6 results on '"Sarah Pywell"'
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2. Effectiveness of SPECT/CT Imaging for Sentinel Node Biopsy Staging of Primary Cutaneous Melanoma and Patient Outcomes
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Clare Beadsmoore, Matthew Gray, Sarah Pywell, Davina Pawaroo, Marc Moncrieff, David Newman, Martin Heaton, and Andrew Snelling
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medicine.diagnostic_test ,business.industry ,Melanoma ,Hazard ratio ,Sentinel node ,medicine.disease ,Confidence interval ,Oncology ,Surgical oncology ,Biopsy ,Cutaneous melanoma ,Cohort ,medicine ,Surgery ,business ,Nuclear medicine - Abstract
Purpose Coregistered SPECT/CT can improve accuracy of sentinel node biopsy (SNB) for staging melanoma. This benefit has implications for pathology services and surgical practice with increased diagnostic and surgical workload. The purpose of this study was to investigate the effectiveness of SPECT/CT imaging. Methods SNB data were collected over a 10-year period. Preoperative SLN mapping was performed by using planar lymphoscintigraphy (LSG) for all patients (n = 1522) and after October 2015, patients underwent a second co-registered SPECT/CT scan (n = 559). The patients were stratified according to the imaging protocol. The number of nodes and nodal basins were assessed. The reasons for cancellation also were assessed. Results A total of 95% (1446/1522) of patients underwent a successful SNB procedure. Significantly more sentinel nodes were identified by the SPECT/CT protocol (3 vs. 2; p < 0.0001). More patients were cancelled in the SPECT/CT cohort (9.3% vs. 2.5%; p < 0.0001). Head & neck, lower limb, and AJCC IB primaries were significantly less likely to proceed to SNB. SPECT/CT identified significantly more positive SNBs (20.9% vs. 16.5%; p = 0.038). SPECT/CT imaging was associated with improved disease-free (hazard ratio [HR] = 0.74; 95% confidence interval [CI]: 0.54–1.0); p = 0.048) and disease-specific survival (HR = 0.48; 95% CI: 0.3–0.78; p = 0.003). Patients who did not proceed to SNB had a significantly increased nodal relapse rate (23.5% vs. 6.8%; HR = 3.4; 95% CI: 1.9–6.2; p < 0.0001) compared with those who underwent SNB. Conclusions This large cohort study confirms the increased accuracy of SPECT/CT for identifying SLN metastases, which would appear to have a significant therapeutic benefit, although an increased risk of cancellation of the SNB procedure on the day of surgery.
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- 2021
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3. ASO Author Reflections: Effectiveness of SPECT/CT imaging for sentinel node biopsy staging of primary cutaneous melanoma and patient outcomes
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Martin Heaton, Sarah Pywell, David Newman, Marc Moncrieff, Clare Beadsmoore, Andrew Snelling, Davina Pawaroo, and Matthew Gray
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Diagnostic Imaging ,Tomography, Emission-Computed, Single-Photon ,medicine.medical_specialty ,Single Photon Emission Computed Tomography Computed Tomography ,Skin Neoplasms ,medicine.diagnostic_test ,Sentinel Lymph Node Biopsy ,business.industry ,ASO Author Reflections ,Sentinel node ,Cohort Studies ,Oncology ,Surgical oncology ,Cutaneous melanoma ,Biopsy ,medicine ,Humans ,Surgery ,Radiology ,Ct imaging ,business ,Melanoma ,Neoplasm Staging - Abstract
Purpose Coregistered SPECT/CT can improve accuracy of sentinel node biopsy (SNB) for staging melanoma. This benefit has implications for pathology services and surgical practice with increased diagnostic and surgical workload. The purpose of this study was to investigate the effectiveness of SPECT/CT imaging. Methods SNB data were collected over a 10-year period. Preoperative SLN mapping was performed by using planar lymphoscintigraphy (LSG) for all patients (n = 1522) and after October 2015, patients underwent a second co-registered SPECT/CT scan (n = 559). The patients were stratified according to the imaging protocol. The number of nodes and nodal basins were assessed. The reasons for cancellation also were assessed. Results A total of 95% (1446/1522) of patients underwent a successful SNB procedure. Significantly more sentinel nodes were identified by the SPECT/CT protocol (3 vs. 2; p < 0.0001). More patients were cancelled in the SPECT/CT cohort (9.3% vs. 2.5%; p < 0.0001). Head & neck, lower limb, and AJCC IB primaries were significantly less likely to proceed to SNB. SPECT/CT identified significantly more positive SNBs (20.9% vs. 16.5%; p = 0.038). SPECT/CT imaging was associated with improved disease-free (hazard ratio [HR] = 0.74; 95% confidence interval [CI]: 0.54–1.0); p = 0.048) and disease-specific survival (HR = 0.48; 95% CI: 0.3–0.78; p = 0.003). Patients who did not proceed to SNB had a significantly increased nodal relapse rate (23.5% vs. 6.8%; HR = 3.4; 95% CI: 1.9–6.2; p < 0.0001) compared with those who underwent SNB. Conclusions This large cohort study confirms the increased accuracy of SPECT/CT for identifying SLN metastases, which would appear to have a significant therapeutic benefit, although an increased risk of cancellation of the SNB procedure on the day of surgery.
