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13 results on '"Sittampalam, M."'

6. Influence of intracerebral hemorrhage location on incidence, characteristics, and outcome

Author

Samarasekera, N., Fonville, A., Lerpiniere, C., Farrall, A.J., Wardlaw, J.M., White, P.M., Smith, C., Al-Shahi Salman, R., Addison, A., Ahmad, K., Alhadad, S., Andrews, P., Bisset, E., Bodkin, P., Bouhaidar, R., Brennan, P., Campbell, B., Chandran, S., Cook, H., Davenport, R., Dennis, M., Derry, C., Dodds, K., Doubal, F., Duncan, S., Elder, A., Fitzpatrick, M., Foley, P., Fouyas, I., Ghosh, S., Gibson, R., Gordon, C., Grant, R., Hewett, R., Hughes, F., Hughes, M., Hunt, D., Hunter, N., Ironside, J., Liaquat, I., Josephson, C., Kamat, A., Kealley, S., Keir, S., Kerr, G., Kerrigan, S., Keston, P., King, M., Knight, R., Macdonald, E., Mackay, G., Macleod, D., Macleod, M., Maguire, C., Makin, S., Mathews, A., Maxwell, F., McClellan, S., Millar, T., Morris, Z., Morse, T., Mumford, C., Murray, K., Myles, L., Nimmo, G., Ng, Y., Pal, S., Rannikmae, K., Rhodes, J., Ross, J., Russell, T., Sandercock, P., Sellar, R., Shanmuganathan, M., Shekhar, H., Simms, H., Sittampalam, M., Soleiman, H., Spiers, H., Statham, P., Stavrinos, N., Stone, J., Stuart, J., Sudlow, C., Summers, D., Taylor, P., Torgersen, A., van Dijke, M., Walker, R., Weller, B., Whiteley, W., Whittle, I., Will, R., Young, W., Anderson, J., Broadbent, S., Butler, L., Caesar, D., Cantley, P., Carter, J., Clegg, G., Coull, A., Crosswaite, A., Dear, J., Dummer, S., Duncan, F., Elder-Gracie, T., Enright, K., Fitzgerald, T., Fothergill, J., Frier, B., Grant, D., Gray, A., Hart, S., Henderson, R., Jaap, A., Leigh-Smith, S., Jones, M., Masson, M., McCallum, L., McKechnie, M., McKillop, G., Mead, G., Morley, W., Morrow, B., Morrow, F., Murchison, J., Murphy, R., Ng, J., Ogundipe, O., Patel, D., Pollock, A., Reed, M., Roberts, G., Selvarajah, J., Smith, R., Stirling, C., Turner, N., Wilson, M., Yordanov, S., Bell, N., Chambers, S., Dewar, S., Farquhar, D., Harmouche, A., Jacob, A., Jackson, K., Knox, A., McCafferty, J., Moultrie, S., Munang, L., Noble, D., Ramsay, S., Spence, L., Threlfall, B., Williams, A., Wilson, J., Fitzgerald, A., Jamieson, A., Lange, P., McIntosh, A., Morrison, L., Todd, I., Samarasekera, N., Fonville, A., Lerpiniere, C., Farrall, A.J., Wardlaw, J.M., White, P.M., Smith, C., Al-Shahi Salman, R., Addison, A., Ahmad, K., Alhadad, S., Andrews, P., Bisset, E., Bodkin, P., Bouhaidar, R., Brennan, P., Campbell, B., Chandran, S., Cook, H., Davenport, R., Dennis, M., Derry, C., Dodds, K., Doubal, F., Duncan, S., Elder, A., Fitzpatrick, M., Foley, P., Fouyas, I., Ghosh, S., Gibson, R., Gordon, C., Grant, R., Hewett, R., Hughes, F., Hughes, M., Hunt, D., Hunter, N., Ironside, J., Liaquat, I., Josephson, C., Kamat, A., Kealley, S., Keir, S., Kerr, G., Kerrigan, S., Keston, P., King, M., Knight, R., Macdonald, E., Mackay, G., Macleod, D., Macleod, M., Maguire, C., Makin, S., Mathews, A., Maxwell, F., McClellan, S., Millar, T., Morris, Z., Morse, T., Mumford, C., Murray, K., Myles, L., Nimmo, G., Ng, Y., Pal, S., Rannikmae, K., Rhodes, J., Ross, J., Russell, T., Sandercock, P., Sellar, R., Shanmuganathan, M., Shekhar, H., Simms, H., Sittampalam, M., Soleiman, H., Spiers, H., Statham, P., Stavrinos, N., Stone, J., Stuart, J., Sudlow, C., Summers, D., Taylor, P., Torgersen, A., van Dijke, M., Walker, R., Weller, B., Whiteley, W., Whittle, I., Will, R., Young, W., Anderson, J., Broadbent, S., Butler, L., Caesar, D., Cantley, P., Carter, J., Clegg, G., Coull, A., Crosswaite, A., Dear, J., Dummer, S., Duncan, F., Elder-Gracie, T., Enright, K., Fitzgerald, T., Fothergill, J., Frier, B., Grant, D., Gray, A., Hart, S., Henderson, R., Jaap, A., Leigh-Smith, S., Jones, M., Masson, M., McCallum, L., McKechnie, M., McKillop, G., Mead, G., Morley, W., Morrow, B., Morrow, F., Murchison, J., Murphy, R., Ng, J., Ogundipe, O., Patel, D., Pollock, A., Reed, M., Roberts, G., Selvarajah, J., Smith, R., Stirling, C., Turner, N., Wilson, M., Yordanov, S., Bell, N., Chambers, S., Dewar, S., Farquhar, D., Harmouche, A., Jacob, A., Jackson, K., Knox, A., McCafferty, J., Moultrie, S., Munang, L., Noble, D., Ramsay, S., Spence, L., Threlfall, B., Williams, A., Wilson, J., Fitzgerald, A., Jamieson, A., Lange, P., McIntosh, A., Morrison, L., and Todd, I.

