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1. Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study

Author

Achuthan, R, Adwan, I, Aggarwal, S, Ahmed, M, Akelund, M, Akolekar, D, Al-Jibury, O, Amanita, M, Appleton, D, Archampong, D, Asgiersson, K, Athwal, R, Augusti, A, Ayaani, S, Bains, S, Baker, B, Baker, E, Baldota, S, Banerjee, D, Barker, S, Barr, L, Barry, P, Basu, N, Bathla, S, Bishop, N, Boland, G, Branford, O A, Bright-Thomas, R, Brindle, R, Brock, L, Brown, V, Bux, F, Byrne, G, Cain, H, Caldon, L, Callaghan, M, Carbone, A, Carpenter, R, Cawthorn, S, Chagla, L, Challoner, T, Chalmers, C, Chalmers, R, Chambers, S, Chana, M, Chand, N, Chandran, V, Chandrashekar, M, Charfare, H, Chatterjee, J, Chatterjee, S, Chattopadhyay, R, Chaudry, A, Chin, K, Chong, K, Chouhan, A, Choy, C, Christopoulos, P, Clarke, D, Clarke, S, Clayton, E, Clifford, R, Cocker, D, Collin, T, Collis, N, Conroy, F, Constantinou, C, Conway, A, Cook, J, Coombs, N, Cox, K, Critchley, A, Dakka, M, Dani, M, Daoud, R, Darragh, L, Darvesh, S, Dash, I, Datta, S, Davies, E, Dawson, S, De Sousa, E, Debnath, D, Deol, H, Devalia, H, Di Micco, R, Dicks, JR, Dickson, J, Dobner, N, Dobson, G, Dunne, N, Egbeare, D, El Sharief, D, Elfadl, D, Eltigani, E, Enver, D, Erel, E, Evans, A, Exarchos, G, Fage, E, Fatayer, H, Fenn, C, Ferguson, D, Foulkes, R, Franks, J, Fung, V, Galea, M, Gandamihardja, T, Gandhi, A, Garnsey, C, Gateley, C, Gattuso, J, Gawne, S, Geerthan, N, Ghattura, A, Giaramadze, A, Gill, J, Godden, AR, Goh, S, Govindarajulu, S, Goyal, S, Graja, T, Granger, S, Green, M, Grover, K, Gui, G, Gurung, R, Gutteridge, E, Hakim, A, Halka, A, Hamilton-Burke, W, Hamo, I, Harding-Mackean, C, Hargreaves, A, Harries, S, Harris, K, Harris, P, Harrison, S, Harvey, J, Hashem, M, Hassan, U, Henderson, J, Henton, J, Hignett, S, Hodgkins, K, Horgan, K, Horn, S, Hu, J, Hussain, A, Iddon, J, Iqbal, A, Irri, R, Irvine, T, Irwin, G, Iskender, A, Ismail, A, Ives, C, James, K, James, R, Jiwa, N, Jobson, M, Joglekar, S, Johnson, L, Johnson, R, Jones, L, Ju Hwang, M, Kalles, V, Kanesalingam, K, Karat, I, Kaushik, M, Kennedy, K, Khalifa, E, Khan, H, Khanbhai, M, Khawaja, S, Khout, H, Kiernan, T, Kim, B, Kirkpatrick, K, Kiruparan, P, Kirwan, C, Kishore, M, Kneeshaw, P, Knight, A, Kohlhardt, S, Krupa, J, Krupa, K, Kuruvilla, R, Laban, C, Lai, LM, Laidlaw, I, Lambert, K, Langlands, F, Lansdown, M, Laurence, N, Laws, S, Ledwidge, S, Lefemine, V, Lennon, H, Linforth, R, Little, K, Luangsomboon, A, Lund, J, Maalo, J, MacLennan, L, Macmillan, RD, MacNeil, F, Mahapatra, TK, Mallidis, E, Mallon, P, Manoloudakis, N, Maraqa, L, Marla, S, Masood, S, Massey, J, Masudi, T, Matey, P, Mazari, F, McCulley, S, McEvoy, K, Mcintosh, J, McIntosh, S, McKenzie, S, McManus, P, McNicholas, J, Michalakis, I, Mills, N, Mitchell, G, Monib, S, Mullan, M, Murphy, C, Murphy, G, Murphy, J, Murthy, B, Musa, S, Nagra, G, Nangalia, R, Narayanan, S, Nasr, R, Navin, C, Newton, R, Nicholson, S, Nuru, N, O'Connell, R, O'Donoghue, J, Ogedegbe, A, Olayinka, OS, Olsen, S, Osborn, G, Osborne, C, Osman, H, Otieno, C, Pakzad, F, Park, A, Parker, S, Partlett, P, Parvaiz, A, Parvanta, L, Patel, G, Peel, A, Peiris, L, Pennick, M, Peppe, A, Perry, D, Pilgrim, S, Piper, J, Poonawalla, S, Popa, E, Pope, V, Pugh, P, Rainsbury, D, Ramsey, K, Rasheed, T, Rathinaezhil, R, Rattay, T, Ravichandran, D, Reed, M, Refsum, S, Remoundos, D, Rigby, K, Robertson, S, Robinson, A, Robinson, J, Roche, N, Roy, PJ, Runkel, M, Rusby, J, Saha, S, Saidan, Z, Salab, M, Saleh, M, Salem, F, Sami, A, Samlalsingh, S, Sarfraz, N, Shah, R, Shaheed, S, Sharaiha, Y, Shetty, G, Shotton, R, Sircar, T, Skene, E, Sloan, S, Smith, B, Smith, J, Soldanova, L, Soliman, F, Soumian, S, Stevens, J, Steventon, C, Stewart-Parker, E, Stringfellow, T, Sutaria, R, Sutton, R, Sweetland, H, Swiech, B, Tadiparthi, S, Tafazal, H, Taheri, N, Tait, C, Tan, M, Tang, S, Tansley, A, Tate, S, Tayeh, S, Taylor, A, Taylor, J, Thawdar, P, Thomas, C, Thomas, S, Thomson, S, Thorne, A, Tillett, R, Tolkien, Z, Tomlins, A, Topps, A, Tsang, F, Turner, EJ, Turton, P, Udayasankar, S, Ugolini, F, Vaughan Williams, E, Vidya, R, Vijaynagar, B, Vinayagam, R, Volleamere, A, Voynov, V, Waheed, S, Walker, T, Walsh, U, Warner, R, Waters, R, Wilkins, A, Williams, K, Wilson, G, Wiltsher, M, Wooler, B, Wright, C, Wright, M, Wyld, L, Youssef, M, Zabkiewicz, C, Zammit, C, Zeidan, B, Zheng, D, Potter, Shelley, Conroy, Elizabeth J, Cutress, Ramsey I, Williamson, Paula R, Whisker, Lisa, Thrush, Steven, Skillman, Joanna, Barnes, Nicola L P, Mylvaganam, Senthurun, Teasdale, Elisabeth, Jain, Abhilash, Gardiner, Matthew D, Blazeby, Jane M, and Holcombe, Chris

Published
2019
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6. Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study

