Publications
289 results found
Bernardo D, Mann ER, Al-Hassi HO, et al., 2012, Human gut-specific homeostatic dendritic cells are generated from blood precursors by the gut microenvironment., Inflammatory Bowel Diseases, Vol: 7, Pages: 1275-1286
BACKGROUND: Dendritic cells (DC) dictate not only the type of T-cell immunity, but also homing patterns of T cells in mice. In humans, we characterized normal human gut DC and tested whether gut-specific homeostatic DC could be generated from blood precursors by factors in the gut microenvironment.METHODS: We characterized the phenotype and function of healthy human gut DC compared with blood and skin DC, and studied whether conditioning of blood DC in the presence of colonic biopsy supernatants (Bx-SN) induced gut-like phenotype and functions.RESULTS: Blood DC mostly expressed both gut and skin homing markers, indicating potential to migrate to both major immune surface organs, and induced multi-homing T cells. However, DC within gut or skin did not demonstrate this multi-homing phenotype, were tissue-specific, and induced tissue-specific T cells. Human gut DC were less stimulatory for allogeneic T cells than their dermal and blood counterparts. Human blood DC cultured in vitro lost homing marker expression. Conditioning of human enriched blood DC with colonic Bx-SN from healthy controls induced a gut-homing phenotype and a homeostatic profile. Moreover, Bx-SN-conditioned DC demonstrated a restricted T-cell stimulatory capacity and preferentially induced gut-specific T cells. Retinoic acid and transforming growth factor beta (TGF-β) mediated the acquisition of the gut-homing and homeostatic properties, respectively, induced by colonic Bx-SN on blood enriched DC.CONCLUSIONS: Tissue-specific factors manipulate immunity via modulating characteristics of DC and may provide tools to generate tissue-specific immunotherapy. (Inflamm Bowel Dis 2011;).
Arebi N, Kalli T, Howson W, et al., 2011, Systematic review of abdominal surgery for chronic idiopathic constipation, COLORECTAL DISEASE, Vol: 13, Pages: 1335-1343, ISSN: 1462-8910
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- Citations: 19
Latchford AR, Neale K, Phillips RKS, et al., 2011, Peutz-Jeghers Syndrome: Intriguing Suggestion of Gastrointestinal Cancer Prevention From Surveillance, DISEASES OF THE COLON & RECTUM, Vol: 54, Pages: 1547-1551, ISSN: 0012-3706
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- Citations: 41
Sinha A, Tekkis PP, Gibbons DC, et al., 2011, Risk factors predicting desmoid occurrence in patients with familial adenomatous polyposis: a meta-analysis, COLORECTAL DISEASE, Vol: 13, Pages: 1222-1229, ISSN: 1462-8910
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- Citations: 69
Cornish JA, Tan E, Singh B, et al., 2011, Female infertility following restorative proctocolectomy, COLORECTAL DISEASE, Vol: 13, Pages: E339-E344, ISSN: 1462-8910
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- Citations: 14
McLaughlin SD, Walker AW, Churcher C, et al., 2011, Ileal Pouch Microbial Diversity <i>Reply</i>, ANNALS OF SURGERY, Vol: 254, Pages: 669-670, ISSN: 0003-4932
Anning L, Koo N, Neely J, et al., 2011, Management of young onset colorectal cancer: divergent practice in the East of England, COLORECTAL DISEASE, Vol: 13, Pages: E297-E302, ISSN: 1462-8910
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- Citations: 7
Landy J, Al-Hassi HO, McLaughlin SD, et al., 2011, Review article: faecal transplantation therapy for gastrointestinal disease, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 34, Pages: 409-415, ISSN: 0269-2813
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- Citations: 70
Skipworth JRA, Morkane C, Raptis DA, et al., 2011, Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis, HPB, Vol: 13, Pages: 342-349, ISSN: 1365-182X
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- Citations: 29
Rodenas-Cuadrado P, Howarth K, Lewis A, et al., 2011, Human and Mouse Gastrointestinal Tumor Distribution is Selected According to a Basal Wnt Signalling Gradient, Conference on Digestive Disease Week 2011, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S128-S128, ISSN: 0016-5085
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- Citations: 1
McNicol F, Luglio G, Clark SK, et al., 2011, Compliance and outcome within an enhanced recovery programme, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 65-65, ISSN: 0007-1323
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- Citations: 1
Coomber R, Watfah J, Clark SK, et al., 2011, Introduction of laparoscopy to ileo-anal pouch surgery in a specialist unit, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 39-39, ISSN: 0007-1323
Sinha A, Phillips RKS, Linge C, et al., 2011, In-vitro charachteristics of desmoid tumour cells in familial adenomatous polyposis, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 14-14, ISSN: 0007-1323
Will OCC, Deheragoda M, Phillips RKS, et al., 2011, The role of cell proliferation and crypt fission in adenoma aggressiveness: a comparison of ileoanal pouch and rectal adenomas in familial adenomatous polyposis, COLORECTAL DISEASE, Vol: 13, Pages: 387-392, ISSN: 1462-8910
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- Citations: 3
Ignjatovic A, Tozer P, Grant K, et al., 2011, OUTCOME OF BENIGN STRICTURES IN ULCERATIVE COLITIS, Annual Meeting on British-Society-of-Gasenterology, Publisher: B M J PUBLISHING GROUP, ISSN: 0017-5749
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- Citations: 3