Abstract

Background and Purpose— The characteristics of intracerebral hemorrhage (ICH) may vary by ICH location because of differences in the distribution of underlying cerebral small vessel diseases. Therefore, we investigated the incidence, characteristics, and outcome of lobar and nonlobar ICH. Methods— In a population-based, prospective inception cohort study of ICH, we used multiple overlapping sources of case ascertainment and follow-up to identify and validate ICH diagnoses in 2010 to 2011 in an adult population of 695 335. Results— There were 128 participants with first-ever primary ICH. The overall incidence of lobar ICH was similar to nonlobar ICH (9.8 [95% confidence interval, 7.7–12.4] versus 8.6 [95% confidence interval, 6.7–11.1] per 100 000 adults/y). At baseline, adults with lobar ICH were more likely to have preceding dementia (21% versus 5%; P=0.01), lower Glasgow Coma Scale scores (median, 13 versus 14; P=0.03), larger ICHs (median, 38 versus 11 mL; P<0.001), subarachnoid extension (57% versus 5%; P<0.001), and subdural extension (15% versus 3%; P=0.02) than those with nonlobar ICH. One-year case fatality was lower after lobar ICH than after nonlobar ICH (adjusted odds ratio for death at 1 year: lobar versus nonlobar ICH 0.21; 95% confidence interval, 0.07–0.63; P=0.006, after adjustment for known predictors of outcome). There were 4 recurrent ICHs, which occurred exclusively in survivors of lobar ICH (annual risk of recurrent ICH after lobar ICH, 11.8%; 95% confidence interval, 4.6%–28.5% versus 0% after nonlobar ICH; log-rank P=0.04). Conclusions— The baseline characteristics and outcome of lobar ICH differ from other locations.

Published
2015

7. Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy for Malignant Anterior Circulation Ischaemic Stroke

Author

Williams, A., Sittampalam, M., Barua, N., and Mohd Nor, A.

Subjects
Article Subject
Abstract

While ischaemic stroke remains a leading cause of death and disability, there have been recent advancements in treatment modalities including thrombolysis and decompressive hemicraniectomy. A retrospective review of patients treated in our NHS teaching hospital, in Plymouth (UK), over a 2 year period identified 17 thrombolysed patients, of whom two had undergone subsequent decompressive hemicraniectomy. These were non-dominant hemisphere strokes in young patients, aged 51 and 57. Initial NIHSS scores were 16 and 17, and they received thrombolysis at 2 hrs 42 min and 5 hrs 10 min post onset of symptoms respectively. CT imaging demonstrated cerebral swelling with significant midline shift in both cases, and decompressive hemicraniectomy was undertaken at 29 hrs 8 min and 27 hrs 30 min post-thrombolysis. We found no significant intra-operative complications attributable to prior use of thrombolytics. Both patients have had acceptable psychological and physical outcomes, with Barthel Index scores of 40 and 25, and MMSE scores of 29/30 and 27/30. We conclude that the use of thrombolytic therapy does not contra-indicate subsequent decompressive hemicraniectomy in well selected patients with non-dominant hemisphere strokes. More research in this field is required to elucidate factors which would facilitate recognition of stroke patients who will benefit most from aggressive medical and neurosurgical intervention.

