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  1. Article ; Online: How much of a problem is too much saliva for patients following head and neck cancer.

    Broderick, Damian / Lowe, Derek / Kanatas, Anastasios / N Rogers, Simon

    The British journal of oral & maxillofacial surgery

    2020  Volume 58, Issue 9, Page(s) e51–e56

    Abstract: The aim of this paper is to report the clinical characteristic of those patients reporting "I have too much saliva" following treatment for head and neck cancer. As a new addition to the saliva question of the University of Washington quality of life ... ...

    Abstract The aim of this paper is to report the clinical characteristic of those patients reporting "I have too much saliva" following treatment for head and neck cancer. As a new addition to the saliva question of the University of Washington quality of life questionnaire (UW-QoL), another aim is to make recommendations on how this new option should be scored and handled. Patients treated with curative intent were recruited between April 2017 and October 2019. Assessment was at the first baseline clinic a median (IQR) of 194 (125-249) days after diagnosis and 103 (71-162) days after the end of treatment. Patients completed the modified UW-QoL version 4, the Patient Concerns Inventory (PCI), Distress Thermometer, and the EQ-5D-5L. In 288 patients, saliva was of normal consistency for 80 (28%), less than normal but enough for 57 (20%), too little for 91 (32%), too much for 45 (16%), and there was no saliva at all for 15 (5%). Of patients with too much saliva, two-thirds (31/45, 69%) had tumours located in the oral cavity and 18/40 (45%) had the highest rates of free flap use during surgery. Salivation response was associated strongly with the other measures of health-related quality of life (HRQoL) and the PCI. Of those with too much saliva their results were similar to or worse than those with too little or no saliva at all. In conclusion, having too much saliva is relatively less frequently reported but is an important HRQoL consideration. Its scoring in the UW-QoL should be at a level similar to that of too little saliva.
    MeSH term(s) Head and Neck Neoplasms/surgery ; Humans ; Quality of Life ; Saliva ; Salivation ; Surveys and Questionnaires
    Language English
    Publishing date 2020-07-07
    Publishing country Scotland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2020.05.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Surgical tracheostomies in Covid-19 patients: important considerations and the "5Ts" of safety.

    Broderick, Damian / Kyzas, Panayiotis / Sanders, Kevin / Sawyerr, Alistair / Katre, Chetan / Vassiliou, Leandros

    The British journal of oral & maxillofacial surgery

    2020  Volume 58, Issue 5, Page(s) 585–589

    Abstract: The coronavirus disease (covid19) pandemic (caused by the SARS-CoV-2 virus) is the greatest healthcare challenge in a generation. Clinicians are modifying the way they approach day-to-day procedures. Safety and reduction of transmission risk is paramount. ...

    Abstract The coronavirus disease (covid19) pandemic (caused by the SARS-CoV-2 virus) is the greatest healthcare challenge in a generation. Clinicians are modifying the way they approach day-to-day procedures. Safety and reduction of transmission risk is paramount. Surgical tracheostomies in covid19 patients are aerosol generating procedures linked with a significant risk of viral contamination. Here, we describe our local approach for these procedures, introducing the "5Ts" of safe tracheostomy practice: Theatre set-up, Team Briefing, Transfer of patient, Tracheostomy Procedure, Team Doffing and De-brief. We identify the critical steps of the procedure and explain how we overcome the risks associated with breaking the transfer circuit to attach the patient to the theatre ventilator. We explain our technique to reduce secretion spillage when opening the trachea. We emphasise the importance of closed tracheal suctioning and mouth suctioning prior to patient transfer. We highlight the importance of maintaining a closed circuit throughout the procedure and describe tips on how to achieve this. We summarise the steps of our protocol in an "easy to reproduce" way. Finally, we emphasise the importance of communication in a constantly changing environment and challenging circumstances.
    MeSH term(s) Aerosols ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Humans ; Infection Control ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2 ; Trachea/virology ; Tracheostomy/methods ; Tracheostomy/standards
    Chemical Substances Aerosols
    Keywords covid19
    Language English
    Publishing date 2020-04-16
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2020.04.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Surgical tracheostomies in Covid-19 patients

    Broderick, Damian / Kyzas, Panayiotis / Sanders, Kevin / Sawyerr, Alistair / Katre, Chetan / Vassiliou, Leandros

    British Journal of Oral and Maxillofacial Surgery

    important considerations and the “5Ts” of safety

    2020  Volume 58, Issue 5, Page(s) 585–589

    Keywords Surgery ; Oral Surgery ; Otorhinolaryngology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2020.04.008
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Surgical tracheostomies in COVID-19 patients: A multidisciplinary approach and lessons learned.

    Broderick, Damian / Kyzas, Panayiotis / Baldwin, Andrew J / Graham, Richard M / Duncan, Tracy / Chaintoutis, Christos / Boultoukas, Evangelos / Vassiliou, Leandros

    Oral oncology

    2020  Volume 106, Page(s) 104767

    Abstract: Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices ... ...

