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Article: The use of NovoSorb biodegradable temporising matrix in wound management: a literature review and case series.

Kidd, Thomas / Kolaityte, Valdone / Bajaj, Kuljyot / Wallace, David / Izadi, David / Bechar, Janak

2023 Volume 32, Issue 8, Page(s) 470–478

Abstract: Objective: NovoSorb (Poly-Novo Ltd, Australia) biodegradable temporising matrix (BTM) is a novel artificial dermal matrix. Previous literature is weighted towards its use in burns reconstruction; however, this paper describes its use within a range of ... ...

Abstract	Objective: NovoSorb (Poly-Novo Ltd, Australia) biodegradable temporising matrix (BTM) is a novel artificial dermal matrix. Previous literature is weighted towards its use in burns reconstruction; however, this paper describes its use within a range of wound aetiologies. The authors present one of the largest and most diverse case series to date, and aim to provide an independent benchmark of clinical practice. Method: A retrospective observational study was performed. Patient demographics and clinical data (wound aetiology, site, total body surface area (TBSA), wound bed, number of debridements, time to BTM integration, time to skin grafting) were collected and subgroup analysis preformed. Results: The cohort consisted of 37 patients (acute trauma wounds, n=19; hard-to-heal wounds, n=9; acute infections, n=6; cancer, n=3). Successful BTM integration, allowing subsequent split-thickness skin grafting (STSG), occurred in 70% of cases, despite an overall complication rate of 51%. Mean time from BTM application to STSG was 53 days. There was no difference in STSG outcomes when grafting was performed either before or after the six-week BTM application period. There was no difference when various wound beds (fascia, tendon, periosteum) were compared. Patients >65 years of age were more likely to experience complications; however, this did not affect the speed of integration. The relation of diabetes and smoking to overall integration had no statistical significance. Conclusion: In comorbid patients in particular, the time between BTM application and STSG may be longer than the manufacturer's recommendation. Furthermore, data suggest greater wound bed optimisation and closer interval monitoring in hard-to-heal/malignant wounds, and in older patients and patients with comorbidities. However, BTM appears robust (even in infection) and is showing promise as a useful reconstructive tool.
MeSH term(s)	Humans ; Aged ; Wound Healing ; Skin/injuries ; Skin Transplantation ; Polyurethanes ; Observational Studies as Topic
Chemical Substances	NovoSorb ; Polyurethanes
Language	English
Publishing date	2023-08-12
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	1353951-6
ISSN	0969-0700
ISSN	0969-0700
DOI	10.12968/jowc.2023.32.8.470
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Article: Counter-regulation of RNA stability by UPF1 and TDP43.

Gomez, Nicolas / Hsieh, Caroline / Li, Xingli / Dykstra, Megan / Waksmacki, Jacob / Altheim, Christopher / Bechar, Yoel / Klim, Joseph / Zaepfel, Benjamin / Rothstein, Jeffrey / Tank, Elizabeth Em / Barmada, Sami J

bioRxiv : the preprint server for biology

2024

Abstract: RNA quality control is crucial for proper regulation of gene expression. Disruption of nonsense mediated mRNA decay (NMD), the primary RNA decay pathway responsible for the degradation of transcripts containing premature termination codons (PTCs), can ... ...

Abstract	RNA quality control is crucial for proper regulation of gene expression. Disruption of nonsense mediated mRNA decay (NMD), the primary RNA decay pathway responsible for the degradation of transcripts containing premature termination codons (PTCs), can disrupt development and lead to multiple diseases in humans and other animals. Similarly, therapies targeting NMD may have applications in hematological, neoplastic and neurological disorders. As such, tools capable of accurately quantifying NMD status could be invaluable for investigations of disease pathogenesis and biomarker identification. Toward this end, we assemble, validate, and apply a next-generation sequencing approach (NMDq) for identifying and measuring the abundance of PTC-containing transcripts. After validating NMDq performance and confirming its utility for tracking RNA surveillance, we apply it to determine pathway activity in two neurodegenerative diseases, amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) characterized by RNA misprocessing and abnormal RNA stability. Despite the genetic and pathologic evidence implicating dysfunctional RNA metabolism, and NMD in particular, in these conditions, we detected no significant differences in PTC-encoding transcripts in ALS models or disease. Contrary to expectations, overexpression of the master NMD regulator UPF1 had little effect on the clearance of transcripts with PTCs, but rather restored RNA homeostasis through differential use and decay of alternatively poly-adenylated isoforms. Together, these data suggest that canonical NMD is not a significant contributor to ALS/FTD pathogenesis, and that UPF1 promotes neuronal survival by regulating transcripts with abnormally long 3'UTRs.
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.31.578310
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Article: Materiovigilance in health centers: The role of notifiers to ensure safer use of medical devices.