Published
2011
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12. Case Report Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy forMalignant Anterior Circulation Ischaemic Stroke.

Author

Williams, A., Sittampalam, M., Barua, N., and Nor, A. Mohd

Subjects
BRAIN surgery, STROKE
Abstract

While ischaemic stroke remains a leading cause of death and disability, there have been recent advancements in treatment modalities including thrombolysis and decompressive hemicraniectomy. A retrospective review of patients treated in our NHS teaching hospital, in Plymouth (UK), over a 2 year period identified 17 thrombolysed patients, of whom two had undergone subsequent decompressive hemicraniectomy. These were non-dominant hemisphere strokes in young patients, aged 51 and 57. Initial NIHSS scores were 16 and 17, and they received thrombolysis at 2 hrs 42min and 5 hrs 10min post onset of symptoms respectively. CT imaging demonstrated cerebral swelling with significantmidline shift in both cases, and decompressive hemicraniectomy was undertaken at 29 hrs 8min and 27 hrs 30 min post-thrombolysis. We found no significant intra-operative complications attributable to prior use of thrombolytics. Both patients have had acceptable psychological and physical outcomes, with Barthel Index scores of 40 and 25, and MMSE scores of 29/30 and 27/30. We conclude that the use of thrombolytic therapy does not contra-indicate subsequent decompressive hemicraniectomy in well selected patients with non-dominant hemisphere strokes. More research in this field is required to elucidate factors which would facilitate recognition of stroke patients who will benefit most from aggressive medical and neurosurgical intervention. [ABSTRACT FROM AUTHOR]

Published
2011
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13. Outcome after curative resection of large (>or=10 cm) gastric gastrointestinal stromal tumors: how frequent is adjacent organ involvement and is concomitant distal pancreatectomy necessary?

Author

Goh, Brian K. P., Chow, Pierce K. H., Kesavan, Sittampalam M., Yap, Wai-Ming, Chung, Yaw-Fui A., and Wong, Wai-Keong

Subjects
CURATIVE medicine, STOMACH tumors, GASTROINTESTINAL tumors, PANCREATECTOMY, STOMACH surgery, CANCER invasiveness, CHI-squared test, GASTRECTOMY, IMMUNOHISTOCHEMISTRY, METASTASIS, NONPARAMETRIC statistics, PANCREATIC diseases, PROGNOSIS, SURGICAL complications, SURVIVAL, TREATMENT effectiveness, PROPORTIONAL hazards models, RETROSPECTIVE studies
Abstract

Introduction: Complete tumor resection with clear margins including adjacent organs is the treatment of choice for gastrointestinal stromal tumors (GISTs). However, true tumor invasion of adjacent organs has been reported to be rare. Concomitant distal pancreatectomy (DP) for suspected tumor infiltration is not infrequently performed during resection of large gastric GISTs. This study aims to determine the true frequency of adjacent organ involvement by large gastric GISTs with particular attention to the pancreas and compares the outcome after curative resection with and without a concomitant DP in order to determine if DP is truly necessary.Methods: A retrospective review of 37 patients who underwent curative resection of large (>or=10 cm) gastric GISTs was conducted.Results: Wedge resections were performed in 22, partial gastectomies in nine, and total gastrectomies in six patients. The median operative time was 180 min (range, 60-330 min), and the patients had a median postoperative stay of 8 days (range, 4-29 days). Overall, there were eight (22%) morbidities including two (5%) mortalities. Nineteen (51%) had concomitant adjacent organ resection, and these included 15 (41%) DPs with splenectomies. Direct organ invasion was demonstrated in 5/19 patients (26%) and 7/30 organs (23%) resected. Only 1/15 (6.7%) DP specimens demonstrated tumor infiltration. Comparison between the patients with and without a concomitant DP demonstrated that performance of a DP was associated with a longer operation time [225 min (range, 105-305 min) vs 158 min (60-330 min), P=.002)], increased postoperative stay [9 days (range, 7-29 days) vs 7.5 days (4-19 days), P=.042], and increased postoperative morbidity [6 (40%) vs 2 (9%), P=.025]. The DP cohort also had a statistically significant poorer 5-year recurrence free survival (22% vs 60%, P=.017).Conclusion: Although adjacent organ involvement is not uncommon with large gastric GISTs, concomitant DP is usually unnecessary as direct pancreatic invasion is rare. Furthermore, concomitant DP with splenectomy is associated with an increase in postoperative morbidity. [ABSTRACT FROM AUTHOR]

Published
2010
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