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Article ; Online: Regarding "A comparison of revision using distal inflow and distal revascularization interval ligation for the management of severe access-related hand ischemia".

Aitken, Emma

2016 Volume 64, Issue 5, Page(s) 1548–1549

Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Letter
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2016.06.122
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Article ; Online: A practical review of barriers and challenges to a definitive randomised trial of grafts versus fistula.

Kingsmore, David / Edgar, Ben / Stevenson, Karen / Greenlaw, Nicola / Aitken, Emma / Jackson, Andrew / Thomson, Peter

The journal of vascular access

2024 , Page(s) 11297298241234610

Abstract: A definitive randomised controlled trial of arteriovenous fistula (AVF) versus arteriovenous grafts (AVG) has been advocated for more than a decade, but as yet, none has been completed. The aim of this article is to summarise the theoretical barriers, ... ...

Abstract	A definitive randomised controlled trial of arteriovenous fistula (AVF) versus arteriovenous grafts (AVG) has been advocated for more than a decade, but as yet, none has been completed. The aim of this article is to summarise the theoretical barriers, review the difficulties in trial design and practicalities that have thus far prevented this from occurring.
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.1177/11297298241234610
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Article ; Online: What are the observed procedural costs of vascular access surgery? Protocol for a systematic review.

Edgar, Ben / Jones, Catrin / Aitken, Emma / Stevenson, Karen / Jackson, Andrew / Gaianu, Lucian / Thomson, Peter / Kasthuri, Ram / Stove, Callum / Kingsmore, David

BMJ open

2024 Volume 14, Issue 1, Page(s) e079773

Abstract: Introduction: A central component in the introduction of a novel surgical procedure or technique is an evaluation of its cost efficiency when compared with a benchmark standard of care. Accurate assessment of costs is thus essential in ensuring ... ...

Abstract	Introduction: A central component in the introduction of a novel surgical procedure or technique is an evaluation of its cost efficiency when compared with a benchmark standard of care. Accurate assessment of costs is thus essential in ensuring appropriate allocation of resources within a healthcare system. The treatment of kidney failure requires a significant volume of resources, and vascular access provision is the main modifiable cost. The costs of providing this service are obscured by generic NHS reference costs, which lack adequate granularity to allow meaningful comparisons between treatments. The aim of this systematic review will be to assess the reporting of procedural costs in all published economic analyses of vascular access surgery and perform a comparison of the reported procedural costs involved in arteriovenous fistula (AVF) and arteriovenous graft (AVG) creation. This will provide an estimate as to the accuracy of the NHS reference costs in this field. Methods and analysis: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A systematic search will be performed of the MEDLINE, Embase and Cochrane databases to identify full-text economic analyses of vascular access for haemodialysis in which the procedural cost of AVF or AVG creation is reported. Publications in English from 1 January 2000 to 30 August 2023, will be eligible for inclusion. Studies will be selected by title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Studies not reporting the procedural costs of surgery will be excluded. Data collected will pertain to procedural costs of AVF and AVG creation. Costs will be adjusted to a common currency using a gross domestic product (GDP) deflator index and conversion rates based on purchasing power parities for GDP. Comparison with NHS reference costs will indicate their reliability for use in future economic analyses in this field. Ethics and dissemination: Ethical approval is not required for this systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations. Prospero registration number: CRD42023458779.
MeSH term(s)	Humans ; Reproducibility of Results ; Systematic Reviews as Topic ; Renal Dialysis ; Delivery of Health Care ; Arteriovenous Shunt, Surgical ; Arteriovenous Fistula
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-079773
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Article ; Online: Could anaesthetic technique be blocking successful outcomes in arteriovenous fistula surgery?

Macfarlane, Alan J R / Neuman, Mark D / Aitken, Emma

British journal of anaesthesia

2020 Volume 126, Issue 2, Page(s) 349–352

MeSH term(s)	Anesthesia/adverse effects ; Arteriovenous Shunt, Surgical/adverse effects ; Humans ; Renal Dialysis ; Risk Assessment ; Risk Factors ; Treatment Failure
Language	English
Publishing date	2020-11-10
Publishing country	England
Document type	Editorial
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.10.014
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Article ; Online: How to set up a clinical trial.

Thomas, Rachel A B / Aitken, Emma Louise / Antonelli, Jean / Marson, Lorna

Postgraduate medical journal

2020 Volume 96, Issue 1139, Page(s) 564–569

Abstract: Clinical trials are considered the gold-standard method for the evaluation of healthcare interventions. However, randomised control trials are complex to perform and many researchers, especially those in the early stages of their career, can find it ... ...