Bechar, H / Attjioui, H / Mimouni, H / Ismaili, R / Tebaa, A / Belahcen, J / Rahali, Y

Annales pharmaceutiques francaises

2021 Volume 80, Issue 3, Page(s) 301–311

Abstract: Background: The implementation of efficient health and vigilance strategy is one of the essential aspects of the health policy of public and private health establishments, in order to reduce the risk of incidents due to medical devices.: Aim: The ... ...

Abstract	Background: The implementation of efficient health and vigilance strategy is one of the essential aspects of the health policy of public and private health establishments, in order to reduce the risk of incidents due to medical devices. Aim: The objective of this study is to demonstrate the importance of user notification and to recognize the role of nursing staff in the materiovigilance process. Methods: This is a retrospective study of materiovigilance cases notified for three years (2016, 2017, and 2018) at the National Institute of Oncology. The evaluation of the incidents was carried out with the aim of taking the necessary measures to prevent and minimize risk. Results: Seven thousand three hundred and eight cases of materiovigilance during the 3 years were collected. A spontaneous collection of reports was predominant (70%). The distribution of the number of incidents by the profile of notifiers shows that reports come from surgeons and much more from nurses. The surgical block (35.7%) and medical oncology services (14.3%) were the services that reported more; the majority of the observed adverse events were attributed to infusion sets (n=7105). Four serious cases of materiovigilance. reported during these 3 years at the level of the vigilance unit considered the most relevant were detailed with examples of immediate actions taken and risk minimization actions. Conclusion: This study highlights the characteristics of incidents reported. The role of the nursing staff and the strong presence of nurses in the vigilance system has been well demonstrated, thus reducing the risk of side effects due to medical devices.
MeSH term(s)	Ambulatory Care Facilities ; Equipment and Supplies/adverse effects ; Humans ; Nurse's Role ; Retrospective Studies
Language	English
Publishing date	2021-09-24
Publishing country	France
Document type	Journal Article
ZDB-ID	307-4
ISSN	0003-4509
ISSN	0003-4509
DOI	10.1016/j.pharma.2021.09.003
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Article ; Online: Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature.

Bechar, J / Sepehripour, S / Hardwicke, J / Filobbos, G

Annals of the Royal College of Surgeons of England

2017 Volume 99, Issue 5, Page(s) 341–346

Abstract: Introduction Early operative debridement of necrotising fasciitis is a major outcome determinant. Identification and diagnosis of such patients can be clinically difficult. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score first ... ...

Abstract	Introduction Early operative debridement of necrotising fasciitis is a major outcome determinant. Identification and diagnosis of such patients can be clinically difficult. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score first published in 2004 is based on routinely performed parameters and offers a method for identifying early cases. No literature review has yet been performed on the application of such a score. Methods A systematic review of English-language literature was performed from 2004 to 2014 to identify articles reporting use of LRINEC score and the incidence of necrotising fasciitis. We performed a critical review of PubMed, Medline and Embase in line with the PRISMA statement. A meta-analysis was performed with a random effects model and 95% confidence interval. Suitable correlation coefficient and receiver operating characteristic (ROC) curves were also calculated. Results After application of inclusion criteria, 16 studies with 846 patients were included. The mean LRINEC score in patients with necrotising fasciitis was 6.06. Two papers reported LRINEC score in patients without necrotising fasciitis with a mean 2.45. All six studies with a reported coefficient of variance were < 1; Pearson correlation coefficient was r = 0.637 (P = 0.011). An ROC curve showed an area under the curve of 0.927. Conclusions The LRINEC score is a useful clinical determinant in the diagnosis and surgical treatment of patients with necrotising fasciitis, with a statistically positive correlation between LRINEC score and a true diagnosis of necrotising fasciitis.
MeSH term(s)	Clinical Laboratory Techniques ; Fasciitis, Necrotizing/blood ; Fasciitis, Necrotizing/diagnosis ; Fasciitis, Necrotizing/physiopathology ; Humans ; ROC Curve ; Severity of Illness Index
Language	English
Publishing date	2017-05-01
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2017.0053
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Article ; Online: Re: Antibiotic prophylaxis in breast reduction surgery: A systematic review and meta-analysis.

Bechar, Janak / Skillman, Joanna / Hardwicke, Joseph

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2017 Volume 71, Issue 3, Page(s) 433–434

MeSH term(s)	Antibiotic Prophylaxis ; Humans ; Mammaplasty ; Mastectomy ; Surgical Wound Infection
Language	English
Publishing date	2017-12-26
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2017.12.016
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Article ; Online: The Detection of Wound Infection by Ion Mobility Chemical Analysis.