Author

Potter, Shelley, primary, Conroy, Elizabeth J, additional, Cutress, Ramsey I, additional, Williamson, Paula R, additional, Whisker, Lisa, additional, Thrush, Steven, additional, Skillman, Joanna, additional, Barnes, Nicola L P, additional, Mylvaganam, Senthurun, additional, Teasdale, Elisabeth, additional, Jain, Abhilash, additional, Gardiner, Matthew D, additional, Blazeby, Jane M, additional, Holcombe, Chris, additional, Achuthan, R, additional, Adwan, I, additional, Aggarwal, S, additional, Ahmed, M, additional, Akelund, M, additional, Akolekar, D, additional, Al-Jibury, O, additional, Amanita, M, additional, Appleton, D, additional, Archampong, D, additional, Asgiersson, K, additional, Athwal, R, additional, Augusti, A, additional, Ayaani, S, additional, Bains, S, additional, Baker, B, additional, Baker, E, additional, Baldota, S, additional, Banerjee, D, additional, Barker, S, additional, Barr, L, additional, Barry, P, additional, Basu, N, additional, Bathla, S, additional, Bishop, N, additional, Boland, G, additional, Branford, O A, additional, Bright-Thomas, R, additional, Brindle, R, additional, Brock, L, additional, Brown, V, additional, Bux, F, additional, Byrne, G, additional, Cain, H, additional, Caldon, L, additional, Callaghan, M, additional, Carbone, A, additional, Carpenter, R, additional, Cawthorn, S, additional, Chagla, L, additional, Challoner, T, additional, Chalmers, C, additional, Chalmers, R, additional, Chambers, S, additional, Chana, M, additional, Chand, N, additional, Chandran, V, additional, Chandrashekar, M, additional, Charfare, H, additional, Chatterjee, J, additional, Chatterjee, S, additional, Chattopadhyay, R, additional, Chaudry, A, additional, Chin, K, additional, Chong, K, additional, Chouhan, A, additional, Choy, C, additional, Christopoulos, P, additional, Clarke, D, additional, Clarke, S, additional, Clayton, E, additional, Clifford, R, additional, Cocker, D, additional, Collin, T, additional, Collis, N, additional, Conroy, F, additional, Constantinou, C, additional, Conway, A, additional, Cook, J, additional, Coombs, N, additional, Cox, K, additional, Critchley, A, additional, Dakka, M, additional, Dani, M, additional, Daoud, R, additional, Darragh, L, additional, Darvesh, S, additional, Dash, I, additional, Datta, S, additional, Davies, E, additional, Dawson, S, additional, De Sousa, E, additional, Debnath, D, additional, Deol, H, additional, Devalia, H, additional, Di Micco, R, additional, Dicks, JR, additional, Dickson, J, additional, Dobner, N, additional, Dobson, G, additional, Dunne, N, additional, Egbeare, D, additional, El Sharief, D, additional, Elfadl, D, additional, Eltigani, E, additional, Enver, D, additional, Erel, E, additional, Evans, A, additional, Exarchos, G, additional, Fage, E, additional, Fatayer, H, additional, Fenn, C, additional, Ferguson, D, additional, Foulkes, R, additional, Franks, J, additional, Fung, V, additional, Galea, M, additional, Gandamihardja, T, additional, Gandhi, A, additional, Garnsey, C, additional, Gateley, C, additional, Gattuso, J, additional, Gawne, S, additional, Geerthan, N, additional, Ghattura, A, additional, Giaramadze, A, additional, Gill, J, additional, Godden, AR, additional, Goh, S, additional, Govindarajulu, S, additional, Goyal, S, additional, Graja, T, additional, Granger, S, additional, Green, M, additional, Grover, K, additional, Gui, G, additional, Gurung, R, additional, Gutteridge, E, additional, Hakim, A, additional, Halka, A, additional, Hamilton-Burke, W, additional, Hamo, I, additional, Harding-Mackean, C, additional, Hargreaves, A, additional, Harries, S, additional, Harris, K, additional, Harris, P, additional, Harrison, S, additional, Harvey, J, additional, Hashem, M, additional, Hassan, U, additional, Henderson, J, additional, Henton, J, additional, Hignett, S, additional, Hodgkins, K, additional, Horgan, K, additional, Horn, S, additional, Hu, J, additional, Hussain, A, additional, Iddon, J, additional, Iqbal, A, additional, Irri, R, additional, Irvine, T, additional, Irwin, G, additional, Iskender, A, additional, Ismail, A, additional, Ives, C, additional, James, K, additional, James, R, additional, Jiwa, N, additional, Jobson, M, additional, Joglekar, S, additional, Johnson, L, additional, Johnson, R, additional, Jones, L, additional, Ju Hwang, M, additional, Kalles, V, additional, Kanesalingam, K, additional, Karat, I, additional, Kaushik, M, additional, Kennedy, K, additional, Khalifa, E, additional, Khan, H, additional, Khanbhai, M, additional, Khawaja, S, additional, Khout, H, additional, Kiernan, T, additional, Kim, B, additional, Kirkpatrick, K, additional, Kiruparan, P, additional, Kirwan, C, additional, Kishore, M, additional, Kneeshaw, P, additional, Knight, A, additional, Kohlhardt, S, additional, Krupa, J, additional, Krupa, K, additional, Kuruvilla, R, additional, Laban, C, additional, Lai, LM, additional, Laidlaw, I, additional, Lambert, K, additional, Langlands, F, additional, Lansdown, M, additional, Laurence, N, additional, Laws, S, additional, Ledwidge, S, additional, Lefemine, V, additional, Lennon, H, additional, Linforth, R, additional, Little, K, additional, Luangsomboon, A, additional, Lund, J, additional, Maalo, J, additional, MacLennan, L, additional, Macmillan, RD, additional, MacNeil, F, additional, Mahapatra, TK, additional, Mallidis, E, additional, Mallon, P, additional, Manoloudakis, N, additional, Maraqa, L, additional, Marla, S, additional, Masood, S, additional, Massey, J, additional, Masudi, T, additional, Matey, P, additional, Mazari, F, additional, McCulley, S, additional, McEvoy, K, additional, Mcintosh, J, additional, McIntosh, S, additional, McKenzie, S, additional, McManus, P, additional, McNicholas, J, additional, Michalakis, I, additional, Mills, N, additional, Mitchell, G, additional, Monib, S, additional, Mullan, M, additional, Murphy, C, additional, Murphy, G, additional, Murphy, J, additional, Murthy, B, additional, Musa, S, additional, Nagra, G, additional, Nangalia, R, additional, Narayanan, S, additional, Nasr, R, additional, Navin, C, additional, Newton, R, additional, Nicholson, S, additional, Nuru, N, additional, O'Connell, R, additional, O'Donoghue, J, additional, Ogedegbe, A, additional, Olayinka, OS, additional, Olsen, S, additional, Osborn, G, additional, Osborne, C, additional, Osman, H, additional, Otieno, C, additional, Pakzad, F, additional, Park, A, additional, Parker, S, additional, Partlett, P, additional, Parvaiz, A, additional, Parvanta, L, additional, Patel, G, additional, Peel, A, additional, Peiris, L, additional, Pennick, M, additional, Peppe, A, additional, Perry, D, additional, Pilgrim, S, additional, Piper, J, additional, Poonawalla, S, additional, Popa, E, additional, Pope, V, additional, Pugh, P, additional, Rainsbury, D, additional, Ramsey, K, additional, Rasheed, T, additional, Rathinaezhil, R, additional, Rattay, T, additional, Ravichandran, D, additional, Reed, M, additional, Refsum, S, additional, Remoundos, D, additional, Rigby, K, additional, Robertson, S, additional, Robinson, A, additional, Robinson, J, additional, Roche, N, additional, Roy, PJ, additional, Runkel, M, additional, Rusby, J, additional, Saha, S, additional, Saidan, Z, additional, Salab, M, additional, Saleh, M, additional, Salem, F, additional, Sami, A, additional, Samlalsingh, S, additional, Sarfraz, N, additional, Shah, R, additional, Shaheed, S, additional, Sharaiha, Y, additional, Shetty, G, additional, Shotton, R, additional, Sircar, T, additional, Skene, E, additional, Sloan, S, additional, Smith, B, additional, Smith, J, additional, Soldanova, L, additional, Soliman, F, additional, Soumian, S, additional, Stevens, J, additional, Steventon, C, additional, Stewart-Parker, E, additional, Stringfellow, T, additional, Sutaria, R, additional, Sutton, R, additional, Sweetland, H, additional, Swiech, B, additional, Tadiparthi, S, additional, Tafazal, H, additional, Taheri, N, additional, Tait, C, additional, Tan, M, additional, Tang, S, additional, Tansley, A, additional, Tate, S, additional, Tayeh, S, additional, Taylor, A, additional, Taylor, J, additional, Thawdar, P, additional, Thomas, C, additional, Thomas, S, additional, Thomson, S, additional, Thorne, A, additional, Tillett, R, additional, Tolkien, Z, additional, Tomlins, A, additional, Topps, A, additional, Tsang, F, additional, Turner, EJ, additional, Turton, P, additional, Udayasankar, S, additional, Ugolini, F, additional, Vaughan Williams, E, additional, Vidya, R, additional, Vijaynagar, B, additional, Vinayagam, R, additional, Volleamere, A, additional, Voynov, V, additional, Waheed, S, additional, Walker, T, additional, Walsh, U, additional, Warner, R, additional, Waters, R, additional, Wilkins, A, additional, Williams, K, additional, Wilson, G, additional, Wiltsher, M, additional, Wooler, B, additional, Wright, C, additional, Wright, M, additional, Wyld, L, additional, Youssef, M, additional, Zabkiewicz, C, additional, Zammit, C, additional, Zeidan, B, additional, and Zheng, D, additional

