23 results on '"Chicken DW"'
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2. Concordance between peri-areolar blue dye and peri-incisional radiotracer injections for sentinel node mapping in patients with a history of primary breast cancer excisonal biopsy
- Author
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Kakhki Vr, Chicken Dw, Elena Saremi, Jangjoo A, Ramin Sadeghi, Soheil Azizi, Mehrabibahar M, and Mohammed Keshtgar
- Subjects
medicine.medical_specialty ,Concordance ,Breast Neoplasms ,Injections ,Quadrant (abdomen) ,Biopsy ,medicine ,Rosaniline Dyes ,Humans ,Coloring Agents ,Lymph node ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Sentinel Lymph Node Biopsy ,General Medicine ,Sentinel node ,Surgery ,Axilla ,medicine.anatomical_structure ,Lymphatic Metastasis ,Female ,Radiology ,Lymph ,Lymph Nodes ,Radiopharmaceuticals ,business ,Gamma probe ,Follow-Up Studies - Abstract
BACKGROUND We evaluated the concordance between peri-areolar blue dye and peri-incisional radiotracer injections for axillary sentinel node mapping of patients with the history of previous breast lesion excisional biopsy. METHODS 80 patients with the history of previous excisional biopsy of the breast lesions were included. All patients received two injections of 99mTc-antimony sulfide colloid in both ends of incision line in an intradermal fashion. 2 mL patient blue V dye was injection to all patients in the peri-areolar area of the index quadrant after induction of anesthesia. All blue or hot nodes were harvested as sentinel lymph nodes. RESULTS At least one sentinel node could be detected during surgery in 79 patients. In total 94 sentinel nodes were detected. All detected sentinel nodes were hot. In three patients sentinel nodes were detected by gamma probe but not blue dye. The tumor location in all of these patients was in the upper lateral quadrant and the incision line was extended into the axillary tail of the breast in all of them. 91 out of 94 sentinel nodes were stained blue, which amounts to 95.8% concordance between blue dye and radiotracer on a per node analysis. CONCLUSIONS Single peri-areolar injection in the index quadrant would suffice for sentinel node mapping of patients with history of excisional biopsy. Care should be taken in patients with large excisional biopsy in the extreme proximity to axilla.
- Published
- 2014
3. Use of the surgical Apgar score to guide postoperative care
- Author
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Haddow, JB, primary, Adwan, H, additional, Clark, SE, additional, Tayeh, S, additional, Antonowicz, SS, additional, Jayia, P, additional, Chicken, DW, additional, Wiggins, T, additional, Davenport, R, additional, Kaptanis, S, additional, Fakhry, M, additional, Knowles, CH, additional, Elmetwally, AS, additional, Geddoa, E, additional, Nair, MS, additional, Naeem, I, additional, Adegbola, S, additional, and Muirhead, LJ, additional
- Published
- 2014
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4. The surgical safety checklist and patient outcomes after surgery
- Author
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T.E.F. Abbott, T. Ahmad, M.K. Phull, A.J. Fowler, R. Hewson, B.M. Biccard, M.S. Chew, M. Gillies, R.M. Pearse, Rupert M. Pearse, Scott Beattie, Pierre-Alain Clavien, Nicolas Demartines, Lee A. Fleisher, Mike Grocott, James Haddow, Andreas Hoeft, Peter Holt, Rui Moreno, Naomi Pritchard, Andrew Rhodes, Duminda Wijeysundera, Matt Wilson, Tahania Ahmed, Kirsty Everingham, Russell Hewson, Marta Januszewska, Mandeep-Kaur Phull, Richard Halliwell, Mark Shulman, Paul Myles, Werner Schmid, Michael Hiesmayr, Patrick Wouters, Stefan de Hert, Suzana Lobo, Xiangming Fang, Lars Rasmussen, Emmanuel Futier, Matthieu Biais, Aurélien Venara, Karem Slim, Michael Sander, Despoina Koulenti, Kostoula Arvaniti, Mathew Chan, Atul Kulkarni, Susilo Chandra, Aida Tantri, Emad Geddoa, Muntadhar Abbas, Giorgio Della Rocca, Datin Sivasakthi, Marzida Mansor, Pastor Luna, Arthur Bouwman, Wolfgang Buhre, Vanessa Beavis, Douglas Campbell, Tim Short, Tunde Osinaike, Ricardo Matos, Ioana Grigoras, Mikhail Kirov, Denis Protsenko, Bruce Biccard, Cesar Aldecoa, Michelle Chew, Christoph Hofer, Martin Hubner, James Ditai, Tamas Szakmany, Lee Fleisher, Marissa Ferguson, Michael MacMahon, Ritchie Cherian, Helen Currow, Kathirgamanathan Kanathiban, David Gillespie, Edward Pathmanathan, Katherine Phillips, Jenifer Reynolds, Joanne Rowley, Jeanene Douglas, Ross Kerridge, Sameer Garg, Michael Bennett, Megha Jain, David Alcock, Nico Terblanche, Rochelle Cotter, Kate Leslie, Marcelle Stewart, Nicolette Zingerle, Antony Clyde, Oliver Hambidge, Adam Rehak, Sharon Cotterell, Wilson Binh Quan Huynh, Timothy McCulloch, Erez Ben-Menachem, Thomas Egan, Jennifer Cope, Paul Fellinger, Markus Haisjackl, Simone Haselberger, Caroline Holaubek, Paul Lichtenegger, Florian Scherz, Franz Hoffer, Veronika Cakova, Andreas Eichwalder, Norbert Fischbach, Reinhold Klug, Elisabeth Schneider, Martin Vesely, Reinhart Wickenhauser, Karl Gernot Grubmueller, Marion Leitgeb, Friedrich Lang, Nancy Toro, Marlene Bauer, Friedrich Laengle, Claudia Haberl, Thomas Mayrhofer, Christoph Trybus, Christian Buerkle, Karin Forstner, Reinhard Germann, Harald Rinoesl, Elke Schindler, Ernst Trampitsch, Gerhard Bogner, Daniel Dankl, Martin Duenser, Gerhard Fritsch, Ilse Gradwohl-Matis, Andreas Hartmann, Thomas Hoelzenbein, Tarkan Jaeger, Franz Landauer, Gregor Lindl, Michael Lux, Johannes Steindl, Ottokar Stundner, Christian Szabo, Jawad Bidgoli, Hans Verdoodt, Patrice Forget, David Kahn, Fernande Lois, Mona Momeni, Caroline Prégardien, Audrey Pospiech, Arnaud Steyaert, Laurent Veevaete, Dirk De Kegel, Karen De Jongh, Luc Foubert, Carine Smitz, Marcel Vercauteren, Jan Poelaert, Veerle Van Mossevelde, Jacques Abeloos, Stefaan Bouchez, Marc Coppens, Luc De Baerdemaeker, Isabel Deblaere, Ann De Bruyne, Kristine Fonck, Bjorn Heyse, Tom Jacobs, Koen Lapage, Anneliese Moerman, Martine Neckebroek, Aliaksandra Parashchanka, Nathalie Roels, Nancy Van Den Eynde, Michael Vandenheuvel, JurgenVan Limmen, Ann Vanluchene, Caroline Vanpeteghem, Piet Wyffels, Christel Huygens, Punitha Vandenbempt, Marc Van de Velde, Dimitri Dylst, Bruno Janssen, Evelien Schreurs, Fábia Berganton Aleixo, Keulle Candido, Hugo Dias Batista, Mario Guimarães, Jaqueline Guizeline, João Hoffmann, Francisco Ricardo Marques Lobo, Vinícius Nascimento, Katia Nishiyama, Lucas Pazetto, Daniela Souza, Rodrigo Souza Rodrigues, Ana Maria Vilela dos Santos, Jaquelline Jardim, Luiz Marcelo Sá Malbouisson, Joao Silva, Paulo do Nascimento Junior, Thalissa Hermínia Baio, Gabriel Isaac Pereira de Castro, Henri Roger Watanabe Oliveira, Cristina Prata Amendola, Gutemberg Cardoso, Daniela Ortega, Ana Flavia Brotto, Mirella Cristine De Oliveira, Álvaro Réa-Neto, Fernando Dias, Maria Eduarda Travi, Luiza Zerman, Pedro Azambuja, Marcos Freitas Knibel, Antonio Martins, William Almeida, Calim Neder Neto, Maria Angela Tardelli, Eliana Caser, Marcio Machado, Crisitiano Aguzzoli, Sérgio Baldisserotto, Fernanda Beck Tabajara, Fernanda Bettega, La Hore Correa Rodrigues Júnior, Julia de Gasperi, Lais Faina, Marcos Farias Nolasco, Bruna Ferreira da Costa Fischer, Mariana Fosch de Campos Ferreira, Cristina Hartmann, Marta Kliemann, Gustavo Luis Hubert Ribeiro, Julia Merladete Fraga, Thiago Motta Netto, Laura Valduga Pozza, Paulo Rafael Wendling, Caroline Azevedo, Juliana Garcia, Marcel Lopes, Bernardo Maia, Paula Maselli, Ralph Melo, Weslley Mendes, Matheus Neves, Jacqueline Ney, Claudio Piras, Christopher Applewhaite, Adrienne Carr, Lorraine Chow, Kaylene Duttchen, Julena Foglia, Michael Greene, Ashley Hinther, Kendra Houston, Thomas Jared McCormick, Jennifer Mikhayel, Sam Montasser, Alex Ragan, Andrew Suen, Adrianna Woolsey, Hai Chuan Yu, Duane Funk, Stephen Kowalski, Regina Legaspi, Heather McDonald, Faisal Siddiqui, Jeremy Pridham, Bernadette Rowe, Sonia Sampson, Barton Thiessen, Geoff Zbitnew, Andre Bernard, Ronald George, Philip Jones, Rita Moor, Naveed Siddiqui, Alexandra Wolfer, Diem Tran, Denyse Winch, Gary Dobson, Thomas McCormick, Osama Montasser, Richard Hall, Leyla Baghirzada, Gerard Curley, Si Yuan Dai, Gregory Hare, Esther Lee, Uma Shastri, Albert Tsui, Anmol Yagnik, Danielle Alvares, Stephen Choi, Heather Dwyer, Kathrina Flores, Colin McCartney, Priya Somascanthan, Jo Carroll, Janneth Pazmino-Canizares, Noam Ami, Vincent Chan, Anahi Perlas, Ruth Argue, Yang Huang, Katie Lavis, Kelly Mayson, Ying Cao, Hong Gao, Tingju Hu, Jie Lv, Jian Yang, Yang Yang, Yi Zhong, Jing Zhou, Xiaohua Zou, Miao He, Xiaoying Li, Dihuan Luo, Haiying Wang, Tian Yu, Liyong Chen, Lijun Wang, Yunfei Cai, Zhongming Cao, Yanling Li, Jiaxin Lian, Haiyun Sun, Sheng Wang, Zhipeng Wang, Kenru Wang, Yi Zhu, Xindan Du, Hao Fan, Yunbin Fu, Lixia Huang, Yanming Huang, Haifang Hwan, Hong Luo, Pi-Sheng Qu, Fan Tao, Zhen Wang, Guoxiang Wang, Shun Wang, Yan Zhang, Xiaolin Zhang, Chao Chen, Weixing Wang, Zhengyuan Liu, Lihua Fan, Jing Tang, Yijun Chen, Yongjie Chen, Yangyang Han, Changshun Huang, Guojin Liang, Jing Shen, Jun Wang, Qiuhong Yang, Jungang Zhen, Haidong Zhou, Junping Chen, Zhang Chen, Xiaoyu Li, Bo Meng, Haiwang Ye, Xiaoyan Zhang, Yanbing Bi, Jianqiao Cao, Fengying Guo, Hong Lin, Yang Liu, Meng Lv, Pengcai Shi, Xiumei Song, Chuanyu Sun, Yongtao Sun, Yuelan Wang, Shenhui Wang, Min Zhang, Rong Chen, Jiabao Hou, Yan Leng, Qing-tao Meng, Li Qian, Zi-ying Shen, Zhong-yuan Xia, Rui Xue, Yuan Zhang, Bo Zhao, Xian-jin Zhou, Qiang Chen, Huinan Guo, Yongqing Guo, Yuehong Qi, Zhi