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Article ; Online: Treatment of recurrent rectal prolapse after a laparoscopic ventral mesh rectopexy.

Brown, S R / Pearson, K / Hainsworth, A / Williams, A

2022 Volume 26, Issue 12, Page(s) 991–995

MeSH term(s)	Humans ; Rectal Prolapse/surgery ; Surgical Mesh/adverse effects ; Laparoscopy ; Digestive System Surgical Procedures ; Treatment Outcome ; Rectum/surgery ; Recurrence
Language	English
Publishing date	2022-08-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-022-02689-8
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Article ; Online: Monkeypox-associated proctitis and rectal wall perforation.

Brown, Lottie / Delaney, Christopher / Hainsworth, Alison

BMJ case reports

2023 Volume 16, Issue 1

Abstract: Monkeypox is a viral zoonotic infection which has rapidly increased in incidence and spread globally since May 2022. There have been reports of rectal complications of monkeypox but so far these are not well not understood. Here, we describe a case of ... ...

Abstract	Monkeypox is a viral zoonotic infection which has rapidly increased in incidence and spread globally since May 2022. There have been reports of rectal complications of monkeypox but so far these are not well not understood. Here, we describe a case of rectal pain in HIV-positive man with confirmed monkeypox. MRI on day 5 of hospital admission revealed proctitis with localised perforation. The patient was treated with tecovirimat, antibiotics, analgesia and laxatives and improved without requiring surgical intervention. All patients presenting with new rectal symptoms and deemed high-risk for monkeypox should be isolated and screened for the disease, and appropriate personal protective equipment should be worn by healthcare professionals caring for them. Clinicians should have a low threshold for cross-sectional imaging in patients with confirmed or suspected monkeypox who experience persistent and severe rectal symptoms or who become systemically unwell to investigate for complications such as perforation and abscess formation. The vast majority of monkeypox cases do not require antibiotics and their use should be reserved for patients who show signs of secondary bacterial infection or sepsis.
MeSH term(s)	Male ; Humans ; Mpox (monkeypox) ; Proctitis/diagnosis ; Rectum ; Pain ; Anti-Bacterial Agents/therapeutic use ; Coinfection
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-01-17
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-252168
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Article ; Online: Racial Disparities in Pelvic Floor Disorders.

Sarzo, Carlotta / Nurmahomed, Nur / Ralston, Charlotte / Igbedioh, Carlene / Schizas, Alexis / Hainsworth, Alison / Ferrari, Linda

Annals of surgery

2024

Abstract: Objective: To investigate the impact of racial disparities and Socioeconomic Status (SES) on pelvic floor disorder (PFD) care.: Summary background data: Racial disparities in colorectal PFD remain uninvestigated, despite prior research in ... ...

Abstract	Objective: To investigate the impact of racial disparities and Socioeconomic Status (SES) on pelvic floor disorder (PFD) care. Summary background data: Racial disparities in colorectal PFD remain uninvestigated, despite prior research in urogynecology. Methods: This retrospective study was conducted at Guy's and St. Thomas' Hospital of London in 2023. Patients with colorectal PFD from 2013 to 2018 were evaluated. Patients were classified according to the Index of Multiple Deprivation (IMD) scores and divided into quintiles. The lowest quintile represents the most deprived, whereas the higher quintile represents the least deprived. Assessed variables: patient complaint, symptoms, consultant and biofeedback referrals, investigations, multidisciplinary meeting (MDM) discussions, treatment, and follow-up appointments. Results: 2001 patients were considered. A total of 1126 patients were initially analyzed, and 875 patients were excluded owing to incomplete data. Eight ethnic groups were identified in this study. Constipation was the most common compliant across ethnic groups (P=0,03). Diagnostics, MDM discussions, and conservative treatment did not vary between ethnicities. White British and Asian patients were significantly more likely to be seen by a consultant (P=0.001) and undergo surgery (P=0.002). In the second part of the study, the IMD was calculated for 1992 patients who were categorized into quintiles. Diagnostic tests, discussion in MDM, Consultant review, and surgical treatments were significantly lower in the two lowest quintiles (P<0.001, P<0.001, P=0.02, and P=0.02, respectively). Conservative treatment did not vary between the IMD groups. Conclusions: Disparities in the diagnosis and treatment of colorectal PFD exist among ethnic minorities and patients of low SES. This study allows for the replication of service provision frameworks in other affected areas to minimize inequalities.
Language	English
Publishing date	2024-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006221
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Article ; Online: Is an uncomplicated postoperative recovery following total pelvic exenteration a more important prognostic factor than achieving R0 in the first 2 years?