Abstract	Clinical trials are considered the gold-standard method for the evaluation of healthcare interventions. However, randomised control trials are complex to perform and many researchers, especially those in the early stages of their career, can find it challenging to know where to start set up, contribute to or lead a trial. This guide provides an introduction to trials and also practical advice to help potential investigators complete their clinical trial to time and to budget by signposting the pathway through the complex regulatory landscape. The authors draw on their own recent experiences of running clinical trials and provide tips and tricks for troubleshooting common problems encountered including trial design and documentation.
MeSH term(s)	Clinical Protocols ; Clinical Trials as Topic ; Data Management ; Ethics Committees, Research ; Guidelines as Topic ; Humans ; Research Personnel ; Research Support as Topic ; State Medicine ; United Kingdom
Language	English
Publishing date	2020-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2019-137379
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Article ; Online: The fate of the fistula following renal transplantation.

Aitken, Emma / Kingsmore, David

Transplant international : official journal of the European Society for Organ Transplantation

2014 Volume 27, Issue 9, Page(s) e90–1

MeSH term(s)	Adult ; Arteriovenous Shunt, Surgical/adverse effects ; Arteriovenous Shunt, Surgical/psychology ; Female ; Follow-Up Studies ; Graft Rejection ; Humans ; Hypertrophy, Left Ventricular/etiology ; Hypertrophy, Left Ventricular/physiopathology ; Hypertrophy, Left Ventricular/prevention & control ; Kidney Failure, Chronic/surgery ; Kidney Failure, Chronic/therapy ; Kidney Transplantation ; Ligation ; Male ; Middle Aged ; Recurrence ; Renal Dialysis/methods ; Renal Dialysis/psychology ; Reoperation ; Stroke Volume ; Unnecessary Procedures
Language	English
Publishing date	2014-09
Publishing country	England
Document type	Letter
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.12326
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Article ; Online: Reply.

Aitken, Emma / Kingsmore, David / Thomson, Peter / Kasthuri, Ram

Journal of vascular surgery

2017 Volume 66, Issue 3, Page(s) 969–970

Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Letter
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2017.05.084
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Article ; Online: A comparison of the effects of oral vs. intravenous hydration on subclinical acute kidney injury in living kidney donors: a protocol of a randomised controlled trial.

Mackinnon, Shona / Aitken, Emma / Ghita, Ryan / Clancy, Marc

BMC nephrology

2017 Volume 18, Issue 1, Page(s) 30

Abstract: Background: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is ...

Abstract	Background: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function. This may be important in both preservation of donor renal function and recipient graft longevity. Methods/design: A prospective single-centre single-blinded randomized controlled trial will be carried out to determine the effects of donor preoperative intravenous fluids. The primary outcome is donor subclinical acute kidney injury (defined as plasma NGAL, >153 ng/ml) on day 1 postoperatively. Secondary outcomes include intraoperative haemodynamics, recipient subclinical acute kidney injury, perioperative complications and donor sleep quality. Donors will be randomised into two groups: the intervention group will receive active pre-hydration consisting of three litres of intravenous Hartmann's solution between midnight and 8 am before morning kidney donation, while the control group will not receive this. Both groups will receive unlimited oral fluids until midnight, as is routine. Plasma NGAL will be measured at pre-specified perioperative time points, intraoperative haemodynamic data will be collected using non-invasive cardiac output monitoring and clinical notes will be used to obtain demographic and clinical data. The researcher will be blinded to the donor fluid hydration status. Blinded statistical analysis will be performed on an intention-to-treat basis. A prospective power calculation estimates a required sample size of 86 patients. Discussion: This study will provide important data, as there is currently little evidence about the use of donor preoperative fluids in laparoscopic nephrectomy. It is hoped that the results obtained will guide future clinical practice. Trial registration: This study has been approved by the West of Scotland Research Ethics Committee 3 (reference no. 14/WS/1160, 27 January 2015) and is registered with the International Standard Randomised Controlled Trial Number Register (reference no. ISRCTN10199225 , 20 April 2015).
MeSH term(s)	Acute Kidney Injury/drug therapy ; Acute Kidney Injury/etiology ; Acute Kidney Injury/prevention & control ; Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Asymptomatic Diseases/therapy ; Dose-Response Relationship, Drug ; Female ; Fluid Therapy/methods ; Graft Survival/drug effects ; Humans ; Injections, Intravenous ; Kidney Transplantation/adverse effects ; Living Donors ; Male ; Middle Aged ; Premedication/methods ; Rehydration Solutions/administration & dosage ; Treatment Outcome ; Young Adult
Chemical Substances	Rehydration Solutions
Language	English
Publishing date	2017-01-19
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-017-0447-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Early-cannulation arteriovenous grafts: Multidisciplinary learning is essential to optimize outcomes.