Wang, Jianfeng Wei, Weiwei Zhang, Lina Zheng, Qi Bao, Yaqiu Chen, Yijiao Chen, Yue Fei, Nianqiang Hu, Xuming Hu, Min Lei, Xiaoqin Li, Xiaocui Lv, Fangfang Miao, Lingling Ouyang, Lu Qian, Conyu Shen, Yu Sun, Yuting Wang, Dong Wang, Chao Wu, Liyuan Xu, Jiaqi Yuan, Lina Zhang, Huan Zhang, Yapping Zhang, Jinning Zhao, Chong Zhao, Lei Zhao, Tianzhao Zheng, Dachun Zhou, Haiyan Zhou, Ce Zhou, Kaizhi Lu, Ting Zhao, Changlin He, Hong Chen, Shasha Chen, Baoli Cheng, Jie He, Lin Jin, Caixia Li, Hui Li, Yuanming Pan, Yugang Shi, Xiao Hong Wen, Shuijing Wu, Guohao Xie, Kai Zhang, Bing Zhao, Xianfu Lu, Feifei Chen, Qisheng Liang, Xuewu Lin, Yunzhi Ling, Gang Liu, Jing Tao, Lu Yang, Jialong Zhou, Fumei Chen, Zhonggui Cheng, Hanying Dai, Yunlin Feng, Benchao Hou, Haixia Gong, Chun hua Hu, Haijin Huang, Jian Huang, Zhangjie Jiang, Mengyuan Li, Jiamei Lin, Mei Liu, Weicheng Liu, Zhen Liu, Zhiyi Liu, Foquan Luo, Longxian Ma, Jia Min, Xiaoyun Shi, Zhiping Song, Xianwen Wan, Yingfen Xiong, Lin Xu, Shuangjia Yang, Qin Zhang, Hongyan Zhang, Huaigen Zhang, Xuekang Zhang, Lili Zhao, Weihong Zhao, Weilu Zhao, Xiaoping Zhu, Yun Bai, Linbi Chen, Sijia Chen, Qinxue Dai, Wujun Geng, Kunyuan Han, Xin He, Luping Huang, Binbin Ji, Danyun Jia, Shenhui Jin, Qianjun Li, Dongdong Liang, Shan Luo, Lulu Lwang, Yunchang Mo, Yuanyuan Pan, Xinyu Qi, Meizi Qian, Jinling Qin, Yelong Ren, Yiyi Shi, Junlu Wang, Junkai Wang, Leilei Wang, Junjie Xie, Yixiu Yan, Yurui Yao, Mingxiao Zhang, Jiashi Zhao, Xiuxiu Zhuang, Yanqiu Ai, Fang Du, Long He, Ledan Huang, Zhisong Li, Huijuan Li, Yetong Li, Liwei Li, Su Meng, Yazhuo Yuan, Enman Zhang, Jie Zhang, Shuna Zhao, Zhenrong Ji, Ling Pei, Li Wang, Chen Chen, Beibei Dong, Jing Li, Ziqiang Miao, Hongying Mu, Chao Qin, Lin Su, Zhiting Wen, Keliang Xie, Yonghao Yu, Fang Yuan, Xianwen Hu, Ye Zhang, Wangpin Xiao, Zhipeng Zhu, Qingqing Dai, Kaiwen Fu, Rong Hu, Xiaolan Hu, Song Huang, Yaqi Li, Yingping Liang, Shuchun Yu, Zheng Guo, Yan Jing, Na Tang, Jie Wu, Dajiang Yuan, Ruilin Zhang, Xiaoying Zhao, Yuhong Li, Hui-Ping Bai, Chun-Xiao Liu, Fei-Fei Liu, Wei Ren, Xiu-Li Wang, Guan-Jie Xu, Na Hu, Bo Li, Yangwen Ou, Yongzhong Tang, Shanglong Yao, Shihai Zhang, Cui-Cui Kong, Bei Liu, Tianlong Wang, Wei Xiao, Bo Lu, Yanfei Xia, Jiali Zhou, Fang Cai, Pushan Chen, Shuangfei Hu, Hongfa Wang, Qiong Xu, Liu Hu, Liang Jing, Bin Li, Qiang Liu, Yuejiang Liu, Xinjian Lu, Zhen Dan Peng, Xiaodong Qiu, Quan Ren, Youliang Tong, Jin Wang, Yazhou Wen, Qiong Wu, Jiangyan Xia, Jue Xie, Xiapei Xiong, Shixia Xu, Tianqin Yang, Hui Ye, Ning Yin, Jing Yuan, Qiuting Zeng, Baoling Zhang, Kang Zheng, Jing Cang, Shiyu Chen, Yu Fan, Shuying Fu, Xiaodong Ge, Baolei Guo, Wenhui Huang, Linghui Jiang, Xinmei Jiang, Yi Liu, Yan Pan, Yun Ren, Qi Shan, Jiaxing Wang, Fei Wang, Chi Wu, Xiaoguang Zhang, Ida Cecilie Christiansen, Simon Nørgaard Granum, Bodil Steen Rasmussen, Morten Daugaard, Rajiv Gambhir, Birgitte Brandsborg, Guðný Erla Steingrímsdóttir, Peter Jensen-Gadegaard, Karsten Skovgaard Olsen, Hanna Siegel, Katrine Zwicky Eskildsen, Mona Ring Gätke, Ida Wibrandt, Simon Bisgaard Heintzelmann, Kai Henrik Wiborg Lange, Rune Sarauw Lundsgaard, Louise Amstrup-Hansen, Claus Hovendal, Michael Larsen, Mette Lenstrup, Tina Kobborg, Jens Rolighed Larsen, Anette Barbre Pedersen, Søren Hübertz Smith, Rebecca Monett Oestervig, Arash Afshari, Cheme Andersen, Kim Ekelund, Erik Lilja Secher, Helene Beloeil, Sigismond Lasocki, Alexandre Ouattara, Marlene Sineus, Serge Molliex, Marie Lim Legouge, Florent Wallet, Antoine Tesniere, Christophe Gaudin, Paul Lehur, Emma Forsans, Stéphane de Rudnicki, Valerie Serra Maudet, Didier Mutter, Ghassan Sojod, Mehdi Ouaissi, Jean-Marc Regimbeau, Jacques Desbordes, Nicolas Comptaer, Diae el Manser, Sabine Ethgen, Gilles Lebuffe, Patrick Auer, Christine Härtl, Maria Deja, Kirill Legashov, Susanne Sonnemann, Carola Wiegand-Loehnert, Elke Falk, Marit Habicher, Stefan Angermair, Beatrix Laetsch, Katrin Schmidt, Christian Von Heymann, Axel Ramminger, Florian Jelschen, Svenja Pabel, Andreas Weyland, Elke Czeslick, Jochen Gille, Michael Malcharek, Armin Sablotzki, Katharina Lueke, Peter Wetzel, Joerg Weimann, Franz-Peter Lenhart, Florian Reichle, Frederike Schirmer, Michael Hüppe, Karl Klotz, Carla Nau, Julika Schön, Thomas Mencke, Christina Wasmund, Carla Bankewitz, Georg Baumgarten, Andreas Fleischer, Vera Guttenthaler, Yvonne Hack, Katharina Kirchgaessner, Olja Männer, Marlen Schurig-Urbaniak, Rafael Struck, Rebekka van Zyl, Maria Wittmann, Ulrich Goebel, Sarah Harris, Siegfried Veit, Evangelia Andreadaki, Flora Souri, Ioannis Katsiadramis, Anthi Skoufi, Maria Vasileiou, Eleni Aimoniotou- Georgiou, Anastasios Katsourakis, Fotini Veroniki, Glyceria Vlachogianni, Konstantina Petra, Dimitra Chlorou, Eirini Oloktsidou, Vasileios Ourailoglou, Konstantinos Papapostolou, Georgia Tsaousi, Panagoula Daikou, Georgia Dedemadi, Ioannis Kalaitzopoulos, Christos Loumpias, Sotirios Bristogiannis, Nikolaos Dafnios, Georgios Gkiokas, Elissaios Kontis, Dimitra Kozompoli, Aspasia Papailia, Theodosios Theodosopoulos, Christol Bizios, Anastasia Koutsikou, Aleaxandra Moustaka, Ioannis Plaitakis, Apostolos Armaganidis, Theodora Christodoulopoulou, Mihail Lignos, Maria Theodorakopoulou, Andreas Asimakos, Eleni Ischaki, Angeliki Tsagkaraki, Spyros Zakynthinos, Eleni Antoniadou, Ioannis Koutelidakis, Dimitrios Lathyris, Irene Pozidou, Nikolaos Voloudakis, Maria Dalamagka, Gkonezou Elena, Christos Chronis, Dimitra Manolakaki, Dimitris Mosxogiannidis, Tatiana Slepova, Isaia-sissy Tsakiridou, Claire Lampiri, Anastasia Vachlioti, Christos Panagiotakis, Dimitrios Sfyras, Fotios Tsimpoukas, Athanasia Tsirogianni, Elena Axioti, Andreas Filippopoulos, Elli Kalliafa, George Kassavetis, Petros Katralis, Ioannis Komnos, Georgios Pilichos, Ifigenia Ravani, Antonis Totis, Eymorfia Apagaki, Andromachi Efthymiadi, Nikolaos Kampagiannis, Theoniki Paraforou, Agoritsa Tsioka, Georgios Georgiou, Aristeidis Vakalos, Aggeliki Bairaktari, Efthimios Charitos, George Markou, Panagiota Niforopoulou, Nikolaos Papakonstantinou, Evdoxia Tsigou, Archontoula Xifara, Menelaos Zoulamoglou, Panagiota Gkioni, Stylianos Karatzas, Aikaterini Kyparissi, Efstratios Mainas, Ioannis Papapanagiotou, Theonymfi Papavasilopoulou, George Fragandreas, Eleni Georgopoulou, Eleni Katsika, Kyriakos Psarras, Eirini Synekidou, Maria Verroiotou, Evangelia Vetsiou, Donika Zaimi, Athina Anagnou, Konstantinos Apostolou, Theodora Melissopoulou, Theophilos Rozenberg, Christos Tsigris, Georgios Boutsikos, Vasileios Kalles, Nikolaos Kotsalas, Christina Lavdaiou, Fotini Paikou, Georgia-Laura Panagou, Anna Spring, Ioannis Botis, Maria Drimala, Georgios Georgakakis, Ellada Kiourtzieva, Panagiota Ntouma, Apostolos Prionas, Kyriakos Xouplidis, Eleftheria Dalampini, Chrysavgi Giannaki, Christina Iasonidou, Orestis Ioannidis, Athina Lavrentieva, Athena Lavrentieva, George Papageorgiou, Maria Kokkinoy, Maria Stafylaraki, Stylianos Gaitanakis, Periclis Karydakis, Josef Paltoglou, Panagiotis Ponireas, Panagiotis Chaloulis, Athanasios Provatidis, Anisoglou Sousana, Varvara Vanessa Gardikou, Maria Konstantivelli, Olga Lataniotou, Elisavet Lisari, Maria Margaroni, Konstantinos Stamatiou, Edouardos Nikolaidis, Ioannis Pnevmatikos, Eleni Sertaridou, Alexandros Andreou, Eleni Arkalaki, Elias Athanasakis, Fotini Chaniotaki, Chatzimichali Aikaterini Chatzimichali, Maria Christofaki, Despina Dermitzaki, Klara Fiorentza, Georgios Frantzeskos, Elisavet Geromarkaki, Kalliopi Kafkalaki, Marina Kalogridaki, Konstyllia Karydi, Sofia Kokkini, Georgios Kougentakis, Tatiana Lefaki, Emmanouhl Lilitsis, Aikaterini Makatounaki, Polychronis Malliotakis, Dimosthenis Michelakis, Maria Neonaki, Vasileia Nyktari, Iliana Palikyra, Eleftherios Papadakis, Alexandra Papaioannou, Konstantinos Sfakianakis, Maria Sgouraki, Xenia Souvatzis, Anastasia Spartinou, Nefeli Stefanidou, Paulina Syrogianni, Georgia Tsagkaraki, Elena Arnaoutoglou, Christina Arnaoutoglou, Christina Bali, Vasilios Bouris, Rodamanthos Doumos, Konstantia-Paraskevi Gkini, Clio Kapaktsi, Vasilios Koulouras, Arian Lena, Dimitra Lepida, Evangelos Michos, Dimitrios Papadopoulos, Minas Paschopoulos, Vaia Aliki Rompou, Ioanna Siouti, Stavros Tsampalas, Ourania Ververidou, Georgios Zilis, Alexandra Charlalampidoy, Gregory Christodoulidis, Andreas Flossos, Konstantinos Stamoulis, Matthew Chan, Man Shing Caleb Tsang, Man Shing Tsang, Man Ling Lai, Chi Pang Yip, Hey Man Heymans Chan, Bassanio Law, Wing Sze Li, Hiu Man Chu, Emily Gar Yee Koo, Chi Cheong Joe Lam, Ka Ho Cheng, Tracy Lam, Susanna Chu, Wing yan Lam, Kin Wai Kevin Wong, Dilys Kwok, Ching Yue Janice Hung, Wai Kit Jacky Chan, Wing Lam Wong, Chun Kwong Eric Chung, Shu Kai Ma, Shuchi Kaushik, Bhagyesh Shah, Dhiren Shah, Sanjay Shah, Praburaj Ar, Radhakrishnan Muthuchellappan, Vandana Agarwal, Jigeeshu Divatia, Sanghamitra Mishra, Ganesh Nimje, Swati Pande, Sukhada Savarkar, Aditi Shrivastava, Martin Thomas, Shashikant Yegnaram, Rahmat Hidayatullah, Nasman Puar, Sumara Niman, Imai Indra, Zulkarnain Hamzah, Annika Yuliana, Ucu Nurhadiat Abidin, Ade Nurkacan Dursin, Andri Kurnia, Ade Susanti, Dini Handayani, Mahaalit Aribawa Alit, Aryabiantara Arya, Tjokorda Gde Agung Senapathi, Utara Hartawan Utara, Widnyana Made Wid, Semarawima Wima, Wiryana Made Wir, Brillyan Jehosua, Jonathan Kaunang, Eka Yudha Lantang, Rini Najoan, Neil Waworuntu, Hadi Awad, Akram Fuad, Burair Geddoa, Abdel Razzaq Khalaf, Sabah Al hussaini, Safauldeensalem Albaj, Maithem Kenber, Alessandra Bettinelli, Savino Spadaro, Carlo AlbertoVolta, Luigi Giancarlo, Vicari