Publications
181 results found
Brown S, Tiernan J, Biggs K, et al., 2016, The HubBLe Trial: haemorrhoidal artery ligation (HAL) versus rubber band ligation (RBL) for symptomatic second- and third-degree haemorrhoids: a multicentre randomised controlled trial and health-economic evaluation, HEALTH TECHNOLOGY ASSESSMENT, Vol: 20, Pages: 1-+, ISSN: 1366-5278
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- Citations: 37
Cheeseman HM, Olejniczak NJ, Rogers PM, et al., 2016, Broadly neutralizing antibodies display potential for prevention of HIV-1 infection of mucosal tissue superior to that of nonneutralizing antibodies, Journal of Virology, Vol: 91, ISSN: 1098-5514
Definition of the key parameters mediating effective antibody blocking of HIV-1 acquisition within mucosal tissue may prove critical to effective vaccine development and the prophylactic use of monoclonal antibodies. Although direct antibody-mediated neutralization is highly effective against cell-free virus, antibodies targeting different sites of envelope vulnerability may display differential activity against mucosal infection. Nonneutralizing antibodies (nnAbs) may also impact mucosal transmission events through Fc-gamma receptor (FcγR)-mediated inhibition. In this study, a panel of broadly neutralizing antibodies (bnAbs) and nnAbs, including those associated with protection in the RV144 vaccine trial, were screened for the ability to block HIV-1 acquisition and replication across a range of cellular and mucosal tissue models. Neutralization potency, as determined by the TZM-bl infection assay, did not fully predict activity in mucosal tissue. CD4-binding site (CD4bs)-specific bnAbs, in particular VRC01, were consistent in blocking HIV-1 infection across all cellular and tissue models. Membrane-proximal external region (MPER) (2F5) and outer domain glycan (2G12) bnAbs were also efficient in preventing infection of mucosal tissues, while the protective efficacy of bnAbs targeting V1-V2 glycans (PG9 and PG16) was more variable. In contrast, nnAbs alone and in combinations, while active in a range of cellular assays, were poorly protective against HIV-1 infection of mucosal tissues. These data suggest that tissue resident effector cell numbers and low FcγR expression may limit the potential of nnAbs to prevent establishment of the initial foci of infection. The solid protection provided by specific bnAbs clearly demonstrates their superior potential over that of nonneutralizing antibodies for preventing HIV-1 infection at the mucosal portals of infection.IMPORTANCE Key parameters mediating effective antibody blocking of HIV-1 acquisition within mucosal
Drake TM, Nepogodiev D, Chapman SJ, et al., 2016, Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery, BRITISH JOURNAL OF SURGERY, Vol: 103, Pages: 1157-1172, ISSN: 0007-1323
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- Citations: 57
Cheeseman HM, Carias AM, Evans AB, et al., 2016, Expression profile of human Fc receptors in mucosal tissue: implications for antibody-dependent cellular effector functions targeting HIV-1 transmission, PLOS One, Vol: 11, ISSN: 1932-6203
The majority of new Human Immunodeficiency Virus (HIV)-1 infections are acquired via sexual transmission at mucosal surfaces. Partial efficacy (31.2%) of the Thai RV144 HIV-1 vaccine trial has been correlated with Antibody-dependent Cellular Cytotoxicity (ADCC) mediated by non-neutralizing antibodies targeting the V1V2 region of the HIV-1 envelope. This has led to speculation that ADCC and other antibody-dependent cellular effector functions might provide an important defense against mucosal acquisition of HIV-1 infection. However, the ability of antibody-dependent cellular effector mechanisms to impact on early mucosal transmission events will depend on a variety of parameters including effector cell type, frequency, the class of Fc-Receptor (FcR) expressed, the number of FcR per cell and the glycoslyation pattern of the induced antibodies. In this study, we characterize and compare the frequency and phenotype of IgG (CD16 [FcγRIII], CD32 [FcγRII] and CD64 [FcγRI]) and IgA (CD89 [FcαR]) receptor expression on effector cells within male and female genital mucosal tissue, colorectal tissue and red blood cell-lysed whole blood. The frequency of FcR expression on CD14+ monocytic cells, myeloid dendritic cells and natural killer cells were similar across the three mucosal tissue compartments, but significantly lower when compared to the FcR expression profile of effector cells isolated from whole blood, with many cells negative for all FcRs. Of the three tissues tested, penile tissue had the highest percentage of FcR positive effector cells. Immunofluorescent staining was used to determine the location of CD14+, CD11c+ and CD56+ cells within the three mucosal tissues. We show that the majority of effector cells across the different mucosal locations reside within the subepithelial lamina propria. The potential implication of the observed FcR expression patterns on the effectiveness of FcR-dependent cellular effector functions to impact on the ini
