87 results on '"Michael Stanton"'
Search Results
2. Uncertain Waters: Beyond a Metropolitan Sublime
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Michael Stanton
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Sublime ,Tower ,Sea ,Late-Capitalism ,Monument ,Architecture ,NA1-9428 - Abstract
The demise of the World Trade Towers grotesquely inflated the sublime! Edmund Burke’s inclusion of fear and awe as elements of aesthetics has come to dominate representational canons, but the extreme effect of the 9/11 attacks rendered the concept intolerable while subsequent architectural work seems to have reacted with the proliferation of extreme and often unsettling contortions, vertiginous cantilevers and unbalanced profiles! Standing for the machinations of the previous millennium, upon their extirpation these minimal monoliths became the most potent auspices for the next. Before falling they were extraordinarily blank formally while provoking sectarian rage toward the institutions they stood for - New York, the U.S. and multinational commerce. An improbable history of the violent demise of his buildings plagued their designer as well! Collapse made them true monuments in the funereal sense of the word and profoundly significant as the globe drifts toward dystopia, advantaging plutocracy and distilling resentment in many cultures.
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- 2023
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3. The Management of Asymptomatic Congenital Pulmonary Airway Malformation: Results of a European Delphi Survey
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Casper M. Kersten, Sergei M. Hermelijn, Dhanya Mullassery, Nagarajan Muthialu, Nazan Cobanoglu, Silvia Gartner, Pietro Bagolan, Carmen Mesas Burgos, Alberto Sgrò, Stijn Heyman, Holger Till, Janne Suominen, Maarten Schurink, Liesbeth Desender, Paul Losty, Henri Steyaert, Suzanne Terheggen-Lagro, Martin Metzelder, Arnaud Bonnard, Rony Sfeir, Michael Singh, Iain Yardley, Noor R. V. M. Rikkers-Mutsaerts, Cornelis K. van der Ent, Niels Qvist, Des W. Cox, Robert Peters, Michiel A. G. E. Bannier, Lucas Wessel, Marijke Proesmans, Michael Stanton, Edward Hannon, Marco Zampoli, Francesco Morini, Harm A. W. M. Tiddens, René M. H. Wijnen, and Johannes M. Schnater
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congenital lung abnormalities ,congenital pulmonary airway malformation ,core outcome set ,outcome parameters ,consensus ,Pediatrics ,RJ1-570 - Abstract
Consensus on the optimal management of asymptomatic congenital pulmonary airway malformation (CPAM) is lacking, and comparison between studies remains difficult due to a large variety in outcome measures. We aimed to define a core outcome set (COS) for pediatric patients with an asymptomatic CPAM. An online, three-round Delphi survey was conducted in two stakeholder groups of specialized caregivers (surgeons and non-surgeons) in various European centers. Proposed outcome parameters were scored according to level of importance, and the final COS was established through consensus. A total of 55 participants (33 surgeons, 22 non-surgeons) from 28 centers in 13 European countries completed the three rounds and rated 43 outcome parameters. The final COS comprises seven outcome parameters: respiratory insufficiency, surgical complications, mass effect/mediastinal shift (at three time-points) and multifocal disease (at two time-points). The seven outcome parameters included in the final COS reflect the diversity in priorities among this large group of European participants. However, we recommend the incorporation of these outcome parameters in the design of future studies, as they describe measurable and validated outcomes as well as the accepted age at measurement.
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- 2022
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4. Conservative treatment for uncomplicated appendicitis in children: the CONTRACT feasibility study, including feasibility RCT
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Nigel J Hall, Frances C Sherratt, Simon Eaton, Isabel Reading, Erin Walker, Maria Chorozoglou, Lucy Beasant, Wendy Wood, Michael Stanton, Harriet J Corbett, Dean Rex, Natalie Hutchings, Elizabeth Dixon, Simon Grist, William van’t Hoff, Esther Crawley, Jane Blazeby, and Bridget Young
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appendicitis ,surgery ,non-operative treatment ,qualitative research ,core outcome set ,feasibility trial ,patient and public involvement ,Medical technology ,R855-855.5 - Abstract
Background: Although non-operative treatment is known to be effective for the treatment of uncomplicated acute appendicitis in children, randomised trial data comparing important outcomes of non-operative treatment with those of appendicectomy are lacking. Objectives: The objectives were to ascertain the feasibility of conducting a multicentre randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of a non-operative treatment pathway with appendicectomy for the treatment of uncomplicated acute appendicitis in children. Design: This was a mixed-methods study, which included a feasibility randomised controlled trial, embedded and parallel qualitative and survey studies, a parallel health economic feasibility study and the development of a core outcome set. Setting: This study was set in three specialist NHS paediatric surgical units in England. Participants: Children (aged 4–15 years) clinically diagnosed with uncomplicated acute appendicitis participated in the feasibility randomised controlled trial. Children, their families, recruiting clinicians and other health-care professionals involved in caring for children with appendicitis took part in the qualitative study. UK specialist paediatric surgeons took part in the survey. Specialist paediatric surgeons, adult general surgeons who treat children, and children and young people who previously had appendicitis, along with their families, took part in the development of the core outcome set. Interventions: Participants in the feasibility randomised controlled trial were randomised to a non-operative treatment pathway (broad-spectrum antibiotics and active observation) or appendicectomy. Main outcome measures: The primary outcome measure was the proportion of eligible patients recruited to the feasibility trial. Data sources: Data were sourced from NHS case notes, questionnaire responses, transcribed audio-recordings of recruitment discussions and qualitative interviews. Results: Overall, 50% (95% confidence interval 40% to 59%) of 115 eligible patients approached about the trial agreed to participate and were randomised. There was high acceptance of randomisation and good adherence to trial procedures and follow-up (follow-up rates of 89%, 85% and 85% at 6 weeks, 3 months and 6 months, respectively). More participants had perforated appendicitis than had been anticipated. Qualitative work enabled us to communicate about the trial effectively with patients and families, to design and deliver bespoke training to optimise recruitment and to understand how to optimise the design and delivery of a future trial. The health economic study indicated that the main cost drivers are the ward stay cost and the cost of the operation; it has also informed quality-of-life assessment methods for future work. A core outcome set for the treatment of uncomplicated acute appendicitis in children and young people was developed, containing 14 outcomes. There is adequate surgeon interest to justify proceeding to an effectiveness trial, with 51% of those surveyed expressing a willingness to recruit with an unchanged trial protocol. Limitations: Because the feasibility randomised controlled trial was performed in only three centres, successful recruitment across a larger number of sites cannot be guaranteed. However, the qualitative work has informed a bespoke training package to facilitate this. Although survey results suggest adequate clinician interest to make a larger trial possible, actual participation may differ, and equipoise may have changed over time. Conclusions: A future effectiveness trial is feasible, following limited additional preparation, to establish appropriate outcome measures and case identification. It is recommended to include a limited package of qualitative work to optimise recruitment, in particular at new centres. Future work: Prior to proceeding to an effectiveness trial, there is a need to develop a robust method for distinguishing children with uncomplicated acute appendicitis from those with more advanced appendicitis, and to reach agreement on a primary outcome measure and effect size that is acceptable to all stakeholder groups involved. Trial registration: Current Controlled Trials ISRCTN15830435. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 10. See the NIHR Journals Library website for further project information.