Sottosanti, Elisa Copetti, Lorenzo Spagnesi, Ilaria Toretti, Chiara Alloj, Silvano Cardellino, Livio Carmino, Eleonora Costanzo, Lucia Caterina Fanfani, Maria Teresa Novelli, Agostino Roasio, Mattia Bellandi, Luigi Beretta, Elena Bignami, Speranza Bocchino, Luca Cabrini, Daniele Corti, Giovanni Landoni, Roberta Meroni, Elena Moizo, Giacomo Monti, Margherita Pintaudi, Valentina Paola Plumari, Daiana Taddeo, Valentina Testa, Dario Winterton, Alberto Zangrillo, Luigi Maria Cloro, Chiara Colangelo, Antonio Colangelo, Giuseppe Rotunno, Miguel Angel Paludi, Cloro Paolo Maria, Antonio Pata, Vieri Parrini, Alessandro Gatta, Mauro Nastasi, Carla Tinti, Antonio Baroselli, Mario Arrigo, Angelo Benevento, Corrado Bottini, Maurizio Cannavo', Christian Gastaldi, Alessandro Marchesi, Angelantonio Pascazio, Francesco Pata, Emilio Pozzi, Alberto Premoli, Gaetano Tessera, Luca Boschi, Rocco D'Andrea, Federico Ghignone, Gilberto Poggioli, Andrea Sibilio, Mario Taffurelli, Giampaolo Ugolini, Mohd Azuan Ab Majid, Rusnah Ab Rahman, James Joseph, Furquan Pathan, Mohammad Hafizshah Sybil Shah, Huey Ling Yap, Seleen Cheah, Im Im Chin, Ji Keon Looi, Siew Ching Tan, Sheshendrasurian Visvalingam, Fan Yin Kwok, Chew Kiok Lee, Tse Siang Tan, Sze Meng Wong, Noor Hairiza Abdullah, Chiat Fong Liew, Lovenia Luxuman, Nor Hafizah Mohd Zin, Muhamad Faiz Norddin, Raja Liza Raja Alias, Juan Yong Wong, Johnny Yong, Mohd Tarmimi Bin Mustapha, Weng Ken Chan, Norizawati Dzulkipli, Pei Xuan Kuan, Yew Ching Lee, Anita Alias, Eng Ching Guok, Chiun Chen Jee, Brian Rhadamantyne Ramon, Cheng Weng Wong, Fara Nur Idayu Abd Ghafar, Faizal Zuhri Aziz, Nabilah Hussain, Hooi Sean Lee, Ismawaty Sukawi, Yuan Liang Woon, Husni Zaeem Abd Hadi, Ummi Azmira Ahmad Azam, Abdul Hafiz Alias, Saiful Aizar Kesut, Jun May Lee, Dar Vin Ooi, Hetty Ayuni Sulaiman, Tengku Alini Tengku Lih, Jeyaganesh Veerakumaran, Eder Rojas, Gerardo Esteban Alvarez Resendiz, Darcy Danitza Mari Zapata, Julio Cesar Jesús Aguilar López, Armando Adolfo Alvarez Flores, Juan Carlos Bravo Amador, Erendira Jocelin Dominguez Avila, Laura Patricia González Aquino, Ricardo Lopez Rodriguez, Mariana Torres Landa, Emma Urias, Markus Hollmann, Abraham Hulst, Osne Kirzner Benedikt Preckel, Ankie Koopman-van Gemert, Marc Buise, Noortje Tolenaar, Eric Weber, Jennifer de Fretes, Peter Houweling, Patricia Ormskerk, Jasper Van Bommel, Marcus Lance, Valerie Smit-Fun, Tom van Zundert, Peter Baas, Hans Donald de Boer, Joost Sprakel, Renske Elferink-Vonk, Peter Noordzij, Laura van Zeggeren, Bastiaan Brand, Rob Spanjersberg, Janneke ten Bokkel-Andela, Sandra Numan, Wilton van Klei, Bas van Zaane, Christa Boer, Yoni van Duivenvoorde, Jens Peter Hering, Sylvia van Rossum, Harry Zonneveldt, Doug Campbell, Siobhan Hoare, Sahayam Santa, Marlynn Ali, Sara Jane Allen, Rachel Bell, Hyun-min David Choi, Matthew Drake, Helen Farrell, Katia Hayes, Kushlin Higgie, Kerry Holmes, Nicole Jenkins, Chang Joon Kim, Steven Kim, Kiew Chai Law, Davina McAllister, Karen Park, Karen Pedersen, Leesa Pfeifer, Anna Pozaroszczyk, Timothy Salmond, Martin Steynor, Michael Tan, Ellen Waymouth, Ahmad Sufian Ab Rahman, John Armstrong, Rosie Dudson, Nia Jenkins, Jayashree Nilakant, Seigne Richard, Pardeep Virdi, Liane Dixon, Roana Donohue, Mehreen Farrow, Ross Kennedy, Henderson Marissa, Margie McKellow, Delany Nicola, Rebecca Pascoe, Stephen John Roberts, George Rowell, Matthew Sumner, Paul Templer, Shardha Chandrasekharan, Graham Fulton, Ib Jammer, Richard More, Leona Wilson, Yuan Hsuan Chang, Julia Foley, Carolyn Fowler, Jonathan Panckhurst, Rachel Sara, Francois Stapelberg, Veronica Cherrett, Donna Louise Ganter, Lloyd McCann, Fiona Gilmour, Rachelle Lumsden, Mark Moores, Sue Olliff, Elitza Sardareva, Joyce Tai, Matthew Wikner, Christopher Wong, Mark Chaddock, Carolyn Czepanski, Patrick McKendry, Daniel Polakovic, Daniel Polakovich, Axe Robert, Margarita Tormo Belda, Tracy Norton, Fadhel Alherz, Lisa Barneto, Alberto Ramirez, Ahmed Sayeed, Nicola Smith, Cambell Bennett, Shane McQuoid, Tracy-Lee Jansen, Zin Nico, John Scott, David Freschini, Angela Freschini, Brian Hopkins, Lara Manson, Deon Stoltz, Alexander Bates, Simon Davis, 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Olivia Goldberg, Harry Goss, Rosanna Greaves, Rudy Harris, Charles Hennings, Eleanor Jones, Nelson Kamali, Naomi Kokkinos, Carys Lewis, Leda Lignos, Evaleen Victoria Malgapo, Rizwana Malik, Andrew Milne, John-Patrick Mulligan, Philippa Nicklin, Natasha Palipane, Thomas Parsons, Rebecca Piper, Rohan Prakash, Byron Ramesh, Sarah Rasip, Jacob Reading, Mariam Rela, Anna Reyes, Robert Stephens, Martin Rooms, Karishma Shah, Henry Simons, Shalil Solanki, Emma Spowart, Amy Stevens, Christopher Thomas, Helena Waggett, Arrash Yassaee, Anthony Kennedy, Sara Scott, Sameer Somanath, Andrew Berg, Miguel Hernandez, Rajesh Nanda, Ghanshyambhai Tank, Natalie Wilson, Debbie Wilson, Yassr Al-Soudaine, Matthew Baldwin, Julie Cornish, Zoe Davies, Leigh Davies, Marc Edwards, Natasha Frewer, Sian Gallard, James Glasbey, Rhiannon Harries, Luke Hopkins, Taeyang Kim, Vilavan Koompirochana, Simon Lawson, Megan Lewis, Zaid Makzal, Sarah Scourfield, Yousra Ahmad, Sarah Bates, Clare Blackwell, Helen Bryant, Hannah Collins, Suzanne Coulter, Ross Cruickshank, Sonya Daniel, Thomas Daubeny, Mark Edwards, Kim Golder, Lesley Hawkins, Bryant Helen, Honor Hinxman, Denny Levett, Karen Salmon, Leanne Seaward, Ben Skinner, Bryony Tyrell, Beverley Wadams, Joseph Walsgrove, Jane Dickson, Kathryn Constantin, Markwell Karen, Peter O'Brien, Lynn O'Donohoe, Hannah Payne, Saul Sundayi, Elaine Walker, Jenny Brooke, Jon Cardy, Sally Humphreys, Laura Kessack, Christiane Kubitzek, Suhas Kumar, Donna Cotterill, Emil Hodzovic, Gurunath Hosdurga, Edward Miles, Glenn Saunders, Marta Campbell, Peter Chan, Kim Jemmett, Ashok Raj, Aditi Naik, Ayo Oshowo, Rajarajan Ramamoorthy, Nimesh Shah, Axel Sylvan, Katharine Blyth, Andrew Burtenshaw, David Freeman, Emily Johnson, Philip Lo, Terry Martin, Emma Plunkett, Julie Wollaston, Joanna Allison, Christine Carroll, Nicholas Craw, Sarah Craw, Tressy Pitt-Kerby, Rebecca Rowland-Axe, Katie Spurdle, Andrew McDonald, Davies Simon, Vivek Sinha, Thomas Smith, Valerie Banner-Goodspeed, Myles Boone, Kathleen Campbell, Fengxin Lu, Joseph Scannell, Julia Sobol, Naraida Balajonda, Karen Clemmons, Carlos Conde, Magdi Elgasim, Bonita Funk, Roger Hall, Thomas Hopkins, Omowunmi Olaleye, Omer Omer, Michelle Pender, Angelo Porto, Alice Stevens, Peter Waweru, Erlinda Yeh, Daniella Bodansky, Adam Evans, Steven Kleopoulos, Robert Maril, Edward Mathney, Angela Sanchez, Elizabeth Tinuoye, Brian Bateman, Kristen Eng, Ning Jiang, Karim Ladha, Joseph Needleman, Lee-lynn Chen, Rondall Lane, David Robinowitz, Neil Ghushe, Mariam Irshad, John O'Connor, Samir Patel, Steven Takemoto, Art Wallace, Michael Mazzeffi, Peter Rock, Karin Wallace, Xiaomao Zhu, Pandora Chua, Matthew Mattera, Rebecca Sharar, Stephan Thilen, Miriam Treggiari, Angela Morgan, Iwan Sofjan, Kathirvel Subramaniam, Michael Avidan, Hannah Maybrier, Maxwell Muench, Troy Wildes, Faculty of Economic and Social Sciences and Solvay Business School, Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Queen Mary University of London (QMUL), Royal Free Hospital [London, UK], NHS Foundation Trust [London], The Royal Marsden, University of Cape Town, Linköping university hospital, University of Edinburgh, Abbott, T E F, Ahmad, T, Phull, M K, Fowler, A J, Hewson, R, Biccard, B M, Chew, M S, Gillies, M, Pearse RM, Beattie S, Clavien PA, Demartines N, Fleisher LA, Grocott M, Haddow J, Hoeft A, Holt P, Moreno R, Pritchard N, Rhodes A, Wijeysundera D, Wilson M, Ahmed T, Everingham K, Hewson R, Januszewska M, Phull MK, Halliwell R, Shulman M, Myles P, Schmid W, Hiesmayr M, Wouters P, de Hert S, Lobo S, Fang X, Rasmussen L, Futier E, Biais M, Venara A, Slim K, Sander M, Koulenti D, Arvaniti K, Chan M, Kulkarni A, Chandra S, Tantri A, Geddoa E, Abbas M, Della Rocca G, Sivasakthi D, Mansor M, Luna P, Bouwman A, Buhre W, Beavis V, Campbell D, Short T, Osinaike T, Matos R, Grigoras I, Kirov M, Protsenko D, Biccard B, Aldecoa C, Chew M, Hofer C, Hubner M, Ditai J, Szakmany T, Fleisher L, Ferguson M, MacMahon M, Cherian R, Currow H, Kanathiban K, Gillespie D, Pathmanathan E, Phillips K, Reynolds J, Rowley J, Douglas J, Kerridge R, Garg S, Bennett M, Jain M, Alcock D, Terblanche N, Cotter R, Leslie K, Stewart M, Zingerle N, Clyde A, Hambidge O, Rehak A, Cotterell S, Huynh WBQ, McCulloch T, Ben-Menachem E, Egan T, Cope J, Fellinger P, Haisjackl M, Haselberger S, Holaubek C, Lichtenegger P, Scherz F, Hoffer F, Cakova V, Eichwalder A, Fischbach N, Klug R, Schneider E, Vesely M, Wickenhauser R, Grubmueller KG, Leitgeb M, Lang F, Toro N, Bauer M, Laengle F, Haberl C, Mayrhofer T, Trybus C, Buerkle C, Forstner K, Germann R, Rinoesl H, Schindler E, Trampitsch E, Bogner G, Dankl D, Duenser M, Fritsch G, Gradwohl-Matis I, Hartmann A, Hoelzenbein T, Jaeger T, Landauer F, Lindl G, Lux M, Steindl J, Stundner O, Szabo C, Bidgoli J, Verdoodt H, Forget P, Kahn D, Lois F, Momeni M, Prégardien C, Pospiech A, Steyaert A, Veevaete L, De Kegel D, De Jongh K, Foubert L, Smitz C, Vercauteren M, Poelaert J, Van Mossevelde V, Abeloos J, Bouchez S, Coppens M, De Baerdemaeker L, Deblaere I, De Bruyne A, Fonck K, Heyse B, Jacobs T, Lapage K, Moerman A, Neckebroek M, Parashchanka A, Roels N, Van Den Eynde N, Vandenheuvel M, Limmen J, Vanluchene A, Vanpeteghem C, Wyffels P, Huygens C, Vandenbempt P, Van de Velde M, Dylst D, Janssen B, Schreurs E, Aleixo FB, Candido