Herrera C, Armanasco N, García-Pérez J, et al., 2016, Maraviroc and reverse transcriptase inhibitors combinations as potential pre-exposure prophylaxis candidates, AIDS, Vol: 30, Pages: 1015-1025, ISSN: 0269-9370
Objective: Receptive anal intercourse in both men and women is associated with the highest probability for sexual acquisition of HIV infection. As part of a program to develop an effective prevention strategy, we performed an ex-vivo preclinical evaluation to determine the efficacy of multiple double combinations of maraviroc (MVC) and reverse transcriptase inhibitors (RTIs).Design: The entry inhibitor, MVC, a nucleotide RTI, tenofovir and two non-nucleoside RTIs, UC781 and TMC120 (dapivirine, DPV), were used in double, combinations against a panel of CCR5-using clade B and clade C HIV-1 isolates and against MVC-escape variants. A gel-formulated version of MVC-DPV combination was also tested.Methods: Indicator cells, cocultures of immature dendritic cells with CD4+T cells, and colorectal tissue explants were used to assess antiviral activity of drug combinations.Results: All dual MVC-RTI combinations tested inhibited MVC-sensitive and resistant isolates in cellular and colorectal explants models. All the combinations were positive with no reduction in the activity of MVC. In tissue explants, the combinations against all viral isolates tested produced an increase in the activity of MVC. An initial gel-formulation of MVC-DPV combination showed greater and prolonged antiviral activity of MVC in mucosal tissue explants.Conclusion: This study demonstrates that combinations based on antiretroviral drugs inhibiting HIV transmission at viral entry and reverse transcription have potential as prevention strategies against colorectal transmission of HIV-1 including MVC-resistant isolates. Preclinical evaluation with colorectal tissue explants indicates that a gel-formulation of MVC-DPV is an effective candidate colorectal microbicide.
Smeds S, Nienhuijs S, Kullmanl E, et al., 2016, Identification and management of the ilio-inguinal and ilio-hypogastric nerves in open inguinal hernia repair: benefits of self-gripping mesh, HERNIA, Vol: 20, Pages: 33-41, ISSN: 1265-4906
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- Citations: 7
Clift AK, Faiz O, Al-Nahhas A, et al., 2016, Role of Staging in Patients with Small Intestinal Neuroendocrine Tumours, Journal of Gastrointestinal Surgery, Vol: 20, Pages: 180-188, ISSN: 1873-4626
Small bowel neuroendocrine tumours are the commonest malignancy arising in the small intestine and have substantiallyincreased in incidence in recent decades. Patients with small bowel neuroendocrine tumours commonly develop lymphnode and/or distant metastases. Here, we examine the role of staging in 84 surgically treated patients with small bowel neuroendocrinetumours, comparing diagnostic information yielded from morphological, functional and endoscopic modalities. Furthermore,we correlate pre-operative staging with intra-operative findings in a sub-cohort of 20 patients. The vast majority ofpatients had been histologically confirmed to have low-grade (Ki-67 <2 %) disease; however, lymph node and distant metastaseswere observed in 74 (88.1 %) and 51 (60.7 %) of patients at presentation, respectively. Liver metastases were evident in 48(57.1 %) patients, with solely peritoneal and bone metastases observed in 2 (2.4 %) and 1 (1.2 %) patients, respectively. Fortypatients (47.6 %) received multimodal treatment. In our sub-cohort analysis, pre-operative imaging understaged disease in 14/20(70 %) when compared with intra-operative findings. In patients with multifocal primary tumours and miliary liver metastases, noimaging modality was able to detect entire disease spread. Overall, presently available imaging modalities heavily underestimatedisease stage, with meticulous intra-operative abdominal examination being superior to any imaging technology. Multimodaltreatment has an important role in prolonging survival.
