Publications by authors named "Philip Stanley"

29 Publications

  • Page 1 of 1

Host-Guest Interactions in a Metal-Organic Framework Isoreticular Series for Molecular Photocatalytic CO Reduction.

Angew Chem Int Ed Engl 2021 May 20. Epub 2021 May 20.

Chair of Inorganic and Metal-Organic Chemistry, Department of Chemistry, Technical University of Munich, Lichtenbergstrasse 4, Garching, Germany.

A strategy to improve homogeneous molecular catalyst stability, efficiency, and selectivity is the immobilization on supporting surfaces or within host matrices. Herein, we examine the co-immobilization of a CO reduction catalyst [ReBr(CO) (4,4'-dcbpy)] and a photosensitizer [Ru(bpy) (5,5'-dcbpy)]Cl using the isoreticular series of metal-organic frameworks (MOFs) UiO-66, -67, and -68. Specific host pore size choice enables distinct catalyst and photosensitizer spatial location-either at the outer MOF particle surface or inside the MOF cavities-affecting catalyst stability, electronic communication between reaction center and photosensitizer, and consequently the apparent catalytic rates. These results allow for a rational understanding of an optimized supramolecular layout of catalyst, photosensitizer, and host matrix.
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http://dx.doi.org/10.1002/anie.202102729DOI Listing
May 2021

Recalcitrant Keratitis with Hyphaema.

Case Rep Ophthalmol 2021 Jan-Apr;12(1):214-218. Epub 2021 Apr 12.

Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore, Singapore.

Purpose: To report a case of recalcitrant pseudomonas keratitis with a rare presentation of hyphaema.

Observation: A 45-year-old female was noted to have contact lens-related pseudomonas keratitis with hyphaema. The organism was refractory to multiple antibiotics and only responded to Tazocin eye drops.

Conclusion And Importance: Hyphaema is a rare presentation in bacterial keratitis and could represent infection with an especially virulent organism. Use of Aspirin could precipitate hyphaema in infective keratitis. Alternative antibiotic choices such as Tazocin, colistin, meropenem, and imipenem can be considered when standard therapy is ineffective for multidrug-resistant Pseudomonas keratitis.
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http://dx.doi.org/10.1159/000512473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077375PMC
April 2021

Decoding DNA data storage for investment.

Biotechnol Adv 2020 12 28;45:107639. Epub 2020 Sep 28.

M Ventures, Gustav Mahlerplein 102, 20(th) Floor, 1082 MA Amsterdam, The Netherlands.

While DNA's perpetual role in biology and life science is well documented, its burgeoning digital applications are beginning to garner significant interest. As the development of novel technologies requires continuous research, product development, startup creation, and financing, this work provides an overview of each respective area and highlights current trends, challenges, and opportunities. These are supported by numerous interviews with key opinion leaders from across academia, government agencies and the commercial sector, as well as investment data analysis. Our findings illustrate the societal and economic need for technological innovation and disruption in data storage, paving the way for nature's own time-tested, advantageous, and unrivaled solution. We anticipate a significant increase in available investment capital and continuous scientific progress, creating a ripe environment on which DNA data storage-enabling startups can capitalize to bring DNA data storage into daily life.
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http://dx.doi.org/10.1016/j.biotechadv.2020.107639DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521213PMC
December 2020

A Randomized Prospective Placebo-Controlled Study of the Effects of Lavender Aromatherapy on Preoperative Anxiety in Cataract Surgery Patients.

J Perianesth Nurs 2020 Aug 13;35(4):403-406. Epub 2020 Mar 13.

Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore.

Purpose: To determine if lavender aromatherapy can reduce preoperative anxiety in cataract surgery patients.

Design: Single-center prospective randomized placebo-controlled trial.

Methods: Seventy-five patients awaiting cataract surgery were randomized to lavender essential oil or grape seed oil (control) and administered the State-Trait Anxiety Inventory. Vital signs were also recorded.

Findings: Patients in the lavender group showed greater improvements in self-reported anxiety using the State-Trait Anxiety Inventory (P = .023, two-sample t test). Compared with the control group, the effects of lavender on the reduction of anxiety were statistically significant when adjusting for age, gender, and baseline scores (P = .012, analysis of covariance).

