6 results on '"Vlad Paraoan"'
Search Results
2. Determining the stress biomarker profile in patients undergoing total knee replacement and the relationship with outcome at 12 months
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Charlotte Armitage, Dimitris K. Grammatopoulos, Andrew J. Metcalfe, Amit Chawla, Ana Penedo, Sam Powell, Tamsyn Clark, Chetan Khatri, Alwyn Havard, Rasheed Rabiu, Timothy Barlow, and Vlad Paraoan
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Male ,medicine.medical_specialty ,Neutrophils ,Total knee replacement ,Significant negative correlation ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Stress, Physiological ,Internal medicine ,Linear regression ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Lymphocyte Count ,Patient Reported Outcome Measures ,Postoperative Period ,030212 general & internal medicine ,Arthroplasty, Replacement, Knee ,Prospective cohort study ,Aged ,Univariate analysis ,Interleukin-6 ,Platelet Count ,Tumor Necrosis Factor-alpha ,business.industry ,Osteoarthritis, Knee ,R1 ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Female ,business ,RA ,Biomarkers ,RD ,Oxford knee score - Abstract
Background:\ud Total knee replacement (TKR) is the commonest joint arthroplasty procedure worldwide. Despite excellent outcomes, some studies have reported dissatisfaction in up to 20% of patients.\ud \ud There is evidence of an association between the biochemical stress response to surgery and outcomes. The objective of this study is to describe the stress biomarker profile for TKR, and correlate this with patient outcomes.\ud \ud Methods:\ud A prospective cohort study of 50 patients undergoing primary TKR was conducted. Serum IL-6, TNF-α, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were measured immediately pre- and post-operatively, and on Days 1 and 3. Follow-up questionnaires including the Oxford Knee Score (OKS) and EuroQol five dimensions (EQ-5D) were completed at 12-months.\ud \ud Univariate analysis was completed using a linear regression model (p
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- 2019
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3. Tibial component sizing and alignment of TKR components does not significantly affect patient reported outcome measures at six months. A case series of 474 participants
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Dveej Bhatt, Damian R. Griffin, Andrew J. Metcalfe, Vlad Paraoan, Imran Ahmed, Chetan Khatri, Bhanu Mishra, and Timothy Barlow
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musculoskeletal diseases ,Adult ,Male ,Knee Joint ,Osteoarthritis ,Affect (psychology) ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Patient Reported Outcome Measures ,Postoperative Period ,Prospective Studies ,Arthroplasty, Replacement, Knee ,Aged ,Orthodontics ,030222 orthopedics ,Tibia ,business.industry ,General Medicine ,Middle Aged ,Osteoarthritis, Knee ,medicine.disease ,Sagittal plane ,medicine.anatomical_structure ,Treatment Outcome ,Coronal plane ,Surgery ,Patient-reported outcome ,Female ,Implant ,business ,Knee Prosthesis ,Body mass index ,Oxford knee score ,RD - Abstract
Objectives Total knee replacement (TKR) is an effective means of alleviating the symptoms of end stage osteoarthritis. However, 20% of patients report dissatisfaction one year post-operatively. Previous literature has demonstrated contradictory evidence regarding the relationship between alignment and tibial component sizing with patient reported outcome measures (PROMs). We aim to investigate the association between alignment of TKR components and effect of tibial component sizing on PROMs. Method A prospective, multicentre case series was performed at six centres. Baseline characteristics were collected at recruitment. Coronal and sagittal plain films were taken day one post-operatively. Trained medical professionals blinded to outcome measured the alignment and degree of over/underhang of the tibial component in the coronal and sagittal place, with Oxford Knee Score (OKS) measured six months post-operatively. Results 474 patients were recruited. Malaligned TKRs caused no significant difference in mean OKS change at six months (independent t -test) (p > 0.05). A multivariate regression model taking into account age, gender, body mass index and baseline OKS also demonstrated no significant difference (p > 0.05). With regards to tibial component sizing, 125 (27%) of patients had appropriately sized tibial components, 120 (26%) had overhang and 219 (53%) had underhang with no significant difference in OKS between the groups (p > 0.05). Conclusion Tibial component sizing and alignment does not significantly affect short-term function, as measured by OKS, after total knee replacement. Dissatisfaction after TKR is likely due to other factors other than alignment of implant.
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- 2017
4. Management and outcomes of thoracic sarcomas - a collaboration between Orthopaedic Oncology and cardiothoracic surgery: seven-year clinical data from a tertiary referral centre.
