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  1. Article ; Online: Pregnancy, parenthood and second-generation bias: women in surgery.

    Donohoe, C L / Mohan, H M

    The British journal of surgery

    2021  Volume 108, Issue 1, Page(s) 1–2

    MeSH term(s) Education, Medical/organization & administration ; Female ; Humans ; Mothers/statistics & numerical data ; Physicians, Women/statistics & numerical data ; Pregnancy/statistics & numerical data ; Sexism ; Surgeons/statistics & numerical data
    Language English
    Publishing date 2021-02-10
    Publishing country England
    Document type 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/znaa014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Use of pudendal nerve blocks in rubber band ligation of haemorrhoids: an Australia-wide cross-sectional analysis.

    Watson, Eleanor G R / Ong, Hwa Ian / Proud, David M / Mohan, Helen M / Korda, Rosemary J

    ANZ journal of surgery

    2024  

    Abstract: Background: Surgeons vary in their approach to preventing pain post rubber band ligation (RBL) of haemorrhoids, with pudendal nerve blocks (PNB) being one analgesic strategy. No data exists on how commonly PNBs are used in RBL in Australia, and whether ... ...

    Abstract Background: Surgeons vary in their approach to preventing pain post rubber band ligation (RBL) of haemorrhoids, with pudendal nerve blocks (PNB) being one analgesic strategy. No data exists on how commonly PNBs are used in RBL in Australia, and whether use varies by year and patient and hospital characteristics.
    Methods: Aggregate data from the National Hospital Morbidity Database was obtained for all admissions for RBL in Australia from 2012 to 2021, with and without a PNB, overall and in relation to sex, age group, hospital remoteness, hospital sector, and year of procedure. Adjusted relative risks (adj. RR) of PNB were estimated using Poisson regression, mutually adjusting for all variables.
    Results: Of the 346 542 admissions for RBL, 14013 (4.04%) involved a PNB. The proportion of patients receiving a PNB increased between 2012-2013 and 2020-2021, from 1.62% to 6.63% (adj. RR 3.99, CI 3.64-4.36). Patients most likely to receive a PNB were female (adj. RR 1.10; CI 1.07-1.14) aged 25-34 years (adj. RR 1.13; CI 1.01-1.26); in major-city (adj. RR 1.25 CI 1.20-1.30) and private hospitals (adj. RR 3.28 CI 3.13-3.45).
    Conclusion: This is the first published analysis of the use of PNB in RBL. Pudendal nerve block use has increased over time, with substantial variation in practice. Blocks were more than three times as likely to be used in private compared to public hospitals. If evidence supporting PNB use is established, equitable access to the procedure should be pursued.
    Language English
    Publishing date 2024-01-04
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.18849
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Surgical treatment of intestinal stricture in inflammatory bowel disease.

    Mohan, Helen M / Coffey, John C

    Journal of digestive diseases

    2020  Volume 21, Issue 6, Page(s) 355–359

    Abstract: Fibroblast infiltration and collagen deposition result in structural changes in the bowel wall, and lead to strictures in intestinal inflammatory disease. While strictures can also occur in other contexts, such as malignancy, this review focuses on the ... ...

    Abstract Fibroblast infiltration and collagen deposition result in structural changes in the bowel wall, and lead to strictures in intestinal inflammatory disease. While strictures can also occur in other contexts, such as malignancy, this review focuses on the surgical treatment of stricture secondary to inflammatory bowel disease. Distinguishing between predominantly inflammation vs established fibrosis as the cause of a stricture can be challenging. While inflammatory strictures may be responsive to medication, predominantly fibrotic strictures usually need surgical intervention. Both endoluminal and extraluminal approaches are described in this review. Endoscopic dilatation of strictures is suitable for short-segment isolated small bowel strictures. Other options are to divide the stricture surgically but preserve the length, performing a strictureplasty or resecting the strictured segment. The mesentery is increasingly recognized as playing a role in stricture recurrence. In a relapsing-remitting disease such as Crohn's disease, the preservation of intestinal length is essential and balance is needed between this and a complete resection to reduce the risk of recurrence. Pre- and postoperative involvement of the multidisciplinary team is essential to improve outcomes in this challenging clinical scenario.
    MeSH term(s) Constriction, Pathologic/etiology ; Constriction, Pathologic/surgery ; Crohn Disease/complications ; Crohn Disease/surgery ; Dilatation/methods ; Endoscopy, Gastrointestinal/methods ; Fibrosis/surgery ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/surgery ; Intestines/pathology ; Intestines/surgery ; Patient Care Team ; Recurrence ; Treatment Outcome
    Language English
    Publishing date 2020-06-18
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 2317117-0
    ISSN 1751-2980 ; 1751-2972
    ISSN (online) 1751-2980
    ISSN 1751-2972
    DOI 10.1111/1751-2980.12880
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Cancer surgery in a time of COVID-19

