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2. Contributors

Author

Ahirwar, Ashok Kumar, primary, Anne, W. Regis, additional, Arockiam, Peter A., additional, Arumugam, Senthil Kumar, additional, Bajpai, Sailesh, additional, Banerjee, Sourav, additional, Bhatia, Saloni, additional, Chakraborty, Sourav, additional, Chouhan, Mukesh, additional, Ciaburro, Giuseppe, additional, Costa, Milton, additional, Deb, Saptashish, additional, Dogan, Onur, additional, Garg, Bhagwati, additional, Guggari, Shankru, additional, Jabbar, M.A., additional, Jaya, M. Harini, additional, Jeeva, S. Carolin, additional, Jolvis Pou, K.R., additional, Kabade, Sarina, additional, Kadappa, Vijayakumar, additional, Kakulapati, V., additional, Katte, Teesta, additional, Kulandai, Joseph, additional, Kumar, Nitesh, additional, Kumar, Ravi, additional, Kumar, S.N., additional, Mabusela, Thabisa E., additional, Mahor, Vinod, additional, Malakar, Santanu, additional, Manas, Ram N., additional, Mitra, Samuel S., additional, Munshi, Mohona, additional, Narayanan, Prathibha, additional, Ngcobo-Sithole, Magnolia B., additional, Notts, Ruby Mary, additional, Ortiz-Rodriguez, Fernando, additional, Pachlasiya, Kiran, additional, Patel, Vijay K., additional, Rai, Rashmi, additional, Rajak, Harish, additional, Rasalkar, Avinash Arvind, additional, Rathod, Sachin B., additional, Rawat, Romil, additional, Reddy, Divijendra Natha S., additional, Reddy, Sheri Mahender, additional, S., Joshi Manisha, additional, Shandilya, Shishir Kumar, additional, Sharma, Aarti Mehta, additional, Sharma, Anuj, additional, Shettihalli, Ashok Kumar, additional, Shirbhate, Ekta, additional, Singh, Priyanka, additional, Sonar, Anusha, additional, Sorte, Smita R., additional, Sreedharala, Neha, additional, Telang, Shrikant, additional, Tiwari, Sanju, additional, V., Umadevi, additional, Venu, Anandhu, additional, and Vinjamuri, Saisha, additional

Published
2022
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5. CONTRIBUTORS