Ralston, Charlotte / Hainsworth, Alison / de Naurois, Julien / Schizas, Alexis / George, Mark

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 26, Issue 1, Page(s) 73–80

Abstract: Aim: Total pelvic exenteration (TPE) can achieve an R0 resection in locally advanced and recurrent rectal cancer (LARC and RRC) and remains the only curative option. The resultant high morbidity creates prolonged complex recoveries, rendering patients ... ...

Abstract	Aim: Total pelvic exenteration (TPE) can achieve an R0 resection in locally advanced and recurrent rectal cancer (LARC and RRC) and remains the only curative option. The resultant high morbidity creates prolonged complex recoveries, rendering patients unfit for adjuvant chemotherapy. This study aims to evaluate the impact of this on overall survival (OS) and disease-free survival (DFS) as it has not been studied previously. Method: This is a retrospective single-centre study from 2017 to 2021 evaluating patients with LARC or RRC who underwent a curative TPE. Demographics, oncological history, perioperative data [using Clavien-Dindo (CD) scoring], disease recurrence and mortality were analysed using multivariate Cox regression to assess the impact of variables on DFS and OS. Results: A total of 120 patients were included with a median follow-up of 3 years. 28% of patients received adjuvant chemotherapy, 27.5% had surgical follow-up and 44% missed systemic treatment. Missed treatment was predominantly due to prolonged recovery or poor performance status (59%). Patients who missed adjuvant chemotherapy experienced significantly higher CD scores (p = 0.0031), reintervention rates (p=0.0056) and further related surgeriesp (p = 0.0314). Missing adjuvant chemotherpy is a significant factor for poorer survival, with almost a three times higher mortality (p=0.0096, hazard ratio 2.7). R status was not a significant factor for OS following multivariate analysis (p = 0.336), indicating that another factor has an impact on survival within the first 2 years. Conclusions: In the initial 2 years after exenteration, an uncomplicated postoperative recovery allows for the delivery of adjuvant chemotherapy, prolonging survival. R0/R1 status was not the main prognostic factor. Longer follow-up and further multivariate analysis may influence decisions about aggressive R0 resection balanced against the patient being fit for chemotherapy postoperatively.
MeSH term(s)	Humans ; Pelvic Exenteration/adverse effects ; Retrospective Studies ; Prognosis ; Neoplasm Staging ; Neoplasm Recurrence, Local/pathology ; Rectal Neoplasms/pathology ; Treatment Outcome
Language	English
Publishing date	2023-12-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16817
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Article ; Online: Pelvic floor investigations for anal incontinence: Are they useful to predict outcomes from conservative treatment?

Cuinas, Karina / Ferrari, Linda / Igbedioh, Carlene / Solanki, Deepa / Williams, Andrew / Schizas, Alexis / Hainsworth, Alison

Neurourology and urodynamics

2023 Volume 42, Issue 5, Page(s) 1122–1131

Abstract: Aims: There are several options for treating anal incontinence (AI), with limited success rate in long-term follow-up. Patients' selection is important to avoid unnecessary investigations and therapies. The aim of this review is to assess the utility of ...

