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Article ; Online: Calcium channel blockers are associated with improved survival in pancreatic cancer patients undergoing neoadjuvant chemotherapy and resection.

Fong, Zhi V / Severs, George / Moir, John / White, Steve / Qadan, Motaz / Tingle, Samuel

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 26, Issue 3, Page(s) 418–425

Abstract: Background: Repurposing existing drugs for use in oncology is more efficient, cost-effective and safe than novel drug discovery. Calcium signalling is increasingly recognised to have a key role in chemoresistance. This study assessed the impact of ... ...

Abstract	Background: Repurposing existing drugs for use in oncology is more efficient, cost-effective and safe than novel drug discovery. Calcium signalling is increasingly recognised to have a key role in chemoresistance. This study assessed the impact of calcium channel blockers (CCB) in pancreatic cancer. Methods: Retrospective population study of patients undergoing resection (curative intent) of pancreatic ductal adenocarcinoma (SEER-Medicare, 2007-2017). Cox models were built to assess the impact on overall survival. As laboratory studies suggest a chemosensitising effect, the impact of CCB was assessed separately in patients receiving neoadjuvant chemotherapy. Results: 6,223 patients were included, of whom 660 were prescribed CCB. In total, 591 received neoadjuvant chemotherapy; in this cohort CCB prescription was associated with improved overall survival when adjusting for multiple prognostic factors (aHR = 0.715, 0.514-0.996, P = 0.047). This effect was not observed in patients not receiving neoadjuvant chemotherapy (aHR = 1.082, 0.982-1.191, P = 0.112). Conclusion: CCB prescription was associated with improved overall survival in patients receiving neoadjuvant chemotherapy prior to pancreatic cancer resection. The association was specific to the group of patients receiving neoadjuvant chemotherapy, mirroring the chemosensitising effect in laboratory studies. This defines patients receiving neoadjuvant chemotherapy as a target population for prospective clinical trials of CCB in pancreatic cancer.
MeSH term(s)	Humans ; Aged ; United States ; Neoadjuvant Therapy/adverse effects ; Calcium Channel Blockers/adverse effects ; Retrospective Studies ; Prospective Studies ; Medicare ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms/pathology ; Carcinoma, Pancreatic Ductal/drug therapy ; Carcinoma, Pancreatic Ductal/surgery ; Carcinoma, Pancreatic Ductal/pathology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Chemical Substances	Calcium Channel Blockers
Language	English
Publishing date	2023-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.12.001
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Zs.A 6326: Show issues

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Article ; Online: Association between systematic use of bio-occlusive dressing and general anaesthesia-associated corneal injury.

Sanders, Riley N / Elhusseiny, Abdelrahman M / Chauhan, Muhammad Z / Scruggs, Stewart / Stewart, Alvin / Tingle, Sarah / Sallam, Ahmed B

British journal of anaesthesia

2022 Volume 129, Issue 6, Page(s) e153–e155

MeSH term(s)	Humans ; Occlusive Dressings ; Corneal Injuries/therapy ; Anesthesia, General/adverse effects
Language	English
Publishing date	2022-09-29
Publishing country	England
Document type	Letter
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2022.08.028
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Article ; Online: Hepatocellular neoplasm of uncertain malignant potential associated with hepatic granulomas featuring p62-positive asteroid bodies.

Tingle, Samuel / Sewpaul, Avinash / Parkinson, Daniel / White, Steven / Tiniakos, Dina

Pathology

2019 Volume 51, Issue 7, Page(s) 742–745

MeSH term(s)	Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Female ; Granuloma/diagnostic imaging ; Granuloma/pathology ; Granuloma/surgery ; Humans ; Liver/diagnostic imaging ; Liver/pathology ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Middle Aged
Language	English
Publishing date	2019-10-23
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2019.08.011
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Zs.A 723: Show issues

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Article ; Online: Use of Dextran 40 After Pancreas Transplant May Reduce Early Inflammation and Significant Bleeding Compared to a Heparin-Based Protocol.