Author

Allen, Stacey, primary, Anderson, D.M., additional, Anderson, Franklin L., additional, Andrews, J. Jeff, additional, Arnold, William P., additional, Bakke, Patrick, additional, Baust, Joanne, additional, Benumof, Jonathan L., additional, Berkow, Lauren, additional, Berry, Arnold J., additional, Bitner, Daniel Martin, additional, Blanchette, Mary, additional, Boatman, Erik A., additional, Boyd, Gwendolyn L., additional, Bracken, Christopher A., additional, Bradford, Carol R., additional, Brady, Kevin M., additional, Brambrink, Ansgar M., additional, Brandt, Darin, additional, Bready, Lois L., additional, Brockwell, Russell C., additional, Broussard, David M., additional, Brown, Allan C.D., additional, Campbell, Carol E., additional, Carlisle, A. Sue, additional, Carter, Bonny, additional, Cassorla, Lydia, additional, Cline, Harold D., additional, Collins, Corey, additional, Combest, Sally, additional, Curry, Saundra E., additional, Diaz-Ramirez, Myrdalis, additional, Dilger, John A., additional, Dillman, Dawn, additional, Donahue, Stephen, additional, Doran, Nivine H., additional, Douglas, M. Joanne, additional, Dumitrascu, George A., additional, Fenton, Lynn A., additional, Fleisch, Juergen, additional, Freeman, Judith A., additional, Frietsch, Thomas, additional, Furman, William R., additional, Garwood, Susan, additional, Gaumond, Ethan, additional, Gerold, Kevin B., additional, Griffin, James D., additional, Gurkowski, Mary Ann, additional, Hantler, Charles B., additional, Hartman, Jinny Kim, additional, Hawkins, Joy L., additional, Heitmiller, Eugenie, additional, Hernandez, Antonio, additional, Hickey, Rosemary, additional, Holahan, Joseph R., additional, Holmgreen, W. Corbett, additional, Hou, Vivian, additional, Hutchens, Michael P., additional, Jarnberg, Per-Olof, additional, Kang, Wendy B., additional, Karan, Suzanne B., additional, Kaye, Celia I., additional, Kendrick, Angela, additional, Kirsch, Jeffrey R., additional, Klein, Kevin K., additional, Koerner, Ines P., additional, LaCassie, Hector, additional, Lalwani, Kirk, additional, Larach, Marilyn Green, additional, Lineberger, Catherine K., additional, Liszka-Hackzell, John J., additional, Loeb, Robert, additional, Luhn, Gaelan B., additional, Mackenzie, Colin F., additional, Malan, T. Philip, additional, Malhotra, Vinod, additional, Mayer, David C., additional, McGoldrick, Kathryn E., additional, McGuire, Katherine R., additional, Merritt, William T., additional, Metcalf, Sara M., additional, Milhoan, Kimberly D., additional, Moeller-Bertram, Tobias, additional, Naples, Joseph J., additional, Nelson, David V., additional, Newell, Christopher D., additional, Ng, Victor, additional, Njoku, Dolores B., additional, Noorily, Susan H., additional, Norton, J. Russell, additional, Onstad, Steven C., additional, Opton, James C., additional, Orr, Malcolm D., additional, Overbaugh, Robert H., additional, Panico, Fred G., additional, Peterson-Layne, Cathleen L., additional, Phillips, Michael G., additional, Pineda, Jorge, additional, Poon, Anthony S., additional, Quezado, Marcelo, additional, Ramamurthy, Rajam S., additional, Ramamurthy, Somayaji, additional, Rasch, Deborah K., additional, Richman, Jeffrey M., additional, Robertson, Kerri M., additional, Robin, Marco S., additional, Robinson, Stephen T., additional, Rogers, James N., additional, Rosen, Mark A., additional, Rusa, Renata, additional, Rushton, Andrew S., additional, Ryan, Susan M., additional, Salgado, Lauren L., additional, Schwartz, Jamie McElrath, additional, Shah, Jaydeep S., additional, Shapiro, David I., additional, Sharma, Aarti, additional, Simmons, Nicholas R., additional, Skrivanek, Gary D., additional, Sloan, Tod B., additional, Spielman, Fred J., additional, Stool, Louis A., additional, Sudheendra, Vijayendra, additional, Swafford, Melba W.G., additional, Swanson, Veronica C., additional, Terrell, Jeffrey E., additional, Tetzlaff, John E., additional, Tiouririne, Mohamed, additional, Vaitkeviciute, Irena, additional, Verber, Michael, additional, Vookles, Jennifer F., additional, Waisel, David B., additional, Walters, Tessa L., additional, Ward, Denham S., additional, Welborn, Leila G., additional, Welch, Gary, additional, Wells, Lynda T., additional, Zaidan, James R., additional, Zimmerman, Angela, additional, and Zuazu, Marcos A., additional

Published
2007
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6. Contributors