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- 2021
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5. Management and early outcomes of children with appendicitis in the UK and Ireland during the COVID-19 pandemic: a survey of surgeons and observational study
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Nigel J Hall, Vivek Gupta, Anna-may Long, Nuha Yassin, Alan Askari, David Colvin, Stewart Cleeve, Arun Kelay, Chris Driver, Clare Rees, Eleri Cusick, Hetal Patel, Ingo Jester, Khalid Elmalik, Sean Marven, Tim Bradnock, Oliver Brown, Andrew Jackson, Richard Egan, Laura Phillips, Marianne Hollyman, Bankole Oyewole, Fenella Welsh, Dale Vimalachandran, Melissa Gabriel, Kate Cross, Iain Yardley, Mark Peter, Andrew Beamish, Sophie Lewis, Milan Gopal, Joshua McIntyre, Merrill McHoney, Ionica Stoica, Hany Gabra, Tristan Boam, Angeliki Kosti, Katie cross, Andrew Mitchell, Michael Terry, George S Bethell, Clare M Rees, Jonathan R Sutcliffe, Florin Djendov, Victor Emordi, Sarah Staight, Christina Major, Oscar Croysdale, Mike Nelson, Hannah Rhodes, Juliette King, Gillian Winter, Selena Curkovic, Raef Jackson, Bhushanrao Jadhav, Thomas Raymond, Vijay Gangalam, Deepak Selvakumar, Reda Habak, Muslim Abdullah, Mohamed Ahmed Osama, Khlud Asanai, Noman Zafar, Sophia Lewis, Florence Kashora, Dixa Thakrar, Dean Rex, Annita Budzanowski, Jennifer Binnington, Simon Timbrell, Megan Ridgeway, Shirley Chan, Amani Asour, Adetayo Aderombi, Donald Menzies, Ali Murtada, Corina Dragu, Vincent Quan, Krashna Patel, Sesi Hotonu, Ashley Meikle, Ajay Belgaumkar, Prabhat Narayan, Thomas Badenoch, Frances Goulder, Katie Siggens, Kizzie Peters, Fiona Kirkham, Paul Froggatt, Karen Lai, Cristina Navarro, Dorinda Chandrabose, Simon Toh, Elizabeth Gemmill, Keira Lily, Mark Dilworth, Dimitrios Stamatiou, Alasdair Macmillan, Danielle Clyde, Majid Rashid, Gandrapu Srinivas, Katherine Buckley, Darren Smith, Henry Dowson, Gautam Singh, Seshu Kumar Bylapudi, Louise Phillips, Kimberley Hallam, Marisa Clemente, Karol Pal, George Ninkovic-Hall, Emila Paul, Theo Pelly, Joe Vance-Daniel, Venkatesh Kanakala, Edward J Nevins, James Dixon, Michael John, Jude Prince, Georgios Karagiannidis, Suzette Samlalsingh, Chrsitine Ozone, Amina Bouhelal, Siddhartha Handa, Sathasivam Rajeev, Ellen Ross, Ali Wadah, John Hallett, Shirish Tewari, Vinay Shah, Nick Reay-Jones, Salman Bodla, Harriet Corbett, Sumita Chhabra, Athanasios Tyraskis, Benjamin Allin, Angus Fitchie, Michael Stanton, Mark Vipond, Harry Dean, Matthew Boal, Jonathan Goring, Mahmoud Marei, Christian Verhoef, Jonathan Ducey, Chipo Mushonga, Dan Frith, Ashok Ram, Ferzine Mohamed, Nadine Dyar, Rick MacMahon, Mohammed Fakhrul-Aldeen, Iain Bain, Graham Branagan, Rachel Carten, Chee Wan Lai, Anindya Niyogi, Claudia Koh, Christian Fox, Stavros Loukogeorgakis, Joe Curry, Jayaram Sivaraj, Milda Jancauskaite, Helen Please, Wayne Fradley, Maki Jitsumara, Sinead Hassett, Ancuta Muntean, Sarah Yassin, Suzanne Lawther, Ciaran Durand, Mohamed Eltom, Kirsty Brennan, Clara Chong, Hasan Mukhtar, Hany Khalil, Stephanie Clark, Ashish Desai, Amulya Saxena, Joshua Cave, Alistair Sharples, Lukas O’Brien, George Kerans, Ashwini Ghorpade, Felicity Arthur, Muhammad Tobbal, Rachael Robertson, Ben Martin, Ben Woodward, Kieran McGovern, and Duncan Rutherford
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Pediatrics ,RJ1-570 - Abstract
Objectives Acute appendicitis is the most common surgical condition in children. In the UK, appendicectomy is the most common treatment with non-operative management unusual. Due to concerns about the risk of SARS-CoV-2 transmission during surgical procedures, surgeons were advised to consider non-operative treatment and avoid laparoscopy where possible. This study aims to report management and outcomes, to date, of children with appendicitis in the UK and Ireland during the COVID-19 pandemic.Design Survey of consultant surgeons who treat children with appendicitis that informed a prospective multicentre observational cohort study.Setting Data were collected from centres in the UK and Ireland for cases admitted between 1 April and 31 May 2020 (first 2 months of the COVID-19 pandemic) at both general surgical and specialist paediatric surgical centres.Participants The study cohort includes 838 children with a clinical and/or radiological diagnosis of acute appendicitis of which 527 (63%) were male.Main outcomes measured Primary outcome was treatment strategy used for acute appendicitis. Other outcomes reported include change in treatment strategy over time, use of diagnostic imaging and important patient outcomes to 30 days following hospital admission.Results From very early in the pandemic surgeons experienced a change in their management of children with appendicitis and almost all surgeons who responded to the survey anticipated further changes during the pandemic. Overall, 326/838 (39%) were initially treated non-operatively of whom 81/326 (25%) proceeded to appendicectomy within the initial hospital admission. Of cases treated initially surgically 243/512 (48%) were performed laparoscopically. Diagnostic imaging was used in 445/838 (53%) children. Cases treated non-operatively had a shorter hospital stay than those treated surgically but hospital readmissions within 30 days were similar between groups. In cases treated surgically the negative appendicectomy rate was 4.5%. There was a trend towards increased use of surgical treatment and from open to laparoscopic appendicectomy as the pandemic progressed.Conclusion Non-operative treatment of appendicitis has been widely used for the first time in children in the UK and Ireland and is safe and effective in selected patients. Overall patient outcomes do not appear to have been adversely impacted by change in management during the pandemic thus far.
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- 2020
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6. Development of a Click Beetle Luciferase Reporter System for Enhanced Bioluminescence Imaging of Listeria monocytogenes: Analysis in Cell Culture and Murine Infection Models
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Sadeeq Ur Rahman, Michael Stanton, Pat G. Casey, Angela Spagnuolo, Giuliano Bensi, Colin Hill, Kevin P. Francis, Mark Tangney, and Cormac G. M. Gahan
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Listeria monocytogenes ,click beetle luciferase ,bioluminescence ,in vivo imaging ,pathogen ,virulence ,Microbiology ,QR1-502 - Abstract
Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that is widely used as a model organism for the analysis of infection biology. In this context, there is a current need to develop improved reporters for enhanced bioluminescence imaging (BLI) of the pathogen in infection models. We have developed a click beetle red luciferase (CBR-luc) based vector (pPL2CBRopt) expressing codon optimized CBR-luc under the control of a highly expressed Listerial promoter (PHELP) for L. monocytogenes and have compared this to a lux-based system expressing bacterial luciferase for BLI of the pathogen using in vitro growth experiments and in vivo models. The CBR-luc plasmid stably integrates into the L. monocytogenes chromosome and can be used to label field isolates and laboratory strains of the pathogen. Growth experiments revealed that CBR-luc labeled L. monocytogenes emits a bright signal in exponential phase that is maintained during stationary phase. In contrast, lux-labeled bacteria produced a light signal that peaked during exponential phase and was significantly reduced during stationary phase. Light from CBR-luc labeled bacteria was more efficient than the signal from lux-labeled bacteria in penetrating an artificial tissue depth assay system. A cell invasion assay using C2Bbe1 cells and a systemic murine infection model revealed that CBR-luc is suited to BLI approaches and demonstrated enhanced sensitivity relative to lux in the context of Listeria infection models. Overall, we demonstrate that this novel CBR reporter system provides efficient, red-shifted light production relative to lux and may have significant applications in the analysis of L. monocytogenes pathogenesis.
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- 2017
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7. A Single-Tunnel Technique for Coracoclavicular and Acromioclavicular Ligament Reconstruction
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Michael B. Banffy, M.D., Carola F. van Eck, M.D., Ph.D., Michael Stanton, M.D., and Neal S. ElAttrache, M.D.
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Orthopedic surgery ,RD701-811 - Abstract
Acromioclavicular (AC) joint separation is a common injury seen in the young adult athletic population. Both the indications for surgical management and the best operative technique remain controversial. One of the most popular reconstruction techniques is the anatomic double-tunnel coracoclavicular (CC) ligament reconstruction. However, there have been several case reports of clavicle fractures with this technique. This article presents a single-tunnel reconstruction technique that aims to restore both the CC and AC ligament function, while minimizing fracture risk.
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- 2017
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8. Development of a Bioluminescent Nitroreductase Probe for Preclinical Imaging.
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Anzhelika G Vorobyeva, Michael Stanton, Aurélien Godinat, Kjetil B Lund, Grigory G Karateev, Kevin P Francis, Elizabeth Allen, Juri G Gelovani, Emmet McCormack, Mark Tangney, and Elena A Dubikovskaya
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Medicine ,Science - Abstract
Bacterial nitroreductases (NTRs) have been widely utilized in the development of novel antibiotics, degradation of pollutants, and gene-directed enzyme prodrug therapy (GDEPT) of cancer that reached clinical trials. In case of GDEPT, since NTR is not naturally present in mammalian cells, the prodrug is activated selectively in NTR-transformed cancer cells, allowing high efficiency treatment of tumors. Currently, no bioluminescent probes exist for sensitive, non-invasive imaging of NTR expression. We therefore developed a "NTR caged luciferin" (NCL) probe that is selectively reduced by NTR, producing light proportional to the NTR activity. Here we report successful application of this probe for imaging of NTR in vitro, in bacteria and cancer cells, as well as in vivo in mouse models of bacterial infection and NTR-expressing tumor xenografts. This novel tool should significantly accelerate the development of cancer therapy approaches based on GDEPT and other fields where NTR expression is important.