Published
2019
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13. Experiences of women referred for urgent assessment of postmenopausal bleeding (PMB)

Author

Tarling, Rachel, Gale, A., Martin-Hirsch, P., Holmes, L., Kanesalingam, K., Dey, Maria Paola, Tarling, Rachel, Gale, A., Martin-Hirsch, P., Holmes, L., Kanesalingam, K., and Dey, Maria Paola

Abstract

Women with postmenopausal bleeding (PMB) are referred for specialist assessment within 2 weeks of presentation to their GP. No research has previously examined women's experiences of expedited referral. This was investigated in the present study using questionnaires (6-item State Anxiety Inventory (6-STAI)) and focus groups. A total of 55 women completed questionnaires. Results showed high levels of anxiety at first hospital visit (mean 47.0 (SD 14.27); 95% CI 43.14–50.93). Scores declined by 90 days, but were higher in those not undergoing hysteroscopy. Fifteen women who underwent hysteroscopy attended focus groups. Women recalled fear of cancer from symptom onset until receipt of results. Anxiety was exacerbated by poor knowledge of PMB and lack of awareness of expedited referral. Post-discharge, those with unexplained or recurrent symptoms expressed frustration and upset. Effective strategies to raise awareness of PMB and its causes are needed, including reasons for expedited referral. Women without cancer may also need more support.