Daulton, Emma / Wicaksono, Alfian / Bechar, Janak / Covington, James A / Hardwicke, Joseph

Biosensors

2020 Volume 10, Issue 3

Abstract: Surgical site infection represents a large burden of care in the National Health Service. Current methods for diagnosis include a subjective clinical assessment and wound swab culture that may take several days to return a result. Both techniques are ... ...

Abstract	Surgical site infection represents a large burden of care in the National Health Service. Current methods for diagnosis include a subjective clinical assessment and wound swab culture that may take several days to return a result. Both techniques are potentially unreliable and result in delays in using targeted antibiotics. Volatile organic compounds (VOCs) are produced by micro-organisms such as those present in an infected wound. This study describes the use of a device to differentiate VOCs produced by an infected wound vs. colonised wound. Malodourous wound dressings were collected from patients, these were a mix of post-operative wounds and vascular leg ulcers. Wound microbiology swabs were taken and antibiotics commenced as clinically appropriate. A control group of soiled, but not malodorous wound dressings were collected from patients who had a split skin graft (SSG) donor site. The analyser used was a G.A.S. GC-IMS. The results from the samples had a sensitivity of 100% and a specificity of 88%, with a positive predictive value of 90%. An area under the curve (AUC) of 91% demonstrates an excellent ability to discriminate those with an infected wound from those without. VOC detection using GC-IMS has the potential to serve as a diagnostic tool for the differentiation of infected and non-infected wounds and facilitate the treatment of wound infections that is cost effective, non-invasive, acceptable to patients, portable, and reliable.
MeSH term(s)	Blood Chemical Analysis/methods ; Humans ; Ions/metabolism ; Wound Infection/diagnosis
Chemical Substances	Ions
Language	English
Publishing date	2020-02-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662125-3
ISSN	2079-6374 ; 2079-6374
ISSN (online)	2079-6374
ISSN	2079-6374
DOI	10.3390/bios10030019
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Article ; Online: Crowdsourcing as a Novel Method to Evaluate Aesthetic Outcomes of Treatment for Unilateral Cleft Lip.

Bechar, Janak / Su, Ting-Li / Richard, Bruce

Plastic and reconstructive surgery

2017 Volume 140, Issue 3, Page(s) 514e–515e

MeSH term(s)	Cleft Lip ; Cleft Palate ; Crowdsourcing ; Esthetics ; Humans ; Treatment Outcome
Language	English
Publishing date	2017-05-23
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000003634
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Article ; Online: Burns Centre and fire services: What information can be exchanged to manage the burn patient?

Pujji, O / Nizar, B / Bechar, J / North, D / Jeffery, S

Burns : journal of the International Society for Burn Injuries

2017 Volume 44, Issue 3, Page(s) 573–581

Abstract: Aim: To describe the experience of using a "Burns Extrication Form" at a regional Burns Centre. Communication between the fire services and burns team previously has been regarded as poor. Significant information is collected by the fire services at the ...

Abstract	Aim: To describe the experience of using a "Burns Extrication Form" at a regional Burns Centre. Communication between the fire services and burns team previously has been regarded as poor. Significant information is collected by the fire services at the scene and this can aid the management of the patient. Methods: The Burns Extrication Form was devised to provide a clear framework of communication between the two services. Information regarding time frames, exposure to heat & smoke, fire loading (potential severity of a fire in a given space by measuring amount of combustible material in confined space), building construction, chemicals involved is passed to the medical team through this form through a National Health Service mailbox. Also, treatment provided by the fire service was documented. All data collected by this form was collated for the purpose of this study. Data ranging from 2014 to 2017 was included in this descriptive study. Results: The patient journey following contact by fire services shows that out of the 598 persons who were involved in a fire only 92 (15%) attended the Accident and Emergency (A&E) department at the Queen Elizabeth Hospital. Signs of smoke inhalation, singed nose hair and coughing were found in 190 (32%) patients; the fire service administered oxygen to 106 (18%) of these patients although this may have been initiated by Ambulance crews who were on scene prior to the Fire Crew. The remaining 506 (85%) may have not attended A&E at UHB or may have attended another A&E in the West Midlands base on the location of the incident and clinical needs. Of the 92 patients who attended the A&E at UHB 48 (52%) were admitted to the Burns Centre in the hospital. Nine (19%) of these patients had smoke inhalation and three of these patients were managed by intubation. Birmingham North and Black Country North had the highest incidence of burns incidents, 120 and 103 respectively. Whilst, the lowest numbers were found in Birmingham South and Coventry and Solihull with 65 and 61 respectively. Additional results are described in the study. Conclusion: Data provided by the Fire Extrication forms helps us to assess the magnitude of fire-related injury across the West Midlands. The fire services have been shown to provide important first aid as one of the first responders at the scene. Their value in assessing the environment in and patient status helps clinicians further down the patient's journey.
MeSH term(s)	Airway Management ; Burn Units ; Burns ; Communication ; Emergency Medical Services ; Firefighters ; First Aid ; Fluid Therapy ; Forms as Topic ; Humans ; Oxygen Inhalation Therapy ; Patient Handoff ; State Medicine ; United Kingdom
Language	English
Publishing date	2017-11-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	197308-3
ISSN	1879-1409 ; 0305-4179
ISSN (online)	1879-1409
ISSN	0305-4179
DOI	10.1016/j.burns.2017.10.018
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Article ; Online: Metabolic consequences for mice lacking Endosialin: LC-MS/MS-based metabolic phenotyping of serum from C56Bl/6J Control and CD248 knock-out mice.

