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Article: Distal periarterial sympathectomy surgery for chronic digital ischemia: A systematic review of the literature.

Cereceda-Monteoliva, Nicholas / Smart, Yat Wing / Ojelade, Elizabeth / Schaller, Gavin / Berber, Onur

2023 Volume 50, Page(s) 76–83

Abstract: Objective: This study assesses the efficacy of distal periarterial sympathectomy in treating chronic digital ischemia by evaluating clinical outcomes of surgery.: Methods: A systematic literature review of distal sympathectomy for chronic digital ... ...

Abstract	Objective: This study assesses the efficacy of distal periarterial sympathectomy in treating chronic digital ischemia by evaluating clinical outcomes of surgery. Methods: A systematic literature review of distal sympathectomy for chronic digital ischemia was conducted. Data extracted included study design, patient statistics, aetiology, follow-up duration, sympathectomy level, and surgical outcomes. Results: 21 studies were analysed, containing a total of 337 patients, 324 hands, and 398 digits. Patient age ranged from 23.2 to 56.6 years. Causes of ischemia included Scleroderma, Raynaud's disease, atherosclerosis/Buerger's disease, systemic lupus erythematosus/discoid lupus, undifferentiated rheumatic disorder/mixed connective tissue disease, CREST syndrome, trauma and unknown diagnoses. Common digital artery sympathectomy was mostly performed. Follow-up spanned 12-120 months. Outcomes: Distal sympathectomy led to reduced pain in 94.7 % patients. Complete resolution of ulceration was seen in 73 % patients. Subsequent amputation was required in 28 % patients. Other complications were reported in 24.1 % patients. Conclusions: This study indicates that distal periarterial sympathectomy may effectively treat chronic digital ischemia, offering pain relief and resolution of digital ulceration. However, risks of complications and amputation persist. Further research is required to inform patient selection and establish the optimal technique and extent of distal sympathectomy surgery, before it can be considered a valid treatment option.
Language	English
Publishing date	2023-12-06
Publishing country	India
Document type	Journal Article
ZDB-ID	2240839-3
ISSN	0972-978X
ISSN	0972-978X
DOI	10.1016/j.jor.2023.11.072
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Range of Movement and Patient-Reported Outcomes in Shoulder Arthroplasty in the Elderly: A Comparison of Anatomical Versus Reverse Shoulder Replacements.

Schaller, Gavin / Cuthbert, Rory / Puvanendran, Arjun / Ravenscroft, Matt / Sandher, Dilraj / Morgan, Barnes / Makki, Daoud

Cureus

2022 Volume 14, Issue 5, Page(s) e24657

Abstract: Introduction Shoulder arthroplasty is in increasing demand in the elderly given the rising prevalence of glenohumeral osteoarthritis (OA) across the population. There is a dearth of evidence in the current literature comparing anatomical total shoulder ... ...

Abstract	Introduction Shoulder arthroplasty is in increasing demand in the elderly given the rising prevalence of glenohumeral osteoarthritis (OA) across the population. There is a dearth of evidence in the current literature comparing anatomical total shoulder arthroplasty and reverse total shoulder arthroplasty (RTSA) in the elderly population. This study compares patient-reported outcome measures and range of movement (ROM) between anatomical and reverse total shoulder replacements in matched patient cohorts over the age of 70 years. Materials and methods This retrospective cohort study compares range of movement and patient-reported outcomes between anatomical total shoulder arthroplasty and reverse total shoulder arthroplasty in matched cohorts over the age of 70 years at a single institution between 2011 and 2015. Overall, 75 patients were recruited, including 44 patients with anatomical total shoulder arthroplasty and 31 patients with reverse total shoulder arthroplasty. Cohorts were matched according to age, preoperative Oxford Shoulder Score (OSS), and preoperative range of movement. The minimum clinical follow-up was one year. Results At one year, range of movement metrics in flexion, abduction, and external rotation all demonstrated greater improvements in the anatomical total shoulder arthroplasty cohort in comparison to the reverse total shoulder arthroplasty cohort (p<0.0001). No statistical difference in Oxford Shoulder Score was evident between cohorts. Conclusion Anatomical total shoulder arthroplasty demonstrates a significant improvement in range of movement in comparison to reverse total shoulder arthroplasty in matched elderly patient cohorts. However, there was no statistical difference in functional assessment scores between reverse shoulder replacement and anatomical shoulder replacement.
Language	English
Publishing date	2022-05-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24657
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Article ; Online: Non-union of paediatric carpal fractures