Published
2013

16. Poster session 2

Author

Perez-Pomares, J. M., primary, Ruiz-Villalba, A., additional, Ziogas, A., additional, Segovia, J. C., additional, Ehrbar, M., additional, Munoz-Chapuli, R., additional, De La Rosa, A., additional, Dominguez, J. N., additional, Hove-Madsen, L., additional, Sankova, B., additional, Sedmera, D., additional, Franco, D., additional, Aranega Jimenez, A., additional, Babaeva, G., additional, Chizh, N., additional, Galchenko, S., additional, Sandomirsky, B., additional, Schwarzl, M., additional, Seiler, S., additional, Steendijk, P., additional, Huber, S., additional, Maechler, H., additional, Truschnig-Wilders, M., additional, Pieske, B., additional, Post, H., additional, Simrick, S., additional, Kreutzer, R., additional, Rao, C., additional, Terracciano, C. M., additional, Kirchhof, P., additional, Fabritz, L., additional, Brand, T., additional, Theveniau-Ruissy, M., additional, Parisot, P., additional, Francou, A., additional, Saint-Michel, E., additional, Mesbah, K., additional, Kelly, R. G., additional, Wu, H.-T., additional, Sie, S.-S., additional, Chen, C.-Y., additional, Kuan, T.-C., additional, Lin, C. S., additional, Ismailoglu, Z., additional, Guven, M., additional, Yakici, A., additional, Ata, Y., additional, Ozcan, S., additional, Yildirim, E., additional, Ongen, Z., additional, Miroshnikova, V., additional, Demina, E., additional, Rodygina, T., additional, Kurjanov, P., additional, Denisenko, A., additional, Schwarzman, A., additional, Rubanenko, A., additional, Shchukin, Y., additional, Germanov, A., additional, Goldbergova, M., additional, Parenica, J., additional, Lipkova, J., additional, Pavek, N., additional, Kala, P., additional, Poloczek, M., additional, Vasku, A., additional, Parenicova, I., additional, Spinar, J., additional, Gambacciani, C., additional, Chiavacci, E., additional, Evangelista, M., additional, Vesentini, N., additional, Kusmic, C., additional, Pitto, L., additional, Chernova, A., additional, Nikulina, S. U. Y., additional, Arvanitis, D. A., additional, Mourouzis, I., additional, Pantos, C., additional, Kranias, E. G., additional, Cokkinos, D. V., additional, Sanoudou, D., additional, Vladimirskaya, T. E., additional, Shved, I. A., additional, Kryvorot, S. G., additional, Schirmer, I. M., additional, Appukuttan, A., additional, Pott, L., additional, Jaquet, K., additional, Ladilov, Y., additional, Archer, C. R., additional, Bootman, M. D., additional, Roderick, H. L., additional, Fusco, A., additional, Sorriento, D., additional, Santulli, G., additional, Trimarco, B., additional, Iaccarino, G., additional, Hagenmueller, M., additional, Riffel, J., additional, Bernhold, E., additional, Katus, H. A., additional, Hardt, S. E., additional, Maqsood, A., additional, Zi, M., additional, Prehar, S., additional, Neyses, L., additional, Ray, S., additional, Oceandy, D., additional, Khatami, N., additional, Wadowski, P., additional, Wagh, V., additional, Hescheler, J., additional, Sachinidis, A., additional, Mohl, W., additional, Chaudhry, B., additional, Burns, D., additional, Henderson, D. J., additional, Bax, N. A. M., additional, Van Marion, M. H., additional, Shah, B., additional, Goumans, M. J., additional, Bouten, C. V. C., additional, Van Der Schaft, D. W. J., additional, Van Oorschot, A. A. M., additional, Maas, S., additional, Braun, J., additional, Van Tuyn, J., additional, De Vries, A. A. F., additional, Gittenberger-De Groot, A. C., additional, Bageghni, S., additional, Drinkhill, M. J., additional, Batten, T. F. C., additional, Ainscough, J. F. X., additional, Onate, B., additional, Vilahur, G., additional, Ferrer-Lorente, R., additional, Ybarra, J., additional, Diez-Caballero, A., additional, Ballesta-Lopez, C., additional, Moscatiello, F., additional, Herrero, J., additional, Badimon, L., additional, Martin-Rendon, E., additional, Clifford, D. M., additional, Fisher, S. A., additional, Brusnkill, S. J., additional, Doree, C., additional, Mathur, A., additional, Clarke, M., additional, Watt, S. M., additional, Hernandez-Vera, R., additional, Kavanagh, D., additional, Yemm, A. I., additional, Frampton, J., additional, Kalia, N., additional, Terajima, Y., additional, Shimizu, T., additional, Tsuruyama, S., additional, Ishii, H., additional, Sekine, H., additional, Hagiwara, N., additional, Okano, T., additional, Vrijsen, K. R., additional, Chamuleau, S. A. J., additional, Sluijter, J. P. G., additional, Doevendans, P. F. M., additional, Madonna, R., additional, Delli Pizzi, S., additional, Di Donato, L., additional, Mariotti, A., additional, Di Carlo, L., additional, D'ugo, E., additional, Teberino, M. A., additional, Merla, A., additional, T, A., additional, De Caterina, R., additional, Kolker, L., additional, Ali, N. N., additional, Maclellan, K., additional, Moore, M., additional, Wheeler, J., additional, Harding, S. E., additional, Fleck, R. A., additional, Rowlinson, J. M., additional, Kraenkel, N., additional, Ascione, R., additional, Madeddu, P., additional, O'sullivan, J. F., additional, Leblond, A. L., additional, Kelly, G., additional, Kumar, A. H. S., additional, Metharom, P., additional, Buneker, C. K., additional, Alizadeh-Vikali, N., additional, Hynes, B. G., additional, O'connor, R., additional, Caplice, N. M., additional, Noseda, M., additional, De Smith, A. J., additional, Leja, T., additional, Rao, P. H., additional, Al-Beidh, F., additional, Abreu Pavia, M. S., additional, Blakemore, A. I., additional, Schneider, M. D., additional, Stathopoulou, K., additional, Cuello, F., additional, Ehler, E., additional, Haworth, R. S., additional, Avkiran, M., additional, Morawietz, H., additional, Eickholt, C., additional, Langbein, H., additional, Brux, M., additional, Goettsch, C., additional, Goettsch, W., additional, Arsov, A., additional, Brunssen, C., additional, Mazilu, L., additional, Parepa, I. R., additional, Suceveanu, A. I., additional, Suceveanu, A. P., additional, De Man, F. S., additional, Guignabert, C., additional, Tu, L., additional, Handoko, M. L., additional, Schalij, I., additional, Fadel, E., additional, Postmus, P. E., additional, Vonk-Noordegraaf, A., additional, Humbert, M., additional, Eddahibi, S., additional, Del Giudice, C., additional, Anastasio, A., additional, Fazal, L., additional, Azibani, F., additional, Bihry, N., additional, Merval, R., additional, Polidano, E., additional, Samuel, J.-L., additional, Delcayre, C., additional, Zhang, Y., additional, Mi, Y. M., additional, Ren, L. L., additional, Cheng, Y. P., additional, Guo, R., additional, Liu, Y., additional, Jiang, Y. N., additional, Kokkinos, A. D., additional, Tretjakovs, P., additional, Jurka, A., additional, Bormane, I., additional, Mikelsone, I., additional, Reihmane, D., additional, Elksne, K., additional, Krievina, G., additional, Verbovenko, J., additional, Bahs, G., additional, Lopez-Andres, N., additional, Rousseau, A., additional, Calvier, L., additional, Akhtar, R., additional, Labat, C., additional, Cruickshank, K., additional, Diez, J., additional, Zannad, F., additional, Lacolley, P., additional, Rossignol, P., additional, Hamesch, K., additional, Subramanian, P., additional, Li, X., additional, Thiemann, A., additional, Heyll, K., additional, Dembowsky, K., additional, Chevalier, E., additional, Weber, C., additional, Schober, A., additional, Yang, L., additional, Kim, G., additional, Gardner, B., additional, Earley, J., additional, Hofmann-Bowman, M., additional, Cheng, C.-F., additional, Lian, W.-S., additional, Lin, H., additional, Jinjolia, N. J., additional, Abuladze, G. A., additional, Tvalchrelidze, S. H. T., additional, Khamnagadaev, I., additional, Shkolnikova, M., additional, Kokov, L., additional, Miklashevich, I., additional, Drozdov, I., additional, Ilyich, I., additional, Bingen, B. O., additional, Askar, S. F. A., additional, Ypey, D. L., additional, Van Der Laarse, A., additional, Schalij, M. J., additional, Pijnappels, D. A., additional, Roney, C. H., additional, Ng, F. S., additional, Chowdhury, R. A., additional, Chang, E. T. Y., additional, Patel, P. M., additional, Lyon, A. R., additional, Siggers, J. H., additional, Peters, N. 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A., additional, Orban, K., additional, Murlasits, Z. S., additional, Balogh, L., additional, Varga, C., additional, Ku, H. C., additional, Su, M. J., additional, Chreih, R.-M., additional, Ginghina, C., additional, Deleanu, D., additional, Ferreira, A. L. B. J., additional, Belal, A., additional, Ali, M. A., additional, Fan, X., additional, Holt, A., additional, Campbell, R., additional, Schulz, R., additional, Bonanad, C., additional, Bodi, V., additional, Sanchis, J., additional, Morales, J. M., additional, Marrachelli, V., additional, Nunez, J., additional, Forteza, M. J., additional, Chaustre, F., additional, Gomez, C., additional, Chorro, F. J., additional, Csont, T., additional, Fekete, V., additional, Murlasits, Z., additional, Aypar, E., additional, Bencsik, P., additional, Sarkozy, M., additional, Varga, Z. V., additional, Ferdinandy, P., additional, Duerr, G. D., additional, Zoerlein, M., additional, Dewald, D., additional, Mesenholl, B., additional, Schneider, P., additional, Ghanem, A., additional, Rittling, S., additional, Welz, A., additional, Dewald, O., additional, Becker, E., additional, Peigney, C., additional, Bouleti, C., additional, Galaup, A., additional, Monnot, C., additional, Ghaleh, B., additional, Germain, S., additional, Timmermans, A., additional, Ginion, A., additional, De Meester, C., additional, Sakamoto, K., additional, Vanoverschelde, J.