Innes, Ailsa / Tingle, Samuel / Ibrahim, Ibrahim / Thompson, Emily / Bates, Lucy / Manas, Derek / White, Steven / Wilson, Colin

Transplantation proceedings

2020 Volume 53, Issue 2, Page(s) 712–715

Abstract: Background: Dextran 40 (D40) is a synthetic colloid with anticoagulant properties that is used instead of heparin after pancreas transplantation; however, there is a lack of evidence on which is more effective. Graft thrombosis and pancreatitis, which ... ...

Abstract	Background: Dextran 40 (D40) is a synthetic colloid with anticoagulant properties that is used instead of heparin after pancreas transplantation; however, there is a lack of evidence on which is more effective. Graft thrombosis and pancreatitis, which may be mediated through microthrombosis or macrothrombosis within the graft, remain significant complications after pancreas transplantation. We hypothesized that D40 reduces inflammation through its antithrombotic promicrocirculatory effects. We evaluated D40 compared to a heparin-based protocol by comparing postoperative complications and post-transplant levels of inflammation. Materials and methods: Data were collected retrospectively for pancreas transplant patients between December 2009 and August 2018. A total of 26 patients had been treated with the pre-dextran protocol and 37 had received D40. Postoperative complications and inflammatory markers (white cell count [WCC], C-reactive protein [CRP], and amylase) on postoperative days 1, 2, 3, and 7 were compared between groups. Potential confounders were also recorded. Results: Patients in the D40 group had similar thrombosis rates but were less likely to have had graft loss as a result of thrombosis or substantial postoperative bleeding compared to the heparin-based protocol. The group who received D40 had significantly lower CRP and WCC on days 2, 3, and 7. The differences on days 3 and 7 remained when the results were adjusted for the significant confounders of cold ischemic time and donor age. Conclusions: D40 appears to be as effective as intravenous heparin at preventing graft thrombosis after pancreas transplant and to confer a reduced risk for bleeding. It may also reduce postoperative inflammatory processes, leading to reduced graft pancreatitis.
MeSH term(s)	Adult ; Anticoagulants/therapeutic use ; Dextrans/therapeutic use ; Female ; Humans ; Inflammation/etiology ; Inflammation/prevention & control ; Male ; Middle Aged ; Pancreas Transplantation/adverse effects ; Pancreas Transplantation/methods ; Pancreatitis/etiology ; Pancreatitis/prevention & control ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Hemorrhage/etiology ; Retrospective Studies ; Thrombosis/etiology ; Thrombosis/prevention & control
Chemical Substances	Anticoagulants ; Dextrans
Language	English
Publishing date	2020-12-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.10.020
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Zs.A 835: Show issues

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Article ; Online: Risk factors and impact of early anastomotic biliary complications after liver transplantation: UK registry analysis.

Tingle, S J / Thompson, E R / Ali, S S / Figueiredo, R / Hudson, M / Sen, G / White, S A / Manas, D M / Wilson, C H

BJS open

2021 Volume 5, Issue 2

Abstract: Background: Biliary leaks and anastomotic strictures are common early anastomotic biliary complications (EABCs) following liver transplantation. However, there are no large multicentre studies investigating their clinical impact or risk factors. This ... ...