Clift A, Faiz O, Al-Nahhas A, et al., 2016, Staging in Small Bowel Neuroendocrine Tumours: Roles and Shortcomings, 13th Annual ENETS Conference for the Diagnosis and Treatment of Neuroendocrine Tumor Disease, Publisher: KARGER, Pages: 55-56, ISSN: 0028-3835
Murugesu S, Rao C, Chacko L, et al., 2015, Straight to Test: Speeding up Colorectal Cancer Management. A Complete Audit Cycle, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 46-47, ISSN: 0007-1323
Beyer-Berjot L, Patel V, Ziprin P, et al., 2015, Enhanced recovery simulation in colorectal surgery: design of virtual online patients, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 29, Pages: 2270-2277, ISSN: 0930-2794
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- Citations: 3
Pucher PH, Qurashi M, Howell A-M, et al., 2015, Development and validation of a symptom-based severity score for haemorrhoidal disease: the Sodergren score, COLORECTAL DISEASE, Vol: 17, Pages: 612-618, ISSN: 1462-8910
AimOne major obstacle in assessing the efficacy of treatment of haemorrhoids and the comparison of trials has been the lack of a standardized, validated symptom severity score. This study aimed to develop an objective, validated symptom‐based score of severity for haemorrhoids that can be used to compare treatments, monitor disease and assist in surgical decisions.MethodA symptom and quality‐of‐life questionnaire was developed from the literature in conjunction with expert surgical opinion. The questionnaire was circulated to patients with confirmed haemorrhoids. A statistical model was used to derive a weighted score of symptoms most affecting patients' quality of life. Patients who were offered operative treatment were independently judged by specialists to have more severe symptoms, with further validation of the scoring system against treatment.ResultsForty‐five patients were included in final validation analysis, of whom 44 (98%) reported multiple symptoms, the most common being rectal bleeding. Patient‐reported effects on quality of life were 47.5 ± 36.3 (1–100 visual analogue scale). Calculated symptom severity scores were used to compare patients receiving operative or ambulatory care, with significant difference in the scores (7.7 ± 3.9 vs 2.8 ± 3.5, P = 0.002) and a receiver operating characteristic area under the curve of 0.842.ConclusionA novel validated score for the assessment of haemorrhoidal disease adopting a standardized global score for symptom severity may have important implications in future for research, assessment and the management of this common pathology.
Awad Z, Hayden L, Muthuswamy K, et al., 2015, Utilisation and outcomes of Case-based discussion in otolaryngology training, CLINICAL OTOLARYNGOLOGY, Vol: 40, Pages: 86-92, ISSN: 1749-4478
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- Citations: 4
Tuffaha H, Amer T, Jayia P, et al., 2015, The STAR score: a method for auditing clinical records, Annals of the Royal College of Surgeons of England, Vol: 94, Pages: 235-239, ISSN: 1478-7083
INTRODUCTIONAdequate medical note keeping is critical in delivering high quality healthcare. However, there are few robust tools available for the auditing of notes. The aim of this paper was to describe the design, validation and implementation of a novel scoring tool to objectively assess surgical notes.METHODSAn initial ‘path finding’ study was performed to evaluate the quality of note keeping using the CRABEL scoring tool. The findings prompted the development of the Surgical Tool for Auditing Records (STAR) as an alternative. STAR was validated using inter-rater reliability analysis. An audit cycle of surgical notes using STAR was performed. The results were analysed and a structured form for the completion of surgical notes was introduced to see if the quality improved in the next audit cycle using STAR. An education exercise was conducted and all participants said the exercise would change their practice, with 25% implementing major changes.RESULTSStatistical analysis of STAR showed that it is reliable (Cronbach’s a = 0.959). On completing the audit cycle, there was an overall increase in the STAR score from 83.344% to 97.675% (p<0.001) with significant improvements in the documentation of the initial clerking from 59.0% to 96.5% (p<0.001) and subsequent entries from 78.4% to 96.1% (p<0.001).CONCLUSIONSThe authors believe in the value of STAR as an effective, reliable and reproducible tool. Coupled with the application of structured forms to note keeping, it can significantly improve the quality of surgical documentation and can be implemented universally.