Abstract	Aims: There are several options for treating anal incontinence (AI), with limited success rate in long-term follow-up. Patients' selection is important to avoid unnecessary investigations and therapies. The aim of this review is to assess the utility of pelvic floor investigations to predict success from conservative treatment in AI. Methods: Baseline demographics, severity scores, and pelvic floor investigations of 490 patients with AI symptoms were retrospectively reviewed. Patient-reported outcomes were used to define success of conservative treatment. Results: Bivariate analysis showed that gender, St Mark's incontinence score, Bowel continence and quality of life domains of International Consultation on Incontinence Modular Questionnaire-Bowel symptoms score, Bristol stool chart, anal squeeze pressure, enterocoele, leak of contrast at rest, and dyssynergia in defecography were associated with patient's outcomes from conservative treatment (p < 0.05). Multivariate analysis showed that only the Bowel continence score was an independent predictor of patient's success with treatment. Conclusions: Pelvic floor investigations are of limited value to predict success of conservative treatment and they should be reserved for patients who fail noninvasive management and might require surgical intervention.
MeSH term(s)	Humans ; Retrospective Studies ; Pelvic Floor ; Conservative Treatment ; Quality of Life ; Fecal Incontinence/therapy ; Fecal Incontinence/diagnosis ; Anal Canal
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.25182
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Article ; Online: Differences in quality of life of patients undergoing total pelvic exenteration compared with standard rectal cancer surgery: a scoping review.

Noor, Zainab / Ralston, Charlotte / Cuffe, Ray / Hainsworth, Alison / Schizas, Alexis / Ferrari, Linda / George, Mark

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 25, Issue 12, Page(s) 2306–2316

Abstract: Aim: Rectal cancer is often treated surgically with an anterior resection (AR) or abdominoperineal excision (APE). However, for patients with locally advanced disease or local recurrence total pelvic exenteration (TPE) surgery can be performed. The ... ...

Abstract	Aim: Rectal cancer is often treated surgically with an anterior resection (AR) or abdominoperineal excision (APE). However, for patients with locally advanced disease or local recurrence total pelvic exenteration (TPE) surgery can be performed. The magnitude of surgery varies, and little research has been done to consider how quality of life (QoL) may vary according to the extent of surgery. Method: A search was conducted on MEDLINE and PubMed for papers published from 2010 to 2021. Inclusion criteria consisted of observational studies comparing adult populations with rectal cancer undergoing APE, AR or TPE, reporting QoL using validated tools. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Outcomes of interest were global QoL, gastrointestinal (GI) symptoms (nausea and vomiting, diarrhoea, and constipation) and pain. Results: Seven studies including 1402 patients were analysed. QoL following TPE generally improves over time, back to baseline or better. AR and APE groups have similar patterns of improvement between baseline and 12 months after surgery, although scores declined in some studies at 12 months. TPE scores are lower overall, and the pattern of improvement differs, with patients tending to have worse nausea and vomiting symptoms. AR and APE patients tend to experience more lower GI symptoms. Conclusion: It is not possible to draw firm conclusions based on the studies analysed. However, QoL returns to baseline following TPE, APE and AR. Preoperative QoL appears to be an indication of postoperative outcomes. Further observational studies are required.
MeSH term(s)	Adult ; Humans ; Animals ; Quality of Life ; Pelvic Exenteration ; Rectal Neoplasms/surgery ; Vomiting ; Nausea/surgery ; Hominidae
Language	English
Publishing date	2023-10-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16775
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Article: "Last night a Xanax saved my life".

Hainsworth, Alan

Australian nursing journal (July 1993)

2012 Volume 20, Issue 1, Page(s) 38

MeSH term(s)	Alprazolam/adverse effects ; Anti-Anxiety Agents/adverse effects ; Australia ; Humans ; Psychiatric Nursing ; Substance-Related Disorders/prevention & control
Chemical Substances	Anti-Anxiety Agents ; Alprazolam (YU55MQ3IZY)
Language	English
Publishing date	2012-07
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1176954-3
ISSN	1320-3185
ISSN	1320-3185
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Article ; Online: Author response to: Comment on: Intraoperative bowel perfusion assessment methods and their effects on anastomotic leak rates: meta-analysis.

Renna, Maxwell S / Grzeda, Mariusz T / Bailey, James / Hainsworth, Alison / Ourselin, Sebastien / Ebner, Michael / Vercauteren, Tom / Schizas, Alexis / Shapey, Jonathan

The British journal of surgery

2023 Volume 111, Issue 1

MeSH term(s)	Humans ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Colectomy/methods ; Perfusion ; Indocyanine Green
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Meta-Analysis ; 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/znad345
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Article ; Online: One-health approach to canine cognitive decline: Dogs Overcoming Geriatric Memory and Aging Initiative for early detection of cognitive decline.