Conclusions: Lavender aromatherapy reduced anxiety in preoperative cataract surgery patients.
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http://dx.doi.org/10.1016/j.jopan.2019.12.004DOI Listing
August 2020

Meta-analysis of amantadine efficacy for improving preclinical research reliability.

Mov Disord 2018 10 4;33(10):1555-1557. Epub 2018 Oct 4.

Motac Neuroscience, Manchester, United Kingdom.

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http://dx.doi.org/10.1002/mds.27486DOI Listing
October 2018

Toxigenic Clostridium difficile colonization among hospitalised adults; risk factors and impact on survival.

J Infect 2017 07 21;75(1):20-25. Epub 2017 Apr 21.

Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom; Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, BN1 9PS, United Kingdom. Electronic address:

Objectives: To establish risk factors for Clostridium difficile colonization among hospitalized patients in England.

Methods: Patients admitted to elderly medicine wards at three acute hospitals in England were recruited to a prospective observational study. Participants were asked to provide a stool sample as soon as possible after enrolment and then weekly during their hospital stay. Samples were cultured for C. difficile before ribotyping and toxin detection by PCR. A multivariable logistic regression model of risk factors for C. difficile colonization was fitted from univariable risk factors significant at the p < 0.05 level.

Results: 410/727 participants submitted ≥1 stool sample and 40 (9.8%) carried toxigenic C. difficile in the first sample taken. Ribotype 106 was identified three times and seven other ribotypes twice. No ribotype 027 strains were identified. Independent predictors of colonization were previous C. difficile infection (OR 4.53 (95% C.I. 1.33-15.48) and malnutrition (MUST score ≥2) (OR 3.29 (95% C.I. 1.47-7.35)). Although C. difficile colonised patients experienced higher 90-day mortality, colonization was not an independent risk for death.

Conclusions: In a non-epidemic setting patients who have previously had CDI and have a MUST score of ≥2 are at increased risk of C. difficile colonization and could be targeted for active surveillance to prevent C. difficile transmission.
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http://dx.doi.org/10.1016/j.jinf.2017.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464213PMC
July 2017

Pharmacological reversal of a pain phenotype in iPSC-derived sensory neurons and patients with inherited erythromelalgia.

Sci Transl Med 2016 04;8(335):335ra56

Pfizer Neuroscience and Pain Research Unit, The Portway Building, Granta Park, Cambridge CB21 6GS, UK.

In common with other chronic pain conditions, there is an unmet clinical need in the treatment of inherited erythromelalgia (IEM). TheSCN9Agene encoding the sodium channel Nav1.7 expressed in the peripheral nervous system plays a critical role in IEM. A gain-of-function mutation in this sodium channel leads to aberrant sensory neuronal activity and extreme pain, particularly in response to heat. Five patients with IEM were treated with a new potent and selective compound that blocked the Nav1.7 sodium channel resulting in a decrease in heat-induced pain in most of the patients. We derived induced pluripotent stem cell (iPSC) lines from four of five subjects and produced sensory neurons that emulated the clinical phenotype of hyperexcitability and aberrant responses to heat stimuli. When we compared the severity of the clinical phenotype with the hyperexcitability of the iPSC-derived sensory neurons, we saw a trend toward a correlation for individual mutations. The in vitro IEM phenotype was sensitive to Nav1.7 blockers, including the clinical test agent. Given the importance of peripherally expressed sodium channels in many pain conditions, our approach may have broader utility for a wide range of pain and sensory conditions.
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http://dx.doi.org/10.1126/scitranslmed.aad7653DOI Listing
April 2016

Efficacy of doxycycline and sodium tetradecyl sulfate sclerotherapy in pediatric head and neck lymphatic malformations.

Int J Pediatr Otorhinolaryngol 2015 Jun 6;79(6):883-887. Epub 2015 Apr 6.

Children's Hospital at Los Angeles, Department of Radiology, Los Angeles, CA, USA.

Objectives: Lymphatic malformations are congenital vascular anomalies that occur from abnormal development of the lymphatic channels. Studies have shown that sclerotherapy can be a reliable alternative to surgery. The purpose of this retrospective study is to evaluate the safety and efficacy of percutaneous sclerotherapy with doxycycline and 3% Sotradecol as primary treatment for pediatric head and neck LMs, and to assess outcomes based on lesion classification, location and sclerosant used.

Study Design: This study was a single center, retrospective, case series study.