Author

Abel, Mark, primary, Adhikary, Gaury S., additional, Albin, Maurice S., additional, Allen, Stacey L., additional, Allen, Steven J., additional, Anagnostou, Jonathan M., additional, Argalious, Maged, additional, Arndt, George A., additional, Aronson, Lori A., additional, Atlee, John L., additional, Avidan, Michael S., additional, Azar, Isaac, additional, Baker, James E., additional, Baliga, Narayan, additional, Bar-Yosef, Shahar, additional, Barr, Juliana, additional, Baysinger, Curtis L., additional, Bedell, Eric, additional, Benca, Joan, additional, Benedict, Patrick E., additional, Bjoraker, David G., additional, Black, Susan, additional, Blau, William S., additional, Blumenthal, Steffan, additional, Boncyk, John C., additional, Borgeat, Alain, additional, Bready, Lois L., additional, Broderick, Thomas P., additional, Brown, David L., additional, Bruijinzeel, Adrie, additional, Bucklin, Brenda A., additional, Caldwell, Matthew D., additional, Camann, William R., additional, Castro, Maria I., additional, Chan, Kevin P., additional, Chaney, Mark A., additional, Chawla, Amit V., additional, Cheng, David C.H., additional, Chiravuri, S. Devi, additional, Collins, Gordon Lee, additional, Connolly, Lois A., additional, Cook, D. Ryan, additional, Cook-Sather, Scott D., additional, Coon, Victoria, additional, Cooper, John R., additional, Coté, Charles J., additional, Coursin, Douglas B., additional, Crews, James C., additional, Davis, Deborah A., additional, Ruyter, Martin L. De, additional, Soto, Hernando De, additional, Dennis, Donn M., additional, Desai, Ronak, additional, DeSimone, Cheryl, additional, DeSouza, Cyrus, additional, Deutschman, Clifford S., additional, Dorje, Pema, additional, Doyle, Anthony R., additional, Drasner, Kenneth, additional, Drexler, Catherine, additional, Duncan, Ellen, additional, Dünser, Martin W., additional, Dziersk, Jörg, additional, Eaton, Michael P., additional, Edmiston, Charles E., additional, Eisenkraft, James B., additional, Ellis, John, additional, Fahy, Brenda G., additional, Fang, Zhuang T., additional, Feldman, Doron, additional, Ferrari, Lynne R., additional, Feuer, Matthew P., additional, Fischer, Stephanie S.F., additional, Fish, M. Pamela, additional, Flick, Randall, additional, Ford, Michael P., additional, Fortney, Jennifer T., additional, Foster, James M.T., additional, Franckowiak, Melissa, additional, Freid, Eugene B., additional, Frost-Pineda, Kimberly, additional, Galinkin, Jeffrey L., additional, Ganesh, Arjunan, additional, Gautam, Hind M., additional, Gebhardt, Rodolfo, additional, Geiduschek, Jeremy M., additional, Gerancher, J.C., additional, Gold, Mark S., additional, Grant, Stuart, additional, Gravlee, Glenn P., additional, Gunnarsson, Ivar, additional, Gurkowski, Mary Ann, additional, Gutsche, Jacob, additional, Guyton, Thomas S., additional, Habibi, Ali, additional, Habibi, Saeed, additional, Hantler, Charles B., additional, Hardman, H. David, additional, Harrison, Barry A., additional, Hawkins, Joy L., additional, Heard, Christopher M.B., additional, Heard, Stephen O., additional, Hebl, James R., additional, Helfand, Robert F., additional, Hickey, Rosemary, additional, Higgins, George A., additional, Holliday, Scott, additional, Hope, William, additional, Horlocker, Terese T., additional, Hosu, Liana, additional, Huncke, Kate, additional, Irefin, Samuel A., additional, Jacobs, William, additional, Jacobsohn, Eric, additional, Jaeger, J. Michael, additional, James, Michael F.M., additional, Janelle, Gregory M., additional, Jobes, David R., additional, Jones, Nicola, additional, Joshi, Shailendra, additional, Kain, Zeev N., additional, Kang, Wendy B., additional, Kaur, Shubjeet, additional, Kaye, Robert D., additional, Kazanjian, Paul E., additional, Kelly, Jeffrey S., additional, Kelly, Kevin J., additional, Kettler, Robert E., additional, Ketzler, Jonathan T., additional, Kharasch, Evan D., additional, Kincaid, M. Sean, additional, King, Kathryn P., additional, Kiviluoma, Kai T., additional, Klafta, Jerome M., additional, Klarr, Pattricia S., additional, Kopp, Sandra L., additional, Kroll, Donald A., additional, Kuchta, Kenneth, additional, Kurth, C. Dean, additional, Lam, Arthur M., additional, Lane, Jeffrey L., additional, Langevin, Paul B., additional, Laxton, Melissa A., additional, Lee, Marcia M., additional, Lee, Mijin, additional, Lee, Peter J., additional, Levin, Philip, additional, Levy, Jerrold H., additional, Lewis, Ian, additional, Liao, Ray