    Abstract Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices implemented by senior clinicians. Here, we report on our early experience and outcomes with open tracheostomies in a cohort of COVID-19 patients. We outline the criteria that guide decision making and explore the challenges faced by our intensive care colleagues in the management of these patients. The cohort was 100% male with 90% of them having a raised Body Mass Index (BMI) and other comorbidities (hypertension and diabetes). 60% have been decannulated and have been stepped down the intensive care unit. We recorded no surgical complications or adverse events. The service to date has been shown to be effective, safe, largely reproducible and reflective.
    MeSH term(s) Adult ; Aged ; Betacoronavirus ; Body Mass Index ; COVID-19 ; Clinical Decision-Making ; Cohort Studies ; Coronavirus Infections/surgery ; Coronavirus Infections/virology ; Critical Care ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pandemics ; Patient Care Team ; Pneumonia, Viral/surgery ; Pneumonia, Viral/virology ; SARS-CoV-2 ; Tracheostomy/adverse effects ; Treatment Outcome
    Keywords covid19
    Language English
    Publishing date 2020-05-03
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1120465-5
    ISSN 1879-0593 ; 0964-1955 ; 1368-8375
    ISSN (online) 1879-0593
    ISSN 0964-1955 ; 1368-8375
    DOI 10.1016/j.oraloncology.2020.104767
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Surgical tracheostomies in Covid-19 patients: important considerations and the "5Ts" of safety

    Broderick, Damian / Kyzas, Panayiotis / Sanders, Kevin / Sawyerr, Alistair / Katre, Chetan / Vassiliou, Leandros

    Br J Oral Maxillofac Surg

    Abstract: The coronavirus disease (covid19) pandemic (caused by the SARS-CoV-2 virus) is the greatest healthcare challenge in a generation. Clinicians are modifying the way they approach day-to-day procedures. Safety and reduction of transmission risk is paramount. ...

    Abstract The coronavirus disease (covid19) pandemic (caused by the SARS-CoV-2 virus) is the greatest healthcare challenge in a generation. Clinicians are modifying the way they approach day-to-day procedures. Safety and reduction of transmission risk is paramount. Surgical tracheostomies in covid19 patients are aerosol generating procedures linked with a significant risk of viral contamination. Here, we describe our local approach for these procedures, introducing the "5Ts" of safe tracheostomy practice: Theatre set-up, Team Briefing, Transfer of patient, Tracheostomy Procedure, Team Doffing and De-brief. We identify the critical steps of the procedure and explain how we overcome the risks associated with breaking the transfer circuit to attach the patient to the theatre ventilator. We explain our technique to reduce secretion spillage when opening the trachea. We emphasise the importance of closed tracheal suctioning and mouth suctioning prior to patient transfer. We highlight the importance of maintaining a closed circuit throughout the procedure and describe tips on how to achieve this. We summarise the steps of our protocol in an "easy to reproduce" way. Finally, we emphasise the importance of communication in a constantly changing environment and challenging circumstances.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #101512
    Database COVID19

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  6. Article ; Online: Surgical tracheostomies in COVID-19 patients

    Broderick, Damian / Kyzas, Panayiotis / Baldwin, Andrew J. / Graham, Richard M. / Duncan, Tracy / Chaintoutis, Christos / Boultoukas, Evangelos / Vassiliou, Leandros

    Oral Oncology

    A multidisciplinary approach and lessons learned

    2020  Volume 106, Page(s) 104767

    Keywords Cancer Research ; Oral Surgery ; Oncology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1120465-5
    ISSN 1879-0593 ; 0964-1955 ; 1368-8375
    ISSN (online) 1879-0593
    ISSN 0964-1955 ; 1368-8375
    DOI 10.1016/j.oraloncology.2020.104767
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article: Midazolam and drug-drug interactions in dental conscious sedation.

    Broderick, Damian / Clarke, Mary / Stassen, Leo

    Journal of the Irish Dental Association

    2014  Volume 60, Issue 1, Page(s) 38–43

    Abstract: Unlabelled: Careful prescribing is paramount in clinical practice. Potential drug-drug interactions need to be considered. Midazolam is the drug of choice for the purpose of IV sedation. To ensure safe clinical practice, the patient's current ... ...

    Abstract Unlabelled: Careful prescribing is paramount in clinical practice. Potential drug-drug interactions need to be considered. Midazolam is the drug of choice for the purpose of IV sedation. To ensure safe clinical practice, the patient's current medications need to be recorded.
    Clinical relevance: An update on the drug interactions relating to midazolam are worthy of scrutiny as its use becomes more commonplace in clinical practice.
    Objective: The dentist should understand the possible implications for drug interactions when sedating patients using midazolam.
    MeSH term(s) Anesthesia, Dental ; Anesthesia, Intravenous ; Anti-Bacterial Agents/pharmacology ; Anticholesteremic Agents/pharmacology ; Antifungal Agents/pharmacology ; Antihypertensive Agents/pharmacology ; Conscious Sedation/methods ; Cytochrome P-450 CYP3A ; Cytochrome P-450 CYP3A Inhibitors ; Drug Interactions ; Humans ; Hypnotics and Sedatives/administration & dosage ; Hypnotics and Sedatives/pharmacology ; Midazolam/administration & dosage ; Midazolam/pharmacology
    Chemical Substances Anti-Bacterial Agents ; Anticholesteremic Agents ; Antifungal Agents ; Antihypertensive Agents ; Cytochrome P-450 CYP3A Inhibitors ; Hypnotics and Sedatives ; Cytochrome P-450 CYP3A (EC 1.14.14.1) ; CYP3A4 protein, human (EC 1.14.14.55) ; Midazolam (R60L0SM5BC)
    Language English
    Publishing date 2014-03-21
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 603659-4
    ISSN 0021-1133
    ISSN 0021-1133
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Surgical tracheostomies in COVID-19 patients: A multidisciplinary approach and lessons learned