Scarlet Nazarian / Ashley Simpson / Gavin Schaller / Rajiv Bajekal

European Journal of Molecular and Clinical Medicine, Vol 2, Pp 23-

A case report and current concepts review

2017 Volume 24

Keywords	Medicine ; R
Language	English
Publishing date	2017-12-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy of surgical helmet systems for protection against COVID-19: a double-blinded randomised control study.

Schaller, Gavin / Nayar, Sandeep Krishan / Erotocritou, Marios / Overton, Alexander / Stelzhammer, Thomas / Berber, Onur

International orthopaedics

2020 Volume 45, Issue 1, Page(s) 39–42

Abstract: Purpose: This study assesses whether sterile surgical helmet systems (SSHS) provide surgeons with additional protection from aerosol pathogens alongside their traditional role protecting against splash. There has been debate on whether to use such ... ...

Abstract	Purpose: This study assesses whether sterile surgical helmet systems (SSHS) provide surgeons with additional protection from aerosol pathogens alongside their traditional role protecting against splash. There has been debate on whether to use such systems in reopening elective orthopaedic surgery during the current COVID-19 pandemic environment. Methods: Thirty-five participants were enrolled in a double-blinded randomised controlled study investigating efficacy of the Stryker Flyte Surgical Helmet (Stryker Corporation, Kalamazoo, MI, USA) as protection against respiratory droplets. Wearing the SSHS in a fit testing hood, subjects were randomised to nebulised saccharin solution or placebo. Twenty were allocated to the saccharin group with 15 to placebo. Positive sweet taste represented a failure of the test. Taste tests were performed with the helmet fan turned on and off. Results: SSHS did not prevent saccharin taste (p < 0.0001). Within the saccharin cohort, 40% recorded a positive taste with the fan on and 100% with the fan off. There was a statistically significant difference in mean time-to-taste saccharin (p = 0.049) comparing fan on (123.5 s) vs. off (62.6 s). Conclusions: SSHS do not protect against aerosol particulate and therefore are not efficacious in protection against COVID-19. The fan system employed may even increase risk to the surgeon by drawing in particulates as well as delay recognition of intraoperative cues, such as exhaust from diathermy, that point to respirator mask leak.
MeSH term(s)	COVID-19 ; Head Protective Devices ; Humans ; Orthopedic Procedures ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-09-08
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	80384-4
ISSN	1432-5195 ; 0341-2695
ISSN (online)	1432-5195
ISSN	0341-2695
DOI	10.1007/s00264-020-04796-3
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Article ; Online: Efficacy of surgical helmet systems for protection against COVID-19

Schaller, Gavin / Nayar, Sandeep Krishan / Erotocritou, Marios / Overton, Alexander / Stelzhammer, Thomas / Berber, Onur

International Orthopaedics ; ISSN 0341-2695 1432-5195

a double-blinded randomised control study

2020

Keywords	Orthopedics and Sports Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
DOI	10.1007/s00264-020-04796-3
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cinnamyl O-amine functionalized chitosan as a new excipient in direct compressed tablets with improved drug delivery.

Ren, Guang / Clancy, Cian / Tamer, Tamer M / Schaller, Barbara / Walker, Gavin M / Collins, Maurice N

International journal of biological macromolecules

2019 Volume 141, Page(s) 936–946

Abstract: The use of chitosan as a potential excipient in pharmaceutical formulations for the delivery of drugs produced via direct compression tableting has been investigated. Chitosan, N-cinnamyl substituted O-amine functionalized chitosan (cinnamyl-chitosan) ... ...