P., additional, Liu, Spencer S., additional, Lobato, Emilio B., additional, Loeb, Robert G., additional, Lombardi, Celeste M., additional, Lotlikar, Prashant, additional, Lotto, Michelle L., additional, Luba, Katarzyna, additional, Lustik, Stewart J., additional, Malhotra, Vinod, additional, Matadial, Christina M., additional, Mayr, Viktoria D., additional, McClain, Deborah A., additional, McCutchen, Thomas, additional, McDonagh, David L., additional, McDonald, Susan B., additional, Means, Lynda J., additional, Meyer, Mark, additional, Minhaj, Mohammed, additional, Moitra, Vivek, additional, Monitto, Constance L., additional, Monk, Terri G., additional, Montenegro, Lisa M., additional, Morey, Timothy E., additional, Mostello, Lucille A., additional, Muhiudeen-Russell, Isobel, additional, Murphy, J. Thomas, additional, Murray, Catherine Friederich, additional, Murray, Michael J., additional, Muzic, David, additional, Nader, Nader D., additional, Nadjat-Haiem, Carsten, additional, Naguib, Mohamed, additional, Naik, Bhiken, additional, Nakata, David A., additional, Napolitano, Charles A., additional, Narr, Bradly J., additional, Natrajan, Krishna M., additional, Naughton, Norah, additional, Neligan, Patrick, additional, Newfield, Philippa, additional, Nicodemus, Hector F., additional, Nicolson, Susan C., additional, Noorily, Susan H., additional, Nunnally, Mark, additional, O'Connor, Christopher J., additional, O'Connor, Michael F., additional, O'Hara, Jerome F., additional, Öhrn, Maria A.K., additional, O'Rourke, Nollag, additional, Pai, Sheela S., additional, Palmer, Craig M., additional, Parmley, C. Lee, additional, Patel, Komal, additional, Pavlin, D. Janet, additional, Perala, Padmavathi, additional, Petrozza, Patricia H., additional, Polley, Linda S., additional, Porembka, David, additional, Praetel, Claudia, additional, Previte, Joseph, additional, Prielipp, Richard C., additional, Prince, William, additional, Proctor, Lester T., additional, Prough, Donald S., additional, Raatikainen, M. J. Pekka, additional, Radke, Lee M., additional, Ramanathan, Sivam, additional, Ramsay, James G., additional, Riesner, Monica N., additional, Riley, Edward T., additional, Roberts, Pamela R., additional, Robertson, Kerri M., additional, Robinson, Marnie, additional, Rose, John B., additional, Rossberg, Mark I., additional, Rothenberg, David M., additional, Rubens, Daniel D., additional, Sadhasivam, Senthilkumar, additional, Sakai, Tetsuro, additional, Salinas, Francis V., additional, Sanford, Theodore J., additional, Satya-Krishna, Ramachandran, additional, Schulman, Scott R., additional, Schure, Annette, additional, Schwartz, Jeffrey J., additional, Seefelder, Christian, additional, Sethuraman, Rajamani, additional, Seubert, Christoph N., additional, Shanewise, Jack S., additional, Shannon, Kelly T., additional, Sharih, Gauhar, additional, Sharma, Aarti, additional, Sladen, Robert N., additional, Slinger, Peter D., additional, Sloan, Tod B., additional, Slonin, Jonathan H., additional, Smythe, Paul, additional, Souders, Jennifer E., additional, Springman, Scott R., additional, Steven, James M., additional, Stoelting, Robert K., additional, Stoneham, Mark D., additional, Stover, E. Price, additional, Stover, Laura, additional, Sudheendra, Vijayendra, additional, Sullivan, Kevin J., additional, Svensén, Christer H., additional, Szocik, James F., additional, Tanaka, Kenichi A., additional, Tasch, Mark D., additional, Tassani-Prell, Peter, additional, Thannikary, Lisa, additional, Torp, Klaus D., additional, Torsher, Laurence C., additional, Trankina, Mark F., additional, Travis, Kenneth W., additional, Tsen, Lawrence C., additional, Tung, Avery, additional, Vallejo, Manuel C., additional, Van Norman, Gail A., additional, Van Tassel, Karen M., additional, Vasdev, Gurinder M.S., additional, Vu, Melissa M., additional, Watcha, Mehernoor F., additional, Watson, Eileen, additional, Weldon, B. Craig, additional, Weller, Robert S., additional, Wells, Lynda, additional, Wenzel, Volker, additional, Wilkhu, Harshdeep, additional, Williams, Brian A., additional, Williams, Glyn D., additional, Wise-Faberowski, Lisa, additional, Wittkugel, Eric P., additional, Wlody, David J., additional, Wong, Gilbert Y., additional, Woodcock, Brian J., additional, Young, Christopher C., additional, Young, William L., additional, Zainer, Christine M., additional, Zakowski, Mark A., additional, Zanaboni, Paul B., additional, and Zhang, R. Victor, additional

