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Article ; Online: An aromatherapy massage intervention on sleep in the ICU: A randomized controlled feasibility study.

Pattison, Natalie / O'Gara, Geraldine / Thomas, Karen / Wigmore, Tim / Dyer, Jeannie

2023 Volume 29, Issue 1, Page(s) 14–21

Abstract: We conducted a feasibility randomized controlled trial exploring the effect of aromatherapy massage on sleep in critically ill patients. Patients were randomized to receive aromatherapy massage or usual care, and feasibility of recruitment and outcome ... ...

Abstract	We conducted a feasibility randomized controlled trial exploring the effect of aromatherapy massage on sleep in critically ill patients. Patients were randomized to receive aromatherapy massage or usual care, and feasibility of recruitment and outcome data completion was captured. Sleep (depth) was assessed through Bispectral Index monitoring and self/nurse-reported Richards-Campbell Sleep Questionnaires, and the Sleep in the ICU Questionnaire. Thirty-four patients participated: 17 were randomized to aromatherapy massage and 17 to control. Five participants who received the intervention completed outcomes for analysis (alongside eight controls). A larger study was deemed unfeasible in this population, highlighting the value of testing feasibility of complex interventions, such as massage for sleep in ICU.
MeSH term(s)	Humans ; Aromatherapy ; Feasibility Studies ; Massage ; Sleep ; Intensive Care Units
Language	English
Publishing date	2023-08-02
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2011956-2
ISSN	1478-5153 ; 1362-1017
ISSN (online)	1478-5153
ISSN	1362-1017
DOI	10.1111/nicc.12957
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Article ; Online: Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study.

Brown, Leo R / Thomson, Georgina G / Gardner, Ellen / Chien, Siobhan / McGovern, Josh / Dolan, Ross D / McSorley, Stephen T / Forshaw, Matthew J / McMillan, Donald C / Wigmore, Stephen J / Crumley, Andrew B / Skipworth, Richard J E

The British journal of surgery

2024 Volume 111, Issue 4

Abstract: Background: Features of cancer cachexia adversely influence patient outcomes, yet few currently inform clinical decision-making. This study assessed the value of the cachexia index (CXI), a novel prognostic marker, in patients for whom neoadjuvant ... ...

Abstract	Background: Features of cancer cachexia adversely influence patient outcomes, yet few currently inform clinical decision-making. This study assessed the value of the cachexia index (CXI), a novel prognostic marker, in patients for whom neoadjuvant chemotherapy and surgery for oesophagogastric cancer is planned. Methods: Consecutive patients newly diagnosed with locally advanced (T3-4 or at least N1) oesophagogastric cancer between 1 January 2010 and 31 December 2015 were identified through the West of Scotland and South-East Scotland Cancer Networks. CXI was calculated as (L3 skeletal muscle index) × (serum albumin)/(neutrophil lymphocyte ratio). Sex-stratified cut-off values were determined based on the area under the curve (AUC), and patients were divided into groups with low or normal CXI. Primary outcomes were disease progression during neoadjuvant chemotherapy and overall survival (at least 5 years of follow-up). Results: Overall, 385 patients (72% men, median age 66 years) were treated with neoadjuvant chemotherapy for oesophageal (274) or gastric (111) cancer across the study interval. Although patients with a low CXI (men: CXI below 52 (AUC 0.707); women: CXI below 41 (AUC 0.759)) were older with more co-morbidity, disease characteristics were comparable to those in patients with a normal CXI. Rates of disease progression during neoadjuvant chemotherapy, leading to inoperability, were higher in patients with a low CXI (28 versus 12%; adjusted OR 3.07, 95% c.i. 1.67 to 5.64; P < 0.001). Low CXI was associated with worsened postoperative mortality (P = 0.019) and decreased overall survival (median 14.9 versus 56.9 months; adjusted HR 1.85, 1.42 to 2.42; P < 0.001). Conclusion: CXI is associated with disease progression, worse postoperative mortality, and overall survival, and could improve prognostication and decision-making in patients with locally advanced oesophagogastric cancer.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Stomach Neoplasms/complications ; Stomach Neoplasms/surgery ; Stomach Neoplasms/drug therapy ; Cachexia/etiology ; Lymphocytes ; Disease Progression ; Cohort Studies ; Prognosis ; Retrospective Studies
Language	English
Publishing date	2024-04-09
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znae098
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Article ; Online: The impact of anaesthetic technique upon outcome in oncological surgery.

Evans, M T / Wigmore, T / Kelliher, L J S

BJA education

2018 Volume 19, Issue 1, Page(s) 14–20

Language	English
Publishing date	2018-11-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2888911-3
ISSN	2058-5357 ; 2058-5349
ISSN (online)	2058-5357
ISSN	2058-5349
DOI	10.1016/j.bjae.2018.09.008
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Article ; Online: Dietary L-Tryptophan consumption determines the number of colonic regulatory T cells and susceptibility to colitis via GPR15.