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- 2015
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9. Adaptive IV&V for Increasingly Complex Software Systems
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Wesley W Deadrick, William Michael Stanton, Scott Tyler Thorn, Lawrence C Ullom, and Van A Casdorph
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Quality Assurance and Reliability - Abstract
As NASA software systems continue to innovate, becoming more complex and nondeterministic, the need for the NASA IV&V Program to become systemically adaptive to ensure mission success is paramount. To ensure adaptability within resource constraints, IV&V has developed an agile, risk-based approach to identify, characterize, scope, focus, and prioritize mission assurance activities. This risk based adaptive framework has been applied to trends such as increased reliance on data driven algorithms for safety and mission critical software behavior, use of MBSE in system design, and application of agile principles to embedded software development. The framework is enabled by continuous innovation of new approaches such as software only test beds, assurance design tools, and initiatives that augment IV&V assurance methods with artificial intelligence and machine learning techniques. This presentation will highlight the trends the NASA IV&V Program is seeing, the innovative steps it is taking to address those challenges, and how it is postured to address evolving risk and constantly changing and new technologies.
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- 2022
10. A QUIRKY LITTLE FELLOW: Be3 AND ITS ANION STUDIED BY PHOTOELECTRON SPECTROSCOPY
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Jaffe, Noah, primary and Heaven, Michael||Stanton,, additional
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- 2023
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11. Prevalence of Substance Use Disorders in Sickle Cell Disease Compared to Other Chronic Conditions: a Population-Based Study of Black American Adults
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Charles R. Jonassaint, Julia O’Brien, Emily Nardo, Robert Feldman, Michael Stanton, Laura DeCastro, and Kaleab Z. Abebe
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Internal Medicine - Published
- 2022
12. Memento mori: dynamic allocation-site-based optimizations.
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Daniel Clifford, Hannes Payer, Michael Stanton, and Ben L. Titzer
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- 2015
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13. Benefits brought by the use of OpenFlow/SDN on the AmLight intercontinental research and education network.
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Julio Ibarra, Jeronimo Bezerra, Heidi Morgan, Luis Fernandez Lopez, Donald A. Cox, Michael Stanton, Iara Machado, and Eduardo Grizendi
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- 2015
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14. ASSESSING THE IMPACT OF AIR PASSENGER TRAFFIC IN AIRPORTS ON COVID-19 RATES IN EUROPEAN REGIONS
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Michael Stanton-Geddes
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This study provides the result of statistical analysis of weekly airport passenger traffic data and the rate of new COVID-19 cases (COVID-19 incidence rate) in Europe at both the country and sub national level during 2020, controlling for the prior incidence rate, the level of stringency of government measures, and the mobility of people. This paper focuses on the relationship between air travel and the COVID-19 incidence rate during the second half of the year because this addresses the real problem faced in Europe about whether to permit air travel after a novel virus was already highly present in the community. The paper does not seek to add to the literature about the role of air travel in the initial propagation of a novel virus, nor does it consider the impact of vaccine availability. The analysis provides evidence that a 10% increase in airport passengers is correlated with a 0.14% increase in the COVID-19 incidence rate in Europe’s subnational regions during the second half of 2020. As comparison, an increase of 10% in the index of the stringency of government measures is correlated with a 4.3% reduction in the COVID-19 rate, and 10% more mobility in the population with a 2.9% increase in the COVID-19 rate. The paper uses a model that is based in literature and applies ordinary least squares (OLS) regression techniques for fixed effects and pooled panel data. The finding that increases in air transport traffic when a novel virus is already widely present suggests that efforts to restrict or control air travel are not likely to be efficient.
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- 2022
15. Complex regional pain syndrome
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Michael Stanton-Hicks
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Adult ,Male ,medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Pain assessment ,Genetic predisposition ,medicine ,Humans ,030212 general & internal medicine ,Rehabilitation ,Mechanism (biology) ,business.industry ,medicine.disease ,Anesthesiology and Pain Medicine ,Complex regional pain syndrome ,Reflex ,Physical therapy ,Female ,Cancer pain ,business ,Neuroscience ,Complex Regional Pain Syndromes ,030217 neurology & neurosurgery - Abstract
As suggested by this article, considerable advances in clinical management and research have taken place during the past 20 years. Although mechanisms underlying the pain syndrome CRPS I and CRPS II remain far from one's understanding, glimpses of the pathophysiology are beginning to take shape. There is now strong evidence that these syndromes exemplify a complex neurologic disease involving the brain at several integrated levels. The changes that occur in CRPS I patients involve somatosensory, sympathetic, and somatomotor systems. The diagnostic criteria have helped to focus on aspects of these foregoing systems and whereas there is no specific laboratory test for CRPS, enough is now known about the pathophysiology to use the following tests: quantitative sensory testing (QST), autonomic testing that include quantitative sudomotor axon reflex test (QSART) for sweating abnormalities, the cold pressor test in conjunction with thermographic imaging to observe the vasoconstrictor response, and laser Doppler flowmetry to monitor background vasomotor control. Recognition of a motor disorder requires accurate documentation and may be a component of the diagnostic criteria in the future. Until a better understanding of mechanistic overtones that would help to put in place mechanism-based therapeutic strategies, current management is built around a rehabilitation model. For this to be successful, as described in the foregoing pages, different non-interventional and interventional modalities are applied in a time-restricted manner to facilitate those modalities that favor progress in the treatment algorithm. As has been described, it is important when using physiotherapeutic maneuvers to minimize joint movement in the affected region to reduce the mechanorecpetor barrage and its increase in perceived pain to encourage and maintain a patient's compliance with their rehabilitation. Finally, of greater significance is the understanding that sympatholysis per se is not a "diagnostic" test for CRPS, but rather a useful procedure that may facilitate treatment for pain that is sympathetically maintained.
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- 2022
16. Copper-Catalyzed Decarboxylative Elimination of Carboxylic Acids to Styrenes
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Michael Stanton and Jessica Hoover
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A copper-catalyzed decarboxylative elimination reaction of (hetero)aromatic propionic acids to vinyl (hetero)arenes has been developed. This method furnishes alkenes from carboxylic acids without the need for stochiometric Pb or Ag additives or expensive or specialized photocatalysts. A series of mechanistic experiments indicate that the reaction proceeds via benzylic deprotonation and subsequent radical decarboxylation; a pathway that is distinct from the single-electron-transfer mechanisms implicated in related decarboxylative elimination reactions.
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- 2023
17. Copper-Catalyzed Decarboxylative Elimination of Carboxylic Acids to Alkenes
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Michael Stanton and Jessica Hoover
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A copper-catalyzed decarboxylative elimination reaction of (hetero)aromatic propionic acids to vinyl (hetero)arenes has been developed. This method furnishes alkenes from carboxylic acids without the need for stochiometric Pb or Ag additives or expensive or specialized photocatalysts. A series of mechanistic experiments indicate that the reaction proceeds via benzylic deprotonation and subsequent radical decarboxylation; a pathway that is distinct from the single-electron-transfer mechanisms implicated in related decarboxylative elimination reactions.
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- 2022
18. A systematic review of the potential consequences of abnormal serum levels of vitamin B6 in people living with Parkinson's disease
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Joseph S. Modica, Catherine Déry, Ryan Canissario, Eric Logigian, Deana Bonno, Michael Stanton, Nicolas Dupré, Michael P. McDermott, Manon Bouchard, Anthony E. Lang, and Karlo J. Lizarraga
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Neurology ,Neurology (clinical) - Published
- 2023
19. Patient-centred outcomes following non-operative treatment or appendicectomy for uncomplicated acute appendicitis in children
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Nigel J Hall, Frances C Sherratt, Simon Eaton, Erin Walker, Maria Chorozoglou, Lucy Beasant, Michael Stanton, Harriet Corbett, Dean Rex, Natalie Hutchings, Elizabeth Dixon, Esther Crawley, Jane Blazeby, Bridget Young, and Isabel Reading
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Pediatrics, Perinatology and Child Health - Abstract
While non-operative treatment has emerged as an alternative to surgery for the treatment of uncomplicated acute appendicitis in children, comparative patient-centred outcomes are not well documented. We investigated these in a feasibility randomised trial. Of 57 randomised participants, data were available for 26. Compared with appendicectomy, children allocated to non-operative treatment reported higher short-term quality of life scores, shorter duration of requiring analgesia, more rapid return to normal activities and shorter parental absence from work. These preliminary data suggest differences exist in recovery profile and quality of life between these treatments that are important to measure in a larger RCT. Trial registration number isISRCTN15830435.