Published
2007
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8. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

Author

Jacobs, Ian J, Menon, Usha, Ryan, Andy, Gentry-Maharaj, Aleksandra, Burnell, Matthew, Kalsi, Jatinderpal K, Amso, Nazar N, Apostolidou, Sophia, Benjamim, Elizabeth, Cruickshank, Derek, Crump, Danielle N, Davies, Susan K, Dawnay, Anne, Dobbs, Stephen, Fletcher, Gwendolen, Ford, Jeremy, Godfrey, Keith, Gunther, Richard, Habib, Mariam, Hallett, Rachel, Herod, Jonathan, Jenkins, Howard, Karpinskyj, Chloe, Leeson, Simon, Lewis, Sara J, Liston, William R, Lopes, Alberto, Mould, Tim, Murdoch, John, Oram, David, Rabideau, Dustin J, Reynolds, Karina, Scott, Ian, Seif, Mourad W, Sharma, Aarti, Singh, Naveena, Taylor, Julie S., Warburton, Fiona, Widschwendter, Martin, Williamson, Karin, Woolas, Robert, Fallowfield, Lesley, McGuire, Alistair, Campbell, Stuart, Parmar, Mahesh, Skates, Steven J, Jacobs, Ian J, Menon, Usha, Ryan, Andy, Gentry-Maharaj, Aleksandra, Burnell, Matthew, Kalsi, Jatinderpal K, Amso, Nazar N, Apostolidou, Sophia, Benjamim, Elizabeth, Cruickshank, Derek, Crump, Danielle N, Davies, Susan K, Dawnay, Anne, Dobbs, Stephen, Fletcher, Gwendolen, Ford, Jeremy, Godfrey, Keith, Gunther, Richard, Habib, Mariam, Hallett, Rachel, Herod, Jonathan, Jenkins, Howard, Karpinskyj, Chloe, Leeson, Simon, Lewis, Sara J, Liston, William R, Lopes, Alberto, Mould, Tim, Murdoch, John, Oram, David, Rabideau, Dustin J, Reynolds, Karina, Scott, Ian, Seif, Mourad W, Sharma, Aarti, Singh, Naveena, Taylor, Julie S., Warburton, Fiona, Widschwendter, Martin, Williamson, Karin, Woolas, Robert, Fallowfield, Lesley, McGuire, Alistair, Campbell, Stuart, Parmar, Mahesh, and Skates, Steven J

Abstract

BackgroundOvarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality. MethodsIn this randomised controlled trial, we recruited postmenopausal women aged 50–74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032. FindingsBetween June 1, 2001, and Oct 21, 2005, we randomly allocated 202 638 women: 50 640 (25·0%) to MMS, 50 639 (25·0%) to USS, and 101 359 (50·0%) to no screening. 202 546 (>99·9%) women were eligible for analysis: 50 624 (>99·9%) women in the MMS group, 50 623 (>99·9%) in the USS group, and 101 299 (>99·9%) in the no screening group. Screening ended on Dec 31, 2011, and included 345 570 MMS and 327 775 USS annual screening episodes. At a median follow-up of 11·1 years (IQR 10·0–12·0), we diagnosed ovarian cancer in 1282 (0·6%) women: 338 (0·7%) in the MMS group

9. Placenta Accreta Spectrum: Evaluation of classic and non-classic presentations, pathologic grading, and uterine scar dehiscence features in a modern institutional series.

Author

Neville G, Carusi D, Yu HY, Sharma A, Quade BJ, and Parra-Herran C

Subjects
Pregnancy, Female, Child, Humans, Cesarean Section adverse effects, Cicatrix, Uterus pathology, Hysterectomy adverse effects, Placenta pathology, Retrospective Studies, Placenta Accreta pathology, Placenta Previa pathology
Abstract