Van, Nguyen T / Zhang, Karen / Wigmore, Rachel M / Kennedy, Anne I / DaSilva, Carolina R / Huang, Jialing / Ambelil, Manju / Villagomez, Jose H / O'Connor, Gerald J / Longman, Randy S / Cao, Miao / Snook, Adam E / Platten, Michael / Kasenty, Gerard / Sigal, Luis J / Prendergast, George C / Kim, Sangwon V

Nature communications

2023 Volume 14, Issue 1, Page(s) 7363

Abstract: ... L-Tryptophan (L-Trp), a ubiquitous dietary component, determines the transcription level of the colonic T cell ...

Abstract	Environmental factors are the major contributor to the onset of immunological disorders such as ulcerative colitis. However, their identities remain unclear. Here, we discover that the amount of consumed L-Tryptophan (L-Trp), a ubiquitous dietary component, determines the transcription level of the colonic T cell homing receptor, GPR15, hence affecting the number of colonic FOXP3
MeSH term(s)	Humans ; Mice ; Animals ; T-Lymphocytes, Regulatory ; Tryptophan ; Colitis/chemically induced ; Colon ; Colitis, Ulcerative ; Receptors, Peptide ; Receptors, G-Protein-Coupled/genetics
Chemical Substances	Tryptophan (8DUH1N11BX) ; GPR15 protein, human ; Receptors, Peptide ; Receptors, G-Protein-Coupled
Language	English
Publishing date	2023-11-14
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-43211-4
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Article: Author Correction: Combining the AKT inhibitor capivasertib and SERD fulvestrant is effective in palbociclib-resistant ER+ breast cancer preclinical models.

NPJ breast cancer

2023 Volume 9, Issue 1, Page(s) 69

Language	English
Publishing date	2023-08-18
Publishing country	United States
Document type	Published Erratum
ISSN	2374-4677
ISSN	2374-4677
DOI	10.1038/s41523-023-00575-6
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Article: Author Correction: Combining the AKT inhibitor capivasertib and SERD fulvestrant is effective in palbociclib-resistant ER+ breast cancer preclinical models.

NPJ breast cancer

2023 Volume 9, Issue 1, Page(s) 76

Language	English
Publishing date	2023-09-19
Publishing country	United States
Document type	Published Erratum
ISSN	2374-4677
ISSN	2374-4677
DOI	10.1038/s41523-023-00581-8
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Article: Combining the AKT inhibitor capivasertib and SERD fulvestrant is effective in palbociclib-resistant ER+ breast cancer preclinical models.

NPJ breast cancer

2023 Volume 9, Issue 1, Page(s) 64

Abstract: Combining the selective AKT inhibitor, capivasertib, and SERD, fulvestrant improved PFS in a Phase III clinical trial (CAPItello-291), treating HR+ breast cancer patients following aromatase inhibitors, with or without CDK4/6 inhibitors. However, ... ...

Abstract	Combining the selective AKT inhibitor, capivasertib, and SERD, fulvestrant improved PFS in a Phase III clinical trial (CAPItello-291), treating HR+ breast cancer patients following aromatase inhibitors, with or without CDK4/6 inhibitors. However, clinical data suggests CDK4/6 treatment may reduce response to subsequent monotherapy endocrine treatment. To support understanding of trials such as CAPItello-291 and gain insight into this emerging population of patients, we explored how CDK4/6 inhibitor treatment influences ER+ breast tumour cell function and response to fulvestrant and capivasertib after CDK4/6 inhibitor treatment. In RB+, RB- T47D and MCF7 palbociclib-resistant cells ER pathway ER and Greb-1 expression were reduced versus naïve cells. PI3K-AKT pathway activation was also modified in RB+ cells, with capivasertib less effective at reducing pS6 in RB+ cells compared to parental cells. Expression profiling of parental versus palbociclib-resistant cells confirmed capivasertib, fulvestrant and the combination differentially impacted gene expression modulation in resistant cells, with different responses seen in T47D and MCF7 cells. Fulvestrant inhibition of ER-dependent genes was reduced. In resistant cells, the combination was less effective at reducing cell cycle genes, but a consistent reduction in cell fraction in S-phase was observed in naïve and resistant cells. Despite modified signalling responses, both RB+ and RB- resistant cells responded to combination treatment despite some reduction in relative efficacy and was effective in vivo in palbociclib-resistant PDX models. Collectively these findings demonstrate that simultaneous inhibition of AKT and ER signalling can be effective in models representing palbociclib resistance despite changes in pathway dependency.
Language	English
Publishing date	2023-08-05
Publishing country	United States
Document type	Journal Article
ISSN	2374-4677
ISSN	2374-4677
DOI	10.1038/s41523-023-00571-w
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Article ; Online: Central venous pressure and liver resection: a systematic review and meta-analysis.

Hughes, Michael J / Ventham, Nicholas T / Harrison, Ewen M / Wigmore, Stephen J

HPB : the official journal of the International Hepato Pancreato Biliary Association

2015 Volume 17, Issue 10, Page(s) 863–871

Abstract: Background: A liver resection under low central venous pressure (CVP) has become standard practice; however, the benefits beyond a reduction in blood loss are not well reported. Moreover, the precise method to achieve CVP reduction has not been ... ...

