Publications by authors named "S R Markar"

229 Publications

Health-related quality of life following total minimally invasive, hybrid minimally invasive or open oesophagectomy: a population-based cohort study.

Br J Surg 2021 Jun;108(6):702-708

Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Background: Minimally invasive oesophagectomy has been shown to reduce the risk of pulmonary complications compared with open oesophagectomy, but the effects on health-related quality of life (HRQoL) and oesophageal cancer survivorship remain unclear. The aim of this study was to assess the longitudinal effects of minimally invasive compared with open oesophagectomy for cancer on HRQoL.

Methods: All patients who had surgery for oesophageal cancer in Sweden from January 2013 to April 2018 were identified. The exposure was total or hybrid minimally invasive oesophagectomy, compared with open surgery. The study outcome was HRQoL, evaluated by means of the European Organisation for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-OG25 at 1 and 2 years after surgery. Mean differences and 95 per cent confidence intervals were adjusted for confounders.

Results: Of the 246 patients recruited, 153 underwent minimally invasive oesophagectomy, of which 75 were hybrid minimally invasive and 78 were total minimally invasive procedures. After adjustment for age, sex, Charlson Co-morbidity Index score, pathological tumour stage and neoadjuvant therapy, there were no clinically and statistically significant differences in overall or disease-specific HRQoL after oesophagectomy between hybrid minimally invasive and total minimally invasive surgical technique versus open surgery.

Conclusion: In this population-based nationwide Swedish study, longitudinal HRQoL after minimally invasive oesophagectomy was similar to that of the open surgical approach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/bjs.11998DOI Listing
June 2021

Selected ion flow tube mass spectrometry for targeted analysis of volatile organic compounds in human breath.

Nat Protoc 2021 Jun 4. Epub 2021 Jun 4.

Department of Surgery and Cancer, Imperial College London, London, UK.

The analysis of volatile organic compounds (VOCs) within breath for noninvasive disease detection and monitoring is an emergent research field that has the potential to reshape current clinical practice. However, adoption of breath testing has been limited by a lack of standardization. This protocol provides a comprehensive workflow for online and offline breath analysis using selected ion flow tube mass spectrometry (SIFT-MS). Following the suggested protocol, 50 human breath samples can be analyzed and interpreted in <3 h. Key advantages of SIFT-MS are exploited, including the acquisition of real-time results and direct compound quantification without need for calibration curves. The protocol includes details of methods developed for targeted analysis of disease-specific VOCs, specifically short-chain fatty acids, aldehydes, phenols, alcohols and alkanes. A procedure to make custom breath collection bags is also described. This standardized protocol for VOC analysis using SIFT-MS is intended to provide a basis for wider application and the use of breath analysis in clinical studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41596-021-00542-0DOI Listing
June 2021

YouTube as a source of public health information regarding COVID-19 vaccination: an assessment of reliability and quality of video content.

JMIR Public Health Surveill 2021 May 21. Epub 2021 May 21.

Department of Surgery & Cancer, Imperial College London, Department of Surgery and Cancer10th floor, Queen Elizabeth Queen Mother Building, St. Mary's Hospital, South Wharf Road, Paddington, GB.

Background: Recent emergency authorisation and rollout of COVID-19 vaccines by regulatory bodies has generated global attention. As the most popular video-sharing platform globally, YouTube is a potent medium for dissemination of key public health information. Understanding the nature of available content regarding COVID-19 vaccination on this widely used platform is of substantial public health interest.

Objective: To evaluate the reliability and quality of information of YouTube videos regarding COVID-19 vaccination.

Methods: For this cross-sectional study, the phrases 'coronavirus vaccine' and 'COVID-19 vaccine' were searched on the UK version of YouTube on December 10, 2020. The 200 most-viewed videos of each search were extracted and screened for relevance and English language. Video content and characteristics were extracted and independently rated against Health on the Net Foundation Code of Conduct (HONcode) and DISCERN quality criteria for consumer health information by two authors.

Results: Forty-eight videos, with a combined total view count of 30,100,561, were included in the analysis. Topics addressed comprised: vaccine science (58%), vaccine trials (58%), side effects (48%), efficacy (35%) and manufacturing (17%). Twenty-one percent of videos encouraged continued public health measures. Only 4.2% of videos made non-factual claims. Ninety-eight percent of video content was scored to have low (56%) or moderate (42%) adherence to HONcode principles. Median overall DISCERN score per channel type ranged from 40.3 (34.8-47) to 64.3 (58.5-66.3). Educational channels produced by both medical and non-medical professionals achieved significantly higher DISCERN scores than other categories. The highest DISCERN scores were achieved by educational videos produced by medical professionals (64.3 (58.5-66.3)) and the lowest scores by independent users (18 (18-20)).

Conclusions: Overall quality and reliability of information on YouTube regarding COVID-19 vaccines remains poor. Videos produced by educational channels, especially by medical professionals, were higher in quality and reliability than those produced by other sources, including health-related organisations. Collaboration between health-related organisations and established medical and educational YouTube content producers provides an opportunity for dissemination of high-quality information regarding COVID-19 vaccination. Such collaboration holds potential as a rapidly implementable public health intervention aiming to engage a wide audience and increase public vaccination awareness and knowledge.

Clinicaltrial:
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/29942DOI Listing
May 2021

Patient-reported outcomes after oesophagectomy in the multicentre LASER study.

Br J Surg 2021 May 11. Epub 2021 May 11.

Oesophago-gastric Centre, Churchill Hospital, University of Oxford, Oxford, UK.

Background: Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life.

Methods: This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models.

Results: Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms.

Conclusion: A long-term symptom burden is common after oesophageal cancer surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/bjs/znab124DOI Listing
May 2021