K, Batista HD, Guimarães M, Guizeline J, Hoffmann J, Lobo FRM, Nascimento V, Nishiyama K, Pazetto L, Souza D, Rodrigues RS, Vilela Dos Santos AM, Jardim J, Sá Malbouisson LM, Silva J, Nascimento Junior PD, Baio TH, Pereira de Castro GI, Watanabe Oliveira HR, Amendola CP, Cardoso G, Ortega D, Brotto AF, De Oliveira MC, Réa-Neto Á, Dias F, Travi ME, Zerman L, Azambuja P, Knibel MF, Martins A, Almeida W, Neto CN, Tardelli MA, Caser E, Machado M, Aguzzoli C, Baldisserotto S, Tabajara FB, Bettega F, Rodrigues Júnior HC, de Gasperi J, Faina L, Nolasco MF, Ferreira da Costa Fischer B, Fosch de Campos Ferreira M, Hartmann C, Kliemann M, Hubert Ribeiro GL, Fraga JM, Netto TM, Pozza LV, Wendling PR, Azevedo C, Garcia J, Lopes M, Maia B, Maselli P, Melo R, Mendes W, Neves M, Ney J, Piras C, Applewhaite C, Carr A, Chow L, Duttchen K, Foglia J, Greene M, Hinther A, Houston K, McCormick TJ, Mikhayel J, Montasser S, Ragan A, Suen A, Woolsey A, Yu HC, Funk D, Kowalski S, Legaspi R, McDonald H, Siddiqui F, Pridham J, Rowe B, Sampson S, Thiessen B, Zbitnew G, Bernard A, George R, Jones P, Moor R, Siddiqui N, Wolfer A, Tran D, Winch D, Dobson G, McCormick T, Montasser O, Hall R, Baghirzada L, Curley G, Dai SY, Hare G, Lee E, Shastri U, Tsui A, Yagnik A, Alvares D, Choi S, Dwyer H, Flores K, McCartney C, Somascanthan P, Carroll J, Pazmino-Canizares J, Wolfer A, Ami N, Chan V, Perlas A, Argue R, Huang Y, Lavis K, Mayson K, Cao Y, Gao H, Hu T, Lv J, Yang J, Yang Y, Zhong Y, Zhou J, Zou X, He M, Li X, Luo D, Wang H, Yu T, Chen L, Wang L, Cai Y, Cao Z, Li Y, Lian J, Sun H, Wang S, Wang Z, Wang K, Zhu Y, Du X, Fan H, Fu Y, Huang L, Huang Y, Hwan H, Luo H, Qu PS, Tao F, Wang Z, Wang G, Wang S, Zhang Y, Zhang X, Chen C, Wang W, Liu Z, Fan L, Tang J, Chen Y, Chen Y, Han Y, Huang C, Liang G, Shen J, Wang J, Yang Q, Zhen J, Zhou H, Chen J, Chen Z, Li X, Meng B, Ye H, Zhang X, Bi Y, Cao J, Guo F, Lin H, Liu Y, Lv M, Shi P, Song X, Sun C, Sun Y, Wang Y, Wang S, Zhang M, Chen R, Hou J, Leng Y, Meng QT, Qian L, Shen ZY, Xia ZY, Xue R, Zhang Y, Zhao B, Zhou XJ, Chen Q, Guo H, Guo Y, Qi Y, Wang Z, Wei J, Zhang W, Zheng L, Bao Q, Chen Y, Chen Y, Fei Y, Hu N, Hu X, Lei M, Li X, Lv X, Miao F, Ouyang L, Qian L, Shen C, Sun Y, Wang Y, Wang D, Wu C, Xu L, Yuan J, Zhang L, Zhang H, Zhang Y, Zhao J, Zhao C, Zhao L, Zheng T, Zhou D, Zhou H, Zhou C, Lu K, Zhao T, He C, Chen H, Chen S, Cheng B, He J, Jin L, Li C, Li H, Pan Y, Shi Y, Wen XH, Wu S, Xie G, Zhang K, Zhao B, Lu X, Chen F, Liang Q, Lin X, Ling Y, Liu G, Tao J, Yang L, Zhou J, Chen F, Cheng Z, Dai H, Feng Y, Hou B, Gong H, Hu CH, Huang H, Huang J, Jiang Z, Li M, Lin J, Liu M, Liu W, Liu Z, Liu Z, Luo F, Ma L, Min J, Shi X, Song Z, Wan X, Xiong Y, Xu L, Yang S, Zhang Q, Zhang H, Zhang H, Zhang X, Zhao L, Zhao W, Zhao W, Zhu X, Bai Y, Chen L, Chen S, Dai Q, Geng W, Han K, He X, Huang L, Ji B, Jia D, Jin S, Li Q, Liang D, Luo S, Lwang L, Mo Y, Pan Y, Qi X, Qian M, Qin J, Ren Y, Shi Y, Wang J, Wang J, Wang L, Xie J, Yan Y, Yao Y, Zhang M, Zhao J, Zhuang X, Ai Y, Du F, He L, Huang L, Li Z, Li H, Li Y, Li L, Meng S, Yuan Y, Zhang E, Zhang J, Zhao S, Ji Z, Pei L, Wang L, Chen C, Dong B, Li J, Miao Z, Mu H, Qin C, Su L, Wen Z, Xie K, Yu Y, Yuan F, Hu X, Zhang Y, Xiao W, Zhu Z, Dai Q, Fu K, Hu R, Hu X, Huang S, Li Y, Liang Y, Yu S, Guo Z, Jing Y, Tang N, Wu J, Yuan D, Zhang R, Zhao X, Li Y, Bai HP, Liu CX, Liu FF, Ren W, Wang XL, Xu GJ, Hu N, Li B, Ou Y, Tang Y, Yao S, Zhang S, Kong CC, Liu B, Wang T, Xiao W, Lu B, Xia Y, Zhou J, Cai F, Chen P, Hu S, Wang H, Xu Q, Hu L, Jing L, Li B, Liu Q, Liu Y, Lu X, Peng ZD, Qiu X, Ren Q, Tong Y, Wang J, Wen Y, Wu Q, Xia J, Xie J, Xiong X, Xu S, Yang T, Ye H, Yin N, Yuan J, Zeng Q, Zhang B, Zheng K, Cang J, Chen S, Fan Y, Fu S, Ge X, Guo B, Huang W, Jiang L, Jiang X, Liu Y, Pan Y, Ren Y, Shan Q, Wang J, Wang F, Wu C, Zhang X, Christiansen IC, Granum SN, Rasmussen BS, Daugaard M, Gambhir R, Brandsborg B, Steingrímsdóttir GE, Jensen-Gadegaard P, Olsen KS, Siegel H, Eskildsen KZ, Gätke MR, Wibrandt I, Heintzelmann SB, Wiborg Lange KH, Lundsgaard RS, Amstrup-Hansen L, Hovendal C, Larsen M, Lenstrup M, Kobborg T, Larsen JR, Pedersen AB, Smith SH, Oestervig RM, Afshari A, Andersen C, Ekelund K, Secher EL, Beloeil H, Lasocki S, Ouattara A, Sineus M, Molliex S, Legouge ML, Wallet F, Tesniere A, Gaudin C, Lehur P, Forsans E, de Rudnicki S, Maudet VS, Mutter D, Sojod G, Ouaissi M, Regimbeau JM, Desbordes J, Comptaer N, Manser DE, Ethgen S, Lebuffe G, Auer P, Härtl C, Deja M, Legashov K, Sonnemann S, Wiegand-Loehnert C, Falk E, Habicher M, Angermair S, Laetsch B, Schmidt K, Von Heymann C, Ramminger A, Jelschen F, Pabel S, Weyland A, Czeslick E, Gille J, Malcharek M, Sablotzki A, Lueke K, Wetzel P, Weimann J, Lenhart FP, Reichle F, Schirmer F, Hüppe M, Klotz K, Nau C, Schön J, Mencke T, Wasmund C, Bankewitz C, Baumgarten G, Fleischer A, Guttenthaler V, Hack Y, Kirchgaessner K, Männer O, Schurig-Urbaniak M, Struck R, van Zyl R, Wittmann M, Goebel U, Harris S, Veit S, Andreadaki E, Souri F, Katsiadramis I, Skoufi A, Vasileiou M, Aimoniotou-Georgiou E, Katsourakis A, Veroniki F, Vlachogianni G, Petra K, Chlorou D, Oloktsidou E, Ourailoglou V, Papapostolou K, Tsaousi G, Daikou P, Dedemadi G, Kalaitzopoulos I, Loumpias C, Bristogiannis S, Dafnios N, Gkiokas G, Kontis E, Kozompoli D, Papailia A, Theodosopoulos T, Bizios C, Koutsikou A, Moustaka A, Plaitakis I, Armaganidis A, Christodoulopoulou T, Lignos M, Theodorakopoulou M, Asimakos A, Ischaki E, Tsagkaraki A, Zakynthinos S, Antoniadou E, Koutelidakis I, Lathyris D, Pozidou I, Voloudakis N, Dalamagka M, Elena G, Chronis C, Manolakaki D, Mosxogiannidis D, Slepova T, Tsakiridou IS, Lampiri C, Vachlioti A, Panagiotakis C, Sfyras D, Tsimpoukas F, Tsirogianni A, Axioti E, Filippopoulos A, Kalliafa E, Kassavetis G, Katralis P, Komnos I, Pilichos G, Ravani I, Totis A, Apagaki E, Efthymiadi A, Kampagiannis N, Paraforou T, Tsioka A, Georgiou G, Vakalos A, Bairaktari A, Charitos E, Markou G, Niforopoulou P, Papakonstantinou N, Tsigou E, Xifara A, Zoulamoglou M, Gkioni P, Karatzas S, Kyparissi A, Mainas E, Papapanagiotou I, Papavasilopoulou T, Fragandreas G, Georgopoulou E, Katsika E, Psarras K, Synekidou E, Verroiotou M, Vetsiou E, Zaimi D, Anagnou A, Apostolou K, Melissopoulou T, Rozenberg T, Tsigris C, Boutsikos G, Kalles V, Kotsalas N, Lavdaiou C, Paikou F, Panagou GL, Spring A, Botis I, Drimala M, Georgakakis G, Kiourtzieva E, Ntouma P, Prionas A, Xouplidis K, Dalampini E, Giannaki C, Iasonidou C, Ioannidis O, Lavrentieva A, Lavrentieva A, Papageorgiou G, Kokkinoy M, Stafylaraki M, Gaitanakis S, Karydakis P, Paltoglou J, Ponireas P, Chaloulis P, Provatidis A, Sousana A, Gardikou VV, Konstantivelli M, Lataniotou O, Lisari E, Margaroni M, Stamatiou K, Nikolaidis E, Pnevmatikos I, Sertaridou E, Andreou A, Arkalaki E, Athanasakis E, Chaniotaki F, Chatzimichali CA, Christofaki M, Dermitzaki D, Fiorentza K, Frantzeskos G, Geromarkaki E, Kafkalaki K, Kalogridaki M, Karydi K, Kokkini S, Kougentakis G, Lefaki T, Lilitsis E, Makatounaki A, Malliotakis P, Michelakis D, Neonaki M, Nyktari V, Palikyra I, Papadakis E, Papaioannou A, Sfakianakis K, Sgouraki M, Souvatzis X, Spartinou A, Stefanidou N, Syrogianni P, Tsagkaraki G, Arnaoutoglou E, Arnaoutoglou C, Bali C, Bouris V, Doumos R, Gkini KP, Kapaktsi C, Koulouras V, Lena A, Lepida D, Michos E, Papadopoulos D, Paschopoulos M, Rompou VA, Siouti I, Tsampalas S, Ververidou O, Zilis G, Charlalampidoy A, Christodoulidis G, Flossos A, Stamoulis K, Chan M, Tsang MSC, Tsang MS, Lai ML, Yip CP, Heymans Chan HM, Law B, Li WS, Chu HM, Koo EGY, Lam CCJ, Cheng KH, Lam T, Chu S, Lam WY, Wong KWK, Kwok D, Hung CYJ, Chan WKJ, Wong WL, Chung CKE, Ma SK, Kaushik S, Shah B, Shah D, Shah S, Ar P, Muthuchellappan R, Agarwal V, Divatia J, Mishra S, Nimje G, Pande S, Savarkar S, Shrivastava A, Thomas M, Yegnaram S, Hidayatullah R, Puar N, Niman S, Indra I, Hamzah Z, Yuliana A, Abidin UN, Dursin AN, Kurnia A, Susanti A, Handayani D, Alit MA, Arya A, Senapathi TGA, Utara UH, Wid WM, Wima S, Wir WM, Jehosua B, Kaunang J, Lantang EY, Najoan R, Waworuntu N, Awad H, Fuad A, Geddoa B, Khalaf AR, Al Hussaini S, Albaj S, Kenber M, Bettinelli A, Spadaro S, AlbertoVolta C, Giancarlo L, Sottosanti V, Copetti E, Spagnesi L, Toretti I, Alloj C, Cardellino S, Carmino L, Costanzo E, Fanfani LC, Novelli MT, Roasio A, Bellandi M, Beretta L, Bignami E, Bocchino S, Cabrini L, Corti D, Landoni G, Meroni R, Moizo E, Monti G, Pintaudi M, Plumari VP, Taddeo D, Testa V, Winterton D, Zangrillo A, Cloro LM, Colangelo C, Colangelo A, Rotunno G, Paludi MA, Maria CP, Pata A, Parrini V, Gatta A, Nastasi M, Tinti C, Baroselli A, Arrigo M, Benevento A, Bottini C, Cannavo' M, Gastaldi C, Marchesi A, Pascazio A, Pata F, Pozzi E, Premoli A, Tessera G, Boschi L, D'Andrea R, Ghignone F, Poggioli G, Sibilio A, Taffurelli M, Ugolini G, Ab Majid MA, Ab Rahman R, Joseph J, Pathan F, Sybil Shah MH, Yap HL, Cheah S, Chin II, Looi JK, Tan SC, Visvalingam S, Kwok FY, Lee CK, Tan TS, Wong SM, Abdullah NH, Liew CF, Luxuman L, Mohd Zin NH, Norddin MF, Raja Alias RL, Wong JY, Yong J, Bin Mustapha MT, Chan WK, Dzulkipli N, Kuan PX, Lee YC, Alias A, Guok EC, Jee CC, Ramon BR, Wong CW, Abd Ghafar FNI, Aziz FZ, Hussain N, Lee HS, Sukawi I, Woon YL, Abd Hadi HZ, Ahmad Azam UA, Alias AH, Kesut SA, Lee JM, Ooi DV, Sulaiman HA, Lih TAT, Veerakumaran J, Rojas E, Resendiz GEA, Zapata DDM, López JCJA, Flores AAA, Amador JCB, Avila EJD, Aquino LPG, Rodriguez RL, Landa MT, Urias E, Hollmann M, Hulst A, Benedikt Preckel OK, Gemert AK, Buise M, Tolenaar