-L., additional, Horman, S., additional, Beauloye, C., additional, Bertrand, L., additional, Maroz-Vadalazhskaya, N., additional, Drozd, E., additional, Kukharenko, L., additional, Russkich, I., additional, Krachak, D., additional, Seljun, Y., additional, Ostrovski, Y., additional, Martin, A.-C., additional, Le Bonniec, B., additional, Lecompte, T., additional, Dizier, B., additional, Emmerich, J., additional, Fischer, A.-M., additional, Samama, C.-M., additional, Godier, A., additional, Mogensen, S., additional, Furchtbauer, E. M., additional, Aalkjaer, C., additional, Choong, W. L., additional, Jovanovic, A., additional, Khan, F., additional, Daniel, J. M., additional, Dutzmann, J. M., additional, Widmer-Teske, R., additional, Guenduez, D., additional, Sedding, D., additional, Castro, M. M., additional, Cena, J. J. C., additional, Cho, W. J. C., additional, Goobie, G. G., additional, Walsh, M. P. W., additional, Schulz, R. S., additional, Dutzmann, J., additional, Preissner, K. T., additional, Sones, W., additional, Kotlikoff, M., additional, Serizawa, K., additional, Yogo, K., additional, Aizawa, K., additional, Hirata, M., additional, Tashiro, Y., additional, Ishizuka, N., additional, Varela, A., additional, Katsiboulas, M., additional, Tousoulis, D., additional, Papaioannou, T. G., additional, Vaina, S., additional, Davos, C. H., additional, Piperi, C., additional, Stefanadis, C., additional, Basdra, E. K., additional, Papavassiliou, A. G., additional, Hermenegildo, C., additional, Lazaro-Franco, M., additional, Sobrino, A., additional, Bueno-Beti, C., additional, Martinez-Gil, N., additional, Walther, T., additional, Peiro, C., additional, Sanchez-Ferrer, C. F., additional, Novella, S., additional, Ciccarelli, M., additional, Franco, A., additional, Dorn, G. W., additional, Cseplo, P., additional, Torok, O., additional, Springo, Z. S., additional, Vamos, Z., additional, Kosa, D., additional, Hamar, J., additional, Koller, A., additional, Bubb, K. J., additional, Ahluwalia, A., additional, Stepien, E. L., additional, Gruca, A., additional, Grzybowska, J., additional, Goralska, J., additional, Dembinska-Kiec, A., additional, Stolinski, J., additional, Partyka, L., additional, Zhang, H., additional, Sweeney, D., additional, Thomas, G. N., additional, Fish, P. V., additional, Taggart, D. P., additional, Cioffi, S., additional, Bilio, M., additional, Martucciello, S., additional, Illingworth, E., additional, Caporali, A., additional, Shantikumar, S., additional, Marchetti, M., additional, Martelli, F., additional, Emanueli, C., additional, Meloni, M., additional, Al Haj Zen, A., additional, Sala-Newby, G., additional, Del Turco, S., additional, Saponaro, C., additional, Dario, B., additional, Sartini, S., additional, Menciassi, A., additional, Dario, P., additional, La Motta, C., additional, Basta, G., additional, Santiemma, V., additional, Bertone, C., additional, Rossi, F., additional, Michelon, E., additional, Bianco, M. J., additional, Castelli, A., additional, Shin, D. I., additional, Seung, K. B., additional, Seo, S. M., additional, Park, H. J., additional, Kim, P. J., additional, Baek, S. H., additional, Choi, Y. S., additional, Her, S. H., additional, Kim, D. B., additional, Lee, J. M., additional, Park, C. S., additional, Rocchiccioli, S., additional, Cecchettini, A., additional, Pelosi, G., additional, Citti, L., additional, Parodi, O., additional, Trivella, M. G., additional, Michel-Monigadon, D., additional, Burger, F., additional, Dunoyer-Geindre, S., additional, Pelli, G., additional, Cravatt, B., additional, Steffens, S., additional, Didangelos, A., additional, Mayr, U., additional, Yin, X., additional, Stegemann, C., additional, Shalhoub, J., additional, Davies, A. H., additional, Monaco, C., additional, Mayr, M., additional, Lypovetska, S., additional, Grytsenko, S., additional, Njerve, I. U., additional, Pettersen, A. A., additional, Opstad, T. B., additional, Bratseth, V., additional, Arnesen, H., additional, Seljeflot, I., additional, Dumitriu, I. E., additional, Baruah, P., additional, Antunes, R. F., additional, Kaski, J. C., additional, Trapero, I., additional, Benet, I., additional, Alguero, C., additional, Chaustre, F. J., additional, Mangold, A., additional, Puthenkalam, S., additional, Distelmaier, K., additional, Adlbrecht, C., additional, Lang, I. M., additional, Koizumi, T., additional, Inoue, I., additional, Komiyama, N., additional, Nishimura, S., additional, Korneeva, O. N., additional, Drapkina, O. M., additional, Fornai, L., additional, Angelini, A., additional, Kiss, A., additional, Giskes, F., additional, Eijkel, G., additional, Fedrigo, M., additional, Valente, M. L., additional, Thiene, G., additional, Heeren, R. M. A., additional, Padro, T., additional, Casani, L., additional, Suades, R., additional, Bertoni, B., additional, Carminati, R., additional, Carlini, V., additional, Pettinari, L., additional, Martinelli, C., additional, Gagliano, N., additional, Noppe, G., additional, Buchlin, P., additional, Marquet, N., additional, Baeyens, N., additional, Morel, N., additional, Baysa, A., additional, Sagave, J., additional, Dahl, C. P., additional, Gullestad, L., additional, Carpi, A., additional, Di Lisa, F., additional, Giorgio, M., additional, Vaage, J., additional, Valen, G., additional, Vafiadaki, E., additional, Papalouka, V., additional, Terzis, G., additional, Spengos, K., additional, Manta, P., additional, Gales, C., additional, Genet, G., additional, Dague, E., additional, Cazorla, O., additional, Payre, B., additional, Mias, C., additional, Ouille, A., additional, Lacampagne, A., additional, Pathak, A., additional, Senard, J. M., additional, Abonnenc, M., additional, Da Costa Martins, P., additional, Srivastava, S., additional, Gautel, M., additional, De Windt, L., additional, Comelli, L., additional, Lande, C., additional, Ucciferri, N., additional, Ikonen, L., additional, Vuorenpaa, H., additional, Kujala, K., additional, Sarkanen, J.-R., additional, Heinonen, T., additional, Ylikomi, T., additional, Aalto-Setala, K., additional, Capros, H., additional, Sprincean, N., additional, Usurelu, N., additional, Egorov, V., additional, Stratu, N., additional, Matchkov, V., additional, Bouzinova, E., additional, Moeller-Nielsen, N., additional, Wiborg, O., additional, Gutierrez, P. S., additional, Aparecida-Silva, R., additional, Borges, L. F., additional, Moreira, L. F. P., additional, Dias, R. R., additional, Kalil, J., additional, Stolf, N. A. G., additional, Zhou, W., additional, Suntharalingam, K., additional, Brand, N., additional, Vilar Compte, R., additional, Ying, L., additional, Bicknell, K., additional, Dannoura, A., additional, Dash, P., additional, Brooks, G., additional, Tsimafeyeu, I., additional, Tishova, Y., additional, Wynn, N., additional, Oyeyipo, I. P., additional, Olatunji, L. A., additional, Maegdefessel, L., additional, Azuma, J., additional, Toh, R., additional, Raaz, U., additional, Merk, D. R., additional, Deng, A., additional, Spin, J. M., additional, Tsao, P. S., additional, Tedeschi, L., additional, Taranta, M., additional, Naldi, I., additional, Grimaldi, S., additional, Cinti, C., additional, Bousquenaud, M., additional, Maskali, F., additional, Poussier, S., additional, Marie, P. Y., additional, Boutley, H., additional, Karcher, G., additional, Wagner, D. R., additional, Devaux, Y., additional, Torre, I., additional, Psilodimitrakopoulos, S., additional, Iruretagoiena, I., additional, Gonzalez-Tendero, A., additional, Artigas, D., additional, Loza-Alvarez, P., additional, Gratacos, E., additional, Amat-Roldan, I., additional, Murray, L., additional, Carberry, D. M., additional, Dunton, P., additional, Miles, M. J., additional, Suleiman, M.-S., additional, Kanesalingam, K., additional, Taylor, R., additional, Mc Collum, C. N., additional, Parniczky, A., additional, Solymar, M., additional, Porpaczy, A., additional, Miseta, A., additional, Lenkey, Z. S., additional, Szabados, S., additional, Cziraki, A., additional, Garai, J., additional, Myloslavska, I., additional, Menazza, S. M., additional, Canton, M. C., additional, Di Lisa, F. D. L., additional, Oliveira, S. H. V., additional, Morais, C. A. S., additional, Miranda, M. R., additional, Oliveira, T. T., additional, Lamego, M. R. A., additional, Lima, L. M., additional, Goncharova, N. S., additional, Naymushin, A. V., additional, Kazimli, A. V., additional, Moiseeva, O. M., additional, Carvalho, M. G., additional, Sabino, A. P., additional, Mota, A. P. L., additional, Sousa, M. O., additional, Niessner, A., additional, Richter, B., additional, Hohensinner, P. J., additional, Rychli, K., additional, Zorn, G., additional, Berger, R., additional, Moertl, D., additional, Pacher, R., additional, Wojta, J., additional, Huelsmann, M., additional, Kukharchik, G., additional, Nesterova, N., additional, Pavlova, A., additional, Gaykovaya, L., additional, Krapivka, N., additional, Konstantinova, I., additional, Sichinava, L., additional, Prapa, S., additional, Mccarthy, K. P., additional, Kilner, P. J., additional, Xu, X. Y., additional, Johnson, M. R., additional, Ho, S. Y., additional, Gatzoulis, M. A., additional, Stoupel, E. G., additional, Garcia, R., additional, Merino, D., additional, Montalvo, C., additional, Hurle, M. A., additional, Nistal, J. F., additional, Villar, A. V., additional, Perez-Moreno, A., additional, Gilabert, R., additional, and Ros, E., additional