Sinha A, Tekkis PP, Phillips RKS, et al., 2011, Parametric survival analysis and predictive models for prophylactic surgery in familial adenomatous polyposis, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 13-13, ISSN: 0007-1323
McLaughlin SD, Clark SK, Tekkis PP, et al., 2011, An open study of maintenance antibiotic therapy for chronic antibiotic-dependent pouchitis: efficacy, complications and outcome, COLORECTAL DISEASE, Vol: 13, Pages: 438-444, ISSN: 1462-8910
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- Citations: 14
West NJ, Clark SK, Belluzzi A, et al., 2011, Eicosapentaenoic acid (EPA) free fatty acid reduces polyp burden in familial adenomatous polyposis (FAP): Results of a randomised, placebo-controlled trial, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 1-1, ISSN: 0007-1323
Bhandari S, Sinha A, Clark SK, 2011, Evaluation of management of desmoids tumours associated with familial adenomatous polyposis in Dutch patients, BRITISH JOURNAL OF CANCER, Vol: 104, Pages: 1236-1236, ISSN: 0007-0920
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- Citations: 1
Burns EM, Bottle A, Aylin P, et al., 2011, Volume analysis of outcome following restorative proctocolectomy., Br J Surg, Vol: 98, Pages: 408-417
BACKGROUND: This observational study aimed to determine national provision and outcome following pouch surgery (restorative proctocolectomy, RPC) and to examine the effect of institutional and surgeon caseload on outcome. METHODS: All patients undergoing primary RPC between April 1996 and March 2008 in England were identified from the administrative database Hospital Episode Statistics. Institutions and surgeons were categorized according to the total RPC caseload performed over the study interval. RESULTS: Some 5771 primary elective pouch procedures were undertaken at 154 National Health Service hospital trusts. Median follow-up was 65 (interquartile range (i.q.r.) 28-106) months. The 30-day in-hospital mortality rate was 0·5 per cent and the 1-year overall mortality rate 1·5 per cent. Some 30·5 per cent of trusts performed fewer than two procedures per year, and 91·4 per cent of surgical teams (456 of 499) carried out 20 or fewer RPCs over 8 years. Median surgeon volume was 4 (i.q.r. 1-9) cases. Failure occurred in 6·4 per cent of cases. Low-volume surgeons operated on more patients at the extremes of age (P < 0·001) and a lower proportion with ulcerative colitis (P < 0·001). Older age, increasing co-morbidity, increasing social deprivation, and both lower provider and surgeon caseload were independent predictors of longer length of stay. Older patient age and low institutional volume status were independent predictors of failure. CONCLUSION: Many English institutions and surgeons carry out extremely low volumes of RPC surgery. Case selection differed significantly between high- and low-volume surgeons. Institutional volume and older age were positively associated with increased pouch failure.
Gibbons DC, Sinha A, Phillips RKS, et al., 2011, Colorectal cancer: no longer the issue in familial adenomatous polyposis?, FAMILIAL CANCER, Vol: 10, Pages: 11-20, ISSN: 1389-9600
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- Citations: 25
von Roon AC, Will OCC, Man RF, et al., 2011, Mucosectomy With Handsewn Anastomosis Reduces the Risk of Adenoma Formation in the Anorectal Segment After Restorative Proctocolectomy for Familial Adenomatous Polyposis, ANNALS OF SURGERY, Vol: 253, Pages: 314-317, ISSN: 0003-4932
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- Citations: 34
Burns EM, Bottle A, Aylin P, et al., 2011, Volume analysis of outcome following restorative proctocolectomy, The British journal of surgery, Vol: 98, Pages: 408-417, ISSN: 1365-2168
BACKGROUND: This observational study aimed to determine national provision and outcome following pouch surgery (restorative proctocolectomy, RPC) and to examine the effect of institutional and surgeon caseload on outcome. METHODS: All patients undergoing primary RPC between April 1996 and March 2008 in England were identified from the administrative database Hospital Episode Statistics. Institutions and surgeons were categorized according to the total RPC caseload performed over the study interval. RESULTS: Some 5771 primary elective pouch procedures were undertaken at 154 National Health Service hospital trusts. Median follow-up was 65 (interquartile range (i.q.r.) 28-106) months. The 30-day in-hospital mortality rate was 0.5 per cent and the 1-year overall mortality rate 1.5 per cent. Some 30.5 per cent of trusts performed fewer than two procedures per year, and 91.4 per cent of surgical teams (456 of 499) carried out 20 or fewer RPCs over 8 years. Median surgeon volume was 4 (i.q.r. 1-9) cases. Failure occurred in 6.4 per cent of cases. Low-volume surgeons operated on more patients at the extremes of age (P < 0.001) and a lower proportion with ulcerative colitis (P < 0.001). Older age, increasing co-morbidity, increasing social deprivation, and both lower provider and surgeon caseload were independent predictors of longer length of stay. Older patient age and low institutional volume status were independent predictors of failure. CONCLUSION: Many English institutions and surgeons carry out extremely low volumes of RPC surgery. Case selection differed significantly between high- and low-volume surgeons. Institutional volume and older age were positively associated with increased pouch failure.