Materials And Methods: The medical records of 38 children who underwent percutaneous sclerotherapy of LMs in the head and neck region at our tertiary care center between 1/1/2006 and 1/31/2011 were reviewed. A mean average of 2.9 (range 1-10) sclerotherapy sessions per child were performed. LMs involved primarily the face (61.3%), posterior neck (48.4%), submental area (45.2%), and anterior neck (35.5%).

Results: Twenty-nine subjects had adequate follow-up data, with 51.7% demonstrating complete resolution, 27.6% moderate improvement, and 20.7% no response. There was no significant difference in the outcome based on the sclerosant agent used or location of the lesion. Lesion type did affect outcome and macrocystic lesions were found to have a significantly higher resolution rate (95.2%) than microcystic or mixed lesions (p < 0.05). The total number of complications was similar between agents and all were minor.

Conclusion: Our results indicate that percutaneous therapy with doxycycline and Sotradecol is safe and effective for children with LMs of the head and neck. Better outcomes were observed with macrocystic LMs.

Level Of Evidence: 4.
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http://dx.doi.org/10.1016/j.ijporl.2015.03.024DOI Listing
June 2015

In memoriam: A life scientific--John Woodland 'Woody' Hastings (1927-2014).

Luminescence 2014 Dec;29(8):959-62

Philadelphia, PA, USA.

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http://dx.doi.org/10.1002/bio.2827DOI Listing
December 2014

Vascular Malformations and Associated Syndromes: The Role of the Orthopaedic Surgeon.

JBJS Rev 2014 May;2(5)

1Department of Orthopaedic Surgery, The Keck School of Medicine of the University of Southern California, 1200 North State Street, GNH-3900, Los Angeles, CA 90033 2Department of General Surgery, The Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 4300, Los Angeles, CA 90033 3Division of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #100, Los Angeles, CA 90027 4Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #96, Los Angeles, CA 90027 5Department of Radiology, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #81, Los Angeles, CA 90027 6Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #69, Los Angeles, California, 90027.

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http://dx.doi.org/10.2106/JBJS.RVW.M.00075DOI Listing
May 2014

The biennial International Bioluminescence and Chemiluminescence Symposium series: a 35-year heritage.

Luminescence 2013 Nov-Dec;28(6):797

Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA, 19104, USA.

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http://dx.doi.org/10.1002/bio.2608DOI Listing
October 2014

Percutaneous liver biopsy: pathologic diagnosis and complications in children.

J Pediatr Gastroenterol Nutr 2013 Nov;57(5):644-8

*Department of Surgery †Department of Radiology ‡Department of Gastroenterology §Department of Pathology, Children's Hospital Los Angeles ||Southern California Clinical and Translational Science Institute, University of Southern California and Children's Hospital Los Angeles, Los Angeles, CA.

Objective: The aim of this study was to determine patient factors that predict diagnostic failure or increased risk of bleeding complications following percutaneous liver biopsy in children.

Methods: A retrospective review of all children undergoing percutaneous liver biopsy at a single institution between July 2008 and July 2011 was performed. Demographics, comorbid conditions, preprocedural diagnoses/indications, procedural details, laboratory data, pathologic diagnosis, and complications were recorded. Continuous data were analyzed by Wilcoxon test and categorical data by Fisher exact test to determine statistical significance.

Results: Two hundred thirteen children (104 girls) with a median age of 7 years (range 1 week-22 years) underwent 328 percutaneous liver biopsies. Nine (4.2%) experienced a decrease in hemoglobin >2 g/dL, 7 required transfusion (3.3%), and 1 patient died (0.5%). Younger age (1.8 vs 84 months, P = 0.05) and lower preprocedural hematocrit (29.3 vs 34.3, P = 0.05) predicted bleeding complications, whereas the number of biopsies, comorbid conditions, and coagulopathy did not. Sixty-three (19.2%) biopsies were insufficient for definitive histologic evaluation on initial biopsy in 57 patients. Twenty-one of 57 patients (37%) underwent repeat percutaneous biopsy and 3 of 57 (8%) underwent surgical biopsy. Biopsy provided definitive diagnosis in 86% of cases when repeat biopsy was performed. Shorter specimen length (1.4 vs 1.7 cm, P < 0.01) and biopsies performed for unexplained elevation of liver function tests (34.9% vs 16.7%, P < 0.01) were predictive of nondiagnosis.