Published
2012
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17. Immediate prepectoral implant reconstruction using TiLOOP Bra Pocket results in improved patient satisfaction over dual plane reconstruction.

Author

Ng EI, Quah GS, Graham S, Kanesalingam K, Meybodi F, Hsu J, Elder EE, and French J

Subjects
Australia, Germany, Humans, Patient Satisfaction, Quality of Life, Retrospective Studies, Breast Implants, Breast Neoplasms surgery
Abstract

Background: Implant-based reconstruction accounts for the majority of breast reconstructive procedures performed in Australia. More recently, immediate prepectoral implant reconstruction using the TiLOOP Bra Pocket has gained popularity. This study compares post-surgical complications and patient-reported quality of life outcomes between immediate prepectoral and dual plane implant reconstruction., Methods: A retrospective study of 80 consecutive patients who underwent nipple-sparing mastectomies and immediate implant reconstruction was conducted. Implants were either completely covered with TiLOOP Bra and/or TiLOOP Bra Pocket (pfm medical, Cologne, Germany) and secured in the prepectoral space (prepectoral group) or placed in the subpectoral plane with inferolateral mesh coverage (dual plane group). Data surrounding patient demographics, clinical details and post-surgical outcomes were compared. Patient-related quality of life outcomes were assessed with the Breast-Q questionnaire., Results: A total of 80 patients (109 breasts) operated on between June 2016 and December 2018 were included. The prepectoral and dual plane groups comprised of 40 patients each, including 50 and 59 operated breasts, respectively. Post-operative complications were comparable with 11 (22%) overall complications in the prepectoral group and eight (14%) in the dual plane group (P = 0.313). Implant loss was uncommon with four (8%) cases in the prepectoral group and five (8.5%) in the dual plane group (P = 0.929). Patient-reported quality of life outcomes were superior after prepectoral reconstruction with patients reporting a significantly higher score in the satisfaction with breasts domain (68.9 versus 57.5; P = 0.036)., Conclusion: Immediate prepectoral implant reconstruction with the TiLOOP Bra Pocket was associated with improved patient satisfaction and demonstrated no difference in early post-operative outcomes., (© 2021 Royal Australasian College of Surgeons.)

Published
2021
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18. Salvaging the Unsalvageable: Negative Pressure Wound Therapy for Severe Infection of Prosthetic Breast Reconstruction.

Author

Meybodi F, Sedaghat N, Elder E, French J, Adams K, Hsu J, Kanesalingam K, and Brennan M

Abstract

Severe infections of implant-based breast reconstruction are challenging to treat. Traditional management is removal of the implant with a further attempt at reconstruction months later once the infection has settled. This study evaluates an alternative management protocol using negative pressure wound therapy with instillation (NPWTi)., Methods: Consecutive patients with severe peri-prosthetic infection following breast reconstruction were managed using the Implant Salvage Protocol: removal of the prosthesis with application of a NPWTi dressing, changed every 3 days until a negative culture was obtained. A new prosthesis was then placed in the pocket. Data were collected on patient demographics, microbiological, hospital/operative information, and overall success of salvage. Descriptive statistics were used for analysis., Results: In total, 30 breast prostheses in 28 patients were treated for severe peri-prosthetic infection. Twenty-five (83%) implants were salvaged. Mean time from initial reconstruction surgery to presentation was 49.5 days (median 23, range 7-420). Mean hospital stay was 11.5 days (median 12.0, range 6-22), mean number of returns to the operating theater was 3.7 (median 3.0, range 2-7), and mean number of days to negative culture was 5.2 (median 4.0, range 1-14). The most common organisms were methicillin-sensitive Staphylococcus aureus (n = 9) and Serratia marcescens (n = 4). Most had a tissue expander (n = 24, 80%) or implant (n = 5, 16.7%) placed at the completion of therapy. There was no record of capsular contracture nor recurrent infection during follow-up (mean 39.4 months, range 6-74 months)., Conclusion: An estimated 83% of prosthetic breast reconstructions with severe infection were successfully salvaged using NPWTi., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Published
2021
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19. Post-surgical pyoderma gangrenosum of the breast: a diagnostic dilemma?

Author

Solis E, Salindera S, Kanesalingam K, and Elder E

Subjects
Administration, Oral, Aged, Breast diagnostic imaging, Breast pathology, Female, Glucocorticoids administration & dosage, Glucocorticoids therapeutic use, Humans, Prednisone administration & dosage, Prednisone therapeutic use, Pyoderma Gangrenosum drug therapy, Treatment Outcome, Ultrasonography methods, Breast surgery, Mammaplasty adverse effects, Pyoderma Gangrenosum diagnosis
Published
2020
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20. Presentation, tumour and treatment features in immigrant women from Arabic-speaking countries treated for breast cancer in Australia.

Author

Heilat GB, Brennan ME, Kanesalingam K, Sriram N, Meybodi F, and French J

Subjects
Adult, Aged, Aged, 80 and over, Australia, Female, Humans, Middle Aged, Middle East ethnology, Retrospective Studies, Young Adult, Breast Neoplasms diagnosis, Breast Neoplasms surgery, Emigrants and Immigrants
Abstract

Background: Australia has a large population of immigrant women from Arabic-speaking countries. The aim of this study was to examine breast cancer tumour and surgical treatment features for women born in Arabic-speaking countries and compare them to women born in Australia and other countries. Another aim was to consider how this information can inform clinical care for this multicultural population., Methods: This is a retrospective audit of an institutional breast cancer database. Demographic, tumour and surgical treatment data were extracted for the Arab women and compared to Australian-born women (comparison 1) and to women born in all other countries (comparison 2); chi-squared analysis was performed to test for differences between groups., Results: A total of 2086 cases with country of birth information were identified, of whom 139 women (6.7%) were born in Arabic-speaking countries, 894 (42.8%) were born in Australia and 1053 (50.4%) were born in other countries (71 nations). Arab women tended to be younger (P = 0.013), more disadvantaged (P < 0.001), were more likely to have symptomatic rather than screen-detected breast cancer (P < 0.001), had a higher rate of high grade (P = 0.021), HER2-positive (P = 0.025) breast cancer compared to Australian-born women or others. There was no difference in tumour (pT) stage, rate of breast conservation versus mastectomy, re-excision and contralateral prophylactic mastectomy between groups. Australian-born women were more likely to undergo breast reconstruction after mastectomy (P < 0.001); reconstruction rate was >29% in all groups., Conclusion: Women born in Arabic-speaking countries were younger, more disadvantaged and showed more aggressive tumour features. This has implications for supportive care during treatment and survivorship., (© 2019 Royal Australasian College of Surgeons.)