Abstract	Background: Biliary leaks and anastomotic strictures are common early anastomotic biliary complications (EABCs) following liver transplantation. However, there are no large multicentre studies investigating their clinical impact or risk factors. This study aimed to define the incidence, risk factors and impact of EABC. Methods: The NHS registry on adult liver transplantation between 2006 and 2017 was reviewed retrospectively. Adjusted regression models were used to assess predictors of EABC, and their impact on outcomes. Results: Analyses included 8304 liver transplant recipients. Patients with EABC (9·6 per cent) had prolonged hospitalization (23 versus 15 days; P < 0·001) and increased chance for readmission within the first year (56 versus 32 per cent; P < 0·001). Patients with EABC had decreased estimated 5-year graft survival of 75·1 versus 84·5 per cent in those without EABC, and decreased 5-year patient survival of 76·9 versus 83·3 per cent; both P < 0.001. Adjusted Cox regression revealed that EABCs have a significant and independent impact on graft survival (leak hazard ratio (HR) 1·344, P = 0·015; stricture HR 1·513, P = 0·002; leak plus stricture HR 1·526, P = 0·036) and patient survival (leak HR 1·215, P = 0·136, stricture HR 1·526, P = 0·001; leak plus stricture HR 1·509; P = 0·043). On adjusted logistic regression, risk factors for EABC included donation after circulatory death grafts, graft aberrant arterial anatomy, biliary anastomosis type, vascular anastomosis time and recipient model of end-stage liver disease. Conclusion: EABCs prolong hospital stay, increase readmission rates and are independent risk factors for graft loss and increased mortality. This study has identified factors that increase the likelihood of EABC occurrence; research into interventions to prevent EABCs in these at-risk groups is vital to improve liver transplantation outcomes.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anastomosis, Surgical/methods ; Bile Ducts/surgery ; Biliary Tract Diseases/epidemiology ; Biliary Tract Diseases/etiology ; Biliary Tract Diseases/surgery ; Female ; Graft Survival ; Humans ; Incidence ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Survival Analysis ; United Kingdom/epidemiology ; Young Adult
Language	English
Publishing date	2021-04-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrab019
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Article ; Online: Performance and learning curve of a surgical care practitioner in completing hip aspirations.

Tingle, S J / Marriott, A / Partington, P F / Carluke, I / Reed, M R

Annals of the Royal College of Surgeons of England

2016 Volume 98, Issue 8, Page(s) 543–546

Abstract: INTRODUCTION The roles of non-medically trained practitioners within the NHS are expanding; they are now being employed by many specialties, including surgery, to relieve pressures on healthcare teams. AIMS To investigate the learning curve and ... ...

Abstract	INTRODUCTION The roles of non-medically trained practitioners within the NHS are expanding; they are now being employed by many specialties, including surgery, to relieve pressures on healthcare teams. AIMS To investigate the learning curve and competence of an orthopaedic surgical care practitioner (SCP) in performing hip aspirations. METHODS Data were retrospectively collected on 510 orthopaedic hip aspirations, of which 360 were completed by a single SCP and 150 were completed by surgeons before the SCP took over routine aspiration. The 360 aspirations completed by an SCP were separated into groups of 30 by date, so any trend in failure rate could be analysed. Ordinal χ
MeSH term(s)	Arthrocentesis/education ; Arthrocentesis/standards ; Clinical Competence ; Hip Joint ; Humans ; Learning Curve ; Surgeons/education ; Surgeons/standards
Language	English
Publishing date	2016-11
Publishing country	England
Document type	Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2016.0315
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Uk I Zs.234: Show issues

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Article ; Online: Early protocol computer tomography and endovascular interventions in pancreas transplantation.

Byrne, Matthew H V / Battle, Joseph / Sewpaul, Avinash / Tingle, Samuel / Thompson, Emily / Brookes, Marcus / Innes, Ailsa / Turner, Paul / White, Steven A / Manas, Derek M / Wilson, Colin H

Clinical transplantation

2020 Volume 35, Issue 1, Page(s) e14158

Abstract: Background: Early vascular complications following pancreatic transplantation are not uncommon (3%-8%). Typically, cross-sectional imaging is requested in response to clinical change. We instituted a change in protocol to request imaging pre-emptively ... ...