Conclusions: Percutaneous liver biopsy is safe with a low rate of bleeding-related complications. Ensuring adequate sample length and careful patient selection may further increase the diagnostic yield.
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http://dx.doi.org/10.1097/MPG.0b013e3182a0e0d8DOI Listing
November 2013

Flap-off epi-LASIK versus automated epithelial brush in PRK: a prospective comparison study of pain and reepithelialization times.

J Refract Surg 2012 Oct;28(10):682-9

Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.

Purpose: To compare the effect of flap-off epi-LASIK versus automated brush epithelial removal on pain and wound healing in low myopic photorefractive keratectomy (PRK).

Methods: In this prospective intraindividual study 60 patients received surface ablation in each eye. Epithelial removal was performed by an automated brush technique in one eye (brush group) and epi-LASIK with flap removal (flap-off group) in the fellow eye. The epithelial defect size was measured daily after surgery until both eyes were reepithelialized. Postoperative pain on a scale from 0 to 6 and topical and oral analgesic medication use was recorded until the bandage contact lens was removed.

Results: The flap-off group had significantly less postoperative pain on days 1 (P=.0003), 2 (P=.0001), 3 (P<.0001), and 4 (P<.0001) compared to the brush group. However, the average difference in pain scores between groups was only 0.33 points out of 6. No difference was noted in the normalized overall percentage rate of healing over the first 4 days in the flap-off group (5.41±1.39%/hour) compared to the brush group (5.42±1.94%/hour) (P=.97).

Conclusions: The flap-off group showed a statistically but not clinically significant advantage over the brush group in pain scores. However, no difference was noted in the percentage rate of epithelial healing time between the two groups.
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http://dx.doi.org/10.3928/1081597X-20120921-02DOI Listing
October 2012

Phase II study of pre-irradiation chemotherapy for childhood intracranial ependymoma. Children's Cancer Group protocol 9942: a report from the Children's Oncology Group.

Pediatr Blood Cancer 2012 Dec 4;59(7):1183-9. Epub 2012 Sep 4.

Division of Pediatric Oncology, Columbia University Medical Center, New York, New York.

Purpose: Standard therapy for childhood intracranial ependymoma is maximal tumor resection followed by involved-field irradiation. Although not used routinely, chemotherapy has produced objective responses in ependymoma, both at recurrence and in infants. Because the presence of residual tumor following surgery is consistently associated with inferior outcome, the potential impact of pre-irradiation chemotherapy was investigated.

Methods: Between 1995 and 1999, the Children's Cancer Group undertook a Phase II trial of pre-irradiation chemotherapy in children 3-21 years of age with intracranial ependymoma and radiological evidence of post-operative residual tumor.

Results: Of 84 patients, 41 had residual tumor, and were given four cycles of cisplatin-based chemotherapy prior to irradiation. Of 35 patients fully evaluable for response to chemotherapy, 14 (40%) demonstrated complete response, 6 (17%) partial response, 10 (29%) minor response or stable disease, and 5 (14%) demonstrated progressive tumor growth. For the entire group, 5-year overall survival (OS) and event-free survival (EFS) was 71 ± 6%, and 57 ± 6%, respectively. The pre-irradiation chemotherapy group demonstrated EFS comparable to that of patients with no residual tumor who received irradiation alone (55 ± 8% vs. 58 ± 9%, P = 0.45). Any benefit of chemotherapy was restricted to patients with greater than 90% tumor resection.

Conclusions: Children with near total resection of ependymoma may benefit from pre-irradiation chemotherapy. Patients with subtotal resection have inferior outcome despite responses to chemotherapy, and should be considered for second-look surgery prior to irradiation. Pediatr Blood Cancer 2012; 59: 1183-1189. © 2012 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/pbc.24274DOI Listing
December 2012

Shining worms in oysters: early scientific papers about luminescence.

Luminescence 2012 Jul-Aug;27(4):247-8. Epub 2012 Feb 7.

Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.

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http://dx.doi.org/10.1002/bio.2336DOI Listing
January 2013

Colonic venous malformation and portal hypertension: association, management, and review of the literature.

Pediatr Surg Int 2012 Apr 3;28(4):435-8. Epub 2012 Jan 3.

Department of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd #100, Los Angeles, CA 90027, USA.