Kingsmore, David B / Stevenson, Karen S / Edgar, Ben / Aitken, Emma / Jackson, Andrew / Isaak, Andrej / Richarz, Sabine / Bainbridge, Leigh / Stove, Callum / Kasthuri, Ram / Thomson, Peter C

The journal of vascular access

2023 , Page(s) 11297298231212758

Abstract: Background: It is likely that there will be an increasing role for early-cannulation arteriovenous grafts (ecAVG) with a wider recognition of the need to tailor vascular access to avoid futile procedures and unnecessary TCVC. However, experience of ... ...

Abstract	Background: It is likely that there will be an increasing role for early-cannulation arteriovenous grafts (ecAVG) with a wider recognition of the need to tailor vascular access to avoid futile procedures and unnecessary TCVC. However, experience of these products is not common and limited to early surgical adopters, with little information on the systemic changes and multi-disciplinary care needed to optimize outcomes. The aim of this study was to report the impact of a multi-disciplinary approach on quantifiable outcomes. Methods: A retrospective analysis of a prospectively maintained database of 295 ecAVG implanted over an 8-year time-period was performed. Indicative outcomes were chosen to reflect nephrology (patient selection), nursing care (cannulation complications of infection and pseudoaneurysm) and radiology (thrombosis) on cumulative impact (functional patency) over three distinct time periods. Results: The incidence of ecAVG increased 10-fold over the three time periods. The use of ecAVG changed significantly from salvage tertiary access to TCVC avoidance and salvage of existing AVF. Nursing complications reduced markedly with significantly fewer over-cannulation episodes and pseudo-aneurysms. With an improved pro-active surveillance programme, the time to first thrombosis doubled and the risk of thrombosis halved. Ultimately this resulted in significantly improved functional patency with a risk of ecAVG loss less than one-third by the last time-period. Conclusions: All aspects of ecAVG use require scrutiny and critical appraisal. Failure or success is not simply achieved by performing good technical surgery with an efficacious product, but by the care taken across a wide range of elements spanning case selection, implantation, use and maintenance.
Language	English
Publishing date	2023-11-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.1177/11297298231212758
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Article: Phylogenetic analysis of resistance to ceftazidime/avibactam, ceftolozane/tazobactam and carbapenems in piperacillin/tazobactam-resistant Pseudomonas aeruginosa from cystic fibrosis patients

Zamudio, Roxana / Aitken, Emma / Gould, Ian M / Hijazi, Karolin / Joshi, Chaitanya / Oggioni, Marco R

International journal of antimicrobial agents. 2019 June, v. 53, no. 6

2019

Abstract: Pseudomonas aeruginosa is one of the most important pathogens in cystic fibrosis. This study was conducted to analyse the genetic basis and phylogenetic profile of resistance to ceftazidime/avibactam, ceftolozane/tazobactam and carbapenems in cystic ... ...

Abstract	Pseudomonas aeruginosa is one of the most important pathogens in cystic fibrosis. This study was conducted to analyse the genetic basis and phylogenetic profile of resistance to ceftazidime/avibactam, ceftolozane/tazobactam and carbapenems in cystic fibrosis P. aeruginosa isolates. Whole genome sequence analysis was conducted of isolates resistant to piperacillin/tazobactam collected from seven hospitals in Scotland since the introduction of these two cephalosporin/β-lactamase inhibitor combinations. Ceftazidime resistance was primarily related to AmpC induction, as tested by cloxacillin inhibition assays, while high-level ceftazidime resistance not reversed by cloxacillin was associated with amino acid variations in AmpC. Only isolates resistant to both ceftazidime/avibactam and ceftolozane/tazobactam carried AmpD mutations, likely resulting in ampC overexpression. All isolates resistant to ceftazidime/avibactam and/or ceftolozane/tazobactam were resistant to carbapenems and showed inactivating mutations in the chromosomal oprD gene. None of the isolates bore class A, B, D plasmid-encoded carbapenemases. This study showed that mutational resistance emerged in phylogenetically distant lineages, which indicates the mutations occur independently without conferring a selective advantage to any phylogenetic lineage. These findings confirm the strong contribution of mutation-driven evolution to the population structure of P. aeruginosa.
Keywords	amino acids ; beta-lactamase ; carbapenems ; ceftazidime ; cloxacillin ; cystic fibrosis ; enzyme inhibitors ; gene overexpression ; genes ; hospitals ; mutation ; pathogens ; patients ; phylogeny ; piperacillin ; population structure ; Pseudomonas aeruginosa ; sequence analysis ; Scotland
Language	English
Dates of publication	2019-06
Size	p. 774-780.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2019.02.022
Database	NAL-Catalogue (AGRICOLA)

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