Published
2020
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21. Targeted axillary dissection after neoadjuvant systemic therapy in patients with node-positive breast cancer.

Author

Kanesalingam K, Sriram N, Heilat G, Ng EE, Meybodi F, Elder E, Brennan M, and French J

Subjects
Adult, Aged, Axilla, Breast Neoplasms pathology, Breast Neoplasms surgery, Chemotherapy, Adjuvant, Feasibility Studies, Female, Humans, Lymph Node Excision instrumentation, Lymphatic Metastasis, Middle Aged, Neoadjuvant Therapy, Retrospective Studies, Sentinel Lymph Node surgery, Antineoplastic Agents therapeutic use, Breast Neoplasms drug therapy, Lymph Node Excision methods, Mastectomy
Abstract

Background: Over the last decade, neoadjuvant systemic therapy (NAST) has gained considerable popularity and its use has been extended to include breast cancer patients with operable node-positive disease. It may no longer be necessary to commit patients who are node-positive at presentation to axillary dissection if they become clinically node-negative after completing NAST. Targeted axillary dissection (TAD) is a technique where the marked pre-NAST positive node is excised along with the sentinel nodes and its response to chemotherapy is assessed and thus helps guide further treatment to the axilla., Methods: The aim of this study was to determine the feasibility of marking positive axillary nodes with a clip and removing the clipped node after neoadjuvant treatment. We also assessed the concordance of the sentinel node with the clipped node., Results: We prospectively evaluated 37 clinically and/or radiologically node-positive patients who underwent NAST. The overall identification rate of the clipped node was 78%. The identification rate was 100% if the clipped node was localized preoperatively and was much lower at 68% in patients who did not have the clipped node localized. The clipped node was not retrieved as the sentinel node in 14% of patients., Conclusion: We present the first Australian series on the feasibility of TAD. TAD is a feasible option in patients having NAST and with every new technique there is a learning curve. With the increasing experience globally and the refinement in marking and localization techniques, the accuracy of performing TAD will likely continue to improve., (© 2019 Royal Australasian College of Surgeons.)

Published
2020
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22. Granulomatous lobular mastitis: Clinical update and case study.

Author

Brennan ME, Morgan M, Heilat GB, and Kanesalingam K

Subjects
Adult, Diagnosis, Differential, Female, Granulomatous Mastitis physiopathology, Humans, Granulomatous Mastitis diagnosis
Abstract

Background: Granulomatous lobular mastitis (GM) is a rare chronic benign inflammatory breast condition. It can present a diagnostic challenge and mimic inflammatory carcinoma. It causes significant morbidity for affected patients., Objective: The aim of this article is to provide a clinical update and case study for general practitioners, who are usually the first to see the patient., Discussion: GM is usually idiopathic. The condition presents with a large painful lump with erythema. There is often ulceration, abscess and sinus formation. Triple assessment is needed to confirm diagnosis. GM may last for 12 months or more before healing occurs. Options for management are conservative/supportive care, oral prednisone or methotrexate, or surgical excision. At present, there is no universally accepted management strategy for GM; therefore, treatment will depend on the symptoms, extent of disease and patient preferences. Supporting the patient in coping with the long-term nature of GM and the chronic discharging lesions is essential.

Published
2020
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23. Postmastectomy radiotherapy and immediate implant-based breast reconstruction: attitudes and practices of Australian and New Zealand breast surgeons.

Author

Kanesalingam K, Heilat G, Sood S, Samarasinghe P, Elder E, French J, Brennan M, and Meybodi F

Subjects
Attitude of Health Personnel, Australia epidemiology, Breast Implantation adverse effects, Breast Implantation trends, Female, Humans, Mammaplasty adverse effects, Mammaplasty trends, Mastectomy adverse effects, Mastectomy methods, New Zealand epidemiology, Postoperative Care standards, Surgeons statistics & numerical data, Surveys and Questionnaires, Breast Implantation methods, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Mammaplasty methods, Radiotherapy, Adjuvant methods
Published
2019
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24. The Modified Lateral Intercostal Artery Perforator Flap.

Author

Meybodi F, Cocco AM, Messer D, Brown A, Kanesalingam K, Elder E, Hsu J, and French J

Abstract

Background: The main surgical options for treatment of breast cancer are breast-conserving surgery and mastectomy. BCS aims to achieve complete excision of the tumor while achieving a pleasing cosmetic result. Excision of tumors in the lateral aspect of the breast has been associated with issues such as contour deformities and asymmetry. Development of volume replacement techniques such as the lateral intercostal artery perforator flap (LICAP) aimed to address these issues. Our modification of the traditional LICAP offers a less visible scar, good access to the axilla, and no need to reposition the patient., Methods: All patients undergoing a modified LICAP were identified from our database. The lateral intercostal artery perforators were marked with ultrasound and 2 "lazy S" lines were drawn to mark the flap. The wide local excision (with or without axillary surgery) was performed and the flap mobilized to fill the defect., Results: Twenty-two patients underwent modified LICAP in 14 months. The mean specimen weight was 86 g. Four patients (18%) had a re-excision for positive margins. Nineteen patients had axillary surgery performed at the time of their modified LICAP flap. No patients had a scar that extended posterior to the posterior axillary line; no patients required a separate incision for axillary surgery; and no patients needed to be repositioned intraoperatively., Conclusions: Our early experience with this innovative procedure has been favorable. The perioperative complication rate is low. Due to the relatively short follow-up, longer term outcomes such as postradiotherapy appearance are yet to be determined.

Published
2019
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25. Optic Discs Swelling Procrastinates Wernicke's Encephalopathy Associated with Hyperemesis Gravidarum: A Case Report and Review of Literature.

Author

Mun-Wei L, Gayathri G, Kwang Hwee G, Ruban K, Suresh Kumar V, and Shatriah I

Abstract

Wernicke's encephalopathy following severe hyperemesis gravidarum is an uncommon clinical entity. We describe a rare manifestation of optic discs swelling in a pregnant woman that has caused a diagnostic dilemma. With high index of suspicion of clinical manifestations and radiological evidences, a clinical diagnosis of Wernicke's encephalopathy was made. Intravenous thiamine therapy was instituted, and prompt improvement of clinical signs was observed. The association of optic discs swelling and Wernicke's encephalopathy after hyperemesis gravidarum is discussed., Competing Interests: The authors have declared that no competing interests exist.

Published
2018
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26. Encapsulating peritoneal sclerosis: presentation without preceding symptoms.

