Citation: British Journal of Cancer. 2017, 116(7), 923-929
Author: Jones RP, Sutton PA, Evans JP, Clifford R, McAvoy A, Lewis J, Rousseau A, Mountford R, McWhirter D, Malik HZ
Abstract: BACKGROUND: Activating mutations in KRAS have been suggested as potential predictive and prognostic biomarkers. However, the prognostic impact of specific point mutations remains less clear. This study assessed the prognostic impact of specific KRAS mutations on survival for patients with colorectal cancer.
METHODS: Retrospective review of patients KRAS typed for advanced and recurrent colorectal cancer between 2010 and 2015 in a UK Cancer Network.
RESULTS: We evaluated the impact of KRAS genotype in 392 patients. Mutated KRAS was detected in 42.9% of tumours. KRAS mutations were more common in moderate vs well-differentiated tumours. On multivariate analysis, primary tumour T stage (HR 2.77 (1.54-4.98), P=0.001), N stage (HR 1.51 (1.01-2.26), P=0.04), curative intent surgery (HR 0.51 (0.34-0.76), P=0.001), tumour grade (HR 0.44 (0.30-0.65), P=0.001) and KRAS mutation (1.54 (1.23-2.12), P=0.005) were all predictive of overall survival. Patients with KRAS codon 12 mutations had worse overall survival (HR 1.76 (95% CI 1.27-2.43), P=0.001). Among the five most common codon 12 mutations, only p.G12C (HR 2.21 (1.15-4.25), P=0.01) and p.G12V (HR 1.69 (1.08-2.62), P=0.02) were predictive of overall survival.
CONCLUSIONS: For patients with colorectal cancer, p.G12C and p.G12V mutations in codon 12 were independently associated with worse overall survival after diagnosis.British Journal of Cancer advance online publication 16 February 2017. doi:10.1038/bjc.2017.37 www.bjcancer.com.
Link to PubMed record
Tuesday, 21 February 2017
WUTH publication: Peritoneal amyloidosis with myopathy in primary systemic (AL) amyloidosis
Citation: BMJ Case Reports. 2017, Feb 10
Author: Al-Adhami A, Steiner K, Ellis S
Link to PubMed record
Author: Al-Adhami A, Steiner K, Ellis S
Link to PubMed record
Tuesday, 14 February 2017
Quality Improvement at WUTH & BMJ Quality
Quality Improvement at WUTH & BMJ Quality
Are you involved in quality improvement in your department? All WUTH staff have access to BMJ Quality, a system that allows you to plan, record and publish your Quality Improvement projects. Join us for a training session on BMJ Quality led by a BMJ Trainer.
Tuesday 7th March 2017
11.45-13.00
Maternity Conference Room, APH
BMJ Quality supports and guides you using bespoke workbooks, learning modules, webinars, videos and other resources, before generating a quality improvement project report which you can submit for publication to the BMJ Quality Improvement Reports, an open access, peer reviewed journal. Whether your quality improvement project is currently just a bright idea in your head, a project that you’re just embarking on, or is finished and ready for publication, you can use BMJ Quality to support your work. To find out more and create your account please contact the McArdle Library ext. 8610.
Predoctoral Bursary for clinicians in pathology and cancer
Predoctoral Bursary for clinicians in pathology and cancer
Please see link below regarding a Predoctoral Bursary for clinicians that is being funded by The Cancer Research UK (CRUK) and the Pathological Society.
The Cancer Research UK (CRUK) and the Pathological Society promote research in pathology and cancer to foster the development of early career clinical academic researchers with a focus on the intersection between these specialties. CRUK and the Pathological Society have set up a joint funding scheme in order to fund Pathological Society members applying for Predoctoral Research Bursaries. The Bursary is awarded for a period of up to 12 months. The bursary will provide the applicant’s salary and/or research expenses up to a total value of £45,000.
Monday, 23 January 2017
WUTH publication: The current status of prophylactic femoral intramedullary nailing for metastatic cancer
Citation: Ecancermedicalscience. 2016 Dec 1
Author: Ormsby NM, Leong WY, Wong W, Hughes HE, Swaminathan V
Abstract: The most common site for cancer to spread is bone. At post-mortem, bony metastases have been found in 70% of patients dying from breast and prostate cancer. Due to the prevalence of cancer, bone metastasis and the associated management represents a huge burden on NHS resources. In patients with metastasis, around 56% of these involve the lower limb long bones. Due to the huge forces placed upon long bones during weight bearing, there is a high risk of fracture through areas of metastasis. It is reported that 23% of pathological fractures occur in the femoral subtrochanteric region. This area is subjected to forces up to four times the body weight, resulting in poor union rate for these fractures, and significant morbidity associated with difficulty in mobilising, and in patient nursing. As cancer treatments improve, the life expectancy in this subgroup of patients is likely to increase. Therefore medium-to-long-term management of these fractures, beyond the palliative, will become essential. We aim to evaluate the current management for metastatic malignant femoral disease, with particular focus on the prophylactic augmentation of diseased femorii using intramedullary nails.