Abstract	The use of chitosan as a potential excipient in pharmaceutical formulations for the delivery of drugs produced via direct compression tableting has been investigated. Chitosan, N-cinnamyl substituted O-amine functionalized chitosan (cinnamyl-chitosan) and microcrystalline cellulose (MCC) were formulated, alongside acetaminophen as the active pharmaceutical ingredient (API), and magnesium stearate (Mg-St) as lubricant in a series of formulated blends. A control blend of MCC, acetaminophen (20 wt%) and Mg-St (0.5 wt%) was studied alongside two chitosan-bearing blends, containing 20 wt% chitosan and 20 wt% cinnamyl-chitosan separately. Particle size, shape and morphology of the raw powders were studied along with flowability of both raw powders and formulated powder blends. A single-punch tablet machine was used for tablet compaction. The relationship between tablet hardness and compression pressure was evaluated, while the plasticity factor (PF) and elasticity factor (EF) were derived from force-displacement curves. Disintegration and dissolution studies were also carried out to investigate the drug delivery potential of the blends. Blends containing chitosan and cinnamyl-chitosan possess good compaction properties with high elasticity due to their large particle sizes, and show excellent dissolution properties, releasing >80% API within 30 min. With good mechanical strength and superior drug delivery performance, in addition to its enhanced antibacterial and antioxidative effect gained though chemical modification, cinnamyl-chitosan exhibits potential to be used as a new cost-effective pharmaceutical excipient in direct compression tableting.
MeSH term(s)	Acetaminophen/administration & dosage ; Acetaminophen/chemistry ; Amines/chemistry ; Chemical Phenomena ; Chitosan/chemistry ; Cinnamates/chemistry ; Drug Compounding ; Drug Delivery Systems ; Molecular Structure ; Particle Size ; Powders/chemistry ; Pressure ; Spectrum Analysis ; Tablets/chemistry
Chemical Substances	Amines ; Cinnamates ; Powders ; Tablets ; Acetaminophen (362O9ITL9D) ; Chitosan (9012-76-4)
Language	English
Publishing date	2019-09-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	282732-3
ISSN	1879-0003 ; 0141-8130
ISSN (online)	1879-0003
ISSN	0141-8130
DOI	10.1016/j.ijbiomac.2019.08.265
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Article ; Online: Traumatic Dystonia: An Important Orthopaedic Differential Diagnosis.

Schaller, Gavin / Tai, Steven / Valavanis, Athinodoros / Korlipara, Prasad / Rudge, Ben

Foot & ankle international

2014 Volume 35, Issue 6, Page(s) 623–625

Language	English
Publishing date	2014-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1183283-6
ISSN	1944-7876 ; 1071-1007
ISSN (online)	1944-7876
ISSN	1071-1007
DOI	10.1177/1071100714528496
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Article: Efficacy of surgical helmet systems for protection against COVID-19: a double-blinded randomised control study

Schaller, Gavin / Nayar, Sandeep Krishan / Erotocritou, Marios / Overton, Alexander / Stelzhammer, Thomas / Berber, Onur

Int. orthop

Abstract: PURPOSE: This study assesses whether sterile surgical helmet systems (SSHS) provide surgeons with additional protection from aerosol pathogens alongside their traditional role protecting against splash. There has been debate on whether to use such ... ...

Abstract	PURPOSE: This study assesses whether sterile surgical helmet systems (SSHS) provide surgeons with additional protection from aerosol pathogens alongside their traditional role protecting against splash. There has been debate on whether to use such systems in reopening elective orthopaedic surgery during the current COVID-19 pandemic environment. METHODS: Thirty-five participants were enrolled in a double-blinded randomised controlled study investigating efficacy of the Stryker Flyte Surgical Helmet (Stryker Corporation, Kalamazoo, MI, USA) as protection against respiratory droplets. Wearing the SSHS in a fit testing hood, subjects were randomised to nebulised saccharin solution or placebo. Twenty were allocated to the saccharin group with 15 to placebo. Positive sweet taste represented a failure of the test. Taste tests were performed with the helmet fan turned on and off. RESULTS: SSHS did not prevent saccharin taste (p < 0.0001). Within the saccharin cohort, 40% recorded a positive taste with the fan on and 100% with the fan off. There was a statistically significant difference in mean time-to-taste saccharin (p = 0.049) comparing fan on (123.5 s) vs. off (62.6 s). CONCLUSIONS: SSHS do not protect against aerosol particulate and therefore are not efficacious in protection against COVID-19. The fan system employed may even increase risk to the surgeon by drawing in particulates as well as delay recognition of intraoperative cues, such as exhaust from diathermy, that point to respirator mask leak.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #746516
Database	COVID19

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Article ; Online: Systematic development of a high dosage formulation to enable direct compression of a poorly flowing API: A case study.