Introduction: The aim of this study is to document the distribution of classic versus non-classic presentation of Placenta Accreta Spectrum (PAS) disorders as well as grading categories by the Society for Pediatric Pathology (SPP) and FIGO systems in an institutional cohort of gravid hysterectomies. We also document the prevalence of uterine scar as a histologic correlate for uterine scar dehiscence, a phenomenon raised by some as central to PAS pathogenesis., Methods: PAS cases were assigned grade and designated as classic (anterior lower uterine segment implantation, prior C-section) or non-classic (implantation away from anterior lower uterine segment and/or no prior C-section). Features of dehiscence (uterine window, histologic evidence of scar) were recorded., Results: Sixty-two patients were included: 76 % had prior C-section; 55 % had other forms of uterine instrumentation. Classic PAS was recorded in 52 % patients; notably, 48 % had non-classic presentation; of these, all but one had prior instrumentation (curettage, myomectomy, laparoscopy). Uterine window was described in 53 % classic and 23 % non-classic PAS. Scar was demonstrated in 31 % classic and 23 % non-classic PAS; trichrome/reticulin stains were confirmatory. 32 % cases were SPP grade 1, 18 % grade 2, 18 % grade 3a and 32 % grade 3d. Grade 3 was significantly more common in classic (72 %) than non-classic (27 %) PAS., Discussion: While most PAS patients have classic presentation, a large subset does not; in addition, scar tissue is not identified histologically in most PAS hysterectomies; in these settings, PAS cannot be fully attributed to scar dehiscence. Uterine instrumentation often precedes non-classic PAS reinforcing the concept of decidual disruption as central to PAS pathogenesis. PAS grading as defined correlates with presentation (classic vs non-classic)., Competing Interests: Declaration of competing interest The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Published
2024
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10. Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial.

Author

Menon U, Gentry-Maharaj A, Burnell M, Singh N, Ryan A, Karpinskyj C, Carlino G, Taylor J, Massingham SK, Raikou M, Kalsi JK, Woolas R, Manchanda R, Arora R, Casey L, Dawnay A, Dobbs S, Leeson S, Mould T, Seif MW, Sharma A, Williamson K, Liu Y, Fallowfield L, McGuire AJ, Campbell S, Skates SJ, Jacobs IJ, and Parmar M

Subjects
Aged, CA-125 Antigen blood, Female, Humans, Longitudinal Studies, Middle Aged, Registries, State Medicine, Ultrasonography, United Kingdom epidemiology, Carcinoma, Ovarian Epithelial, Early Detection of Cancer, Ovarian Neoplasms epidemiology, Ovarian Neoplasms mortality
Abstract

Background: Ovarian cancer continues to have a poor prognosis with the majority of women diagnosed with advanced disease. Therefore, we undertook the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) to determine if population screening can reduce deaths due to the disease. We report on ovarian cancer mortality after long-term follow-up in UKCTOCS., Methods: In this randomised controlled trial, postmenopausal women aged 50-74 years were recruited from 13 centres in National Health Service trusts in England, Wales, and Northern Ireland. Exclusion criteria were bilateral oophorectomy, previous ovarian or active non-ovarian malignancy, or increased familial ovarian cancer risk. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer generated random numbers to annual multimodal screening (MMS), annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. Follow-up was through national registries. The primary outcome was death due to ovarian or tubal cancer (WHO 2014 criteria) by June 30, 2020. Analyses were by intention to screen, comparing MMS and USS separately with no screening using the versatile test. Investigators and participants were aware of screening type, whereas the outcomes review committee were masked to randomisation group. This study is registered with ISRCTN, 22488978, and ClinicalTrials.gov, NCT00058032., Findings: Between April 17, 2001, and Sept 29, 2005, of 1 243 282 women invited, 202 638 were recruited and randomly assigned, and 202 562 were included in the analysis: 50 625 (25·0%) in the MMS group, 50 623 (25·0%) in the USS group, and 101 314 (50·0%) in the no screening group. At a median follow-up of 16·3 years (IQR 15·1-17·3), 2055 women were diagnosed with tubal or ovarian cancer: 522 (1·0%) of 50 625 in the MMS group, 517 (1·0%) of 50 623 in the USS group, and 1016 (1·0%) of 101 314 in the no screening group. Compared with no screening, there was a 47·2% (95% CI 19·7 to 81·1) increase in stage I and 24·5% (-41·8 to -2·0) decrease in stage IV disease incidence in the MMS group. Overall the incidence of stage I or II disease was 39·2% (95% CI 16·1 to 66·9) higher in the MMS group than in the no screening group, whereas the incidence of stage III or IV disease was 10·2% (-21·3 to 2·4) lower. 1206 women died of the disease: 296 (0·6%) of 50 625 in the MMS group, 291 (0·6%) of 50 623 in the USS group, and 619 (0·6%) of 101 314 in the no screening group. No significant reduction in ovarian and tubal cancer deaths was observed in the MMS (p=0·58) or USS (p=0·36) groups compared with the no screening group., Interpretation: The reduction in stage III or IV disease incidence in the MMS group was not sufficient to translate into lives saved, illustrating the importance of specifying cancer mortality as the primary outcome in screening trials. Given that screening did not significantly reduce ovarian and tubal cancer deaths, general population screening cannot be recommended., Funding: National Institute for Health Research, Cancer Research UK, and The Eve Appeal., Competing Interests: Declaration of interests UM has stock ownership awarded by University College London (UCL) in Abcodia, which holds the licence for ROCA. She has received grants from the Medical Research Council (MRC), Cancer Research UK, the National Institute for Health Research (NIHR), and The Eve Appeal. She holds patent number EP10178345.4 for Breast Cancer Diagnostics. MP has received grants and AG-M, MB, AR, CK, GC, and SKM have been funded by grants from MRC, Cancer Research UK, NIHR, and The Eve Appeal. RM has received grants from The Eve Appeal, Rosetrees Charity, and Barts Charity, and personal fees from AstraZeneca. SJS holds the (expired) patent for ROCA, patented and owned by Massachusetts General Hospital and Queen Mary University of London, licenced to Abcodia. He reports stock options from SISCAPA Assay Technologies, and personal fees from Abcodia, Guardant Health, and Freenome, outside the submitted work. IJJ reports grants from Eve Appeal Charity, Medical Research Council, Cancer Research UK, and NIHR during the conduct of the study. He co-invented the ROCA in 1995, it was patented by Massachusetts General Hospital and Queen Mary University of London and is owned by these universities. Massachusetts General Hospital and Queen Mary University of London granted a licence to ROCA to Abcodia in 2014. IJJ is non-executive director, shareholder, and consultant to Abcodia and has rights to royalties from sales of the ROCA. He founded (1985), was a trustee of (2012–14), and is now an Emeritus trustee (2015–present) of The Eve Appeal, one of the funding agencies for UKCTOCS. All other authors declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Published
2021
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11. A case study: Glycosaminoglycan profiles of autologous chondrocyte implantation (ACI) tissue improve as the tissue matures.