KEYWORDS:
arthroplasty; internal fixation; intramedullary nailing; metastatic cancer; pathological fracture; prophylactic nailing
Link to PubMed record
Author: Ormsby NM, Leong WY, Wong W, Hughes HE, Swaminathan V
Abstract: The most common site for cancer to spread is bone. At post-mortem, bony metastases have been found in 70% of patients dying from breast and prostate cancer. Due to the prevalence of cancer, bone metastasis and the associated management represents a huge burden on NHS resources. In patients with metastasis, around 56% of these involve the lower limb long bones. Due to the huge forces placed upon long bones during weight bearing, there is a high risk of fracture through areas of metastasis. It is reported that 23% of pathological fractures occur in the femoral subtrochanteric region. This area is subjected to forces up to four times the body weight, resulting in poor union rate for these fractures, and significant morbidity associated with difficulty in mobilising, and in patient nursing. As cancer treatments improve, the life expectancy in this subgroup of patients is likely to increase. Therefore medium-to-long-term management of these fractures, beyond the palliative, will become essential. We aim to evaluate the current management for metastatic malignant femoral disease, with particular focus on the prophylactic augmentation of diseased femorii using intramedullary nails.
KEYWORDS:
arthroplasty; internal fixation; intramedullary nailing; metastatic cancer; pathological fracture; prophylactic nailing
Link to PubMed record
Friday, 13 January 2017
Allied Health Professions (AHP) Research Bursary
The Cheshire & Merseyside AHP Research Network is offering bursaries of up to £1000 to facilitate small scale research studies conducted and led by AHPs.
Please note these applications are only open to AHPs (registered with HCPC) who work in the Cheshire & Merseyside region.
The applicant is expected to complete a small research project and provide a written report of results.
Examples of suitable studies may include pilot work (small scale preliminary studies) and proof of concept (feasibility studies collecting and analysing data to obtain evidence to support or refute ideas or plans). Preference will be given to projects that incorporate patient and public involvement.
Funding may be used in a number of ways, for example:
To back fill staff time – release researcher from clinical duties to undertake the research,
For training – for help with statistics, surveys, interviews, etc,
For transcription costs,
For payment of patient and public expenses.
Only direct costs can be covered by the Bursary.
The applicant is expected to forge a link with their NHS Trust Research office and establish a mentor within the Trust, who will be able to provide support.
Applicants should submit their application form via email by Monday 27th February 2017, 5pm to rowef@liverpool.ac.uk.
Please note these applications are only open to AHPs (registered with HCPC) who work in the Cheshire & Merseyside region.
The applicant is expected to complete a small research project and provide a written report of results.
Examples of suitable studies may include pilot work (small scale preliminary studies) and proof of concept (feasibility studies collecting and analysing data to obtain evidence to support or refute ideas or plans). Preference will be given to projects that incorporate patient and public involvement.
Funding may be used in a number of ways, for example:
To back fill staff time – release researcher from clinical duties to undertake the research,
For training – for help with statistics, surveys, interviews, etc,
For transcription costs,
For payment of patient and public expenses.
Only direct costs can be covered by the Bursary.
The applicant is expected to forge a link with their NHS Trust Research office and establish a mentor within the Trust, who will be able to provide support.
Applicants should submit their application form via email by Monday 27th February 2017, 5pm to rowef@liverpool.ac.uk.
Thursday, 29 December 2016
WUTH publication: On-scene treatment of spinal injuries in motor sports
Citation: European Journal of Trauma and Emergency Surgery. 2017, 43(2), 191-200
Author: Kreinest M, Scholz M, Trafford P
Abstract: Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated. If a competitor must first be extricated from the racing vehicle, the correct method of extrication must be chosen. To avoid secondary injury to the spine after a racing accident, in-line extrication from the vehicle and immobilization of the patient are standard procedures in motor sports and have been used for decades. Since immobilization can be associated with disadvantages and complications, the need for immobilization of trauma patients outside of motor sports medicine has become the subject of an increasing number of reports in the scientific literature. Even in motor sports, where specific safety systems that offer spinal protection are present, the indications for spinal immobilization need to be carefully considered rather than being blindly adopted as a matter of course. The aim of this article is to use recent literature to present an overview about the treatment of spinal injuries in motor sports. Further, we present a new protocol for indications for immobilizing the spine in motor sports that is based on the ABCDE principles and takes into account the condition of the patient.
KEYWORDS: Emergency; Extrication; Immobilization protocol; Out-of-hospital; Prehospital
Link to PubMed record
Author: Kreinest M, Scholz M, Trafford P
Abstract: Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated. If a competitor must first be extricated from the racing vehicle, the correct method of extrication must be chosen. To avoid secondary injury to the spine after a racing accident, in-line extrication from the vehicle and immobilization of the patient are standard procedures in motor sports and have been used for decades. Since immobilization can be associated with disadvantages and complications, the need for immobilization of trauma patients outside of motor sports medicine has become the subject of an increasing number of reports in the scientific literature. Even in motor sports, where specific safety systems that offer spinal protection are present, the indications for spinal immobilization need to be carefully considered rather than being blindly adopted as a matter of course. The aim of this article is to use recent literature to present an overview about the treatment of spinal injuries in motor sports. Further, we present a new protocol for indications for immobilizing the spine in motor sports that is based on the ABCDE principles and takes into account the condition of the patient.