    Broderick, Damian / Kyzas, Panayiotis / Baldwin, Andrew J / Graham, Richard M / Duncan, Tracy / Chaintoutis, Christos / Boultoukas, Evangelos / Vassiliou, Leandros

    Oral Oncol

    Abstract: Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices ... ...

    Abstract Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices implemented by senior clinicians. Here, we report on our early experience and outcomes with open tracheostomies in a cohort of COVID-19 patients. We outline the criteria that guide decision making and explore the challenges faced by our intensive care colleagues in the management of these patients. The cohort was 100% male with 90% of them having a raised Body Mass Index (BMI) and other comorbidities (hypertension and diabetes). 60% have been decannulated and have been stepped down the intensive care unit. We recorded no surgical complications or adverse events. The service to date has been shown to be effective, safe, largely reproducible and reflective.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #155153
    Database COVID19

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  9. Article ; Online: The effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis: Results from the global SECURE-AD registry.

    Musters, Annelie H / Broderick, Conor / Prieto-Merino, David / Chiricozzi, Andrea / Damiani, Giovanni / Peris, Ketty / Dhar, Sandipan / De, Abhishek / Freeman, Esther / Arents, Bernd W M / Burton, Tim / Bosma, Angela Leigh-Ann L / Chi, Ching-Chi / Fletcher, Godfrey / Drucker, Aaron M / Kabashima, Kenji / de Monchy, Emilie F / Panda, Maitreyee / Wall, Dmitri Robert /
    Vestergaard, Christian / Mahé, Emmanuel / Bonzano, Laura / Kattach, Leila / Napolitano, Maddalena / Ordoñez-Rubiano, María Fernanda / Haufe, Eva / Patruno, Cataldo / Irvine, Alan D / Spuls, Phyllis I / Flohr, Carsten

    Journal of the European Academy of Dermatology and Venereology : JEADV

    2022  

    Abstract: Background: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD).: Objective: To investigate COVID-19 outcomes in patients with AD treated with or without ... ...

    Abstract Background: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD).
    Objective: To investigate COVID-19 outcomes in patients with AD treated with or without systemic immunomodulatory treatments, using a global registry platform.
    Methods: Clinicians were encouraged to report cases of COVID-19 in their patients with AD in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry. Data entered from 1 April 2020 to 31 October 2021 were analysed using multivariable logistic regression. The primary outcome was hospitalization from COVID-19, according to AD treatment groups.
    Results: 442 AD patients (mean age 35.9 years, 51.8% male) from 27 countries with strongly suspected or confirmed COVID-19 were included in analyses. 428 (96.8%) patients were treated with a single systemic therapy (n = 297 [67.2%]) or topical therapy only (n = 131 [29.6%]). Most patients treated with systemic therapies received dupilumab (n = 216). Fourteen patients (3.2%) received a combination of systemic therapies. Twenty-six patients (5.9%) were hospitalized. No deaths were reported. Patients treated with topical treatments had significantly higher odds of hospitalization, compared with those treated with dupilumab monotherapy (odds ratio (OR) 4.65 [95%CI 1.71-14.78]), including after adjustment for confounding variables (adjusted OR (aOR) 4.99 [95%CI 1.4-20.84]). Combination systemic therapy which did not include systemic corticosteroids was associated with increased odds of hospitalization, compared with single agent non-steroidal immunosuppressive systemic treatment (OR 8.09 [95%CI 0.4-59.96], aOR 37.57 [95%CI 1.05-871.11]). Hospitalization was most likely in patients treated with combination systemic therapy which included systemic corticosteroids (OR 40.43 [95%CI 8.16-207.49], aOR 45.75 [95%CI 4.54-616.22]).
    Conclusions: Overall, the risk of COVID-19 complications appears low in patients with AD, even when treated with systemic immunomodulatory agents. Dupilumab monotherapy was associated with lower hospitalization than other therapies. Combination systemic treatment, particularly combinations including systemic corticosteroids, was associated with the highest risk of severe COVID-19.
    Language English
    Publishing date 2022-09-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1128828-0
    ISSN 1468-3083 ; 0926-9959
    ISSN (online) 1468-3083
    ISSN 0926-9959
    DOI 10.1111/jdv.18613
    Database MEDical Literature Analysis and Retrieval System OnLINE

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