- Published
- 2023
20. CONservative TReatment of Appendicitis in Children: a randomised controlled feasibility Trial (CONTRACT)
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Maria Chorozoglou, Bridget Young, Esther Crawley, Michael Stanton, Nigel J. Hall, Harriet J Corbett, Simon Grist, Wendy Wood, Isabel Reading, Frances C Sherratt, Dean Rex, Lucy Beasant, Erin Walker, Elizabeth Dixon, Natalie Hutchings, Simon Eaton, and Jane M Blazeby
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medicine.medical_specialty ,Psychological intervention ,gastroenterology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030225 pediatrics ,therapeutics ,Medicine ,Adverse effect ,Original Research ,business.industry ,Clinical course ,Health services research ,medicine.disease ,health services research ,Appendicitis ,Miscellaneous ,Conservative treatment ,Clinical diagnosis ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,business ,qualitative research - Abstract
ObjectiveTo establish the feasibility of a multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy in children with uncomplicated acute appendicitis.DesignFeasibility randomised controlled trial with embedded qualitative study to inform recruiter training to optimise recruitment and the design of a future definitive trial.SettingThree specialist paediatric surgery centres in the UK.PatientsChildren (aged 4–15 years) with a clinical diagnosis of uncomplicated acute appendicitis.InterventionsAppendicectomy or a non-operative treatment pathway (comprising broad-spectrum antibiotics and active observation).Main outcome measuresPrimary outcome measure was the proportion of eligible patients recruited. Secondary outcomes evaluated adherence to interventions, data collection during follow-up, safety of treatment pathways and clinical course.ResultsFifty per cent of eligible participants (95% CI 40 to 59) approached about the trial agreed to participate and were randomised. Repeated bespoke recruiter training was associated with an increase in recruitment rate over the course of the trial from 38% to 72%. There was high acceptance of randomisation, good patient and surgeon adherence to trial procedures and satisfactory completion of follow-up. Although more participants had perforated appendicitis than had been anticipated, treatment pathways were found to be safe and adverse event profiles acceptable.ConclusionRecruitment to a randomised controlled trial examining the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy for the treatment of uncomplicated acute appendicitis in children is feasible.Trial registration numberNCT15830435.
- Published
- 2021
21. Very Low Frequencies Maintain Pain Relief From Dorsal Root Ganglion Stimulation: An Evaluation of Dorsal Root Ganglion Neurostimulation Frequency Tapering
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Tariq A Yousef, Kris Vissers, Kenneth B. Chapman, Michael Stanton-Hicks, and Noud van Helmond
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medicine.medical_treatment ,Stimulation ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,0302 clinical medicine ,Dorsal root ganglion ,Ganglia, Spinal ,medicine ,Humans ,Pain Management ,Neurostimulation ,Endogenous opioid ,Spinal Cord Stimulation ,business.industry ,Chronic pain ,General Medicine ,medicine.disease ,Low back pain ,Mechanoreceptor ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Neurology ,Anesthesia ,Excitatory postsynaptic potential ,Quality of Life ,Neurology (clinical) ,medicine.symptom ,Chronic Pain ,business ,030217 neurology & neurosurgery - Abstract
Contains fulltext : 235081.pdf (Publisher’s version ) (Closed access) BACKGROUND: Dorsal root ganglion neurostimulation (DRG-S) is effective in treating various refractory chronic pain syndromes. In preclinical studies, DRG-S at very low frequencies (
- Published
- 2021
22. Surgery and paediatric inflammatory bowel disease
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Michael Stanton, Arun Kelay, and Lucinda Tullie
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medicine.medical_specialty ,Subtotal Colectomy ,business.industry ,Incidence (epidemiology) ,Review Article ,Disease ,Anastomosis ,medicine.disease ,Ulcerative colitis ,Inflammatory bowel disease ,Resection ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,medicine ,030211 gastroenterology & hepatology ,Pouch ,business - Abstract
The incidence of paediatric Crohn's disease (CD) and ulcerative colitis (UC) is increasing. Surgical intervention is required during childhood in approximately 25% of children diagnosed with CD, and for 10% of those diagnosed with UC. Although there is evidence that the rate of surgical intervention undertaken in children is decreasing since the introduction of biologic therapy, this may only represent a delay rather than true reversal of the risk of surgery. Surgery for CD is not curative and limited resection is the key principle thus preserving bowel length. For UC, subtotal colectomy is relatively curative; ileo-anal pouch anastomosis can be performed to restore bowel continuity.
- Published
- 2019
23. A Tale of Two Forms of Protest
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Michael Stanton, Julia Kretzenbacher, and Martin Radzaj
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The COVID-19 pandemic triggered extraordinary legislative and executive responses across the globe. In 2020, the Victorian Government used, for the first time, powers in the Public Health and Wellbeing Act 2008 (Vic) to impose significant restrictions on the freedoms of the public. This article considers the powers to make directions under the Victorian regime and the potential relevance of the implied freedom of political communication in the Australian Constitution and the human rights protected by the Charter of Human Rights and Responsibilities Act 2006 (Vic). We conclude that some forms of protest activity may have remained lawful during the Victorian lockdowns, although the purpose of the protest activity and the manner of protest may be relevant considerations when adopting a Charter-consistent interpretation of the statutory provisions.
- Published
- 2021
24. Will persistent spinal pain syndrome replace failed back surgery syndrome?
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Michael Stanton-Hicks, Nick Christelis, Giancarlo Barolat, Simon Thomson, Brian A. Simpson, and Marc Russo
- Subjects
medicine.medical_specialty ,Spinal Cord Stimulation ,business.industry ,Spinal pain ,Spinal surgery ,Surgery ,Anesthesiology and Pain Medicine ,Treatment Outcome ,medicine ,Humans ,Failed Back Surgery Syndrome ,business ,Somatoform Disorders ,Failed back surgery ,Pain Measurement - Abstract
Failed back surgery syndrome (FBSS) is a stigmatizing and misleading term, and in many cases surgery is not relevant to the development, persistence, worsening or recurrence of the symptoms. An international panel recently proposed the notion of Persistent spinal pain syndrome (PSPS) as the preferred option to replace FBSS. The new label avoids ambiguity and inappropriately-implied causation. PSPS type 1 applies when there was no spinal surgery; type 2 applies when surgery had occurred. PSPS is therefore broader than FBSS but more accurate.
- Published
- 2021
25. Taxonomy and pain clinic patients
- Author
-
Marc A, Russo, Eric, Visser, Richard B, North, Michael, Stanton-Hicks, Peter, Georgius, Willem, Volschenk, and Danielle M, Santarelli
- Subjects
Anesthesiology and Pain Medicine ,Neurology ,Humans ,Pain Clinics ,Neurology (clinical) ,Pain Measurement - Published
- 2022
26. Octava conferencia de directores de tecnología de información y comunicación en instituciones de educación superior, TICAL2018 y II Encuentro Latinoamericano de e-Ciencia Mapeamento de serviços de suporte à e-Ciência
- Author
-
Iara Machado, Daniela F. Brauner, Michael Stanton, Leandro Ciuffo, and Carolina Howard Felicíssimo
- Subjects
Marketing ,Pharmacology ,Organizational Behavior and Human Resource Management ,Strategy and Management ,Drug Discovery ,Pharmaceutical Science ,lcsh:H1-99 ,lcsh:Social sciences (General) - Abstract
Este artigo apresenta um mapeamento não exaustivo de serviços para suporte a e-ciência ofertados por universidades, redes acadêmicas, serviços nacionais de dados e centros de computação. Com isso, esse trabalho tem dois objetivos: (i) auxiliar universidades e redes de ensino e pesquisa na identificação de um portfólio de serviços especializados para apoio à ciência baseada em dados e (ii) servir de insumo para um projeto estratégico da Rede Nacional de Ensino e Pesquisa (RNP) que visa modelar um Centro de Suporte a e-Ciência (CSeC) a nível nacional no Brasil. O mapeamento é apresentado na forma de uma lista de serviços classificados de acordo com uma categorização sugerida pelos autores.
- Published
- 2019
27. Recovery of foot drop in chronic inflammatory demyelinating polyneuropathy (CIDP)
- Author
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Dinushi Weerasinghe, Aravindhan Veerapandiyan, David N. Herrmann, Eric L. Logigian, Michael Stanton, and Chary Akmyradov
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Foot drop ,Adolescent ,Physiology ,Disease duration ,Chronic inflammatory demyelinating polyneuropathy ,030105 genetics & heredity ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Young Adult ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Medicine ,Humans ,Child ,Peroneal Neuropathies ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Electrodiagnosis ,Recovery of Function ,Middle Aged ,medicine.disease ,Compound muscle action potential ,Axon loss ,Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ,Cardiology ,Female ,Neurology (clinical) ,Presentation (obstetrics) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Foot drop is common in chronic inflammatory demyelinating polyneuropathy (CIDP), but its prognosis is uncertain.CIDP patients with less than anti-gravity strength (3/5 power) of ankle dorsiflexion (ADF) on Medical Research Council manual muscle testing on presentation at our center were identified by retrospective review. After initiation of standard treatment, ADF power was serially tabulated, and predictors of recovery were determined.Of the 27 identified patients, ADF power at presentation was3/5 in 48/54 legs. At 1 y after treatment, ADF power improved to/= 3/5 in 17/27 patients in one (N = 6) or both (N = 11) legs. On multi-variate analysis, predictors of recovery of ADF power were tibialis anterior compound muscle action potential amplitude at presentation, shorter disease duration, and female gender.Foot drop improves to anti-gravity power in most treated CIDP patients depending in part on the severity of fibular motor axon loss at onset of treatment.