Abstract	Background: A liver resection under low central venous pressure (CVP) has become standard practice; however, the benefits beyond a reduction in blood loss are not well reported. Moreover, the precise method to achieve CVP reduction has not been established. A systematic review and meta-analysis of randomized controlled trials (RTCs) was performed to assess the effects of CVP on clinical outcome and to identify the optimum method of CVP reduction. Methods: EMBASE, Medline, PubMed and the Cochrane database were searched for trials comparing low CVP surgery with controls. The primary outcome was post-operative complications within 30 days. Secondary outcomes included estimated blood loss (EBL), blood transfusion rates and length of stay (LOS). Sub-group analysis was performed to assess the CVP reduction method on the outcome. Results: Eight trials were identified. No difference was observed in the morbidity rate between the high CVP and control groups [odds ratio (OR) = 0.96 (95% confidence interval (CI) 0.66, 1.40) P = 0.84, I(2) = 0%]. EBL [weighted mean difference (WMD) = -308.63 ml (95% CI -474.67, -142.58) P = < 0.001, I(2) = 73%] and blood transfusion rates [OR 0.65 (95% CI 0.44, 0.97) P = 0.040, I(2) = 37%] were significantly lower in the low CVP groups. Neither anaesthetic nor surgical methods of CVP reduction were associated with a reduced post-operative morbidity. Conclusion: Low CVP surgery is associated with a reduction in EBL; however, this does not translate into an improvement in post-operative morbidity. The optimum method of CVP reduction has not been identified.
MeSH term(s)	Blood Loss, Surgical/physiopathology ; Blood Loss, Surgical/prevention & control ; Blood Transfusion ; Central Venous Pressure/physiology ; Hepatectomy/methods ; Humans ; Hypotension, Controlled/methods
Language	English
Publishing date	2015-10
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1111/hpb.12462
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Article ; Online: Systematic review of management of incidental gallbladder cancer after cholecystectomy.

Søreide, K / Guest, R V / Harrison, E M / Kendall, T J / Garden, O J / Wigmore, S J

The British journal of surgery

2018 Volume 106, Issue 1, Page(s) 32–45

Abstract: ... for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port-site ...

Abstract	Background: Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods: A systematic PubMed search of the English literature to May 2018 was conducted. Results: The search identified 12 systematic reviews and meta-analyses, in addition to several consensus reports, multi-institutional series and national audits. Some 0·25-0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one-third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5-year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross-sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET-avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port-site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion: Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.
MeSH term(s)	Biomarkers, Tumor/metabolism ; Chemotherapy, Adjuvant/statistics & numerical data ; Cholecystectomy ; Conversion to Open Surgery/statistics & numerical data ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/therapy ; Humans ; Incidental Findings ; Laparoscopy/adverse effects ; Laparoscopy/statistics & numerical data ; Neoplasm Metastasis ; Neoplasm Seeding ; Postoperative Complications/pathology ; Postoperative Complications/therapy ; Prognosis ; Reoperation/statistics & numerical data ; Risk Assessment
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2018-12-23
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11035
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Article ; Online: Adjacent central venous catheters can result in immediate aspiration of infused drugs during renal replacement therapy.

Kam, K Y R / Mari, J M / Wigmore, T J

Anaesthesia

2012 Volume 67, Issue 2, Page(s) 115–121

Abstract: Dual-lumen haemodiafiltration catheters enable continuous renal replacement therapy in the critically ill and are often co-located with central venous catheters used to infuse drugs. The extent to which infusions are immediately aspirated by an adjacent ... ...

Abstract	Dual-lumen haemodiafiltration catheters enable continuous renal replacement therapy in the critically ill and are often co-located with central venous catheters used to infuse drugs. The extent to which infusions are immediately aspirated by an adjacent haemodiafiltration catheter remains unknown. A bench model was constructed to evaluate this effect. A central venous catheter and a haemodiafiltration catheter were inserted into a simulated central vein and flow generated using centrifugal pumps within the simulated vein and haemodiafiltration circuit. Ink was used as a visual tracer and creatinine solution as a quantifiable tracer. Tracers were completely aspirated by the haemodiafiltration catheter unless the infusion was at least 1 cm downstream to the arterial port. No tracer was aspirated from catheters infusing at least 2 cm downstream. Orientation of side ports did not affect tracer elimination. Co-location of central venous and haemodiafiltration catheters may lead to complete aspiration of infusions into the haemodiafilter with resultant drug under-dosing.
MeSH term(s)	Algorithms ; Catheterization, Central Venous/adverse effects ; Catheters/adverse effects ; Creatinine/analysis ; Hemodiafiltration ; Humans ; Infusion Pumps ; Infusions, Intravenous ; Models, Theoretical ; Renal Replacement Therapy ; Respiratory Aspiration ; Ultrasonography, Doppler, Duplex ; Vena Cava, Inferior/physiology ; Vena Cava, Superior/physiology
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2012-02
Publishing country	England
Document type	Journal Article
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/j.1365-2044.2011.06955.x
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