We present a case of an adolescent with lower gastrointestinal bleeding caused by a colorectal venous malformation (VM) with concomitant portal hypertension. After an episode of massive gastrointestinal bleeding, we performed an extended right hemicolectomy and resection of the VM and selective portosystemic shunt. Here, we present the case and review the literature regarding portal hypertension and gastrointestinal vascular malformations. Additionally, we discuss the physiologic and hemodynamic effects of gastrointestinal vascular malformations on the portal system.
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http://dx.doi.org/10.1007/s00383-011-3041-yDOI Listing
April 2012

Ewing sarcoma of the tibia mimicking fibrous dysplasia.

J Pediatr Orthop B 2013 May;22(3):222-7

Children's Orthopaedic Center, Children's Hospital Los Angeles School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.

Ewing sarcoma (ES) family of tumors is the second most common primary bone malignancy in children. It usually presents as an aggressive looking lesion often located in the meta-diaphyseal region of long bones, with bone destruction, permeation, cortical thinning and/or destruction, periosteal reaction, and large soft-tissue mass. The purpose of this study is to illustrate the occurrence of a fibrous dysplasia (FD)-appearing ES of the tibia. These cases underscore the potential difficulties encountered in the diagnosis of ES. In this study, we performed a retrospective review of children who presented with an otherwise benign-appearing lesion of the tibia, suggestive of FD, which proved to be ES after biopsy. As a result, all patients presented with a history of indolent lower extremity pain of several months of duration, without significant swelling or constitutional symptoms. Plain films revealed an otherwise benign-appearing/FD-like lesion without bone destruction and mild cortical thinning, little or no periosteal reaction. Magnetic resonance imaging revealed the intramedullary extension of the lesion without significant cortical or periosteal involvement and no soft tissue mass. Lesions were hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging. All patients underwent open incisional biopsy and after cytogenetic and molecular studies, the diagnosis of ES was confirmed. We conclude that ES is a deadly malignant tumor if left untreated or if mismanaged. Although it usually presents as an aggressive-looking lesion, at times it may mimic FD and has a benign-looking appearance, making the diagnosis unlikely and challenging. Summation of these cases demonstrates that the potential reasons for misdiagnoses include a low level of suspicion, an atypical site occurrence, a benign radiographic appearance, and a lack of or insufficient histologic specimens.
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http://dx.doi.org/10.1097/BPB.0b013e32834dfe4dDOI Listing
May 2013

Riboflavin and ultraviolet light a therapy as an adjuvant treatment for medically refractive Acanthamoeba keratitis: report of 3 cases.

Ophthalmology 2011 Feb 29;118(2):324-31. Epub 2010 Sep 29.

The Wilmer Ophthalmological Institute, The Johns Hopkins University, School of Medicine, Baltimore, Maryland 21205, USA.

Purpose: To present the first 3 cases of Acanthamoeba keratitis (AK), unresponsive to medical treatment, that were successfully treated with a novel adjunctive therapy using ultraviolet light A (UVA) and riboflavin (B2).

Design: Interventional case series.

Participants: Two patients with confirmed AK and 1 patient with presumptive AK, which were all refractive to multidrug conventional therapy.

Intervention: Two treatment sessions involving topical application of 0.1% B2 solution to the ocular surface combined with 30 minutes of UVA irradiation focused on the corneal ulcer.

Main Outcome Measures: Clinical examination by slit lamp, confocal microscopy, and histopathology, when available.

Results: All patients in these series showed a rapid reduction in their symptoms and decreased ulcer size after the first treatment session. The progress of the clinical improvement began to slow after 1 to 3 weeks of the first application and was then renewed after the second application. All ancillary signs of inflammation mostly resolved after the second treatment session. The ulcers in all patients continued to decrease and were closed within 3 to 7 weeks of the first application. Two patients developed dense central corneal scars, and penetrating keratoplasty was performed for visual rehabilitation. Histopathologic examination of the excised tissue revealed no Acanthamoeba organisms. The remaining patient had no symptoms or signs of infection, both clinically and by confocal microscopy, and was left with a semitransparent eccentric scar that did not affect visual acuity.

Conclusions: The adjunctive use of UVA and B2 therapy seems to be a possible alternative for selected cases of medication-resistant AK.
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http://dx.doi.org/10.1016/j.ophtha.2010.06.041DOI Listing
February 2011

Perirectal arteriovenous malformation treated by angioembolization and low anterior resection.