- Published
- 2022
4. ASO Visual Abstract: Effectiveness of SPECT/CT Imaging for Sentinel Node Biopsy Staging of Primary Cutaneous Melanoma and Patient Outcomes
- Author
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Martin Heaton, Sarah Pywell, Matthew Gray, Davina Pawaroo, Clare Beadsmoore, Marc Moncrieff, Andrew Snelling, and David Newman
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medicine.medical_specialty ,Oncology ,medicine.diagnostic_test ,business.industry ,Surgical oncology ,Cutaneous melanoma ,Biopsy ,Medicine ,Surgery ,Radiology ,Sentinel node ,Ct imaging ,business - Published
- 2021
- Full Text
- View/download PDF
5. Atypical Chest Pain: An Unusual Presentation of Spinal Metastasis due to Penile Carcinoma
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Mohammad Taimur Khan, Sarah Pywell, N. Sivanadarajah, Mohammad Zain Sohail, Shumaila Hasan, Cameron Dott, and Georgios Mamarelis
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030203 arthritis & rheumatology ,medicine.medical_specialty ,Neurology ,Cord ,business.industry ,lcsh:Surgery ,Case Report ,lcsh:RD1-811 ,medicine.disease ,Chest pain ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Penile Carcinoma ,medicine ,Carcinoma ,Back pain ,Spinal metastasis ,Pharmacology (medical) ,medicine.symptom ,Presentation (obstetrics) ,business ,030217 neurology & neurosurgery - Abstract
Spinal metastases may present in a myriad of ways, most commonly back pain with or without neurology. We report an unusual presentation of isolated atypical chest pain preceding metastatic cord compression, secondary to penile carcinoma. Spinal metastasis from penile carcinoma is rare with few cases reported. This unusual presentation highlights the need for a heightened level of clinical suspicion for spinal metastases as a possible cause for chest pain in any patients with a history of carcinoma. The case is discussed with reference to the literature.
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- 2016
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6. Early years postgraduate surgical training programmes in the UK are failing to meet national quality standards: An analysis from the ASiT/BOTA Lost Tribe prospective cohort study of 2,569 surgical trainees
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James C. Glasbey, Rhiannon L. Harries, Andrew J. Beamish, Vimal J. Gokani, Helen Mohan, Adam P. Williams, Simon Fleming, Aaron Chai, Abhinav Singh, Adam C.S. Stoneham, Adam J. Lunt, Adeeb H. Rehman, Adeel A. Dhahri, Adrien R.A. Yvon, Agneish Dutta, Ahmad K. Abou-Foul, Ahmed Abdelrahman, Ahmed Daoub, Ahmed Sanalla, Aitor de Gea Rico, Alastair Konarski, Alex E. Ward, Alex J. Wilkin, Alexandra K. Winter, Ali Arnaout, Ali Bakhsh, Alireza Esfandiari, Alistair W. Hardy, Amad N. Khan, Amitabh Thacoor, Ana D. Gavrila, Anca-Mihaela Nedea, Andreas Fontalis, Andrew J. Hall, Andrew J. Williamson, Angeliki Kosti, Anna Harlinska, Anthony Adimonye, Anthony Egglestone, Anthony J. Thaventhiran, Antonia Myatt, Anuhya Vusirikala, Arab S. Rawashdeh, Arjun C. Paramasivan, Arthur E. Cotton, Ashley B. Scrimshire, Ashwanth C. Ramesh, Ashwin K. Krishnamoorthy, Asif Ahmed, Ayeshah Abdul-Hamid, Ayushah Khan, Babatunde Oremule, Beatrice Ho, Ben Barkham, Ben Collard, Ben F. Edgar, Benjamin Drake, Bethan E. John, Catherine R. Gordon, Catherine Rossborough, Chang Y. Park, Charalampos Seretis, Charles H.N. Johnson, Charn Gill, Chiara Serino, Chinomso I. Ogbuokiri, Chloe Swords, Chong Y. Kang, Chris McKinnon, Christopher E. Brown, Christopher J. Manning, Christopher J. Marusza, Christopher P. Jones, Cillian T. Forde, Claire L. Wilson, Claudia Koh, Conal Horgan, Daniel