- Published
- 2021
28. Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11
- Author
-
Michael Stanton-Hicks, Sam Eldabe, Rollin M. Gallagher, Giancarlo Barolat, Marc Russo, Timothy R. Deer, David Kloth, Dennis C. Turk, Simon Thomson, Eric Buchser, Erika A. Petersen, Richard B. North, John D. Loeser, Konstantin V. Slavin, Nick Christelis, Stephan A. Schug, Ralf Baron, Todd Wetzel, Philippe Rigoard, Daniel B. Carr, Robert Levy, Christophe Perruchoud, Ivano Dones, Brian A. Simpson, Frank J P M Huygen, and Anesthesiology
- Subjects
medicine.medical_specialty ,education ,Delphi method ,Persistent Spinal Pain Syndrome ,Review Article ,ICD-11 ,International Classification of Diseases ,Schema (psychology) ,Back pain ,medicine ,Humans ,Pain Management ,Interventional Pain & Spine Medicine Section ,Causation ,Failed Back Surgery Syndrome ,Intensive care medicine ,Legal profession ,health care economics and organizations ,business.industry ,Chronic pain ,General Medicine ,Pain Taxonomy ,medicine.disease ,Neuromodulation (medicine) ,Spinal pain ,Spine ,Editor's Choice ,Anesthesiology and Pain Medicine ,Neurology (clinical) ,medicine.symptom ,Chronic Pain ,AcademicSubjects/MED00010 ,business ,Pain Classification - Abstract
ObjectiveFor many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misrepresents causation. Alternative terms have been suggested, but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS.MethodsThis article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established.Results14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option—Persistent spinal pain syndrome—was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification.ConclusionsThis project is important to those in the fields of pain management, spine surgery, and neuromodulation, as well as patients labeled with FBSS. Through a shift in perspective, it could facilitate the application of the new ICD-11 classification and allow clearer discussion among medical professionals, industry, funding organizations, academia, and the legal profession.
- Published
- 2021
29. The Evolution of Complex Regional Pain Syndrome : From Schloss Rettershof to a New Clinical Language
- Author
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Michael Stanton-Hicks and Michael Stanton-Hicks
- Subjects
- Pain medicine, Neurosciences, Anesthesiology, Neurology
- Abstract
Long before any written accounts of what has come to be described as Complex Regional Pain Syndrome (CRPS), this book entails a record that began in the department of Anesthesiology headed by Dr. John Bonica who during the Pacific arena of World War II came to manage thousands of wounded servicemen many of whom suffered from this complicated clinical entity often long after their original wounds had healed. Divided into two sections, the first provides a detailed chronology of the research and establishment of diagnostic criteria for CRPS. The second section provides an overview of how CRPS is evaluated and treated, along with the research that serves as its foundations.
- Published
- 2024
30. Failed back surgery syndrome: a term overdue for replacement
- Author
-
Michael Stanton-Hicks, M A Russo, Simon Thomson, Brian A. Simpson, Giancarlo Barolat, and N Christelis
- Subjects
medicine.medical_specialty ,Neurology ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,General surgery ,MEDLINE ,Interventional radiology ,Term (time) ,Replantation ,medicine ,Surgery ,Neurology (clinical) ,Neurosurgery ,business ,Failed back surgery ,Neuroradiology - Published
- 2021
31. Mechanisms for the Clinical Utility of Low-Frequency Stimulation in Neuromodulation of the Dorsal Root Ganglion
- Author
-
Allison M. Foster, Tariq A Yousef, Michael Stanton-Hicks, Noud van Helmond, and Kenneth B. Chapman
- Subjects
Sensory system ,Stimulation ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,0302 clinical medicine ,Nerve Fibers ,Dorsal root ganglion ,Ganglia, Spinal ,medicine ,Humans ,Pain Management ,Endogenous opioid ,Spinal Cord Stimulation ,business.industry ,Chronic pain ,General Medicine ,medicine.disease ,Neuromodulation (medicine) ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Nociception ,nervous system ,Neurology ,Excitatory postsynaptic potential ,Neurology (clinical) ,Chronic Pain ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Item does not contain fulltext BACKGROUND: Dorsal root ganglion stimulation (DRG-S) involves the electrical modulation of the somata of afferent neural fibers to treat chronic pain. DRG-S has demonstrated clinical efficacy at frequencies lower than typically used with spinal cord stimulation (SCS). In a clinical study, we found that the frequency of DRG-S can be tapered to a frequency as low as 4 Hz with no loss of efficacy. This review discusses possible mechanisms of action underlying effective pain relief with very low-frequency DRG-S. MATERIALS AND METHODS: We performed a literature review to explore the role of frequency in neural transmission and the corresponding relevance of frequency settings with neuromodulation. FINDINGS: Sensory neural transmission is a frequency-modulated system, with signal frequency determining which mechanisms are activated in the dorsal horn. In the dorsal horn, low-frequency signaling (25 Hz) are excitatory. Physiologically, low-threshold mechanoreceptors (LTMRs) fibers transmit or modulate innocuous mechanical touch at frequencies as low as 0.5-5 Hz, while nociceptive fibers transmit pain at high frequencies. We postulate that very low-frequency DRG-S, at least partially, harnesses LTMRs and the native endogenous opioid system. Utilizing lower stimulation frequency decreases the total energy delivery used for DRG-S, extends battery life, and facilitates the development of devices with smaller generators.
- Published
- 2021
32. The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment
- Author
-
Kris Vissers, Noud van Helmond, Michael Stanton-Hicks, Kenneth B. Chapman, and Pauline S. Groenen
- Subjects
musculoskeletal diseases ,Nerve root ,Stimulation ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,0302 clinical medicine ,Dorsal root ganglion ,Ganglia, Spinal ,Humans ,Medicine ,Spinal Cord Stimulation ,business.industry ,Chronic pain ,General Medicine ,Anatomy ,medicine.disease ,Spinal cord ,musculoskeletal system ,Low back pain ,Spine ,Neuromodulation (medicine) ,body regions ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Neurology ,Neurology (clinical) ,Chronic Pain ,medicine.symptom ,business ,Lead Placement ,Low Back Pain ,030217 neurology & neurosurgery - Abstract
Contains fulltext : 235068.pdf (Publisher’s version ) (Closed access) BACKGROUND: Dorsal root ganglion stimulation (DRG-S) is a novel approach to treat chronic pain. Lead placement at L2 has been reported to be an effective treatment for axial low back pain (LBP) primarily of discogenic etiology. We have recently shown, in a diverse cohort including cases of multilevel instrumentation following extensive prior back surgeries, that DRG-S lead placement at T12 is another promising target. Local effects at the T12 DRG, alone, are insufficient to explain these results. MATERIALS AND METHODS: We performed a literature review to explore the mechanisms of LBP relief with T12 DRG-S. FINDINGS: Branches of individual spinal nerve roots innervate facet joints and posterior spinal structures, while the discs and anterior vertebrae are carried via L2, and converge in the dorsal horn (DH) of the spinal cord at T8-T9. The T12 nerve root contains cutaneous afferents from the low back and enters the DH of the spinal cord at T10. Low back Aδ and C-fibers then ascend via Lissauer's tract (LT) to T8-T9, converging with other low back afferents. DRG-S at T12, then, results in inhibition of the converged low back fibers via endorphin-mediated and GABAergic frequency-dependent mechanisms. Therefore, T12 lead placement may be the optimal location for DRG-S to treat LBP.
- Published
- 2021
33. Acquired anorectal disorders: Prolapse, fistula, and hemorrhoids
- Author
-
Michael Stanton
- Subjects
Anal fistula ,medicine.medical_specialty ,Constipation ,business.industry ,Fistula ,Perianal Abscess ,Anal Margin ,Anal canal ,medicine.disease ,Surgery ,Rectal prolapse ,medicine.anatomical_structure ,Hemorrhoids ,medicine ,medicine.symptom ,business - Abstract
Acquired anorectal disorders in children include anal fissures, perianal abscess/fistula, hemorrhoids, and rectal prolapse. In general, fissures, hemorrhoids, and rectal prolapse are initially treated by attempting to normalize stooling. This is by dietary modification, stool softeners (e.g. Laxido, Movicol) and/or stimulant laxatives (e.g. senna). Although rectal prolapse is common and usually resolves spontaneously, in a proportion symptoms will persist despite normalization of stooling. Anal fistula is a communication between the perianal skin and the anal canal following perianal abscess. Fistulas are “low” in infants/children and usually pass straight between the skin sinus and the anal canal at the level of the dentate line. Presentation is with a perianal swelling, with bleeding, though itching and tenderness are also possible. This is often preceded by constipation with straining. The swelling is usually a small bluish/purple lump at the anal margin, rather than the more obvious prolapsing swellings seen in adults.