KEYWORDS: Emergency; Extrication; Immobilization protocol; Out-of-hospital; Prehospital
Link to PubMed record
Friday, 16 December 2016
WUTH publication: The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group, Report 1: baseline characteristics and visual acuity outcomes in eyes treated with intravitreal injections of ranibizumab for diabetic macular oedema
Citation: The British Journal of Ophthalmology, 2017, 101(1), 75-80
Author: Egan C, Zhu H, Lee A, Sim D, Mitry D, Bailey C, Johnston R, Chakravarthy U, Denniston A, Tufail A, Khan R, Mahmood S, Menon G, Akerele T, Downey L, McKibbin M, Varma A, Lobo A, Wilkinson E, Fitt A, Brand C, Tsaloumas M, Mandal K, Kumar V, Natha S, Crabb D, UK AMD and DR EMR Users Group
Abstract: AIMS: To describe baseline characteristics and visual outcome for eyes treated with ranibizumab for diabetic macular oedema (DMO) from a multicentre database.METHODS: Structured clinical data were anonymised and extracted from an electronic medical record from 19 participating UK centres: age at first injection, ETDRS visual acuity (VA), number of injections, ETDRS diabetic retinopathy (DR) and maculopathy grade at baseline and visits. The main outcomes were change in mean VA from baseline, number of injections and clinic visits and characteristics affecting VA change and DR grade. RESULTS: Data from 12 989 clinic visits was collated from baseline and follow-up for 3103 eyes. Mean age at first treatment was 66 years. Mean VA (letters) for eyes followed at least 2 years was 51.1 (SD=19.3) at baseline, 54.2 (SD: 18.6) and 52.5 (SD: 19.4) at 1 and 2 years, respectively. Mean visual gain was five letters. The proportion of eyes with VA of 72 letters or better was 25% (baseline) and 33% (1 year) for treatment naïve eyes. Eyes followed for at least 6 months received a mean of 3.3 injections over a mean of 6.9 outpatient visits in 1 year.CONCLUSIONS: In a large cohort of eyes with DMO treated with ranibizumab injections in the UK, 33% of patients achieved better than or equal to 6/12 in the treated eye at 12 months compared with 25% at baseline. The mean visual gain was five letters. Eyes with excellent VA at baseline maintain good vision at 18 months.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/KEYWORDS: Macula; Public health; Retina; Treatment Medical; Treatment Surgery
Link to PubMed record
Author: Egan C, Zhu H, Lee A, Sim D, Mitry D, Bailey C, Johnston R, Chakravarthy U, Denniston A, Tufail A, Khan R, Mahmood S, Menon G, Akerele T, Downey L, McKibbin M, Varma A, Lobo A, Wilkinson E, Fitt A, Brand C, Tsaloumas M, Mandal K, Kumar V, Natha S, Crabb D, UK AMD and DR EMR Users Group
Abstract: AIMS: To describe baseline characteristics and visual outcome for eyes treated with ranibizumab for diabetic macular oedema (DMO) from a multicentre database.METHODS: Structured clinical data were anonymised and extracted from an electronic medical record from 19 participating UK centres: age at first injection, ETDRS visual acuity (VA), number of injections, ETDRS diabetic retinopathy (DR) and maculopathy grade at baseline and visits. The main outcomes were change in mean VA from baseline, number of injections and clinic visits and characteristics affecting VA change and DR grade. RESULTS: Data from 12 989 clinic visits was collated from baseline and follow-up for 3103 eyes. Mean age at first treatment was 66 years. Mean VA (letters) for eyes followed at least 2 years was 51.1 (SD=19.3) at baseline, 54.2 (SD: 18.6) and 52.5 (SD: 19.4) at 1 and 2 years, respectively. Mean visual gain was five letters. The proportion of eyes with VA of 72 letters or better was 25% (baseline) and 33% (1 year) for treatment naïve eyes. Eyes followed for at least 6 months received a mean of 3.3 injections over a mean of 6.9 outpatient visits in 1 year.CONCLUSIONS: In a large cohort of eyes with DMO treated with ranibizumab injections in the UK, 33% of patients achieved better than or equal to 6/12 in the treated eye at 12 months compared with 25% at baseline. The mean visual gain was five letters. Eyes with excellent VA at baseline maintain good vision at 18 months.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/KEYWORDS: Macula; Public health; Retina; Treatment Medical; Treatment Surgery
Link to PubMed record
Wednesday, 19 October 2016
Healthcare Databases Advanced Search (HDAS) has changed
So how you search MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, British Nursing Index, HMIC and Health Business Elite will be different.
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