Hunter, Robert P / Ehrenzweig, Joel / Hainsworth, Atticus / Crawford, Abbe / Dagan, Asaf / Sage, Jaime / Araujo, Joseph

American journal of veterinary research

2023 Volume 84, Issue 11

Abstract: Treatment options for human dementia remain limited, and additional research is needed to develop and validate translational models. Canine cognitive decline (CCD) is common in older dogs and a major source of morbidity. The decline includes ... ...

Abstract	Treatment options for human dementia remain limited, and additional research is needed to develop and validate translational models. Canine cognitive decline (CCD) is common in older dogs and a major source of morbidity. The decline includes physiological and behavioral changes comparable to those in humans diagnosed with dementia. There are also corresponding changes in plasma neurodegenerative biomarkers and neuropathology. Biomarkers for both human and canine cognitive decline can be used to identify and quantify the onset of behavioral data suggestive of CCD. Successful correlations would provide reference values for the early identification of neurodegeneration in canine patients. This could allow for the subsequent testing of interventions directed at ameliorating CCD and offer translational value leading to safe and effective treatment of dementia in people. Research can help exploit, track, and provide benefits from the rapid progression of spontaneous naturally occurring CCD in a large heterogenous community of companion dogs. Research efforts should work to deliver information using blood biomarkers, comorbidities, and wearable technologies to track and evaluate biometric data associated with neurodegeneration and cognitive decline that can be used by both human and companion animal researchers. The synergistic approach between human and veterinary medicine epitomized in one health underscores the interconnectedness of the well-being of both species. Leveraging the insights gained from studying CCD can not only lead to innovative interventions for pets but will also shed light on the complex mechanisms of human dementia.
MeSH term(s)	Humans ; Dogs ; Animals ; Aged ; One Health ; Aging/pathology ; Aging/psychology ; Cognitive Dysfunction/diagnosis ; Biomarkers ; Dementia ; Dog Diseases/diagnosis ; Dog Diseases/pathology
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	390796-x
ISSN	1943-5681 ; 0002-9645
ISSN (online)	1943-5681
ISSN	0002-9645
DOI	10.2460/ajvr.23.02.0032
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Article ; Online: Preoperative predictors of success after transvaginal rectocoele repair.

Ferrari, Linda / Cuinas, Karina / Hainsworth, Alison / Darakhshan, Amir / Schizas, Alexis / Kelleher, Cornelius / Williams, Andrew Brian

Techniques in coloproctology

2023 Volume 27, Issue 10, Page(s) 859–866

Abstract: Purpose: Determine predictors of success for transvaginal rectocoele repair (TVRR). Primary aim is to establish predictors of successful treatment analysing patients' characteristics, baseline symptoms, pelvic floor test results and pre-operative ... ...

Abstract	Purpose: Determine predictors of success for transvaginal rectocoele repair (TVRR). Primary aim is to establish predictors of successful treatment analysing patients' characteristics, baseline symptoms, pelvic floor test results and pre-operative conservative treatment. Methods: Retrospective single institution study in a tertiary referral centre for pelvic floor disorders. 207 patients underwent TVRR for symptomatic rectocoele. Information about symptoms related to obstructive defaecation, anal incontinence and vaginal prolapse, results of pelvic floor investigations, multimodality conservative management and variation in surgical technique have been recorded. Symptom related information have been collected at surgical follow-up. Results: 115 patients had residual symptoms after surgical repair of rectocoele, while 97 were symptoms free. Factors associated with residual symptoms after surgical repair are previous proctological procedures, urge AI symptoms, absence of vaginal bulge symptoms, use of transanal irrigation and having a concomitant enterocoele repair during procedure. Conclusion: Factors able to predict a less favourable outcome after TVRR in patients with concomitant ODS are previous proctological procedures, presence of urge AI, short anal canal length on anorectal physiology, seepage on defaecating proctography, use of transanal irrigation, absence of vaginal bulge symptoms and enterocoele repair during surgery. These information are important for a tailored decision making process and to manage patients' expectations before surgical repair.
MeSH term(s)	Female ; Humans ; Rectocele/surgery ; Retrospective Studies ; Constipation/surgery ; Defecography ; Fecal Incontinence/complications ; Treatment Outcome
Language	English
Publishing date	2023-05-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-023-02822-1
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