Armitage, Emily G / Barnes, Alan / Patrick, Kieran / Bechar, Janak / Harrison, Matthew J / Lavery, Gareth G / Rainger, G Ed / Buckley, Christopher D / Loftus, Neil J / Wilson, Ian D / Naylor, Amy J

Metabolomics : Official journal of the Metabolomic Society

2021 Volume 17, Issue 2, Page(s) 14

Abstract: Introduction: The Endosialin/CD248/TEM1 protein is expressed in adipose tissue and its expression increases with obesity. Recently, genetic deletion of CD248 has been shown to protect mice against atherosclerosis on a high fat diet.: Objectives: We ... ...

Abstract	Introduction: The Endosialin/CD248/TEM1 protein is expressed in adipose tissue and its expression increases with obesity. Recently, genetic deletion of CD248 has been shown to protect mice against atherosclerosis on a high fat diet. Objectives: We investigated the effect of high fat diet feeding on visceral fat pads and circulating lipid profiles in CD248 knockout mice compared to controls. Methods: From 10 weeks old, CD248 Results: We demonstrate a specific reduction in the size of the perirenal fat pad in CD248 Conclusions: Overall these results show a clear and protective metabolic consequence of CD248 deletion in mice, implicating CD248 in lipid metabolism or trafficking and opening new avenues for further investigation using anti-CD248 targeting agents.
Language	English
Publishing date	2021-01-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2250617-2
ISSN	1573-3890 ; 1573-3882
ISSN (online)	1573-3890
ISSN	1573-3882
DOI	10.1007/s11306-020-01764-1
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Article ; Online: The role of side stream dark field microvasculature imaging in a rare case of vancomycin-resistant enterococcal endocarditis complicated by heparin-induced thrombocytopenia.

Bechar, Janak / Polesello, Luigi / Lombrano, Maria / Martinelli, Giampaolo / Luckraz, Heyman

Annals of cardiac anaesthesia

2016 Volume 19, Issue 1, Page(s) 197–200

Abstract: Sidestream dark field (SDF) imaging allows direct visualization of microvascular architecture and function. We examine the role of an SDF imaging device in visualizing the sub-lingual microvasculature as a surrogate for splanchnic microperfusion. We ... ...

Abstract	Sidestream dark field (SDF) imaging allows direct visualization of microvascular architecture and function. We examine the role of an SDF imaging device in visualizing the sub-lingual microvasculature as a surrogate for splanchnic microperfusion. We demonstrate good correlation between current monitoring techniques and the SDF imaging device in a rare case of vancomycin-resistant enterococcal (VRE) sepsis along with heparin-induced thrombocytopenia (HIT). To the best of our knowledge, VRE endocarditis with concurrent HIT has not been described in literature. The role of SDF imaging may predict the earlier need for escalation of care, improving morbidity and mortality.
MeSH term(s)	Anticoagulants/adverse effects ; Capillaries/pathology ; Coronary Circulation ; Endocarditis, Bacterial/complications ; Endocarditis, Bacterial/pathology ; Heparin/adverse effects ; Humans ; Male ; Middle Aged ; Thrombocytopenia/chemically induced ; Thrombocytopenia/complications ; Vancomycin Resistance
Chemical Substances	Anticoagulants ; Heparin (9005-49-6)
Language	English
Publishing date	2016-01
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	2106866-5
ISSN	0974-5181 ; 0971-9784
ISSN (online)	0974-5181
ISSN	0971-9784
DOI	10.4103/0971-9784.173048
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