Author

Sharma A, Rees D, Roberts S, and Kuiper NJ

Subjects
Adult, Cartilage Diseases diagnostic imaging, Chondrocytes metabolism, Humans, Time Factors, Transplantation, Autologous, Young Adult, Cartilage Diseases metabolism, Cartilage Diseases therapy, Chondrocytes transplantation, Glycosaminoglycans metabolism
Abstract

Background: Autologous chondrocyte implantation (ACI) has been used to treat cartilage defects in thousands of patients worldwide with good clinical effectiveness 10-20years after implantation. Information concerning the quality of the repair cartilage is still limited because biopsies are small and rare. Glycosaminoglycan structure influences physiological function and is likely to be important in the long term stability of the repair tissue. The aim of this study was to assess glycosaminoglycans in ACI tissue over a two year period., Methods: Biopsies were taken from one patient (25years old) at 12months and 20months post-ACI-treatment and from three normal cadavers (21, 22 and 25years old). Fluorophore-assisted carbohydrate electrophoresis (FACE) was used to quantitatively assess the individual glycosaminoglycans., Results: At 12months the ACI biopsy had 40% less hyaluronan than the age-matched cadaveric biopsies but by 20months the ACI biopsy had the same amount of hyaluronan as the controls. Both the 12 and 20month ACI biopsies had less chondroitin sulphate disaccharides and shorter chondroitin sulphate chains than the age-matched cadaveric biopsies. However, chondroitin sulphate chain length doubled as the ACI repair tissue matured at 12months (3913Da±464) and 20months (6923Da±711) and there was less keratan sulphate as compared to the controls., Conclusions: Although the glycosaminoglycan composition of the repair tissue is not identical to mature articular cartilage its quality continues to improve with time., (Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.)

Published
2017
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12. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial.