Almoudaris AM, Clark S, Vincent C, et al., 2011, Establishing quality in colorectal surgery, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Vol: 13, Pages: 961-973, ISSN: 1463-1318
AIM: The review aimed to offer a contemporary perspective of the quality of current colorectal surgery. METHOD: A literature search was undertaken to identify relevant indicators. Citations were included if they related to quality in colorectal surgery. The search terms used included the Medical Subject Heading terms and Boolean characters: 'colon' OR 'colorectal', OR 'rectal' OR 'rectum' AND 'Quality Indicators', OR 'Quality Assurance', OR 'Quality of healthcare', OR 'Reference Standards', OR 'Quality' plus a variable floating term. A two-person independent review was undertaken from resulting citations and their consequent reference lists. The search was limited to citations from 2000 to 2010 in humans and to the English language. RESULTS: Metrics identified as potential quality indicators in colorectal surgery are discussed according to the structure, process and outcome framework. CONCLUSION: A clear appreciation of the scope of individual metrics for quality appraisal purposes is necessary if they are to be used meaningfully for performance benchmarking.
Faiz O, Haji A, Bottle A, et al., 2011, Elective colonic surgery for cancer in the elderly: an investigation into postoperative mortality in English NHS hospitals between 1996 and 2007, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Vol: 13, Pages: 779-785, ISSN: 1463-1318
BACKGROUND: This study was primarily aimed to quantify perioperative mortality risk in elderly patients undergoing elective colonic resectional surgery. In addition, the safety of minimally invasive colonic surgery in this patient group was evaluated. METHODS: All patients aged > 75 undergoing elective colonic resection for colorectal malignancy between 1996 and 2007 in English NHS hospitals were included from the Hospital Episode Statistics (HES) dataset. RESULTS: Between the study dates, 28,746 patients > 75 years underwent elective colonic resection. The national annual number of colonic excisions carried out amongst elderly patients increased from 2188 patients in 1996/7 to 3240 patients in 2006/7. Following adjustment for gender, comorbidity and surgical approach, advancing age was an independent predictor for 30-day mortality (OR 2.47 for patients aged 85-89 vs 75-79, P < 0.001). Use of laparoscopy was a significant predictor of reduced perioperative mortality (OR 0.56, P = 0.003) once adjusted for advancing age, gender and comorbidity. Comparison of 30-day and 1-year postoperative mortality following elective colonic resection in patients aged 90 revealed a large excess of patients dying outside of the immediate perioperative period (10.1% and 26.2% for proximal cancers, respectively; 12.9% and 36.1% for distal colonic resections, respectively). CONCLUSIONS: Advancing age is an independent risk factor for postoperative death in elderly patients undergoing elective colonic resection for cancer. The risk of death in the elderly is extremely high and surgical decision-making should incorporate the mortality risk that occurs outside the immediate perioperative period. In this national series, patients selected for a laparoscopic procedure were at lower risk of perioperative death than those undergoing the conventional approach.
Ignjatovic A, Burling D, Ilangovan R, et al., 2010, Flat colon polyps: what should radiologists know?, CLINICAL RADIOLOGY, Vol: 65, Pages: 958-966, ISSN: 0009-9260
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- Citations: 7
Mann ER, Bernardo D, Al-Hassi HO, et al., 2010, Human dendritic cell function is dependent on tissue of residence, Annual Congress of the British-Society-for-Immunology, Publisher: WILEY-BLACKWELL PUBLISHING, INC, Pages: 40-40, ISSN: 0019-2805
Sinha A, Tekkis PP, Rashid S, et al., 2010, Risk factors for secondary proctectomy in patients with familial adenomatous polyposis, BRITISH JOURNAL OF SURGERY, Vol: 97, Pages: 1710-1715, ISSN: 0007-1323
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- Citations: 35
McLaughlin SD, Clark SK, Tekkis PP, et al., 2010, The bacterial pathogenesis and treatment of pouchitis., Therap Adv Gastroenterol, Vol: 3, Pages: 335-348
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis is the operation of choice for patients with ulcerative colitis. Pouchitis is the most common cause of pouch dysfunction. Although the pathogenesis of this disease is not well understood, bacteria have been implicated in the disease process. Numerous bacterial studies have been reported over the last 25 years with few unifying findings. In addition, many different treatments for pouchitis have been reported with varying results. Antibiotic treatment remains the most studied and is the mainstay of treatment. In this article we review the aetiology of pouchitis and the evidenced-based treatment options.
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