- Published
- 2020
34. Ongoing care for the patient with an anorectal malfromation; transitioning to adulthood
- Author
-
Alessandra C. Gasior, Michael Stanton, Dalia Aminoff, and Paola Midrio
- Subjects
Adult ,medicine.medical_specialty ,Transition to Adult Care ,Adolescent ,Patient Care Planning ,03 medical and health sciences ,Health services ,Young Adult ,0302 clinical medicine ,030225 pediatrics ,Health care ,Medicine ,Humans ,Transitional care ,Young adult ,Patient Care Team ,business.industry ,Professional-Patient Relations ,Mental health ,Anorectal Malformations ,Patient population ,030220 oncology & carcinogenesis ,Family medicine ,Pediatrics, Perinatology and Child Health ,Surgery ,business ,Psychosocial ,Healthcare system - Abstract
Planned health care transition can improve the ability of young adults to manage their own health care to effecively use health services and ultimately maximize life-long functioning and well-being. Transitional care is a purposeful, planned process that addresses the medical, psychosocial and educational needs of adolescents and young adults with chronic physical and medical conditions as they move from child-centered to adult-oriented healthcare systems. Unsuccessful surgical transtion may result in physical and mental health implications for young patients, negative long-term outcomes and suboptimal use of health care resources. Anorectal malformation and Hirschsprung patients are an especially vulnerable patient population with ongoing surgical, physiologic and pyschosocial challenges.
- Published
- 2020
35. Direct Peripheral Nerve Stimulation for the Treatment of Complex Regional Pain Syndrome: A 30-Year Review
- Author
-
Afrin Sagir, Jason Hale, Chen Liang, Phillip Telefus, Michael Stanton-Hicks, Mark Hendrickson, and Mark Chmiela
- Subjects
Peripheral nerve stimulation ,Spinal cord stimulation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Functional ability ,Peripheral Nerves ,Retrospective Studies ,Spinal Cord Stimulation ,business.industry ,General Medicine ,medicine.disease ,Neuromodulation (medicine) ,Reflex Sympathetic Dystrophy ,Anesthesiology and Pain Medicine ,Complex regional pain syndrome ,Neurology ,Opioid ,Anesthesia ,Reflex ,Functional status ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Complex Regional Pain Syndromes ,medicine.drug - Abstract
INTRODUCTION Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD), is a difficult to treat condition characterized by debilitating pain and limitations in functional ability. Neuromodulation, in the form of spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS), have been traditionally used as a treatment for CRPS with variable success. OBJECTIVE This chart review describes the use of implantable PNS systems in the treatment of CRPS of the upper and lower extremities spanning nearly three decades. MATERIALS AND METHODS A retrospective chart review was performed on 240 patients with PNS implanted between 1990 and 2017 at our institution. Of these, 165 patients were identified who had PNS systems implanted for a diagnosis of CRPS. Patient profile, including baseline characteristics, comorbidities, past/current interventions/medications and targeted nerves, was descriptively summarized through standard summary statistics. Patients' pain scores and opioid consumptions at baseline (preimplant), 1 month, 6 months, and 12 months were collected and compared. Device revisions and explants were summarized, and patient functional outcomes were described. RESULTS Pain scores at baseline and at 12-month follow-up were decreased from a mean of 7.4 ± 1.6 to 5.5 ± 2.4 and estimated to be 1.87 (95% CI: [1.29, 2.46], paired t-test p-value
- Published
- 2020
36. Is Maternal Obesity Associated With Fetal Congenital Lung Malformations?
- Author
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Linden Stocker, Diana Wellseley, Rajeswari Parasuraman, Michael Stanton, and David Howe
- Abstract
BackgroundPrevious data demonstrated an increased incidence in congenital lung malformations (CLM) and hypothesised a link with maternal obesity.MethodA retrospective case-control study (1994-2017) including all cases of CLM and matched controls (N=114 pregnancies). For each diagnosis of a baby diagnosed antenatally with CLM, two controls were selected. Primary outcome measure was mean Body Mass Index of women of affected pregnancies.ResultsThe women in affected pregnancies had a greater BMI (26.7 ±5.2kg/m2 (n=38)) than the control women (24.6±4.7 kg/m2 (n=76)) (p=0.03). 60.5% (n=46) of women in the control group and 39.5% (n=15) women in the CLM group had a normal BMI (2). Women with a BMI > 25kg/m2 had a 1.53 relative risk (RR) of having an affected baby (p=0.02, 95% CI 1.05-2.24). ConclusionObesity is not associated with increased rates of CLM. There is a small clinical difference in the BMI of women affected by CLM.
- Published
- 2020
37. Implementing an early feeding pathway post-gastrostomy insertion reduces inpatient stay
- Author
-
Nigel J. Hall, Christine Lam, Michael Stanton, Karen Dick, Ori Ron, S Charlie Keys, Francesca Stedman, George S Bethell, and Lara Kitteringham
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Early feeding ,03 medical and health sciences ,Enteral Nutrition ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,Postoperative Period ,Child ,Retrospective Studies ,Gastrostomy ,Inpatients ,Study quality ,Inpatient stay ,business.industry ,Infant ,General Medicine ,Length of Stay ,Quality Improvement ,Surgery ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,Case note ,business - Abstract
Background: There is no consensus regarding optimal postoperative feeding strategy following gastrostomy insertion in children. The aim of this study was to determine whether implementing an early postoperative feeding pathway reduces length of stay (LOS) without increasing complications. Methods: A retrospective case note review of all children having a new gastrostomy inserted during a one-year period prior to (July 2016–July 2017) and following (July 2017–July 2018) pathway introduction was performed. Children unable to follow the pathway for coexisting medical or nutritional reasons were excluded. The pathway comprised feeding 50% of normal feed 2 hours postprocedure, followed by 100% of normal feed at 5 and 8 h. Previously, patients were fed postoperatively according to surgeon preference. Results: 116 cases met inclusion criteria, 55 prior to and 61 after pathway implementation. Children following the early feeding pathway had a shorter postoperative LOS than the historical group (median 28 vs 33 h, p < 0.003), while immediate (< 72 h) and early (< 30 day) complication rates were similar (8.2 vs 7.3%, p = 1.00 and 12 vs 16%, p = 0.59, respectively). Conclusions: Early postoperative feeding after gastrostomy insertion is safe and reduces LOS. Type of study: Quality improvement. Level of evidence: III
- Published
- 2020
38. Derivation and validation of a novel clinical decision aid to distinguish between uncomplicated and complicated appendicitis in children
- Author
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Michael Stanton, Semiu E Folaranmi, Stavros P. Loukogeorgakis, Nigel J. Hall, Christina Major, Harriet J. Corbett, Dean Rex, and Ceri E. Jones
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Derivation ,Complicated appendicitis ,Clinical decision ,Intensive care medicine ,business - Abstract
Aim of Study:Non-operative treatment of acute uncomplicated appendicitis (UA) in children might be equally effective to surgery but requires accurate discrimination from those with complicated appendicitis (CA) to ensure safety and maximise efficacy. We aimed to identify specific clinical and laboratory parameters that would aid distinction between UA and CA in children.Methods:Retrospective review of consecutive children with a clinical +/- radiological diagnosis of acute appendicitis that underwent appendicectomy in three specialist paediatric surgical centres between March 2017 and February 2018. Demographic, clinical and laboratory data were retrieved and analysed in relation to intra-operative and histopathological findings. CA was defined as gangrene and/or perforation seen intra-operatively and/or in histopathological analysis. Multiple logistic regression analysis was used to derive a novel prediction model that could accurately distinguish UA and CA. A priori we set analytical parameters so as to ensure the score had a positive predictive value (PPV) for UA of >95%. The resulting scoring system was validated in an independent cohort of children.Main Results: The prediction model was derived from 130 children (UA: 71; CA: 59) with median age (range) 10 (2-15) years. Initial univariate analysis identified six factors significantly associated (pConclusions: Our novel scoring system can discriminate between UA and CA in children with high accuracy. Children with a score
- Published
- 2020
39. Performing a digital rectal examination: indications and examination
- Author
-
Mohammad A Heetun, Max Allin, Michael Stanton, and Sanjaya Wijeyekoon
- Subjects
Physician-Patient Relations ,medicine.medical_specialty ,Informed Consent ,medicine.diagnostic_test ,business.industry ,General surgery ,MEDLINE ,General Medicine ,Rectal examination ,Patient care ,Informed consent ,Medical Chaperones ,medicine ,Humans ,Patient Care ,business ,Digital Rectal Examination - Published
- 2018
40. Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care-An Evidence-based Guideline From European Crohn's and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition
- Author
-
Sally Lawrence, Christian Braegger, Frank M. Ruemmele, Gábor Veres, Lissy de Ridder, Javier Martín de Carpi, Esther Orlanski-Meyer, Richard K. Russell, Mikko P. Pakarinen, Caterina Strisciuglio, Dan Turner, Amit Assa, Michael Stanton, Claudio Romano, Seamus Hussey, Nicholas M. Croft, Anne M. Griffiths, Marina Aloi, Víctor Manuel Navas-López, David C. Wilson, Konstantinos H. Katsanos, Jiri Bronsky, Turner, Dan, Ruemmele, Frank M, Orlanski-Meyer, Esther, Griffiths, Anne M, de Carpi, Javier Martin, Bronsky, Jiri, Veres, Gabor, Aloi, Marina, Strisciuglio, Caterina, Braegger, Christian P, Assa, Amit, Romano, Claudio, Hussey, Séamu, Stanton, Michael, Pakarinen, Mikko, de Ridder, Lissy, Katsanos, Konstantino, Croft, Nick, Navas-López, Victor, Wilson, David C, Lawrence, Sally, Russell, Richard K, Pediatrics, and University of Zurich