Author

Yiannoullou P, Kanesalingam K, van Dellen D, and Augustine T

Subjects
Aged, Asymptomatic Diseases, Humans, Incidental Findings, Male, Peritoneal Fibrosis etiology, Peritoneal Fibrosis surgery, Peritonitis diagnosis, Peritonitis etiology, Predictive Value of Tests, Tomography, X-Ray Computed, Treatment Outcome, Peritoneal Dialysis, Continuous Ambulatory adverse effects, Peritoneal Fibrosis diagnosis
Abstract

Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis (PD), resulting in malnutrition and ultimately overt intestinal obstruction. We present the case of a 71-year-old man diagnosed with EPS incidentally at laparotomy for removal of PD catheter following an episode of PD peritonitis. He had been treated with continuous ambulatory PD for 18 months. He presented with anasarca and did not exhibit persistent symptoms of gastrointestinal dysfunction to suggest the EPS. Computed tomography scanning obtained 18 days prior to confirmation of the diagnosis did not demonstrate any features suggestive of EPS, highlighting a deficiency in the sensitivity of the diagnostic investigations. Management of the EPS is typically complicated by late diagnosis and concomitant malnutrition. This case highlights both the insidious nature of the EPS and a management problem to the surgeon faced with an unexpected abdominal cocoon. It further accentuates the necessity for increasingly sensitive diagnostic investigations to allow earlier diagnosis, thereby facilitating successful treatment.

Published
2015
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27. Does source of funding and conflict of interest influence the outcome and quality of spinal research?

Author

Amiri AR, Kanesalingam K, Cro S, and Casey AT

Subjects
Clinical Trials as Topic economics, Clinical Trials as Topic ethics, Clinical Trials as Topic standards, Humans, Practice Guidelines as Topic standards, Biomedical Research economics, Biomedical Research ethics, Biomedical Research standards, Conflict of Interest, Evidence-Based Medicine economics, Evidence-Based Medicine ethics, Evidence-Based Medicine standards, Neurosurgical Procedures economics, Neurosurgical Procedures ethics, Neurosurgical Procedures standards, Orthopedics economics, Orthopedics ethics, Orthopedics standards, Outcome and Process Assessment, Health Care, Spine surgery
Abstract

Background/context: There has been longstanding controversy surrounding the influence of funding source on the conduct and outcome of medical research. In 2011, a systematic review of the use of recombinant bone morphogenetic protein-2 revealed underreporting of unfavorable outcomes in some industry-sponsored trials. We hypothesize that Industrial funding and the presence of potential conflict of interest will be associated with low levels of evidence (LOE) and greater proportions of favorable outcomes in spinal research., Purpose: The aim of this study is to investigate the association between funding source and potential conflict of interest on the LOE and study outcome in the current spinal research., Study Design/setting: Systematic review of all the spinal publications in five leading spinal, orthopedics, neurosurgery, and general medical journals during 2010 (print and online). Supplements were included., Outcome Measure: Outcome and the LOE of research papers., Methods: Two reviewers independently assessed all publications. Commentaries, editorials, letters, open operating theatres, case reports, narrative reviews, and study protocols were excluded. The self-reported potential conflict of interest and type of funding was extracted from each paper. Funding type was classified as foundation, industry, public, intramural, multiple (including industry), multiple (without industry), and unfunded. The outcome of each study was classified as favorable, unfavorable, equivocal, or not applicable. Clinical publications were ranked using the LOE guidelines produced by the Oxford Center for Evidence-Based Medicine., Results: Overall, 1356 papers were analyzed, out of which 864 were suitable for LOE grading. There was good interobserver reliability for assignment of LOE grade, κ=0.897 (p<.01) and study outcome κ=0.804 (p<.01). A significant association was found between LOE and source of funding (p<.01). Industry-funded studies had the greatest proportion of level IV evidence (65%). There was a significant association between the funding source and study outcome (p=.01). The proportion of industry-funded studies with favorable outcomes (88%) was higher than that of publicly and foundation-funded studies (73% and 74%, respectively). The associated odds ratio for reporting favorable outcomes in industry-funded studies compared with studies with public and foundation funding was 2.7 (95% confidence interval [CI], 1.4-5.3), and 2.6 (95% CI, 1.3-5.2), respectively. A significant association between LOE and study outcome (p<.01) was also identified. Level I studies had the highest proportions of unfavorable (14%) and equivocal (23%) outcomes. Level IV studies had the highest proportion of favorable outcome (85%). There was no association between self-reported conflict of interest and LOE (p=.83) or study outcome (p=.25)., Conclusion: We demonstrated a significant association between source of funding, study outcome, and LOE in spinal research. A large proportion of industry funded research was shown to provide level IV evidence and report favorable outcome., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Published
2014
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28. Adult tethered cord syndrome resembling plantar fasciitis and peripheral neuropathy.

Author

Amiri AR, Kanesalingam K, Srinivasan V, and Price RF

Subjects
Diagnosis, Differential, Electromyography, Fasciitis, Plantar diagnosis, Humans, Magnetic Resonance Imaging, Male, Peripheral Nervous System Diseases diagnosis, Young Adult, Neural Tube Defects diagnosis, Neural Tube Defects surgery
Abstract

Adult tethered cord syndrome without spinal dysraphism is rare, and can present with subtle symptoms that could mimic other pathologies. As a result, timely diagnosis of this condition has proved to be a significant challenge. It is crucial for clinicians to be aware of adult tethered cord syndrome and its presenting symptoms in order to achieve early diagnosis and subsequent management. We present such a case with particular attention to the presenting history and examination. Following diagnosis, the patient underwent a laminectomy and cord untethering, resulting in significant improvement to his symptoms.

Published
2013
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29. Level of evidence of clinical spinal research and its correlation with journal impact factor.

Author

Amiri AR, Kanesalingam K, Cro S, and Casey AT

Subjects
Humans, Orthopedics standards, Biomedical Research standards, Evidence-Based Medicine standards, Journal Impact Factor, Periodicals as Topic, Spine
Abstract

Background: Over the past two decades, there has been a growing recognition and emphasis on the practice of evidence-based medicine (EBM). The level of evidence (LOE) is used to classify clinical studies based on their quality and design. To compare the quality of scientific journals, the impact factor (IF) is the most widely used ranking measure. However, the calculation of IF is not directly dependent on the quality or LOE of clinical articles published in a journal., Purpose: The primary aim of this study was to evaluate the current LOE for clinical research in leading spinal journals and assess the relationship between LOE and IF. We hypothesized that most clinical research would provide level IV evidence, and that a positive correlation would exist between the proportion of high LOE articles and the journal IF., Study Design: A systematic review of all the articles in five general spinal journals was undertaken during 2010., Sample: All online articles in The Spine Journal, Spine, European Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques during 2010, as well as supplements were included., Outcome Measure: The LOE for each clinical study was assessed using guidelines produced by the Oxford Centre for Evidence-Based Medicine., Methods: Two reviewers independently assessed all articles., Results: Overall 703 articles were suitable for LOE grading. Of these, 4.7% provided level I evidence, 23.2% level II, 12.5% level III, and 59.6% level IV. There was a significant association between LOE and type of study (p<.001); articles on therapeutic studies had the largest proportion (71.8%) of level IV evidence. There was a strong positive correlation between the proportion of level I and II evidence and the journal impact factor (ρ=0.9; 95% confidence interval 0.1 to 0.99; p=.037)., Conclusion: Spinal surgery journals with a higher IF contain a larger proportion of studies with high LOE, however most clinical articles provide level IV evidence of which the highest proportion are therapeutic studies. Clinicians, researchers, and journal editors should work hand in hand to enhance evidence-based practice in spinal care., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Published
2013
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