, D., Shanik, G., Zaidi, S. Z., Hehir, D. J., Cross, K. S., Colgan, M. P., Moore, D. J., Shanik, D. G., Lacy, P., Cross, S., Hehir, D., Moore, D., Shanik, G., Coleman, J. E., McEnroe, C. S., Gelfand, J. A., O’Donnell, T. F., Callow, A. D., Buckley, D. J., O’Riordain, D. S., O’Donnell, J. A., Meagher, P., Boos, K., Gillen, P., Corrigan, T., Vashisht, R., Sian, M., Sharp, E. J, O’Malley, M. K., Kerin, M. J., Wilkinson, D., Parkin, A., Kester, R. C., Maher, M. M., Waldron, R. P., Waldron, D. J., Brady, M. P., Allen, M., Lyncy, T. H, Waymont, B., Emtage, L., Blackledge, G. R., Hughes, M. A., Wallace, D. M. A., O’Sullivan, D., Mynderse, L., Barrett, D. M., Rogers, E., Grimes, H., Chambers, F., Lowe, D., Bredin, H. C., Corcoran, M. O., Waldron, D. J., Prasad, B., O’Sullivan, D. C., Gillen, M. Barry P., McNicholas, M., Traynor, O., Bredin, H., O’Dowd, T. H., Corcoran, M., O’Donoghue, J. M., Corcoran, M., McGuire, M., McNamara, A., Creagh, T., Grainger, R., McDermott, T. B. D., Butler, M. R., Gleeson, M., Creagh, T., Grainger, R., McDermott, T. E. D., Hurley, J. P., Hone, R., Neligan, M., Hurley, J., White, M., McDonagh, P., Phelan, D., McGovern, E., Quinn, F., Breatnach, F., O’Meara, A., McGrath, J. P., McCann, S. R., Gaffney, E. F., Hennessy, A, Leader, M., Taleb, F. S., McKiernan, M. V., Leyden, P. J., McCann, J. J., Coleman, J., Quereshi, A., Ajayi, N., McEntee, G., Osborne, H., Bouchier-Hayes, D. J., Johnston, S., O’Malley, K., Smyth, E., Bouchier-Hayes, D. L, Darzi, A., Quereshi, A., McEntee, G., O’Connell, P. R., Gorey, T., McAnena, O. J., Reed, M. W., Duncan, J. L., Reilly, C. S., McGibney, C., Lawlor, P., Lawless, B., McGuinness, E., and Leahy, S.

Published
1992
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36. Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis.

Author

Parker, S. G., Mallett, S., Quinn, L., Wood, C. P. J., Boulton, R. W., Jamshaid, S., Erotocritou, M., Gowda, S., Collier, W., Plumb, A. A. O., Windsor, A. C. J., Archer, L., and Halligan, S.

Subjects
VENTRAL hernia, LAPAROSCOPIC surgery, HEMATOMA
Abstract

Background: Ventra hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. Methods: PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results: Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m²), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III-IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. Conclusion: This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research. [ABSTRACT FROM AUTHOR]

Published
2021
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40. Temporal and external validation of a prediction model for adverse outcomes among inpatients with diabetes.

Author

Adderley, N. J., Mallett, S., Marshall, T., Ghosh, S., Rayman, G., Bellary, S., Coleman, J., Akiboye, F., Toulis, K. A., and Nirantharakumar, K.

Subjects
*INSULIN therapy, *ACADEMIC medical centers, *AGE distribution, *C-reactive protein, *CONFIDENCE intervals, *DIABETES, *GLOMERULAR filtration rate, *HEMOGLOBINS, *LENGTH of stay in hospitals, *HOSPITAL admission & discharge, *INTENSIVE care units, *MEDICAL protocols, *NATIONAL health services, *NEUTROPHILS, *PATIENTS, *POTASSIUM, *SEX distribution, *SODIUM, *ALBUMINS, *ADVERSE health care events, *STATISTICAL models, MORTALITY risk factors, RESEARCH evaluation
Abstract

Abstract: Aim: To temporally and externally validate our previously developed prediction model, which used data from University Hospitals Birmingham to identify inpatients with diabetes at high risk of adverse outcome (mortality or excessive length of stay), in order to demonstrate its applicability to other hospital populations within the UK. Methods: Temporal validation was performed using data from University Hospitals Birmingham and external validation was performed using data from both the Heart of England NHS Foundation Trust and Ipswich Hospital. All adult inpatients with diabetes were included. Variables included in the model were age, gender, ethnicity, admission type, intensive therapy unit admission, insulin therapy, albumin, sodium, potassium, haemoglobin, C‐reactive protein, estimated GFR and neutrophil count. Adverse outcome was defined as excessive length of stay or death. Results: Model discrimination in the temporal and external validation datasets was good. In temporal validation using data from University Hospitals Birmingham, the area under the curve was 0.797 (95% CI 0.785–0.810), sensitivity was 70% (95% CI 67–72) and specificity was 75% (95% CI 74–76). In external validation using data from Heart of England NHS Foundation Trust, the area under the curve was 0.758 (95% CI 0.747–0.768), sensitivity was 73% (95% CI 71‐74) and specificity was 66% (95% CI 65–67). In external validation using data from Ipswich, the area under the curve was 0.736 (95% CI 0.711–0.761), sensitivity was 63% (95% CI 59–68) and specificity was 69% (95% CI 67–72). These results were similar to those for the internally validated model derived from University Hospitals Birmingham. Conclusions: The prediction model to identify patients with diabetes at high risk of developing an adverse event while in hospital performed well in temporal and external validation. The externally validated prediction model is a novel tool that can be used to improve care pathways for inpatients with diabetes. Further research to assess clinical utility is needed. [ABSTRACT FROM AUTHOR]

Published
2018
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43. Intraoperative management of coagulation.