J. Lin, Daniel L. Ashmore, Daniel Ness, Daniel O. Akhtar, Daniel T. Doherty, Daniel W. Scholfield, David C. Ensor, David G. Bratt, David J.R. Spence, David R. Thomson, David W. Ferguson, Denish Apparau, Devaraj M. Navaratnam, Dinh Mai, Duncan G. Rutherford, Edward Karam, Eiling Wu, Eleanor F. Zimmermann, Eleftheria Douka, Elinor Flatt, Elizabeth G. Kane, Elizabeth L. Thornhill, Emanuele Gammeri, Emma G. Littlehales, Epaminondas M. Valsamis, Erin J. Hankin, Erin R.M. Meenan, Etienne N. Botha, Farhan Khalid, Fatema Patel, Fiachra R. Power, Fiona M. Rutherford, Fozia Saeed, Francesca L. Guest, Francisco J. Barbosa, Fraser G. Cameron, Furqan R. Raja, Gajendiran Thiruchandran, Gavish Munbauhal, Gemma E. Dovey, Gemma E. Hogg, George E. Dovell, George Matheron, George T. Hill, Georgia R. Layton, Georgiana G.S. Jong, Georgina Hicks, Graham J. Millward, Grahame A. Shaw, Gregory F.W. Stamp, Hammad Parwaiz, Han Hong Chong, Hannah C. Copley, Hannah C. Lennox-Warburton, Hannah M. Emerson, Harry F. Dean, Hazim Eltyeb, Howard O. Chu, Iannish Sadien, Imran M. Mohamed, Iram Parwaiz, Isabella M.H. Drummond, Jack C.H. Pearce, Jacob J. Ahmed, Jacob Koris, Jaideep S. Rait, James A. Bailey, James A. Cohen, James A. Kennedy, James B. Olivier, James Bailey, James E. Archer, James J. Stewart, James N.J.Monteiro de Barros, James R. Allen, James W. O'Brien, null James, T. McGhee, Jared N. Quarcoopome, Jasmine C. Winyard, Jason L. Roberts, Jennifer S. Barwell, Jeremy Rodrigues, Jessica A.R. Chapman, Jessica Y. Fairbanks, Jessika Voll, Jie Q. Lim, Jin H. Chang, Joanna L. Bovis, John Ferns, Johnson Pok Him Tam, Jonathan B.T. Herron, Jonathan D.R. Macdonald, Jonathan R. Ducey, Joseph W. DIxon, Joshua T. Luck, Kalon Hewage, Kamal M. Yakoub, Kamran F. Bhopal, Karen A. Vejsbjerg, Karim Aboelmagd, Katarzyna D. Bera, Katharine E. Hamlett, Katherine E. Fok, Katherine V. Hurst, Kathryn L. Gillams, Katie L. Siggens, Katie Young, Kenneth M. Burns, Kerry A. Burke, Kevin Seebah, Khalid A. Shah, Kieran R. Bentick, Kiran Majid, Kirsty L. Davies, Krystal Tan, Kwaku W. Baryeh, Laura A.F. Phillips, Laura N. Ellerton, Leeying J. Giet, Liam Monaghan, Lok Ka Cheung, Louise L. Shen, Louise Paramore, Lucy J. Arrowsmith, Lukas A. Attwell, Luke Thornton, Luting Xu, Madeline L. Leadon, Madhavi Natarajan, Maria C.R. Houlihan, Marisa Cheah, Markus L. Sagmeister, Maryam Abubakar, Matthew F. Flynn, Matthew Harris, Matthew J. Stone, Matthew J. Young, Matthew P. Gray, Matthew P. Horner, Matthew Schembri, Matthew Trail, Melvin Joy, Michael J. Rice, Michael P. Thomas, Michael T.C. Poon, Michael T. Stoddart, Michelle L. Fong, Mitchell T. Foster, Mohamed F. Mohamud, Mohammed N. Hoque, Mohammedabbas Remtulla, Mohsin Javed Karim, Monika Rezacova, Muhammad B. Siddiqui, Muhammad R. Iqbal, Mussa Mensa, Nadine McCauley, Natasha J. Bauer, Nathan Walker, Navid A. Hakim, Ngonidzashe Knight, Niall O'Hara, Nicholas A. Fawcett, Nicholas Wong, Nicola F.D. Allen, Nilofer Husnoo, Nimisha Vallabh, Nisaharan Srikandarajah, Nnaemeka Chidumije, Obaiy Elamin, Odunayo O. Akinlaja, Olga Griffiths, Oliver D. Brown, Oliver Shastri, Olivia J. Cameron, Olivia Kenyon, Omar A. Javed, Opeyemi O. Sogaolu, Panagiota Birmpili, Patricia Haylock-Vize, Patrick A. Green, Patrick J. Carroll, Peiming Yang, Philip Beak, Pia Persson, Pok Him Johnson Tam, Rabia Waqar, Rachael L. Morley, Rachel Clare Bowden, Rachel L. Eyre, Rahul M. Pankhania, Rajpreet S. Sahemey, Rakan Kabariti, M. Rawashdeh, Rawashdeh S. Arab, Rebecca A. Rollett, Rebecca S. Nicholas, Rebecca V. Morgan, Richard Limb, Richard Mark Robinson, Richard S. Hayes, Ridwan Daureeawoo, Robert A. Cooke, Robert A.J. Espey, Robert Chessman, Robert D.J. Whitham, Robert