N, Weber E, de Fretes J, Houweling P, Ormskerk P, Van Bommel J, Lance M, Smit-Fun V, van Zundert T, Baas P, de Boer HD, Sprakel J, Elferink-Vonk R, Noordzij P, van Zeggeren L, Brand B, Spanjersberg R, Bokkel-Andela JT, Numan S, van Klei W, van Zaane B, Boer C, van Duivenvoorde Y, Hering JP, van Rossum S, Zonneveldt H, Campbell D, Hoare S, Santa S, Ali M, Allen SJ, Beavis V, Bell R, Choi HD, Drake M, Farrell H, Hayes K, Higgie K, Holmes K, Jenkins N, Kim CJ, Kim S, Law KC, McAllister D, Park K, Pedersen K, Pfeifer L, Pozaroszczyk A, Salmond T, Steynor M, Tan M, Waymouth E, Ab Rahman AS, Armstrong J, Dudson R, Jenkins N, Nilakant J, Richard S, Virdi P, Dixon L, Donohue R, Farrow M, Kennedy R, Marissa H, McKellow M, Nicola D, Pascoe R, Roberts SJ, Rowell G, Sumner M, Templer P, Chandrasekharan S, Fulton G, Jammer I, More R, Wilson L, Chang YH, Foley J, Fowler C, Panckhurst J, Sara R, Stapelberg F, Cherrett V, Ganter DL, McCann L, Gilmour F, Lumsden R, Moores M, Olliff S, Sardareva E, Tai J, Wikner M, Wong C, Chaddock M, Czepanski C, McKendry P, Polakovic D, Polakovich D, Robert A, Belda MT, Norton T, Alherz F, Barneto L, Ramirez A, Sayeed A, Smith N, Bennett C, McQuoid S, Jansen TL, Nico Z, Scott J, Freschini D, Freschini A, Hopkins B, Manson L, Stoltz D, Bates A, Davis S, Freeman V, McGaughran L, Williams M, Sharma SB, Burrows T, Byrne K, English D, Johnson R, Manikkam B, Naidoo S, Rumball M, Whittle N, Franks R, Gibson-Lapsley H, Salter R, Walsh D, Cooper R, Perry K, Obobolo A, Sule UM, Ahmad A, Atiku M, Mohammed AD, Sarki AM, Adekola O, Akanmu O, Durodola A, Olukoju O, Raji V, Olajumoke T, Oyebamiji E, Adenekan A, Adetoye A, Faponle F, Olateju S, Owojuyigbe A, Talabi A, Adenike O, Adewale B, Collins N, Ezekiel E, Fatungase OM, Grace A, Sola S, Stella O, Ademola A, Adeolu AA, Adigun T, Akinwale M, Fasina O, Gbolahan O, Idowu O, Olonisakin RP, Osinaike BB, Asudo F, Mshelia D, Abdur-Rahman L, Agodirin O, Bello J, Bolaji B, Oyedepo OO, Ezike H, Iloabachie I, Okonkwo I, Onuora E, Onyeka T, Ugwu I, Umeh F, Alagbe-Briggs O, Dodiyi-Manuel A, Echem R, Obasuyi B, Onajin-Obembe B, Bandeira ME, Martins A, Tomé M, Costa ACMM, Krystopchuk A, Branco T, Esteves S, Melo MA, Monte J, Rua F, Martins I, Pinho-Oliveira VM, Rodrigues CM, Cabral R, Marques S, Rêgo S, Jesus JST, Marques MC, Romao C, Dias S, Santos AM, Alves MJ, Salta C, Cruz S, Duarte C, Paiva AAF, Cabral TDN, Faria E Maia D, Correia da Silva RFM, Langner A, Resendes HO, Soares MDC, Abrunhosa A, Faria F, Miranda L, Pereira H, Serra S, Ionescu D, Margarit S, Mitre C, Vasian H, Manga G, Stefan A, Tomescu D, Filipescu D, Paunescu MA, Stefan M, Stoica R, Gavril L, Pătrășcanu E, Ristescu I, Rusu D, Diaconescu C, Iosep GF, Pulbere D, Ursu I, Balanescu A, Grintescu I, Mirea L, Rentea I, Vartic M, Lupu MN, Stanescu D, Streanga L, Antal O, Hagau N, Patras D, Petrisor C, Tosa F, Tranca S, Copotoiu SM, Ungureanu LL, Harsan CR, Papurica M, Cernea DD, Dragoescu NA, CarmenVaida LA, Ciobotaru OR, Aignatoaie M, Carp CP, Cobzaru I, Mardare O, Purcarin B, Tutunaru V, 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Craw N, Craw S, Pitt-Kerby T, Rowland-Axe R, Spurdle K, McDonald A, Simon D, Sinha V, Smith T, Banner-Goodspeed V, Boone M, Campbell K, Lu F, Scannell J, Sobol J, Balajonda N, Clemmons K, Conde C, Elgasim M, Funk B, Hall R, Hopkins T, Olaleye O, Omer O, Pender M, Porto A, Stevens A, Waweru P, Yeh E, Bodansky D, Evans A, Kleopoulos S, Maril R, Mathney E, Sanchez A, Tinuoye E, Bateman B, Eng K, Jiang N, Ladha K, Needleman J, Chen LL, Lane R, Robinowitz D, Ghushe N, Irshad M, O'Connor J, Patel S, Takemoto S, Wallace A, Mazzeffi M, Rock P, Wallace K, Zhu X, Chua P, Mattera M, Sharar R, Thilen S, Treggiari M, Morgan A, Sofjan I, Subramaniam K, Avidan M, Maybrier H, Muench M, Wildes T., Université de Lille, CHU Lille, Queen Mary University of London [QMUL], Graduate School, Medical Microbiology and Infection Prevention, Clinical Immunology and Rheumatology, 01 Internal and external specialisms, ACS - Heart failure & arrhythmias, AGEM - Endocrinology, metabolism and nutrition, APH - Quality of Care, ACS - Diabetes & metabolism, AII - Amsterdam institute for Infection and Immunity, ACS - Microcirculation, Pearse, R M, International Surgical Outcomes Study (ISO), Group, Zangrillo, A, Landoni, G, Beretta, L., International Surgical Outcomes Study (ISOS) group, Pearse, R.M., Beattie, S., Clavien, P.A., Demartines, N., Fleisher, L.A., Grocott, M., Haddow, J., Hoeft, A., Holt, P., Moreno, R., Pritchard, N., Rhodes, A., Wijeysundera, D., Wilson, M., Ahmed, T., Everingham, K., Hewson, R., Januszewska, M., Phull, M.K., Halliwell, R., Shulman, M., Myles, P., Schmid, W., Hiesmayr, M., Wouters, P., de Hert, S., Lobo, S., Fang, X., Rasmussen, L., Futier, E., Biais, M., Venara, A., Slim, K., Sander, M., Koulenti, D., Arvaniti, K., Chan, M., Kulkarni, A., Chandra, S., Tantri, A., Geddoa, E., Abbas, M., Della Rocca, G., Sivasakthi, D., Mansor, M., Luna, P., Bouwman, A., Buhre, W., Beavis, V., Campbell, D., Short, T., Osinaike, T., Matos, R., Grigoras, I., Kirov, M., Protsenko, D., 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R.R., Chirkut, S., Cronje, L., de Vasconcellos, K., Dube, N.Z., Gama, N.S., Green, G.M., Green-Thompson, R., Kinoo, S.M., Kistnasami, P., Maharaj, K., Moodley, M.S., Mothae, S.J., Aslam F Noorbhai, M., Rughubar, V., Reddy, J., Singh, A., Skinner, D.L., Smith, M.J., Singh, B., Misra, R., Naidoo, M., Ramdharee, P., Selibea, Y., Sewpersad, S., Sham, S., Wessels, J.D., Africander, C., Bejia, T., Blakemore, S.P., Botes, M., Bunwarie, B., Hernandez, C.B., Jeeraz, M.A., Legutko, D.A., Lopez, A.G., De Meyer, J.N., Muzenda, T., Naidoo, N., Patel, M., Pentela, R., Junge, M., Mansoor, N., Rademan, L., Scislowski, P., Seedat, I., van den Berg, B., van der Merwe, D., van Wyk, S., Govender, K., Naicker, D., Ramjee, R., Saley, M., Kuhn, W.P., Matos-Puig, R., Alberto Lisi, Z.M., Perez, G., Beltran, A.V., Lozano, A., Navarro, C.D., Duca, A., Ernesto, EPM, Ferrando, C., Fuentes, I., García-Pérez, M.L., Gracia, E., Palomares, A.I., Katime, A., Miñana, A., Incertis, R.R., Romero, E., Romero Garcia, C.S., Rubio, C., Artiles, T.S., Soro, M., Valls, P., Laguarda, G.A., Benavent, P., Cuenca, V.C., Cueva, A., Lafuente, M., Parra, A.M., Rodrigo, A.R., Sanchez-Morcillo, S., Tormo, S., Redondo, F.J., De Andrés Ibanez, J.A., Diago, L.G., José Hernández Cádiz, M., Manuel, G.G., Peris, R., Saiz, C., Vivo, J.T., Soto, MTT, Brunete, T., Cancho, D., Delgado García, D.R., Zamudio, D., Del Valle, S.G., Serrano, M.L., Alonso, E., Anillo, V., Maseda, E., Salgado, P., Suarez, L., Suarez-de-la-Rica, A., Villagrán, M.J., Alonso, J.I., Cabezuelo, E., Garcia-Saiz, I., Lopez Del Moral, O., Martín, S., Gonzalez, A.P., Doncel, MST, Vera, M.A., José Ávila Sánchez, F., Castaño, B., Moreira, B.C., Risco, S.F., Martín, D.P., Martín, F.P., Poza, P., Ruiz, A., Serna Martínez, W.F., Vicente, B.V., Dominguez, S.V., Fernández, S., Munoz-López, A., Bernat, M.J., Mas, A., Planas, K., Jawad, M., Saeed, Y., Hedin, A., Levander, H., Holmström, S., Lönn, D., Zoerner, F., Åkring, I., Widmark, C., Zettergren, J., Liljequist, V.A., Nystrom, L., Odeberg-Wernerman, S., Oldner, A., Fagerlund, M.J., Reje, P., Lyckner, S., Sperber, J., Adolfsson, A., Klarin, B., Ögren, K., Barras, J.P., Bührer, T., Despotidis, V., Helmy, N., Holliger, S., Raptis, D.A., Schmid, R., Meyer, A., Jaquet, Y., Kessler, U., Muradbegovic, M., Nahum, S.R., Rotunno, T., Schiltz, B., Voruz, F., Worreth, M., Christoforidis, D., Popeskou, S.G., Furrer, M., Prevost, G.A., Stocker, A., Lang, K., Breitenstein, S., Ganter, M.T., Geisen, M., Soll, C., Korkmaz, M., Lubach, I., Schmitz, M., Meyer Zu Schwabedissen, M., Moritz, MZS, Zingg, U., Hillermann, T., Wildi, S., Pinto, B.B., Walder, B., Mariotti, G., Slankamenac, K., Namuyuga, M., Kyomugisha, E., Kituuka, O., Shikanda, A.W., Kakembo, N., Tom, C.O., Antonina, W., Bua, E., Ssettabi, E.M., Epodoi, J., Kabagenyi, F., Kirya, F., Dempsey, G., Seasman, C., Nawaz Khan, R.B., Kurasz, C., Macgregor, M., Shawki, B., Francis, D., Hariharan, V., Chau, S., Ellis, K., Butt, G., Chicken, D.W., Christmas, N., Allen, S., Daniel, G.D., Dempster, A., Kemp, J., Matthews, L., Mcglone, P., Tambellini, J., Trodd, D., Freitas, K., Garg, A., Gupta, J.K., Karpate, S., O'Hara, C., Troko, J., Angus, K., Bradley, J., Brennan, E., Brooks, C., Brown, J., Brown, G., Finch, A., Gratrix, K., Hesketh, S., Hill, G., Jeffs, C., Morgan, M., Pemberton, C., Slawson, N., Spickett, H., Swarbrick, G., Van Duyvenvoorde, G., Brennan, A., Briscoe, R., Cooper, S., Lawton, T., Northey, M., Senaratne, R., Stanworth, H., Burrows, L., Cain, H., Craven, R., Davies, K., Jonas, A., Pachucki, M., Walkden, G., Davies, H., Gudaca, M., Hobrok, M., Arawwawala, D., Fergey, L., Gardiner, M., Gunn, J., Johnson, L., Lofting, A., Lyle, A., Neela, F.M., Smolen, S., Topliffe, J., Williams, S., Bland, M., Balaji, P., Kaura, V., Lanka, P., Ahmed, A., Myatt, J., Shenoy, R., Soon, W.C., Tan, J., Karadia, S., Self, J., Durant, E., Tripathi, S., Bullock, C., Ghosh, A., Hughes, T., Zsisku, L., Bengeri, S., Cowton, A., Khalid, M.S., Limb, J., McAdam, C., Porritt, M., Rafi, M.A., Shekar, P., Adams, D., Harden, C., Hollands, H., King, A., March, L., Minto, G., Patrick, A., Squire, R., Waugh, D., Kumara, P., Simeson, K., Yarwood, J., Browning, J., Hatton, J., Julian, H., Mitra, A., Newton, M., Pernu, P.K., Wilson, A., Commey, T., Foot, H., Glover, L., Gupta, A., Lancaster, N., Levin, J., Mackenzie, F., Mestanza, C., Nofal, E., Pout, L., Varden, R., Wild, J., Jones, S., Moreton, S., Pulletz, M., Davies, C., Martin, M., Thomas, S., Burns, K., McArthur, C., Patel, P., Lau, G., Rich, N., Davis, F., Lyons, R., Port, B., Prout, R., Smith, C., Adelaja, Y., Bennett, V., Bidd, H., Dumitrescu, A., Murphy, J.F., Keen, A., Mguni, N., Ong, C., Adams, G., Boshier, P., Brown, R., Butryn, I., Chatterjee, J., Freethy, A., Lockwood, G., Tsakok, M., Tsiligiannis, S., Peat, W., Stephenson, L., Bradburn, M., Pick, S., Cunha, P., Olagbaiye, O., Tayeh, S., Packianathaswamy, B., Abernethy, C., Balasubramaniam, M., Bennett, R., Bolton, D., Martinson, V., Naylor, C., Bell, S., Heather, B., Kushakovsky, V., Alcock, L., Alexander, H., Anderson, C., Baker, P., Brookes, M., Cawthorn, L., Cirstea, E., Clarkson, R., Colling, K., Coulter, I., Das, S., Haigh, K., Hamdan, A., Hugill, K., Kottam, L., Lisseter, E., Mawdsley, M., McGivern, J., Padala, K., Phelps, V., Ramesh