Cookson NE, Mirnezami R, Ziprin P, 2015, Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy, CASE REPORTS IN GASTROINTESTINAL MEDICINE, Vol: 2015, ISSN: 2090-6528
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- Citations: 7
Sanders DL, Nienhuijs S, Ziprin P, et al., 2014, Randomized clinical trial comparing self-gripping mesh with suture fixation of lightweight polypropylene mesh in open inguinal hernia repair, BRITISH JOURNAL OF SURGERY, Vol: 101, Pages: 1373-1382, ISSN: 0007-1323
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- Citations: 42
Awad Z, Touska P, Arora A, et al., 2014, Face and content validity of sheep heads in endoscopic rhinology training, INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY, Vol: 4, Pages: 851-858, ISSN: 2042-6976
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- Citations: 19
Khatib M, Hald N, Brenton H, et al., 2014, Validation of open inguinal hernia repair simulation model: a randomized controlled educational trial, AMERICAN JOURNAL OF SURGERY, Vol: 208, Pages: 295-301, ISSN: 0002-9610
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- Citations: 20
Gall TMH, Basyouny M, Frampton AE, et al., 2014, Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases, COLORECTAL DISEASE, Vol: 16, Pages: O197-O205, ISSN: 1462-8910
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- Citations: 9
Awad Z, Hayden L, Muthuswamy K, et al., 2014, Does direct observation of procedural skills reflect trainee's progress in otolaryngology?, CLINICAL OTOLARYNGOLOGY, Vol: 39, Pages: 169-173, ISSN: 1749-4478
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- Citations: 18
Currie A, Burns EM, Aylin P, et al., 2014, The impact of shortened postgraduate surgical training on colorectal cancer outcome, INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol: 29, Pages: 631-638, ISSN: 0179-1958
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- Citations: 1
Gami B, Kubba F, Ziprin P, 2014, Human papilloma virus and squamous cell carcinoma of the anus., Clin Med Insights Oncol, Vol: 8, Pages: 113-119, ISSN: 1179-5549
The incidence of anal cancer is increasing. In the UK, the incidence is estimated at approximately 1.5 per 100,000. Most of this increase is attributed to certain at-risk populations. Persons who are human immunodeficiency virus (HIV)-positive and men who have sex with men (MSM), Organ transplant recipients, women with a history of cervical cancer, human papilloma virus (HPV), or cervical intraepithelial neoplasia (CIN) are known to have a greater risk for anal cancer. This paper will focus on HPV as a risk factor for anal intraepithelial neoplasia (AIN) and discusses the etiology, anatomy, pathogenesis, management of squamous cell carcinoma (SCC) of the anus.
Balaji S, Singh P, Corker H, et al., 2013, A comparison of cosmetic outcomes following single-incision and multi-port laparoscopic colectomy., Int J Surg, Vol: 11
Awad Z, Yao A, Ghufoor K, et al., 2013, Comparing two models for rigid bronchoscopy and foreign body retrieval training., Int J Surg, Vol: 11
Nachiappan S, Markar S, Karthikesaligam A, et al., 2013, Prophylactic Mesh Placement in High-Risk Patients Undergoing Elective Laparotomy: A Systematic Review, WORLD JOURNAL OF SURGERY, Vol: 37, Pages: 1861-1871, ISSN: 0364-2313
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- Citations: 40
Gami B, Osborne M, Goldin R, et al., 2013, The frequency of patients with known AIN progressing to anal SCC, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 129-129, ISSN: 0007-1323
Pucher PH, Sodergren MH, Lord AC, et al., 2013, Clinical outcome following Doppler-guided haemorrhoidal artery ligation: a systematic review, COLORECTAL DISEASE, Vol: 15, Pages: E284-E294, ISSN: 1462-8910
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- Citations: 54
Nachiappan S, Markar S, Karthikesalingam A, et al., 2013, Erratum to: Prophylactic Mesh Placement in High-Risk Patients Undergoing Elective Laparotomy: A Systematic Review., World J Surg
Patel N, King D, Ziprin P, et al., 2013, MID STAFFS INQUIRY Patient reporting of clinical incidents, BMJ-BRITISH MEDICAL JOURNAL, Vol: 346, ISSN: 1756-1833
Gami B, Ziprin P, Goldin RD, et al., 2013, Anal intraepithelial neoplasia progression to squamous cell carcinoma, Gastrointestinal Cancers Symposium of the American-Society-of-Clinical-Oncology (ASCO), Publisher: AMER SOC CLINICAL ONCOLOGY, ISSN: 0732-183X
Jimenez B, Mirnezami R, Kinross J, et al., 2013, <SUP>1</SUP>H HR-MAS NMR Spectroscopy of Tumor-Induced Local Metabolic "Field-Effects" Enables Colorectal Cancer Staging and Prognostication, JOURNAL OF PROTEOME RESEARCH, Vol: 12, Pages: 959-968, ISSN: 1535-3893
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- Citations: 88
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