Author

Jacobs IJ, Menon U, Ryan A, Gentry-Maharaj A, Burnell M, Kalsi JK, Amso NN, Apostolidou S, Benjamin E, Cruickshank D, Crump DN, Davies SK, Dawnay A, Dobbs S, Fletcher G, Ford J, Godfrey K, Gunu R, Habib M, Hallett R, Herod J, Jenkins H, Karpinskyj C, Leeson S, Lewis SJ, Liston WR, Lopes A, Mould T, Murdoch J, Oram D, Rabideau DJ, Reynolds K, Scott I, Seif MW, Sharma A, Singh N, Taylor J, Warburton F, Widschwendter M, Williamson K, Woolas R, Fallowfield L, McGuire AJ, Campbell S, Parmar M, and Skates SJ

Subjects
Aged, Algorithms, CA-125 Antigen blood, Female, Humans, Membrane Proteins blood, Middle Aged, Outcome Assessment, Health Care, Proportional Hazards Models, United Kingdom, Early Detection of Cancer, Ovarian Neoplasms diagnosis, Ovarian Neoplasms mortality
Abstract

Background: Ovarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality., Methods: In this randomised controlled trial, we recruited postmenopausal women aged 50-74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032., Findings: Between June 1, 2001, and Oct 21, 2005, we randomly allocated 202,638 women: 50,640 (25·0%) to MMS, 50,639 (25·0%) to USS, and 101,359 (50·0%) to no screening. 202,546 (>99·9%) women were eligible for analysis: 50,624 (>99·9%) women in the MMS group, 50,623 (>99·9%) in the USS group, and 101,299 (>99·9%) in the no screening group. Screening ended on Dec 31, 2011, and included 345,570 MMS and 327,775 USS annual screening episodes. At a median follow-up of 11·1 years (IQR 10·0-12·0), we diagnosed ovarian cancer in 1282 (0·6%) women: 338 (0·7%) in the MMS group, 314 (0·6%) in the USS group, and 630 (0·6%) in the no screening group. Of these women, 148 (0·29%) women in the MMS group, 154 (0·30%) in the USS group, and 347 (0·34%) in the no screening group had died of ovarian cancer. The primary analysis using a Cox proportional hazards model gave a mortality reduction over years 0-14 of 15% (95% CI -3 to 30; p=0·10) with MMS and 11% (-7 to 27; p=0·21) with USS. The Royston-Parmar flexible parametric model showed that in the MMS group, this mortality effect was made up of 8% (-20 to 31) in years 0-7 and 23% (1-46) in years 7-14, and in the USS group, of 2% (-27 to 26) in years 0-7 and 21% (-2 to 42) in years 7-14. A prespecified analysis of death from ovarian cancer of MMS versus no screening with exclusion of prevalent cases showed significantly different death rates (p=0·021), with an overall average mortality reduction of 20% (-2 to 40) and a reduction of 8% (-27 to 43) in years 0-7 and 28% (-3 to 49) in years 7-14 in favour of MMS., Interpretation: Although the mortality reduction was not significant in the primary analysis, we noted a significant mortality reduction with MMS when prevalent cases were excluded. We noted encouraging evidence of a mortality reduction in years 7-14, but further follow-up is needed before firm conclusions can be reached on the efficacy and cost-effectiveness of ovarian cancer screening., Funding: Medical Research Council, Cancer Research UK, Department of Health, The Eve Appeal., (Copyright © 2016 Jacobs Menon et al. Open Access article published under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.)

Published
2016
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13. Intraoperative drug-eluting stent thrombosis in a patient undergoing robotic prostatectomy.

Author

Sharma A and Berkeley A

Subjects
Aged, Coronary Artery Disease complications, Coronary Artery Disease therapy, Electrocardiography, Fatal Outcome, Humans, Intraoperative Complications etiology, Male, Platelet Aggregation Inhibitors adverse effects, Platelet Aggregation Inhibitors therapeutic use, Prostatic Neoplasms surgery, Shock, Cardiogenic etiology, Shock, Cardiogenic therapy, Thrombosis etiology, Ventricular Fibrillation etiology, Drug-Eluting Stents adverse effects, Intraoperative Complications therapy, Prostatectomy, Robotics, Thrombosis therapy
Abstract

Insertion of drug-eluting stents is one of the strategies for treating patients with coronary artery disease. These patients can be a perioperative challenge in management as they need to be maintained on antiplatelet therapy to prevent stent thrombosis, which puts them at an increased risk for surgical bleeding. Recently revised guidelines on elective surgery following insertion of a drug-eluting stent recommend dual antiplatelet therapy for a period of twelve months. The management of a patient who presented for surgery more than two years after the insertion of a drug-eluting stent, and who developed in-stent thrombosis intraoperatively, is presented.

Published
2009
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