Kumar, V., Stewart, K., Towse, K., Tregonning, J., Vahedi, A., Walker, A., Baines, D., Bilolikar, A., Chande, S., Copley, E., Dunk, N., Kulkarni, R., Kumar, P., Metodiev, Y., Ncomanzi, D., Raithatha, B., Raymode, P., Szafranski, J., Twohey, L., Watt, P., Weatherall, L., Weatherill, J., Whitman, Z., Wighton, E., Abayasinghe, C., Chan, A., Darwish, S., Gill, J., Glasgow, E., Hadfield, D., Harris, C., Hopkins, P., Kochhar, A., Kunst, G., Mellis, C., Pool, A., Riozzi, P., Selman, A., Smith, E.J., Vele, L., Gercek, Y., Guy, K., Holden, D., Watson, N., Whysall, K., Andreou, P., Hales, D., Thompson, J., Bowrey, S., McDonald, S., Gilmore, J., Hills, V., Kelly, C., Kelly, S., Lloyd, G., Abbott, T., Gall, L., Torrance, H., Vivian, M., Berntsen, E., Nolan, T., Turner, A., Vohra, A., Brown, A., Clark, R., Coughlan, E., Daniel, C., Patvardhan, C., Pearson, R., Predeep, S., Saad, H., Shanmugam, M., Varley, S., Wylie, K., Cooper, L., Makowski, A., Misztal, B., Moldovan, E., Pegg, C., Donovan, A., Foot, J., Large, S., Claxton, A., Netke, B., Armstrong, R., Calderwood, C., Kwok, A., Mohr, O., Oyeniyi, P., Patnaik, L., Post, B., Ali, S., Arshad, H., Baker, G., Brenner, L., Brincat, M., Brunswicker, A., Cox, H., Cozar, O.I., Cheong, E., Durst, A., Fengas, L., Flatt, J., Glister, G., Narwani, V., Photi, E., Rankin, A., Rosbergen, M., Beaton, C., Horn, R., Hunt, J., Rousseau, G., Stancombe, L., Absar, M., Allsop, J., Drinkwater, Z., Hodgkiss, T., Smith, K., Alexander-Sefre, F., Campey, L., Dudgeon, L., Hall, K., Hitchcock, R., James, L., Winstone, U., Ahmad, N., Bauchmuller, K., Harrison, J., Jeffery, H., Miller, D., Pinder, A., Pothuneedi, S., Rosser, J., Sanghera, S., Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al'Amri, K., Aladin, H., Arshad, M.A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Reynolds, T., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S.A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Hall, A.M., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Paddle, J., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Potter, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., Marques de Araujo, D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Brown, C.W., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Harper, M., Jack, J., Ridley, C., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Jansen van Vuuren, A., Jowitt, T., Kalashetty, G., Lloyd, F., Patel, K., Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Hove, M.O., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K.A., Bertram, W., Looseley, A., Mouton, R., Hanna, G., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Ramessur, S., Salvana, A., Watson, A., Ali, H., Critchley, R., Endersby, S., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Chan, Y.L., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Matthewman, M.C., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E.V., Malik, R., Milne, A., Mulligan, J.P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Stephens, R., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Collins, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Salmon, K., Seaward, L., Skinner, B., Tyrell, B., Wadams, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Oshowo, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., McDonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Elgasim, M., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L.L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., O'Connor, J., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.
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Male ,Postoperative Complications/epidemiology ,Hospital mortality ,[SDV]Life Sciences [q-bio] ,surgery ,Postoperative Complications ,0302 clinical medicine ,cohort studies ,030202 anesthesiology ,patient safety ,030212 general & internal medicine ,Postoperative Period ,Medicine(all) ,Middle Aged ,Checklist ,3. Good health ,Treatment Outcome ,operative/mortality ,Elective Surgical Procedures ,Surgical Procedures, Operative ,Meta-analysis ,Cohort ,Cohort studies ,Female ,Elective Surgical Procedure ,postoperative care/methods ,postoperative care/statistics and numerical data ,surgical procedures ,Anesthesiology and Pain Medicine ,Cohort study ,Adult ,medicine.medical_specialty ,Evidence-based medicine ,NO ,03 medical and health sciences ,Patient safety ,medicine ,postoperative care/method ,Humans ,Elective Surgical Procedures/standards ,Aged ,Cohort Studies ,Evidence-Based Medicine ,Hospital Mortality ,Patient Safety ,Postoperative Complications/mortality ,Postoperative Complications/prevention & control ,Surgical Procedures, Operative/methods ,business.industry ,Odds ratio ,Surgery ,Observational study ,business ,cohort studie - Abstract
BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.METHODS: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals.RESULTS: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); PCONCLUSIONS: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
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- 2018
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5. Uremic Bilateral Breast Calciphylaxis: A Case Report and Literature Review.
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Hassan N, Saad Abdalla Al-Zawi A, Idaewor P, Rasheed N, and Chicken DW
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Calciphylaxis, also called calcific uremic arteriolopathy, is a rare benign cutaneous manifestation. Although little is known about its pathogenesis, it is thought to be a result of vascular wall calcification leading to soft tissue necrosis, and it is usually encountered in patients with end-stage kidney disease (ESKD) on long-term renal dialysis. Breast calciphylaxis is a rare entity that may present as a breast mass or necrotic ulcers, and it is common for it to be initially mistaken for a malignant breast pathology. In this article, we present a case of bilateral breast calciphylaxis in a 66-year-old female with ESKD receiving long-term dialysis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Hassan et al.)
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- 2023
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6. Diverticulitis and Diverticulosis of the Appendix: A Case Series.
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Lesi OK, Probert S, Iqbal MR, Ajuluchukwu OM, Olugbemi M, Rasheed N, Lovett B, Idaewor P, Chicken DW, and Saad Abdalla Al-Zawi A
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Introduction Diverticula of the appendix is a rare entity, may be complicated by inflammation/infection, and clinically mimics acute appendicitis. The reported associated risk factors include male gender, Hirschprung's disease, cystic fibrosis and adult age, where some reports claim that they are also associated with an increased risk of appendiceal malignancy. Imaging has a place in pre-operative diagnosis, however, most of the cases were diagnosed during a pathological examination after surgery. They are associated with a higher rate of perforation (more than four times compared with classical acute appendicitis). In this review, we present a case series of five patients diagnosed with diverticulitis and one with diverticulosis of the appendix that were managed at a single centre. Our aim is to explore the common clinical, radiological, and intra-operative findings associated with this disease as well as the outcome of management. Materials and methods A total number of six cases of diverticular disease of the appendix diagnosed and managed at Basildon University hospital in the period between 2016 and 2020 were studied. The demographic details and clinical data including presenting symptoms, laboratory results, radiological characteristics, intraoperative findings and histopathological features were analysed. Results The study group included four males and two females, with an age range of 20-84 years. The most common presenting clinical symptoms were right iliac fossa abdominal pain, nausea, anorexia, and diarrhoea. Half of the cases showed a thickened appendix in the pre-operative CT scan. An inflamed or perforated appendix was seen in five cases as well as inflammation of the diverticula. Conclusion Appendiceal diverticulitis is an uncommon pathology that imitates acute appendicitis, and appendicectomy is the standard treatment. Prophylactic appendicectomy is recommended for non-inflamed diverticula - this is due to the potential risk of inflammation, perforation, and the risk of developing an appendiceal neoplasm., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Lesi et al.)