    Ghignone, F. / Mohan, H.M. / Montroni, I.

    European Journal of Surgical Oncology

    Many questions, few certainties

    2020  Volume 46, Issue 6, Page(s) 1196–1197

    Keywords Surgery ; Oncology ; General Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 632519-1
    ISSN 0748-7983
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2020.04.046
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Pathogenic mutations in UBQLN2 exhibit diverse aggregation propensity and neurotoxicity.

    Safren, Nathaniel / Dao, Thuy P / Mohan, Harihar Milaganur / Huang, Camellia / Trotter, Bryce / Castañeda, Carlos A / Paulson, Henry / Barmada, Sami / Sharkey, Lisa M

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 6049

    Abstract: The ubiquitin-adaptor protein UBQLN2 promotes degradation of several aggregate-prone proteins implicated in neurodegenerative diseases. Missense UBQLN2 mutations also cause X-linked amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). ... ...

    Abstract The ubiquitin-adaptor protein UBQLN2 promotes degradation of several aggregate-prone proteins implicated in neurodegenerative diseases. Missense UBQLN2 mutations also cause X-linked amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Previously we demonstrated that the liquid-like properties of UBQLN2 molecular assemblies are altered by a specific pathogenic mutation, P506T, and that the propensity of UBQLN2 to aggregate correlated with neurotoxicity. Here, we systematically assess the effects of multiple, spatially distinct ALS/FTD-linked missense mutations on UBQLN2 aggregation propensity, neurotoxicity, phase separation, and autophagic flux. In contrast to what we observed for the P506T mutation, no other tested pathogenic mutant exhibited a clear correlation between aggregation propensity and neurotoxicity. These results emphasize the unique nature of pathogenic UBQLN2 mutations and argue against a generalizable link between aggregation propensity and neurodegeneration in UBQLN2-linked ALS/FTD.
    MeSH term(s) Humans ; Frontotemporal Dementia/genetics ; Amyotrophic Lateral Sclerosis/metabolism ; Autophagy-Related Proteins/genetics ; Mutation ; Adaptor Proteins, Signal Transducing/metabolism
    Chemical Substances Autophagy-Related Proteins ; Adaptor Proteins, Signal Transducing ; UBQLN2 protein, human
    Language English
    Publishing date 2024-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-55582-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Analgesic effect of local anaesthetic in haemorrhoid banding: systematic review and meta-analysis.

    Watson, Eleanor G R / Ong, Hwa Ian / Shearer, Nicholas J W / Smart, Philip J / Burgess, Adele N / Proud, David M / Mohan, Helen M

    International journal of colorectal disease

    2024  Volume 39, Issue 1, Page(s) 34

    Abstract: Purpose: Rubber band ligation of haemorrhoids can be,painful and there is no consensus regarding the optimal analgesic strategy. This study aims to determine whether there is a difference in post-procedural pain in adults undergoing haemorrhoid banding ... ...