Schaller, Barbara E / Moroney, Kevin M / Castro-Dominguez, Bernardo / Cronin, Patrick / Belen-Girona, Jorge / Ruane, Patrick / Croker, Denise M / Walker, Gavin M

International journal of pharmaceutics

2019 Volume 566, Page(s) 615–630

Abstract: In this work, the transfer of oral solid dosage forms, currently manufactured via wet granulation, to a continuous direct compression process was considered. Two main challenges were addressed: (1) a poorly flowing API (Canagliflozin) and (2) high drug ... ...

Abstract	In this work, the transfer of oral solid dosage forms, currently manufactured via wet granulation, to a continuous direct compression process was considered. Two main challenges were addressed: (1) a poorly flowing API (Canagliflozin) and (2) high drug loading (51 wt%). A scientific approach was utilised for formulation development, targeting flow and compaction behaviour suitable for manufacturing scale. This was achieved through systematic screening of excipients to identify feasible formulations. Targeted design of experiments based on factors such as formulation mixture and processing parameters were utilised to investigate key responses for tablet properties, flow and compaction behaviour. Flow behaviour was primarily evaluated from percentage compressibility and shear cell testing on a powder flow rheometer (FT4). The compaction behaviour was studied using a compaction simulator (Gamlen). The relationships between tablet porosity, tensile strength and compaction pressure were used to evaluate tabletability, compactibility and compressibility to assess scale-up. The success of this design procedure is illustrated by scaling up from the compaction simulator to a Riva Piccola rotary tablet press, while maintaining critical quality attributes (CQAs). Compactibility was identified as a suitable scale-up relationship. The developed procedure should allow accelerated development of formulations for continuous direct compression.
MeSH term(s)	Canagliflozin/chemistry ; Drug Compounding/methods ; Excipients/chemistry ; Particle Size ; Porosity ; Powders ; Rheology ; Tablets ; Tensile Strength
Chemical Substances	Excipients ; Powders ; Tablets ; Canagliflozin (0SAC974Z85)
Language	English
Publishing date	2019-05-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	428962-6
ISSN	1873-3476 ; 0378-5173
ISSN (online)	1873-3476
ISSN	0378-5173
DOI	10.1016/j.ijpharm.2019.05.073
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Article: An evaluation of the Johanson model for roller compaction process development for a high dose API

Moroney, Kevin M / Cronin, Patrick / Adeleye, Opeyemi A / Schaller, Barbara E / Howard, Matthew A / Castro-Dominguez, Bernardo / Ramachandran, Rohit / Walker, Gavin M

Powder technology. 2020 Apr. 15, v. 366

2020

Abstract: Roller compaction (RC) is a dry granulation technique applied to improve the flow and compressibility of drug formulations. RC implementation for high drug load formulations can be challenging due to flow issues and a high consumption of active ... ...

Abstract	Roller compaction (RC) is a dry granulation technique applied to improve the flow and compressibility of drug formulations. RC implementation for high drug load formulations can be challenging due to flow issues and a high consumption of active pharmaceutical ingredient (API) for robust process development. This work addresses these challenges using process modelling for design and scale-up of an RC process on the same equipment and transfer to different equipment. A modified application of existing models incorporating a new description of mass transport in the feed screw is evaluated for guaifenesin formulations with a 90% drug loading. The model is calibrated using low-throughput data on a Vector Freund TF Mini RC and used to predict ribbon density and throughput for various process settings at high-throughput. It is found that the modelling framework can reasonably predict high-throughput behaviour on the same RC but the predictive performance decreases for transfer between equipment.
Keywords	active pharmaceutical ingredients ; compressibility ; drug formulations ; equipment ; guaifenesin ; mass transfer ; models
Language	English
Dates of publication	2020-0415
Size	p. 82-95.
Publishing place	Elsevier B.V.
Document type	Article
ISSN	0032-5910
DOI	10.1016/j.powtec.2020.02.058
Database	NAL-Catalogue (AGRICOLA)

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