- Subjects
Male ,medicine.medical_treatment ,Pediatric Ulcerative Colitis Activity Index ,calprotectin ,Inflammatory bowel disease ,0302 clinical medicine ,Ambulatory Care ,guidelines ,Child ,Societies, Medical ,Colectomy ,Anti-TNF, calprotectin, children, guidelines, inflammatory bowel disease-unclassified, management, mesalamine, monitoring, pediatric ulcerative colitis activity index, pediatrics, thiopurines, treatment, ulcerative colitis, vedolizumab, pediatrics, perinatology and child health, gastroenterology ,treatment ,Gastroenterology ,Ulcerative colitis ,Europe ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Child Nutritional Physiological Phenomena ,management ,medicine.drug ,vedolizumab ,medicine.medical_specialty ,inflammatory bowel disease-unclassified ,pediatrics ,610 Medicine & health ,mesalamine ,Primary sclerosing cholangitis ,Vedolizumab ,03 medical and health sciences ,Ambulatory care ,children ,Internal medicine ,medicine ,Humans ,2715 Gastroenterology ,2735 Pediatrics, Perinatology and Child Health ,Colitis ,Intensive care medicine ,ulcerative colitis ,business.industry ,thiopurines ,anti-TNF ,Hepatology ,medicine.disease ,digestive system diseases ,monitoring ,10036 Medical Clinic ,Pediatrics, Perinatology and Child Health ,Colitis, Ulcerative ,business - Abstract
Background: The contemporary management of ambulatory ulcerative colitis (UC) continues to be challenging with similar to 20% of children needing a colectomy within childhood years. We thus aimed to standardize daily treatment of pediatric UC and inflammatory bowel diseases (IBD)-unclassified through detailed recommendations and practice points. Methods: These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). An extensive literature search with subsequent evidence appraisal using robust methodology was performed before 2 face-to-face meetings. All 40 included recommendations and 86 practice points were endorsed by 43 experts in Paediatric IBD with at least an 88% consensus rate. Results: These guidelines discuss how to optimize the use of mesalamine (including topical), systemic and locally active steroids, thiopurines and, for more severe disease, biologics. The use of other emerging therapies and the role of surgery are also covered. Algorithms are provided to aid therapeutic decision-making based on clinical assessment and the Paediatric UC Activity Index (PUCAI). Advice on contemporary therapeutic targets incorporating the use of calprotectin and the role of therapeutic drug monitoring are presented, as well as other management considerations around pouchitis, extraintestinal manifestations, nutrition, growth, psychology, and transition. A brief section on disease classification using the PIBD-classes criteria and IBD-unclassified is also part of these guidelines. Conclusions: These guidelines provide a guide to clinicians managing children with UC and IBD-unclassified management to provide modem management strategies while maintaining vigilance around appropriate outcomes and safety issues.
- Published
- 2018
41. Letter: Persistent Spinal Pain Syndrome Should Replace Failed Back Surgery Syndrome
- Author
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Brian A, Simpson, Nick, Christelis, Marc A, Russo, Michael, Stanton-Hicks, Giancarlo, Barolat, and Simon, Thomson
- Subjects
Spinal Cord Stimulation ,Treatment Outcome ,Humans ,Surgery ,Neurology (clinical) ,Failed Back Surgery Syndrome ,Spine - Published
- 2021
42. Neuropathy due to coexistent vitamin B12 and B6 deficiencies in patients with Parkinson's disease: A case series
- Author
-
Joseph S. Modica, Eric L. Logigian, Karlo J. Lizarraga, Ryan Canissario, and Michael Stanton
- Subjects
medicine.medical_specialty ,Parkinson's disease ,business.industry ,Peripheral Nervous System Diseases ,Parkinson Disease ,medicine.disease ,Pyridoxine ,Gastroenterology ,Vitamin B 12 ,Peripheral neuropathy ,Neurology ,Internal medicine ,medicine ,Humans ,In patient ,Neurology (clinical) ,Vitamin B12 ,Vitamin b6 ,business ,medicine.drug - Published
- 2021
43. Persistent spinal pain syndrome: a proposed replacement for failed back surgery syndrome
- Author
-
Michael Stanton-Hicks, Marc Russo, Giancarlo Barolat, Nick Christelis, Brian A. Simpson, and Simon Thomson
- Subjects
Clinical communication ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Neurology (clinical) ,General Medicine ,Intensive care medicine ,business ,Spinal pain ,Failed back surgery - Abstract
Sir,Flawed nomenclature and classification inevitably hamper diagnosis, clinical communication and research, and may impede access to appropriate treatment. This is clearly illustrated by the term ...
- Published
- 2021
44. Persistent Spinal Pain Syndrome: Reply to Ordia and Vaisman
- Author
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Brian A. Simpson, Michael Stanton-Hicks, Simon Thomson, Marc Russo, Giancarlo Barolat, and Nick Christelis
- Subjects
Anesthesiology and Pain Medicine ,business.industry ,Anesthesia ,Medicine ,Neurology (clinical) ,General Medicine ,business ,Spinal pain - Published
- 2021
45. Meta-analysis without study-specific variance information: Heterogeneity case
- Author
-
Patarawan Sangnawakij, Stephen Adams, Michael Stanton, Dankmar Böhning, Heinz Holling, and Sa-Aat Niwitpong
- Subjects
Statistics and Probability ,Epidemiology ,Statistics as Topic ,Sample (statistics) ,01 natural sciences ,Standard deviation ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,Meta-Analysis as Topic ,Health Information Management ,Statistics ,Humans ,030212 general & internal medicine ,0101 mathematics ,Mathematics ,Likelihood Functions ,Models, Statistical ,Estimator ,Variance (accounting) ,Random effects model ,Causality ,Study heterogeneity ,Standard error ,Sample size determination ,Sample Size - Abstract
The random effects model in meta-analysis is a standard statistical tool often used to analyze the effect sizes of the quantity of interest if there is heterogeneity between studies. In the special case considered here, meta-analytic data contain only the sample means in two treatment arms and the sample sizes, but no sample standard deviation. The statistical comparison between two arms for this case is not possible within the existing meta-analytic inference framework. Therefore, the main objective of this paper is to estimate the overall mean difference and associated variances, the between-study variance and the within-study variance, as specified as the important elements in the random effects model. These estimators are obtained using maximum likelihood estimation. The standard errors of the estimators and a quantification of the degree of heterogeneity are also investigated. A measure of heterogeneity is suggested which adjusts the original suggested measure of Higgins’ I2 for within study sample size. The performance of the proposed estimators is evaluated using simulations. It can be concluded that all estimated means converged to their associated true parameter values, and its standard errors tended to be small if the number of the studies involved in the meta-analysis was large. The proposed estimators could be favorably applied in a meta-analysis on comparing two surgeries for asymptomatic congenital lung malformations in young children.
- Published
- 2017
46. A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score
- Author
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Jean Jacques Vatine, Stephen Bruehl, Michael Stanton-Hicks, Jacobus J. van Hilten, Frank Birklein, Hadas Frank, Florian Brunner, Roberto S.G.M. Perez, Christian Maihöfner, A. Kirsling, Maxine M. Kuroda, Anatoly Livshitz, David Dayanim, R. Norman Harden, Angela Mailis-Gagnon, Joe Graciosa, Sean Mackey, Tanja Schlereth, Johan Marinus, Sara B. Connoly, Michael Massey, Elias Abousaad, University of Zurich, Harden, R Norman, Anesthesiology, APH - Methodology, and APH - Personalized Medicine
- Subjects
Adult ,Male ,medicine.medical_specialty ,CRPS Severity Score ,MEDLINE ,Pain ,610 Medicine & health ,Severity of Illness Index ,Reflex sympathetic dystrophy ,Severity ,Diagnosis, Differential ,Treatment and control groups ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Validation ,Severity of illness ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Aged ,Pain Measurement ,business.industry ,Middle Aged ,medicine.disease ,Complex regional pain syndrome ,Prospective ,2728 Neurology (clinical) ,Anesthesiology and Pain Medicine ,Neurology ,Categorization ,Multicenter study ,2808 Neurology ,Physical therapy ,Female ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,2703 Anesthesiology and Pain Medicine ,Neurology (clinical) ,Outcomes research ,business ,Complex Regional Pain Syndromes ,030217 neurology & neurosurgery - Abstract
Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRPS to compare changes over time in CSS scores between patients initiating a new treatment program and patients on stable treatment regimens. New vs stable categorizations were supported by greater changes in pain and function in the former. Results indicated that CSS values in the stable CRPS treatment group exhibited much less change over time relative to the new treatment group, with intraclass correlations nearly twice as large in the former. A calculated smallest real difference value revealed that a change in the CSS of ≥4.9 scale points would indicate real differences in CRPS symptomatology (with 95% confidence). Across groups, larger changes in CRPS features on the CSS over time were associated in the expected direction with greater changes in pain intensity, fatigue, social functioning, ability to engage in physical roles, and general well-being. The overall pattern of findings further supports the validity of the CSS as a measure of CRPS severity and suggests it may prove useful in clinical monitoring and outcomes research.