    Abstract Purpose: Rubber band ligation of haemorrhoids can be,painful and there is no consensus regarding the optimal analgesic strategy. This study aims to determine whether there is a difference in post-procedural pain in adults undergoing haemorrhoid banding who have received local anaesthetic, a pudendal nerve block or no regional or local analgesia.
    Methods: MEDLINE, Embase, Google Scholar and clinical trial registries were searched for randomised trials of local anaesthetic or pudendal nerve block use in banding. Primary outcomes were patient-reported pain scores. The quality of the evidence was assessed using the GRADE approach.
    Results: Seven studies were included in the final review. No articles were identified that studied pudendal nerve blocks. The difference in numerical pain scores between treatment groups favoured the local anaesthetic group at all timepoints. The mean difference in scores on a 10-point scale was at 1 h,-1.43 (95% CI-2.30 to-0.56, p < 0.01, n = 342 (175 in treatment group)); 6 h,-0.52 (95% CI-1.04 to 0.01, p = 0.05, n = 250 (130 in treatment group)); and 24 h,-0.31 (95% CI-0.82 to 0.19, p = 0.86, n = 247 (127 in treatment group)). Of reported safety outcomes, vasovagal symptoms proceeded to meta-analysis, with a risk ratio of 1.01 (95% CI 0.64-1.60). The quality of the evidence was rated down to 'low' due to inconsistency and imprecision.
    Conclusion: This review supports the use of LA for reducing early post-procedural pain following haemorrhoid banding. The evidence was limited by small sample sizes and substantial heterogeneity across studies.
    Registration: PROSPERO (ID CRD42022322234).
    MeSH term(s) Humans ; Anesthesia, Local ; Anesthetics, Local ; Hemorrhoids/surgery ; Pain ; Pain, Procedural
    Chemical Substances Anesthetics, Local
    Language English
    Publishing date 2024-03-04
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-024-04609-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Does complete pathological response increase perioperative morbidity risk in rectal cancer?

    Tiang, Thomas K S / Yeoh, Adrian S S / Othman, Bushra / Mohan, Helen M / Burgess, Adele N / Smart, Philip J / Proud, David M

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

    2024  

    Abstract: Aim: The optimal management of patients with clinical complete response after neoadjuvant treatment for rectal cancer is controversial. The aim of this study is to compare the morbidity between patients with locally advanced rectal cancer who have had a ...

    Abstract Aim: The optimal management of patients with clinical complete response after neoadjuvant treatment for rectal cancer is controversial. The aim of this study is to compare the morbidity between patients with locally advanced rectal cancer who have had a pathological complete response (pCR) or not after neoadjuvant chemoradiotherapy (NCRT) and total mesorectal excision (TME). The study hypothesis was that pCR may impact the surgical complication rate.
    Method: A retrospective cohort study was conducted of a prospectively maintained database in Australia and New Zealand, the Binational Colorectal Cancer Audit, that identified patients with locally advanced rectal cancer (<15 cm from anal verge) from 1 January 2007 to 31 December 2019. Patients were included if they had locally advanced rectal cancer and had undergone NCRT and proceeded to surgical resection.
    Results: There were 4584 patients who satisfied the inclusion criteria, 65% being male. The mean age was 63 years and 11% had a pCR (ypT0N0). TME with anastomosis was performed in 67.8% of patients, and the majority of the cohort received long-course radiotherapy (81.7%). Both major and minor complications were higher in the TME without anastomosis group (17.3% vs. 14.7% and 30.6% vs. 20.8%, respectively), and the 30-day mortality was 1.31%. In the TME with anastomosis group, pCR did not contribute to higher rates of surgical complications, but male gender (p < 0.0012), age (p < 0.0001), preoperative N stage (p = 0.0092) and American Society of Anesthesologists (ASA) score ≥3 (p < 0.0002) did. In addition, pCR had no significant effect (p = 0.44) but male gender (p = 0.0047) and interval to surgery (p = 0.015) contributed to higher rates of anastomotic leak. In the TME without anastomosis cohort, the only variable that contributed to higher rates of complications was ASA score ≥3 (p = 0.033).
    Conclusion: Patients undergoing TME dissection for rectal cancer following NCRT showed no difference in complications whether they had achieved pCR or not.
    Language English
    Publishing date 2024-03-11
    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.16939
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Cancer surgery in a time of COVID-19: Many questions, few certainties.