E. Payne, Robert Staruch, Roberto J.R. Alho, Robin Gordon, Rory Cuthbert, Roseanna B. Harrison, Rupert A. Scott, Ruth M. Parks, Ryan C.T. Cheong, Ryan L. Hillier-Smith, Ryan Moffatt, Saad Rehman, Sabah Ambren, Sabria Abdulal, Sagar Kulkarni, Sam Hopwood, Samantha H. Greenfield, Samir K. Mehta, Samuel Haines, Sarah A. AlSaati, Sarah A. Williams, Sarah El-Badawy, Sarah L. Barlow, Sarah Pywell, Sarah-jayne Pollock, Savvas Lampridis, Scarlet Nazarian, Sean Rezvani, Sean Scattergood, Sebastian M. Toescu, Sesi Hotonu, Shafaque Shaikh, Shamil Rupani, Shumaila Hasan, Shwetha Pradeep, Simon J. Cole, Siona A. Growcott, Sofia E. Bedoya, Sonia I. Ike, Stefan V. Bodnarescu, Stella C. Seppings, Stephanie A. Poyntz, Stevan J. Jordan, Sundas Iqbal, Suparna Das, Suravi Chatterjee-Woolman, Syed Shumon, Tamsin E.M. Morrison, Tara Sibartie, Tariq Aboelmagd, Thomas B. Russell, Thomas C. Seddon, Thomas D. Stringfellow, Thomas Goldsmith, Thomas H.F. Banks, Thomas Tolley, Tobenna J. Oputa, Todd T. Kanzara, Tom Challoner, Tomas Urbonas, Tomos B. Richards, Victoria J. Morrison-Jones, Vivek Garikapati, Waheeb A.K. Al-Azzani, Wajiha Zahra, Weiguang Ho, Wesam Al-Dhahir, William G.W. Gibson, Yasmin Grant, Yasser Hijazi, Yayganeh Chiang, Zobia K. Gundkalli, Zoe M. Seymour, and Zoe Panayi
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medicine.medical_specialty ,media_common.quotation_subject ,education ,Specialties, Surgical ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,medicine ,Tribe ,Humans ,Quality (business) ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Societies, Medical ,media_common ,Quality Indicators, Health Care ,Descriptive statistics ,business.industry ,General Medicine ,Surgical training ,United Kingdom ,Education, Medical, Graduate ,030220 oncology & carcinogenesis ,Family medicine ,Workforce ,Cohort ,Surgery ,Observational study ,Clinical Competence ,Guideline Adherence ,business - Abstract
Introduction This study aimed to assess training of Senior House Officer-grade equivalent doctors in postgraduate surgical training or service (SHO-DIPST) in surgical specialties across the United Kingdom (UK), against nationally agreed Joint Committee on Surgical Training Quality Indicators (JCST QIs). Specific recommendations are made, with a view to improving quality of training, workforce retention and recruitment to Higher Surgical Training. Method Prospective, observational, multicentre study conducted by the Association of Surgeons in Training, using the UK National Research Collaborative model. Any centres in the UK providing acute surgical services were eligible. SHO-DIPST with a permanent contract, on out-of-hours ‘on-call rota' were included across four, one-week data capture periods (September to October 2016, February to March 2017). Adherence to five quality indicators was reported using descriptive statistics. P-values were calculated using Student's t-test for continuous data, with a 5% level of significance. Results 2569 SHO-DIPST were included from all ten surgical specialties in 141 NHS trusts across all 16 Local Education and Training Boards in the UK. 960 SHO-DIPST were in registered ‘training' posts (37.3%). The median number of SHO-DIPST per rota was 7.0 (IQR 5.0–9.0). Adherence to the five included JCST QIs ranged from 6.0 to 53.1%. Only four SHO-DIPST posts across the study population met all five JCST QIs (0.3%). The total number of training sessions was higher for those in registered training posts (p Conclusions Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training.
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- 2017
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