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- 2022
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7. Instituting a Green Zone for Elective Surgery During the Second Wave of COVID-19.
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Iqbal MR, Subramonian S, Matwala K, Morrison C, Karamanakos S, Haque SU, Chicken DW, Lovett B, and Walton SJ
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Objective Elective surgery came to a standstill during the first wave of COVID-19. The safe resumption of elective surgery with COVID-19 prevalent in the community remains a significant challenge. The aim of this study was to look into the outcomes of elective general surgery in a dedicated 'Green Zone (GZ)' during the second wave of COVID-19 in the United Kingdom. Method A 'Green Zone' pathway, meant to provide a COVID-free environment, was created. A retrospective review of prospectively collected data was done on consecutive patients who underwent an elective general surgical procedure at a single NHS trust over a six-month period (September 1, 2020, to February 28, 2021). The primary outcome was 30-day COVID-19 mortality. Secondary outcomes included 30-day non-COVID-19 mortality, readmissions, and complications. Results The study included 331 patients with a median age of 55 years (interquartile range, IQR, 41-67); 169 (51%) were females. The majority of the patients were American Society of Anaesthesiologists grade 2 (ASA 2; n=177, 53%) followed by ASA 3 (n=76, 23%). Forty-seven patients (14%) had been shielding earlier in the year. Most of the cases were day cases (n=224, 67%). There was no 30-day COVID-19 or non-COVID-19 mortality. One patient developed COVID-19 three weeks after the index operation. Thirty-day readmission and complication rate were 4% (n=14) and 6% (n=21). Most of the complications were Clavien-Dindo grade 2 (n=10, 3%) followed by an equal number of grades 1 and 3b (n=5, 1.5%). Conclusion This study has shown that a dedicated 'Green Zone' elective operating pathway is safe and feasible provided a balanced risk assessment approach is adopted., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Iqbal et al.)
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- 2021
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8. Elastic scattering spectroscopy for early detection of breast cancer: partially supervised Bayesian image classification of scanned sentinel lymph nodes.
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Zhu Y, Fearn T, Chicken DW, Austwick MR, Somasundaram SK, Mosse CA, Clark B, Bigio IJ, Keshtgar MRS, and Bown SG
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- Bayes Theorem, Elasticity Imaging Techniques methods, Female, Humans, Markov Chains, Principal Component Analysis, Sensitivity and Specificity, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Early Detection of Cancer methods, Image Interpretation, Computer-Assisted methods, Sentinel Lymph Node diagnostic imaging, Sentinel Lymph Node pathology, Spectrum Analysis methods
- Abstract
Sentinel lymph node biopsy is a standard diagnosis procedure to determine whether breast cancer has spread to the lymph glands in the armpit (the axillary nodes). The metastatic status of the sentinel node (the first node in the axillary chain that drains the affected breast) is the determining factor in surgery between conservative lumpectomy and more radical mastectomy including axillary node excision. The traditional assessment of the node requires sample preparation and pathologist interpretation. An automated elastic scattering spectroscopy (ESS) scanning device was constructed to take measurements from the entire cut surface of the excised sentinel node and to produce ESS images for cancer diagnosis. Here, we report on a partially supervised image classification scheme employing a Bayesian multivariate, finite mixture model with a Markov random field (MRF) spatial prior. A reduced dimensional space was applied to represent the scanning data of the node by a statistical image, in which normal, metastatic, and nonnodal-tissue pixels are identified. Our results show that our model enables rapid imaging of lymph nodes. It can be used to recognize nonnodal areas automatically at the same time as diagnosing sentinel node metastases with sensitivity and specificity of 85% and 94%, respectively. ESS images can help surgeons by providing a reliable and rapid intraoperative determination of sentinel nodal metastases in breast cancer., ((2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).)
- Published
- 2018
- Full Text
- View/download PDF
9. Concordance between peri-areolar blue dye and peri-incisional radiotracer injections for sentinel node mapping in patients with a history of primary breast cancer excisonal biopsy.
- Author
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Mehrabibahar M, Azizi S, Jangjoo A, Saremi E, Kakhki VR, Sadeghi R, Chicken DW, and Keshtgar M
- Subjects
- Axilla, Breast Neoplasms metabolism, Breast Neoplasms surgery, Female, Follow-Up Studies, Humans, Injections, Lymph Nodes surgery, Lymphatic Metastasis, Retrospective Studies, Rosaniline Dyes, Breast Neoplasms diagnosis, Coloring Agents administration & dosage, Lymph Nodes pathology, Radiopharmaceuticals administration & dosage, Sentinel Lymph Node Biopsy methods
- Abstract
Background: We evaluated the concordance between peri-areolar blue dye and peri-incisional radiotracer injections for axillary sentinel node mapping of patients with the history of previous breast lesion excisional biopsy., Methods: 80 patients with the history of previous excisional biopsy of the breast lesions were included. All patients received two injections of 99mTc-antimony sulfide colloid in both ends of incision line in an intradermal fashion. 2 mL patient blue V dye was injection to all patients in the peri-areolar area of the index quadrant after induction of anesthesia. All blue or hot nodes were harvested as sentinel lymph nodes., Results: At least one sentinel node could be detected during surgery in 79 patients. In total 94 sentinel nodes were detected. All detected sentinel nodes were hot. In three patients sentinel nodes were detected by gamma probe but not blue dye. The tumor location in all of these patients was in the upper lateral quadrant and the incision line was extended into the axillary tail of the breast in all of them. 91 out of 94 sentinel nodes were stained blue, which amounts to 95.8% concordance between blue dye and radiotracer on a per node analysis., Conclusions: Single peri-areolar injection in the index quadrant would suffice for sentinel node mapping of patients with history of excisional biopsy. Care should be taken in patients with large excisional biopsy in the extreme proximity to axilla.
- Published
- 2014
10. Optical scanning for rapid intraoperative diagnosis of sentinel node metastases in breast cancer.
- Author
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Keshtgar MR, Chicken DW, Austwick MR, Somasundaram SK, Mosse CA, Zhu Y, Bigio IJ, and Bown SG
- Subjects
- Algorithms, Breast Neoplasms surgery, Equipment Design, Female, Humans, Intraoperative Care instrumentation, Lymph Node Excision, ROC Curve, Scattering, Radiation, Sensitivity and Specificity, Spectrum Analysis instrumentation, Breast Neoplasms diagnosis, Diagnosis, Computer-Assisted methods, Intraoperative Care methods, Lymphatic Metastasis diagnosis, Sentinel Lymph Node Biopsy, Spectrum Analysis methods
- Abstract
Background: Intraoperative diagnosis of sentinel node metastases enables an immediate decision to proceed to axillary lymph node dissection, avoiding a second operation in node-positive women with breast cancer., Methods: An optical scanner was developed that interrogated the cut surface of bivalved, but otherwise unprocessed, sentinel lymph nodes with pulses of white light by elastic scattering spectroscopy (ESS). The scattered light underwent spectral analysis, and individual spectra were initially correlated with conventional histology to develop a diagnostic algorithm. This algorithm was used to create false colour-coded maps of scans from an independent set of nodes, and the optimal criteria for discriminating between normal and cancer spectra were defined statistically., Results: The discriminant algorithm was developed from a training set of 2989 spectra obtained from 30 metastatic and 331 normal nodes. Subsequent scans from 129 independent nodes were analysed. The scanner detected macrometastases (larger than 2 mm) with a sensitivity of 76 per cent (69 per cent including micrometastases) and specificity of 96 per cent., Conclusion: In this proof-of-principle study, the ESS results were comparable with current intraoperative diagnostic techniques of lymph node assessment., (Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.)
- Published
- 2010
- Full Text
- View/download PDF
11. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes.
- Author
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Austwick MR, Clark B, Mosse CA, Johnson K, Chicken DW, Somasundaram SK, Calabro KW, Zhu Y, Falzon M, Kocjan G, Fearn T, Bown SG, Bigio IJ, and Keshtgar MR
- Subjects
- Algorithms, Elasticity Imaging Techniques methods, Female, Humans, Light, Lymphatic Metastasis, Reproducibility of Results, Scattering, Radiation, Sensitivity and Specificity, Breast Neoplasms diagnosis, Breast Neoplasms secondary, Carcinoma diagnosis, Carcinoma secondary, Diagnosis, Computer-Assisted methods, Sentinel Lymph Node Biopsy methods, Spectrum Analysis methods
- Abstract
A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20x20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample.
- Published
- 2010
- Full Text
- View/download PDF
12. Sentinel node imaging in breast cancer using superficial injections: technical details and observations.
- Author
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Somasundaram SK, Chicken DW, Waddington WA, Bomanji J, Ell PJ, and Keshtgar MR
- Subjects
- Adult, Aged, Aged, 80 and over, Coloring Agents administration & dosage, Female, Humans, Injections methods, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Lymphatic Metastasis pathology, Middle Aged, Radionuclide Imaging, Rosaniline Dyes administration & dosage, United Kingdom, Breast Neoplasms pathology, Lymphatic Metastasis diagnostic imaging, Radiopharmaceuticals administration & dosage, Sentinel Lymph Node Biopsy methods, Technetium Tc 99m Aggregated Albumin administration & dosage
- Abstract
Introduction: Sentinel lymph node (SLN) biopsy is the evolving standard of care for the management of early breast cancer. Accurate identification of the SLN is paramount for success of this procedure. Various techniques are described for SLN identification, but the superficial injection techniques, advocated by the UK National Training Programme (NEW START), are validated, reproducible and rapid. Pre-operative lymphoscintigraphy provides a road map for the surgeon and requires a reporting template., Methods: As one of the NEW START training institutions in the UK practising this technique, we reviewed a mature series of 100 unselected, consecutive SLN lymphoscintigraphy procedures. We correlated the imaging, operative and pathology findings and have provided technical details of the technique and a template for reporting SLN lymphoscintigrams., Results: The SLN localisation rate was 99% with one failed imaging. Seven patients required delayed imaging. The mean activity of the radiocolloid injected was 14.4MBq (range 8.3-23 MBq). The SLNs were visualised in the ipsilateral axilla in 98 images, intramammary in 3, and internal mammary in 1. A mean of 1.35 nodes were classified as 'True' SLNs on imaging criteria. Intra-operatively, a mean of 1.91 SLNs were excised. 32 of 116 hot and blue nodes, 7 of 15 only blue nodes, 13 of 47 only hot and 7 of 13 parasentinel nodes harboured metastases., Conclusion: The NEW START recommended, combined superficial injection techniques, have high localisation rates. Pre-operative sentinel node imaging is recommended and a template for reporting is provided.
- Published
- 2009
- Full Text
- View/download PDF
13. Patients' view on intraoperative diagnosis of sentinel nodes in breast cancer: is it an automatic choice?
- Author
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Chicken DW, Sivanadarajah N, and Keshtgar MR
- Subjects
- Breast Neoplasms surgery, Carcinoma surgery, Decision Making, Female, Humans, Patient Satisfaction, Predictive Value of Tests, Surveys and Questionnaires, Breast Neoplasms pathology, Breast Neoplasms psychology, Carcinoma psychology, Carcinoma secondary, Health Knowledge, Attitudes, Practice, Sentinel Lymph Node Biopsy psychology
- Abstract
Unlabelled: Intraoperative detection of sentinel node metastases in breast cancer enables immediate axillary lymph node dissection. This approach, however, introduces uncertainty for patients as to the extent of surgery. Waking to find a surgical drain implies more extensive surgery and worse prognosis disease. False negative diagnoses may cause disappointment., Aim: To evaluate patients' views and preferences on intraoperative diagnosis of sentinel nodes in breast cancer., Methods: Questionnaire based survey of 100 patients who had previously undergone sentinel node biopsy with intraoperative diagnosis using touch imprint cytology (TIC). Patients were encouraged to add free text comments., Results: Sixty-four patients responded to the questionnaire. Patients rated the information provided and their understanding of the procedure highly. Fifty-nine percent of respondents overestimated the sensitivity of TIC. Ninety-five percent of patients would choose to undergo intraoperative diagnosis in future if required. Five percent of patients would choose not to undergo intraoperative diagnosis, citing the resultant uncertainty, disappointment on waking and needing time to come in terms with the diagnosis of metastases as reasons., Conclusion: Given the choice, most patients would choose intraoperative diagnosis, though a minority would explicitly not, due to the adverse psychological effect thereof. Despite a good understanding of the procedure, the majority of patients overestimate the sensitivity of intraoperative diagnosis of sentinel nodes, which may heighten disappointment when a false negative diagnosis occurs. Intraoperative diagnosis should not be the automatic choice and patients should be actively involved in this decision making process.