J Pediatr Surg 2010 Jul;45(7):1542-5

Pediatric General Surgery, Children's Hospital Los Angeles, CA, USA.

We present a case of a child with ongoing lower gastrointestinal bleeding caused by a rectosigmoid arteriovenous malformation. To reduce perioperative bleeding, we performed preoperative angioembolization followed by subsequent resection by low anterior resection. Here we present the case and review the literature regarding neoadjuvent embolization for gastrointestinal and pelvic arteriovenous malformations.
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http://dx.doi.org/10.1016/j.jpedsurg.2010.03.026DOI Listing
July 2010

Persistent vomiting.

Pract Neurol 2009 Feb;9(1):46-9

Bradford Royal Infirmary, Bradford, UK.

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http://dx.doi.org/10.1136/jnnp.2008.168203DOI Listing
February 2009

Myeloablative chemotherapy with autologous bone marrow rescue in children and adolescents with recurrent malignant astrocytoma: outcome compared with conventional chemotherapy: a report from the Children's Oncology Group.

Pediatr Blood Cancer 2008 Dec;51(6):806-11

The Children's Center for Cancer & Blood Diseases, Department of Pediatrics, Children's Hospital, Los Angeles, California 90027, USA.

Purpose: Children and adolescents with malignant astrocytomas recurring after initial treatment have a dismal prognosis, with only rare patients surviving 1-year beyond recurrence. The purpose of this study was to attempt to improve their survival.

Methods: Twenty-seven children and adolescents with malignant astrocytomas [17 glioblastoma multiforme and 10 anaplastic astrocytoma (AA)] following initial tumor progression, received myeloablative chemotherapy followed by autologous marrow rescue with one of three thiotepa and etoposide-based chemotherapy regimens, administered alone (n = 11) or combined with carmustine (n = 5) or carboplatin (n = 11). Time to progression and death following myeloablative chemotherapy for these patients was compared non-randomly with outcome of a contemporaneously treated cohort of similar patients who received only conventional chemotherapy following initial tumor progression. The two cohorts were compared for age, histology, prior therapies, extent of surgical resection at progression, and time from initial diagnosis to progression.

Results: Five of 27 children (two with glioblastoma multiforme and three with AA) survive event-free from 8.3 to 13.3 years (median of 11.1 years) following myeloablative chemotherapy. Of 56 children with recurrent malignant astrocytoma who received conventional chemotherapy following initial progression, no patient survives. Differences in distributions of survival were not significant when stratified by surgical debulking (P = 0.39). However, for patients who were surgically debulked, the survival distributions are significantly different (P = 0.017).

Conclusions: Myeloablative chemotherapy with autologous marrow rescue can produce durable remissions in children and young adults with recurrent malignant gliomas, in the setting of minimal residual tumor burden achieved surgically.
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http://dx.doi.org/10.1002/pbc.21732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844080PMC
December 2008

Laser refractive surgery in the United States Navy.

Curr Opin Ophthalmol 2008 Jul;19(4):321-4

Wilmer Ophthalmological Institute, Baltimore, Maryland, USA.

Purpose Of Review: The aim of this article is to highlight the numerous contributions the US Navy has made to the field of laser refractive surgery. It summarizes and draws together published papers, national meeting presentations, and unpublished data of clinical and laboratory studies involving the excimer laser and the laser-assisted in-situ keratomileusis (LASIK) flap.

Recent Findings: Photorefractive keratectomy (PRK) is the most widely performed refractive procedure in the US Navy, but this trend is slowly changing as femtosecond laser-assisted LASIK becomes more widely performed. Based on the results of recent studies, PRK is approved for designated Naval aviators and flight officers; post-PRK students are now allowed into flight training. Wavefront-guided PRK and LASIK are more predictable and provided better results than conventional PRK and LASIK. Femtosecond laser-assisted LASIK is now a waiverable procedure for US military personnel and US Astronauts (excluding Naval aviators, as of this writing).

Summary: Since its personnel must meet strict visual requirements to accomplish their mission in a variety of environments, the US Navy places particular emphasis on safety and quality of vision after laser refractive surgery. The US Navy has been evaluating the safety and efficacy of laser refractive surgery since 1993 and will continue to do so.
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http://dx.doi.org/10.1097/ICU.0b013e3283009ee3DOI Listing
July 2008

Learning from death: a hospital mortality reduction programme.