- Published
- 2017
47. Active observation versus interval appendicectomy after successful non-operative treatment of an appendix mass in children (CHINA study): an open-label, randomised controlled trial
- Author
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Michael Stanton, Nigel J. Hall, Simon Eaton, David M. Burge, and Agostino Pierro
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Male ,Pediatrics ,medicine.medical_specialty ,Blinding ,Adolescent ,Cost-Benefit Analysis ,medicine.medical_treatment ,Clinical Decision-Making ,Psychological intervention ,law.invention ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Randomized controlled trial ,Recurrence ,Risk Factors ,law ,030225 pediatrics ,Secondary Prevention ,Appendectomy ,Humans ,Medicine ,Prospective Studies ,Child ,Watchful Waiting ,Prospective cohort study ,Hepatology ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Length of Stay ,Appendicitis ,medicine.disease ,Anti-Bacterial Agents ,Gastrointestinal disease ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,business ,Watchful waiting - Abstract
SummaryBackgroundDespite a scarcity of supporting evidence, most surgeons recommend routine interval appendicectomy after successful non-operative treatment of an appendix mass in children. We aimed to compare routine interval appendicectomy with active observation.MethodsWe enrolled participants in the CHildren's INterval Appendicectomy (CHINA) study, a multicentre, open-label, randomised controlled study at 19 specialist paediatric surgery centres, 17 of which were in the UK, one in Sweden, and one in New Zealand. 106 children aged 3–15 years were assigned (1:1) by weighted minimisation to interval appendicectomy or active observation with minimisation for age, trial centre, sex, and presence of a faecolith on imaging. Eligible children had acute appendicitis with an appendix mass and were successfully treated without appendicectomy or other surgical intervention. Children were excluded from the study if they had coexisting gastrointestinal disease or had a substantial coexisting medical condition or immune defect. Because of the nature of the interventions, blinding was not possible. The primary outcome was the proportion of children developing histologically proven recurrent acute appendicitis or a clinical diagnosis of recurrent appendix mass within 1 year of enrolment after successful non-operative treatment of appendix mass (active observation group) and incidence of severe complications related to interval appendicectomy. Data were analysed on an intention-to-treat basis. This study is registered with ISRCTN, number 93815412.FindingsBetween Aug 8, 2011, and Dec 31, 2014, we randomly assigned 106 patients, 52 patients to interval appendicectomy and 54 to active observation. Two children in the interval appendicectomy group were withdrawn due to withdrawal of consent; two in the active observation group were withdrawn because they became ineligible after allocation. Six children under active observation had histologically proven recurrent acute appendicitis. Three children in the interval appendicectomy group had severe complications. Thus, the proportion of children with histologically proven recurrent acute appendicitis under active observation was 12% (95% CI 5–23) and the proportion of children with severe complications related to interval appendicectomy was 6% (95% CI 1–17).InterpretationMore than three-quarters of children could avoid appendicectomy during early follow-up after successful non-operative treatment of an appendix mass. Although the risk of complications after interval appendicectomy is low, complications can be severe. Adoption of a wait-and-see approach, reserving appendicectomy for those who develop recurrence or recurrent symptoms, results in fewer days in hospital, fewer days away from normal daily activity, and is cheaper than routine interval appendicectomy. These high-quality data will allow clinicians, parents, and children to make an evidence-based decision regarding the justification for interval appendicectomy.FundingBUPA Foundation.
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- 2017
48. Statistical methodology for estimating the mean difference in a meta-analysis without study-specific variance information
- Author
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Heinz Holling, Michael Stanton, Stephen Adams, Patarawan Sangnawakij, and Dankmar Böhning
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Statistics and Probability ,Score test ,Epidemiology ,Variance (accounting) ,01 natural sciences ,Confidence interval ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,Standard error ,Strictly standardized mean difference ,Sample size determination ,Statistics ,Statistical inference ,Econometrics ,030212 general & internal medicine ,0101 mathematics ,Mathematics ,Type I and type II errors - Abstract
Statistical inference for analyzing the results from several independent studies on the same quantity of interest has been investigated frequently in recent decades. Typically, any meta-analytic inference requires that the quantity of interest is available from each study together with an estimate of its variability. The current work is motivated by a meta-analysis on comparing two treatments (thoracoscopic and open) of congenital lung malformations in young children. Quantities of interest include continuous end-points such as length of operation or number of chest tube days. As studies only report mean values (and no standard errors or confidence intervals), the question arises how meta-analytic inference can be developed. We suggest two methods to estimate study-specific variances in such a meta-analysis, where only sample means and sample sizes are available in the treatment arms. A general likelihood ratio test is derived for testing equality of variances in two groups. By means of simulation studies, the bias and estimated standard error of the overall mean difference from both methodologies are evaluated and compared with two existing approaches: complete study analysis only and partial variance information. The performance of the test is evaluated in terms of type I error. Additionally, we illustrate these methods in the meta-analysis on comparing thoracoscopic and open surgery for congenital lung malformations and in a meta-analysis on the change in renal function after kidney donation. Copyright © 2017 John Wiley & Sons, Ltd.
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- 2017
49. Bilious vomiting in the newborn
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Michael Stanton and Lucinda Tullie
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medicine.medical_specialty ,business.industry ,General surgery ,Time critical ,medicine.disease ,digestive system diseases ,Bilious vomiting ,Surgery ,Duodenal atresia ,Volvulus ,Bowel obstruction ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,parasitic diseases ,medicine ,Vomiting ,Surgical emergency ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Bilious (dark green) vomiting in the newborn is a surgical emergency as the underlying diagnosis may be volvulus of the entire midgut secondary to malrotation. This diagnosis is time critical as, untreated, volvulus will lead to midgut necrosis, resulting in short gut syndrome or death. While a range of other diagnoses are possible, transfer to a paediatric surgical centre should be undertaken urgently so that malrotation/volvulus can be excluded or treated. This review focuses on the causes, investigation and management of proximal bowel obstruction in the neonate that present primarily with bilious vomiting.
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- 2016
50. Reflex Sympathetic Dystrophy
- Author
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Michael Stanton-Hicks, Robert A. Boas, and Wilfrid Jänig
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Sympathetic nerve blocks ,business.industry ,Chronic pain ,Dystrophy ,medicine.disease ,Psychosomatic aspects ,Pathophysiology ,Clonidine ,Anesthesia ,Edema ,medicine ,Reflex ,medicine.symptom ,business ,medicine.drug - Abstract
Section I General Considerations.- 1. Reflex sympathetic dystrophy: Clinical features.- 2. Reflex sympathetic dystrophy: Incidence and epidemiology.- 3. Chronic pain mechanisms.- 4. Sympathetically maintained pain principles of diagnosis and therapy.- 5. Psychosomatic aspects of reflex sympathetic dystrophy.- Summary of Section I.- Section II Basic Researches in Pathophysiology of RSD.- 6. Pathobiology of reflex sympathetic dystrophy: Some general considerations.- 7. Spinal hyperexcitability in sympathetically maintained pain.- 8. Neuropharmacologies aspects of reflex sympathetic dystrophy.- 9. Clinical and neurophysiological observations relating to pathophysiological mechanisms of reflex sympathetic dystrophy.- 10. Mechanisms and role of peripheral blood flow dysregulation in pain sensation and edema in reflex sympathetic dystrophy.- Summary of Section II.- Section III Therapeutic Techniques in BSD.- 11. Sympathetic nerve blocks: Their role in sympathetic pain.- 12. Intravenous regional sympathetic blocks.- 13. Reflex sympathetic dystrophy - Neurosurgical approaches.- 14. Peripheral nerve stimulator implant for treatment of RSD.- 15. Psychological support of the patient with reflex sympathetic dystrophy.- 16. Reflex sympathetic dystrophy non-invasive methods of treatment.- 17. Multi-disciplinary management of reflex sympathetic dystrophy.- Summary of Section III.- Section IV New Techniques.- 18. Three-phase bone scanning in reflex sympathetic dystrophy.- 19. An investigation of the role of clonidine in the treatment of reflex sympathetic dystrophy.- Summary of Section IV.- Summary Comments.- Proposed Definition of Reflex Sympathetic Dystrophy.
- Published
- 2019
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