- Published
- 2007
- Full Text
- View/download PDF
14. Allergy to technetium-labelled nanocolloidal albumin for sentinel node identification.
- Author
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Chicken DW, Mansouri R, Ell PJ, and Keshtgar MR
- Subjects
- Aged, 80 and over, Breast Neoplasms diagnostic imaging, Female, Humans, Radionuclide Imaging, Sentinel Lymph Node Biopsy, Coloring Agents adverse effects, Drug Hypersensitivity etiology, Radiopharmaceuticals adverse effects, Rosaniline Dyes adverse effects, Technetium Tc 99m Aggregated Albumin adverse effects
- Abstract
Optimal sentinel node identification requires using the combination technique with blue dye and radiocolloid. Allergic reactions to the common blue dyes in use are well recognised. In this report, we present a patient with breast carcinoma who developed a type I hypersensitivity reaction to intradermal injection of technetium-99m labelled nanocolloidal albumin. While reactions to colloids are rare, and in this case minor, operators using this radiopharmaceutical should be prepared for a potential severe anaphylactic reaction.
- Published
- 2007
- Full Text
- View/download PDF
15. Detection of the sentinel lymph node in breast cancer.
- Author
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Somasundaram SK, Chicken DW, and Keshtgar MR
- Subjects
- Biomarkers, Tumor analysis, Breast Neoplasms surgery, Humans, Breast Neoplasms pathology, Lymph Nodes pathology, Neoplasm Staging methods, Radiopharmaceuticals, Sentinel Lymph Node Biopsy methods
- Abstract
Introduction: Axillary lymph node status for lymphatic staging in breast cancer is the best prognostic indicator and guides systemic treatment. Sentinel lymph node (SLN) biopsy is a novel, minimally invasive technique for lymphatic staging proven to improve quality of life. The accurate detection of the SLN is paramount for the success of the procedure., Methods: Relevant literature was reviewed with regards to the different dyes and techniques used for the detection of SLN in breast cancer., Results: Highest identification rates and lowest false negative rates are achieved by using the combined blue dye and radiocolloid technique with pre-operative imaging using a gamma camera. There is a well-recognized learning curve to successfully perform SLN biopsy., Conclusions: The concept of SLN has been well validated and is the standard of care in early breast cancer. A multidisciplinary approach and structured training is the key to the successful introduction of the technique.
- Published
- 2007
- Full Text
- View/download PDF
16. Allergic reactions to patent blue dye.
- Author
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Mansouri R, Chicken DW, and Keshtgar MR
- Subjects
- Anaphylaxis chemically induced, Female, Humans, Retrospective Studies, Breast Neoplasms pathology, Coloring Agents adverse effects, Rosaniline Dyes adverse effects, Sentinel Lymph Node Biopsy adverse effects, Urticaria chemically induced
- Published
- 2006
- Full Text
- View/download PDF
17. Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer.
- Author
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Chicken DW, Kocjan G, Falzon M, Lee AC, Douek M, Sainsbury R, and Keshtgar MR
- Subjects
- Breast Neoplasms surgery, Carcinoma, Ductal, Breast surgery, False Negative Reactions, Female, Humans, Intraoperative Care methods, Lymph Node Excision, Lymphatic Metastasis pathology, Pilot Projects, Sensitivity and Specificity, Breast Neoplasms pathology, Carcinoma, Ductal, Breast pathology, Sentinel Lymph Node Biopsy standards
- Abstract
Background: Intraoperative detection of sentinel lymph node (SLN) metastases enables the surgeon to take an immediate decision to proceed to completion axillary lymph node dissection (ALND). The aim of this study was to determine the accuracy of touch imprint cytology (TIC) for the diagnosis of SLN metastases in sentinel nodes from women with breast cancer., Methods: Touch imprints from 235 sentinel nodes in 133 women with breast cancer were diagnosed by cytopathology and compared with definitive histopathology results. After a feasibility study, a real-time study was performed with the surgeon proceeding to ALND based on the TIC diagnosis. The clinical opinion of the operating surgeon as to whether the SLN appeared to contain metastases was recorded, as was the time taken for the result to be available., Results: TIC detected metastases with a sensitivity of 81.1 per cent and a specificity of 100 per cent. False-negative TIC diagnoses were associated with micrometastases and lobular carcinoma. The majority of false-negative diagnoses were due to sampling rather than interpretation errors. Clinical assessment of sentinel nodes had a sensitivity of 64.3 per cent and a specificity of 87.6 per cent., Conclusion: TIC is feasible and enables the rapid diagnosis of SLN metastases with an acceptable accuracy for clinical use in ductal carcinoma of the breast.
- Published
- 2006
- Full Text
- View/download PDF
18. New approaches in breast cancer management: sentinel node biopsy and intraoperative radiotherapy.
- Author
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Keshtgar MR, Chicken DW, and Tobias JS
- Subjects
- Axilla, Breast Neoplasms radiotherapy, Female, Humans, Intraoperative Period, Lymphatic Metastasis, Neoplasm Invasiveness, Neoplasm Staging, Radiotherapy, Adjuvant, Breast Neoplasms pathology, Breast Neoplasms surgery, Lymph Nodes pathology, Lymph Nodes surgery, Sentinel Lymph Node Biopsy methods
- Abstract
Breast cancer is presenting earlier, and treatment is becoming less invasive. We review two recent changes in the approach to management. Sentinel lymph node biopsy is a minimally invasive technique to identify the first draining lymph node in direct communication with the primary tumor; it enables "selective lymphadenectomy." Axillary lymph node dissection is reserved as a therapeutic procedure only for proven node positive patients. The concept has been validated, the techniques have been optimized, and randomized controlled trials have confirmed lower morbidity without compromising regional control compared with conventional treatment. The procedure is considered by many as the standard of care for staging the axilla in early breast cancer, although several unanswered questions remain. Adequate training and experience in the technique are vital to ensure high sentinel node identification and low false negative rates. Intraoperative radiotherapy is an attractive concept that enables delivery of single fraction radiotherapy in the operating room immediately after resection of the primary tumor. It is convenient for patients and appears effective in pilot studies. Partial breast irradiation to the index quadrant has been practiced for many years in the form o brachytherapy. Trials are under way comparing intraoperative radiotherapy with conventional external bea irradiation. Intra-operative radiotherapy should not be used outside of clinical trials until the results of the current randomized trials are known.
- Published
- 2005
19. Monitoring recovery after laser surgery of the breast with optical tomography: a case study.
- Author
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Hebden JC, Yates TD, Gibson A, Everdell N, Arridge SR, Chicken DW, Douek M, and Keshtgar MR
- Subjects
- Adult, Algorithms, Breast Neoplasms diagnostic imaging, Female, Fibroadenoma diagnostic imaging, Follow-Up Studies, Humans, Prognosis, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome, Ultrasonography, Breast Neoplasms pathology, Breast Neoplasms surgery, Fibroadenoma pathology, Fibroadenoma surgery, Image Interpretation, Computer-Assisted methods, Laser Therapy methods, Tomography, Optical methods
- Abstract
Results are presented of a study to monitor the changes in the optical properties of breast tissue over a 12-month period after interstitial laser photocoagulation treatment of a fibroadenoma. The study involved generating cross-sectional images of the breast with a multichannel time-resolved imaging system and a nonlinear image reconstruction algorithm. Images of the internal absorbing and scattering properties revealed the expected initial inflammatory response, followed by the development of low-scattering cysts consistent with corresponding ultrasound examinations. Although results indicate that purely qualitative images can potentially provide clinically valuable data, means of enhancing diagnostic information by overcoming present limitations of the approach are discussed.
- Published
- 2005
- Full Text
- View/download PDF
20. A training simulator for sentinel node biopsy in breast cancer: a new standard.
- Author
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Keshtgar MR, Chicken DW, Waddington WA, Raven W, and Ell PJ
- Subjects
- Axilla, Female, Humans, Image Processing, Computer-Assisted methods, Image Processing, Computer-Assisted standards, Lymph Nodes pathology, Radiographic Image Enhancement methods, Radiographic Image Enhancement standards, Sentinel Lymph Node Biopsy methods, Sentinel Lymph Node Biopsy standards, Breast Neoplasms pathology, Sentinel Lymph Node Biopsy education, Teaching methods, Teaching standards
- Abstract
Background: Sentinel node biopsy is becoming the staging investigation of choice for early breast cancer. Optimal identification of the sentinel node requires the utilization of a radionuclide in combination with blue dye. Gamma probe guided surgery is a skill that is currently unfamiliar to many surgeons. Appropriate training within the surgical skills laboratory could play a major role in the widespread implementation of this technique, but no suitable model currently exists for this purpose., Aim: To develop a realistic phantom for the teaching and practice of the core new skills required of a surgeon to perform gamma probe guided sentinel node biopsy in breast cancer., Methods: We describe the development of our sentinel node biopsy simulator which consists of a torso with its arm extended in an operating position. The replaceable breast and axilla are constructed from a thermoplastic elastomer gel, which has similar physical and radiation attenuation properties to that of human tissue. Radionuclide injection sites and radioactive sentinel nodes are simulated by hollow blue coloured PVC beads filled with Technetium-99m. The model allows demonstration and practice of injection techniques, imaging techniques and gamma probe guided removal of sentinel nodes., Conclusion: We believe that training for sentinel node biopsy should begin in the surgical skills laboratory. The model we have developed is able to provide an accurate simulation of all new practical skills required for accurate sentinel node identification. It is an important aid to training in the sentinel lymph node biopsy procedure for breast carcinoma.
- Published
- 2005
- Full Text
- View/download PDF
21. Elastic scattering spectroscopy for intraoperative determination of sentinel lymph node status in the breast.
- Author
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Johnson KS, Chicken DW, Pickard DC, Lee AC, Briggs G, Falzon M, Bigio IJ, Keshtgar MR, and Bown SG
- Subjects
- Algorithms, Axilla, Breast Neoplasms chemistry, Breast Neoplasms classification, Breast Neoplasms diagnosis, Discriminant Analysis, Elasticity, Female, Humans, Intraoperative Care methods, Light, Lymph Nodes chemistry, Lymphatic Metastasis, Principal Component Analysis, Reproducibility of Results, Scattering, Radiation, Sensitivity and Specificity, Breast Neoplasms pathology, Image Interpretation, Computer-Assisted methods, Lymph Nodes pathology, Sentinel Lymph Node Biopsy methods, Spectrum Analysis methods, Tomography, Optical methods
- Abstract
The ability to provide the best treatment for breast cancer depends on establishing whether or not the cancer has spread to the lymph nodes under the arm. Conventional assessment requires tissue removal, preparation, and expert microscopic interpretation. In this study, elastic scattering spectroscopy (ESS) is used to interrogate excised nodes with pulsed broadband illumination and collection of the backscattered light. Multiple spectra are taken from 139 excised nodes (53 containing cancer) in 68 patients, and spectral analysis is performed using a combination of principal component analysis and linear discriminant analysis to correlate the spectra with conventional histology. The data are divided into training and test sets. In test sets containing spectra from only normal nodes and nodes with complete replacement by cancer, ESS detects the spectra from cancerous nodes with 84% sensitivity and 91% specificity (per-spectrum analysis). In test sets that included normal nodes and nodes with partial as well as complete replacement by cancer, ESS detects the nodes with cancer with an average sensitivity of 75% and specificity of 89% (per-node analysis). These results are comparable to those from conventional touch imprint cytology and frozen section histology, but do not require an expert pathologist for interpretation. With automation of the technique, results could be made available almost instantaneously. ESS is a promising technique for the rapid, accurate, and straightforward detection of metastases in excised sentinel lymph nodes., (Copyright 2004 Society of Photo-Optical Instrumentation Engineers.)
- Published
- 2004
- Full Text
- View/download PDF
22. The emerging role and implications of sentinel node biopsy in breast carcinoma.
- Author
-
Chicken DW and Keshtgar MR
- Abstract
The surgical management of breast cancer has become less invasive in recent years. Accurate lymphatic staging remains crucial for determining adjuvant treatment and prognosis. Sentinel node biopsy enables highly accurate lymphatic staging with minimal morbidity. In this article we give a historical overview, outline the technique, give succinct guidelines for practice based on current evidence, examine recently published work as well as highlight the most important trials in progress. The advent of sentinel node biopsy for the routine treatment of breast carcinoma will have significant implications on the whole team involved in beast cancer care. Training for the entire team needs to be addressed, and preparations made as patients are likely to soon demand this procedure as part of the routine management of their breast carcinoma.
- Published
- 2004
23. A warning to users of disposable tonsillectomy instruments.
- Author
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Chicken DW, Sivaji N, and Kanegaonkar RG
- Subjects
- Equipment Failure, Humans, Intraoperative Period, Disposable Equipment, Tonsillectomy instrumentation
- Published
- 2001
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