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Shamsi, Zaid Ahmed, Paraoan, Vlad, Kim, Chang, Saifuddin, Sarah Raihanah, Cosker, Thomas D A, Whitwell, Duncan, Gibbons, Christopher L M H, Stavroulias, Dionisios, and DiChiara, Francesco
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MEDICAL sciences ,CANCER treatment ,ADJUVANT chemotherapy ,STATISTICAL hypothesis testing ,SURGERY - Abstract
Introduction: Sarcomas are rare cancers originating from mesenchymal tissues, manifesting in diverse anatomical locations, but notably in connective tissue, muscles and the skeleton. Thoracic sarcomas present a unique diagnostic and surgical challenge attributable to their rarity and pathoanatomy. Standard practice currently comprises wide surgical excision, often accompanied by adjuvant chemotherapy and/or radiotherapy. This approach necessitates a multidisciplinary team, ideally in specialised cancer centres. The Oxford Bone and Soft Tissue Tumour Service is one such centre, and routinely treats such cancers through collaboration between orthopaedic oncology and cardiothoracic surgeons, as well as members of the wider MDT. This study reports the current management and outcomes of primary thoracic sarcoma patients at the Oxford Sarcoma Service over a seven-year period. Objectives: Given the rarity of thoracic sarcomas, and their associated diagnostic and management complexities, our aim is to report on the treatment strategies and outcomes of primary thoracic sarcoma patients treated at the Oxford Sarcoma Service from 2017 to 2023. Methods: Data pertaining to all thoracic sarcoma cases discussed in multidisciplinary meetings at the Oxford tertiary centre from 2017 to 2023 were retrieved from the local electronic database. These were analysed using appropriate statistical tests to determine significance of the various observations made. Results: Of 113 identified cases, chondrosarcoma emerged as the most prevalent histological subtype among 22 distinct varieties. 58% of cases exhibited high-grade features. 32 sarcoma-related deaths occurred, with a mean time from diagnosis to death of 23.16 months. A notable association was observed between high-grade sarcomas and mortality (p = 0.0280). Surgical resection was performed in 77 cases, with 49% of these undergoing surgical resection alone i.e. the patient received no radio- or chemotherapy. Both surgical intervention (p < 0.0001) and clear margins (p = 0.0051) were significantly linked to improved survival. Local recurrence was noted in 28.6% of the 77 surgical cases, and predominantly in the high-grade sarcomas (81.8%). However, no statistical association was found between recurrence and margin status in our data. Conclusion: Our results indicate that primary resection remains the cornerstone of thoracic sarcoma treatment, representing the single strongest independent factor for survival in treatable cases. Variability in outcomes and overall survival likely stems from factors such as histological diversity, predominance of high-grade sarcomas, and wide age range at diagnosis. Ongoing prospective database update and collaborative efforts across centres would further clarify prognoses and recommendations for specific tumours, based on observational data. [ABSTRACT FROM AUTHOR]
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- 2025
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5. Characterization of initiating physiological events of mammary gland involution: Evidence for cathepsin B involvement
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Christine J. Watson and Vlad Paraoan
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Pathology ,medicine.medical_specialty ,Endocrinology ,business.industry ,Internal medicine ,Medicine ,Surgery ,General Medicine ,business ,Mammary gland involution ,Cathepsin B - Full Text
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6. ePosters.
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APPENDICITIS ,CHOLECYSTITIS ,MEDICAL personnel ,ENZYME-linked immunosorbent assay ,GASTRIC banding ,MEDICAL care ,GENERAL Data Protection Regulation, 2016 - Abstract
WS4.224 The current practice of preoperative risk assessment in patients undergoing elective surgery... Ashrafun Nessa, Irfan Ahmed Aberdeen Royal Infirmary Aim: In the preoperative assessment of a surgical patient, it is prudent to counsel the patient on the risks of postoperative mortality and need for critical care monitoring after surgery, identifying patients for prehabilitation, perioperative shared decision-making process, guiding allocation of resources and improving patient outcomes. WS4.269 Preventing Post-operative Nausea and Vomiting (PONV) - are we doing enough for day case patie... Will Sargent, Emma Gorst Ealing Hospital, London North West University Healthcare Aim: • Enhanced recovery protocols recommend risk-stratification of patients and tailoring of antiemetic prophylaxis accordingly to prevent post-operative nausea and vomiting (PONV) • The widely-used Apfel score for PONV risk was created before the routine propofol induction and antiemetic prophylaxis • As more procedures are performed as day case, patients may be sent home before PONV manifests • We wanted to see how effective our current strategies are at preventing post-operative PONV Method: • 65 patients undergoing general surgical or gynaecological procedures were prospectively risk-stratified for PONV according to their Apfel score (high risk >2) • Their anaesthesia and intra-operative prophylactic antiemesis was recorded from the anaesthetic chart • They were asked about PONV at 2 and 24 hours after their operation end, the latter by telephone Results • 24.2% (15/62) patients were nauseated after leaving hospital • 35.5% (11/31) high-risk patients experienced PONV vs 12.9% (4/31) in the low-risk group (p <0.05, Fisher's exact test) • There was no difference in the number of antiemetic agents used between high- and low-risk groups (median 2). [Extracted from the article]
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- 2020
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