Institution
Barts Health NHS Trust
Healthcare•London, United Kingdom•
About: Barts Health NHS Trust is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 3483 authors who have published 3807 publications receiving 81829 citations.
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TL;DR: In this article, the authors established the prevalence, prognosis, and subsequent primary cancer incidence of patients with Lynch syndrome (LS) in relation to sporadic mismatch repair deficient (MMRd)-EC in the large combined Post Operative Radiation Therapy in Endometrial Carcinoma-1, -2, and -3 trial cohort.
Abstract: BACKGROUND: Standard screening of endometrial cancer (EC) for Lynch syndrome (LS) is gaining traction; however, the prognostic impact of an underlying hereditary etiology is unknown. We established the prevalence, prognosis, and subsequent primary cancer incidence of patients with LS-associated EC in relation to sporadic mismatch repair deficient (MMRd)-EC in the large combined Post Operative Radiation Therapy in Endometrial Carcinoma-1, -2, and -3 trial cohort. METHODS: After MMR-immunohistochemistry, MLH1-promoter methylation testing, and next-generation sequencing, tumors were classified into 3 groups according to the molecular cause of their MMRd-EC. Kaplan-Meier method, log-rank test, and Cox model were used for survival analysis. Competing risk analysis was used to estimate the subsequent cancer probability. All statistical tests were 2-sided. RESULTS: Among the 1336 ECs, 410 (30.7%) were MMRd. A total of 380 (92.7%) were fully triaged: 275 (72.4%) were MLH1-hypermethylated MMRd-ECs; 36 (9.5%) LS MMRd-ECs, and 69 (18.2%) MMRd-ECs due to other causes. Limiting screening of EC patients to 60 years or younger or to 70 years or younger would have resulted in missing 18 (50.0%) and 6 (16.7%) LS diagnoses, respectively. Five-year recurrence-free survival was 91.7% (95% confidence interval [CI] = 83.1% to 100%; hazard ratio = 0.45, 95% CI = 0.16 to 1.24, P = .12) for LS, 95.5% (95% CI = 90.7% to 100%; hazard ratio = 0.17, 95% CI = 0.05 to 0.55, P = .003) for "other" vs 78.6% (95% CI = 73.8% to 83.7%) for MLH1-hypermethylated MMRd-EC. The probability of subsequent LS-associated cancer at 10 years was 11.6% (95% CI = 0.0% to 24.7%), 1.5% (95% CI = 0.0% to 4.3%), and 7.0% (95% CI = 3.0% to 10.9%) within the LS, "other," and MLH1-hypermethylated MMRd-EC groups, respectively. CONCLUSIONS: The LS prevalence in the Post Operative Radiation Therapy in Endometrial Carcinoma trial population was 2.8% and among MMRd-ECs was 9.5%. Patients with LS-associated ECs showed a trend towards better recurrence-free survival and higher risk for second cancers compared with patients with MLH1-hypermethylated MMRd-EC.
33 citations
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TL;DR: The developed LSS could be used to enable concentration-guided dosing of linezolid and was validated with an external group of patients with MDR-/XDR-TB from Sondalo, Italy.
33 citations
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TL;DR: Patients in this study generally reported increased knowledge and empowerment about blood pressure control and avoiding further strokes, and this simple, pragmatic intervention might be more widely used.
Abstract: Background Stroke is the leading cause of adult disability in the UK. Hypertension is the leading modifiable risk factor for stroke. There is increasing interest n home blood pressure monitors for self-monitoring, but no published research on the experiences of stroke patients who do self-monitor Aim To explore stroke patients9 experiences of self-monitoring with nurse-led support Design and setting A qualitative study of 26 (66%) patients from the first 39 participants to complete the intervention arm of a community-based randomised controlled trial (RCT) of home blood pressure monitoring in 381 patients recruited from hospital stroke clinics in south London Method Semi-structured face-to-face interviews were conducted with 26 patients. Interviews were digitally recorded and transcribed, and a thematic analysis of the data was undertaken Results Participants were highly motivated to avoid a further stroke and developed a strong focus on blood pressure control and attaining a ‘good result’. Only aminority reported anxiety about their blood pressure. Participants gained a welcome sense of empowerment and control over managing their health; some felt confident and ‘experimented’ with their medication doses. Eight patients required physical help to self-monitor and there was uncertainty about where responsibility lay for such help. Patients who lived alone and were functionally impaired had the least positive experience. Active engagement with the home blood pressure monitoring process by GPs was variable Conclusion Patients in this study generally reported increased knowledge and empowerment about blood pressure control and avoiding further strokes. The technique is overall welcome, acceptable, and successful, even in patients with disabilities. Since home blood pressure monitoring can also lead to improved blood pressure control, this simple, pragmatic interventionmight bemore widely used
33 citations
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33 citations
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University of Sassari1, International Union Against Tuberculosis and Lung Disease2, The Catholic University of America3, World Health Organization4, University of Bologna5, University Medical Center Groningen6, Queen Mary University of London7, Université libre de Bruxelles8, University of Insubria9, Barts Health NHS Trust10, University College London11
TL;DR: Simone Dore, Heinke Kunst, Alberto Matteelli, Charalampos Moschos, Fabrizio Palmieri, Apostolos Papavasileiou, Marie-Christine Payen, Andrea Piana, Antonio Spanevello, Dante Vargas Vasquez, Pietro Viggiani, Veronica White, Alimuddin Zumla and Giovanni Battista Migliori.
Abstract: Simon Tiberi, Giovanni Sotgiu, Lia D’Ambrosio, Rosella Centis, Marcos Abdo Arbex, Edith Alarcon Arrascue, Jan Willem Alffenaar, Jose A. Caminero, Mina Gaga, Gina Gualano, Alena Skrahina, Ivan Solovic, Giorgia Sulis, Marina Tadolini, Valentina Alarcon Guizado, Saverio De Lorenzo, Aurora Jazmin Roby Arias, Anna Scardigli, Onno W. Akkerman, Alena Aleksa, Janina Artsukevich, Vera Avchinko, Eduardo Henrique Bonini, Felix Antonio Chong Marin, Lorena Collahuazo Lopez, Gerard de Vries, Simone Dore, Heinke Kunst, Alberto Matteelli, Charalampos Moschos, Fabrizio Palmieri, Apostolos Papavasileiou, Marie-Christine Payen, Andrea Piana, Antonio Spanevello, Dante Vargas Vasquez, Pietro Viggiani, Veronica White, Alimuddin Zumla and Giovanni Battista Migliori
33 citations
Authors
Showing all 3516 results
Name | H-index | Papers | Citations |
---|---|---|---|
James F. Wilson | 146 | 677 | 101883 |
Donna Neuberg | 135 | 810 | 72653 |
Stephen G. Ellis | 127 | 655 | 65073 |
John E. Deanfield | 120 | 497 | 61067 |
Nicola Maffulli | 115 | 1570 | 59548 |
Mark J. Caulfield | 113 | 362 | 95358 |
Perry M. Elliott | 107 | 560 | 65814 |
Jadwiga A. Wedzicha | 104 | 505 | 49160 |
Andrew V. Schally | 102 | 1107 | 50314 |
Patricia B. Munroe | 94 | 339 | 62378 |
Khalid S. Khan | 92 | 684 | 33700 |
Gavin Giovannoni | 89 | 852 | 38443 |
Christoph Thiemermann | 89 | 474 | 28732 |
Thomas T. MacDonald | 87 | 340 | 25611 |
Abba J. Kastin | 87 | 598 | 32864 |