J R Soc Med 2006 Jun;99(6):303-8

Clinical & Scientific Support Services, Bradford Teaching Hospitals NHS Trust, Bradford Royal Infirmary, Bradford BD9 6RJ.

Problem: There are wide variations in hospital mortality. Much of this variation remains unexplained and may reflect quality of care.

Setting: A large acute hospital in an urban district in the North of England.

Design: Before and after evaluation of a hospital mortality reduction programme.

Strategies For Change: Audit of hospital deaths to inform an evidence-based approach to identify processes of care to target for the hospital strategy. Establishment of a hospital mortality reduction group with senior leadership and support to ensure the alignment of the hospital departments to achieve a common goal. Robust measurement and regular feedback of hospital deaths using statistical process control charts and summaries of death certificates and routine hospital data. Whole system working across a health community to provide appropriate end of life care. Training and awareness in processes of high quality care such as clinical observation, medication safety and infection control.

Effects: Hospital standardized mortality ratios fell significantly in the 3 years following the start of the programme from 94.6 (95% confidence interval 89.4, 99.9) in 2001 to 77.5 (95% CI 73.1, 82.1) in 2005. This translates as 905 fewer hospital deaths than expected during the period 2002-2005.

Lessons Learnt: Improving the safety of hospital care and reducing hospital deaths provides a clear and well supported goal from clinicians, managers and patients. Good leadership, good information, a quality improvement strategy based on good local evidence and a community-wide approach may be effective in improving the quality of processes of care sufficiently to reduce hospital mortality.
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http://dx.doi.org/10.1258/jrsm.99.6.303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472716PMC
June 2006

Intra-abdominal infections.

Clin Med (Lond) 2004 Nov-Dec;4(6):519-23

St James's University Hospital, Leeds.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951987PMC
http://dx.doi.org/10.7861/clinmedicine.4-6-519DOI Listing
April 2005

A randomised, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatigue syndrome.

J Psychosom Res 2004 Feb;56(2):189-97

Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.

Objective: There is no management regime for chronic fatigue syndrome (CFS) that has been found to be universally beneficial and no treatment can be considered a "cure". Patients with CFS may use complementary and alternative medicine (CAM). Our aim was to evaluate homeopathic treatment in reducing subjective symptoms of CFS.

Method: Using a triple-blind design (patient and homeopath blind to group assignment and data analyst blind to group until after initial analyses to reduce the possibility of bias due to data analyst), we randomly assigned patients to homeopathic medicine or identical placebo. One hundred and three patients meeting the Oxford criteria for CFS were recruited from two specialist hospital out patient departments. Patients had monthly consultations with a professional homeopath for 6 months. Main outcome measures were scores on the subscales of the Multidimensional Fatigue Inventory (MFI) and proportions of each group attaining clinically significant improvements on each subscale. Secondary outcome measures were the Fatigue Impact Scale (FIS) and the Functional Limitations Profile (FLP). Ninety-two patients completed treatment in the trial (47 homeopathic treatment, 45 placebo). Eighty-six patients returned fully or partially completed posttreatment outcome measures (41 homeopathic treatment group who completed treatment, 2 homeopathic treatment group who did not complete treatment, 38 placebo group who completed treatment, and 5 placebo group who did not complete treatment).

Results: Seventeen of 103 patients withdrew from treatment or were lost to follow-up. Patients in the homeopathic medicine group showed significantly more improvement on the MFI general fatigue subscale (one of the primary outcome measures) and the FLP physical subscale but not on other subscales. Although group differences were not statistically significant on four out of the five MFI subscales (the primary outcome measures), more people in the homeopathic medicine group showed clinically significant improvement. More people in the homeopathic medicine group showed clinical improvement on all primary outcomes (relative risk=2.75, P=.09).

Conclusions: There is weak but equivocal evidence that the effects of homeopathic medicine are superior to placebo. Results also suggest that there may be nonspecific benefits from the homeopathic consultation. Further studies are needed to determine whether these differences hold in larger samples.
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http://dx.doi.org/10.1016/S0022-3999(03)00377-5DOI Listing
February 2004

Takayusu's arteritis in children.

Tech Vasc Interv Radiol 2003 Dec;6(4):158-68

Department of Radiology, USC Keck School of Medicine, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.

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http://dx.doi.org/10.1053/j.tvir.2003.10.002DOI Listing
December 2003