Author

Clevenger, B. and Mallett, S. V.

Abstract

The article discusses intraoperative coagulation management in patients. Topics covered include blood management pillars including minimizing bleeding and blood loss, maximizing erythropoiesis and harnessing patient reserve and anemia tolerance as well as hemorrhage tests such as thromboelastography (TEG) and blood transfusion protocols. Also mentioned are dilutional coagulopathy, liver disease and pharmacological and blood products including platelet, cryoprecipitate and tranexamic acid.

Published
2014
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44. Preoperative assessment of coagulation and bleeding risk.

Author

Clevenger, B. and Mallett, S. V.

Abstract

The article discusses preoperative coagulation and bleeding risk assessment of patients. Topics covered include three stages in the cell-based coagulation model including initiation, propagation and amplification and viscoelastic coagulation tests such as rotational thromboelastometry (ROTEM) and thromboelastography (TEG). Also mentioned are the multiple platelet analyser (Multiplate), platelet mapping assays and antiplatelet agents such as adenosine diphosphate inhibitors and thromboxane.

Published
2014
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45. Spawning activity of the Australian lungfish Neoceratodus forsteri in an impoundment.

Author

Roberts, D. T., Mallett, S., Krück, N. C., Loh, W., and Tibbetts, I.

Subjects
*FISH spawning, *AUSTRALIAN lungfish, *RARE fishes, *FISH eggs, *HABITATS, *FISH ecology, *FISHERIES
Abstract

This study assessed the spawning activity of the threatened Australian lungfish Neoceratodus forsteri by measuring egg densities within the artificial habitat of a large impoundment (Lake Wivenhoe, Australia). Eggs were sampled (August to November 2009) from multiple locations across the impoundment, but occurred at highest densities in water shallower than 40 cm along shorelines with a dense cover of submerged terrestrial vegetation. The numbers of eggs declined over the study period and all samples were dominated by early developmental stages and high proportions of unviable eggs. The quality of the littoral spawning habitats declined over the study as flooded terrestrial grasses decomposed and filamentous algae coverage increased. Water temperatures at the spawning site exhibited extreme variations, ranging over 20·4° C in water shallower than 5 cm. Dissolved oxygen concentrations regularly declined to <1 mg l−1 at 40 and 80 cm water depth. Spawning habitats utilised by N. forsteri within impoundments expose embryos to increased risk of desiccation or excessive submergence through water-level variations, and extremes in temperature and dissolved oxygen concentration that present numerous challenges for successful spawning and recruitment of N. forsteri in large impoundment environments. [ABSTRACT FROM AUTHOR]

Published
2014
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47. Reporting of prognostic studies of tumour markers: a review of published articles in relation to REMARK guidelines.

Author

Mallett, S., Timmer, A., Sauerbrei, W., and Altman, D. G.

Subjects
*TUMOR markers, *PROGNOSTIC tests, *DNA microarrays, *PROTEOMICS, *SURVIVAL analysis (Biometry), *MEDICAL informatics
Abstract

Background:Poor reporting compromises the reliability and clinical value of prognostic tumour marker studies. We review articles to assess the reporting of patients and events using REMARK guidelines, at the time of guideline publication.Methods:We sampled 50 prognostic tumour marker studies from higher impact cancer journals between 2006 and 2007. The inclusion criteria were cancer; focus on single biological tumour marker; survival analysis; multivariable analysis; and not gene array or proteomic data. Articles were assessed for the REMARK profile and other REMARK guideline items. We propose a reporting aid, the REMARK profile, motivated by the CONSORT flowchart.Results:In 50 studies assessed for the REMARK profile, the number of eligible patients (56% of articles), excluded patients (54%) and patients in analyses (98%) was reported. Only 50% of articles reported the number of outcome events. In multivariable analyses, 54% and 30% of articles reported patient and event numbers for all variables. Of the studies, 66% used archival samples, indicating a potentially biased patient selection. Only 36% of studies reported clearly defined outcomes.Conclusions:Good reporting is critical for the interpretability and clinical applicability of prognostic studies. Current reporting of key information, such as the number of outcome events in all patients and subgroups, is poor. Use of the REMARK profile would greatly improve reporting and enhance prognostic research. [ABSTRACT FROM AUTHOR]

Published
2010
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49. Use of the platelet function analyser (PFA-100®) to quantify the effect of low dose aspirin in patients with ischaemic heart disease.

Author

Coakley, M., Self, R., Marchant, W., Mackie, I., Mallett, S. V., and Mythen, M.

Subjects
ASPIRIN, CORONARY disease, SURGERY, BLOOD diseases, PREVENTION
Abstract

Continuing aspirin up until surgery in cardiac surgical patients may increase peri-operative blood loss. It is possible that there is a subset of patients particularly sensitive to aspirin. The platelet function analyser (PFA-100®) can demonstrate the antiplatelet effect of aspirin. This study was designed to assess the effect of daily 75 mg aspirin on platelet function, as measured by the PFA-100®, in 92 patients with ischaemic heart disease. Patients were classified into three groups according to their PFA-100® results; aspirin hyper-responders (16%), aspirin normal responders (33%) and aspirin non-responders (51%). The PFA-100® has potential as a screening tool to identify patients who are either hyper-responsive or resistant to aspirin. Pre-operative PFA-100® screening to isolate aspirin hyper-responders could enable the vast majority of patients to continue with aspirin therapy pre-operatively, avoiding the risks of stopping treatment. [ABSTRACT FROM AUTHOR]

Published
2005
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