    Ghignone, F / Mohan, H M / Montroni, I

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2020  Volume 46, Issue 6, Page(s) 1196–1197

    MeSH term(s) Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/epidemiology ; Global Health ; Humans ; Neoplasms/epidemiology ; Neoplasms/surgery ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Surgical Oncology ; Surgical Procedures, Operative/standards
    Keywords covid19
    Language English
    Publishing date 2020-04-30
    Publishing country England
    Document type Letter
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2020.04.046
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Lateral pelvic sidewall dissection in rectal cancer: case selection and training to optimize outcomes.

    Lokuhetty, Naradha / Mohan, Helen M / Kong, Joseph C / Heriot, Alexander G / Warrier, Satish K

    The British journal of surgery

    2022  Volume 109, Issue 4, Page(s) 306–307

    MeSH term(s) Humans ; Lymph Node Excision ; Lymph Nodes ; Pelvis ; Rectal Neoplasms/surgery
    Language English
    Publishing date 2022-01-19
    Publishing country England
    Document type 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/znab446
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Metabolomic Pathway Activity with Genomic Single-Nucleotide Polymorphisms Associated with Colorectal Cancer Recurrence and 5-Year Overall Survival.

    Fleming, Christina A / Mohan, Helen M / O'Leary, Donal P / Corrigan, Mark / Redmond, H Paul

    Journal of gastrointestinal cancer

    2022  Volume 54, Issue 1, Page(s) 247–258

    Abstract: Purpose: Metabolomic analysis in colorectal cancer (CRC) is an emerging research area with both prognostic and therapeutic targeting potential. We aimed to identify metabolomic pathway activity prognostic for CRC recurrence and overall survival and ... ...

    Abstract Purpose: Metabolomic analysis in colorectal cancer (CRC) is an emerging research area with both prognostic and therapeutic targeting potential. We aimed to identify metabolomic pathway activity prognostic for CRC recurrence and overall survival and cross-reference such metabolomic data with prognostic genomic single-nucleotide polymorphisms (SNPs).
    Methods: A systematic search of PubMed, Embase and Cochrane Library was performed for studies reporting prognostic metabolomic pathway activity in CRC in keeping with PRISMA guidelines. The QUADOMICS tool was used to assess study quality. MetaboAnalyst software (version4.0) was used to map metabolites that were associated with recurrence and survival in CRC to recognise metabolic pathways and identify genomic SNPs associated with CRC prognosis, referencing the following databases: Human Metabolome Database (HMDB), the Small Molecule Pathway Database (SMPDB), PubChem and Kyoto Encyclopaedia of Genes and Genomes (KEGG) Pathway Database.
    Results: Nine studies met the inclusion criteria, reporting on 1117 patients. Increased metabolic activity in the urea cycle (p = 0.002, FDR = 0.198), ammonia recycling (p = 0.004, FDR = 0.359) and glycine and serine metabolism (p = 0.004, FDR = 0.374) was prognostic of CRC recurrence. Increased activity in aspartate metabolism (p < 0.001, FDR = 0.079) and ammonia recycling (p = 0.004, FDR = 0.345) was prognostic of survival. Eight resulting SNPs were prognostic for CRC recurrence (rs2194980, rs1392880, rs2567397, rs715, rs169712, rs2300701, rs313408, rs7018169) and three for survival (rs2194980, rs169712, rs12106698) of which two overlapped with recurrence (rs2194980, rs169712).
    Conclusions: With a caveat on study heterogeneity, specific metabolites and metabolic pathway activity appear evident in the setting of poor prognostic colorectal cancers and such metabolic signatures are associated with specific genomic SNPs.
    MeSH term(s) Humans ; Ammonia ; Colorectal Neoplasms/drug therapy ; Genomics ; Metabolomics/methods ; Polymorphism, Single Nucleotide ; Prognosis
    Chemical Substances Ammonia (7664-41-7)
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 2452514-5
    ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
    ISSN (online) 1941-6636 ; 1559-0739
    ISSN 1941-6628 ; 1537-3649
    DOI 10.1007/s12029-022-00813-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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