Abstract	Background: Early vascular complications following pancreatic transplantation are not uncommon (3%-8%). Typically, cross-sectional imaging is requested in response to clinical change. We instituted a change in protocol to request imaging pre-emptively to identify patients with thrombotic complications. Methods: In 2013, protocol computer tomography angiography (CTA) at days 3-5 and day 10 following pancreas transplantation was introduced. A retrospective analysis of all pancreas transplants performed at our institution from January 2001 to May 2019 was undertaken. Results: A total of 115 patients received pancreas transplants during this time period. A total of 78 received pancreas transplant without routine CTA and 37 patients with the new protocol. Following the change in protocol, we detected a high number of subclinical thromboses (41.7%). There was a significant decrease in invasive intervention for thrombosis (78.6% before vs 30.8% after, p = .02), and graft survival was significantly higher (61.5% before vs 86.1% after, p = .04). There was also a significant reduction in the number of graft failures (all-cause) where thrombosis was present (23.4% before vs 5.6% after, p = .02). Patient survival was unaffected (p = .48). Conclusions: Implementation of early protocol CTA identifies a large number of patients with subclinical graft thromboses that are more amenable to conservative management and significantly reduces the requirement for invasive intervention.
MeSH term(s)	Graft Survival ; Humans ; Pancreas Transplantation/adverse effects ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-12-06
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.14158
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Article ; Online: Anesthesia case of the month. Capnogram obtained from a 5-month-old 4.4-kg (9.68-lb) sexually intact female Yorkshire Terrier mix undergoing elective ovariohysterectomy.

Carter, Jennifer E / Nordaune, Jason L / Pienschke, Eric C / Tingle, Soyna

Journal of the American Veterinary Medical Association

2012 Volume 241, Issue 11, Page(s) 1441–1443

MeSH term(s)	Anesthesia, General/veterinary ; Anesthesia, Inhalation/instrumentation ; Anesthesia, Inhalation/methods ; Anesthesia, Inhalation/veterinary ; Animals ; Capnography/veterinary ; Carbon Dioxide ; Dogs/physiology ; Female ; Hysterectomy/veterinary ; Monitoring, Intraoperative/veterinary ; Monitoring, Physiologic/veterinary ; Ovariectomy/veterinary
Chemical Substances	Carbon Dioxide (142M471B3J)
Language	English
Publishing date	2012-12-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	390811-2
ISSN	1943-569X ; 0003-1488
ISSN (online)	1943-569X
ISSN	0003-1488
DOI	10.2460/javma.241.11.1441
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Zs.A 423: Show issues

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Article: Phosphorus leaching from agricultural soils of the delmarva peninsula, USA.

Kleinman, Peter J A / Church, Clinton / Saporito, Lou S / McGrath, Josh M / Reiter, Mark S / Allen, Arthur L / Tingle, Shawn / Binford, Greg D / Han, Kun / Joern, Brad C

Journal of environmental quality

2015 Volume 44, Issue 2, Page(s) 524–534

Abstract: Leaching of phosphorus (P) mobilizes edaphic and applied sources of P and is a primary pathway of concern in agricultural soils of the Delmarva Peninsula, which defines the eastern boundary of the eutrophic Chesapeake Bay. We evaluated P leaching before ... ...

Abstract	Leaching of phosphorus (P) mobilizes edaphic and applied sources of P and is a primary pathway of concern in agricultural soils of the Delmarva Peninsula, which defines the eastern boundary of the eutrophic Chesapeake Bay. We evaluated P leaching before and after poultry litter application from intact soil columns (30 cm diameter × 50 cm depth) obtained from low- and high-P members of four dominant Delmarva Peninsula soils. Surface soil textures ranged from fine sand to silt loam, and Mehlich-3 soil P ranged from 64 to 628 mg kg. Irrigation of soil columns before litter application pointed to surface soil P controls on dissolved P in leachate (with soil P sorption saturation providing a stronger relationship than Mehlich-3 P); however, strong relationships between P in the subsoil (45-50 cm) and leachate P concentrations were also observed ( = 0.61-0.73). After poultry litter application (4.5 Mg ha), leachate P concentrations and loads increased significantly for the finest-textured soils, consistent with observations that well-structured soils have the greatest propensity to transmit applied P. Phosphorus derived from poultry litter appeared to contribute 41 and 76% of total P loss in leachate from the two soils with the finest textures. Results point to soil P, including P sorption saturation, as a sound metric of P loss potential in leachate when manure is not an acute source of P but highlight the need to factor in macropore transport potential to predict leaching losses from applied P sources.
Language	English
Publishing date	2015-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	120525-0
ISSN	1537-2537 ; 0047-2425
ISSN (online)	1537-2537
ISSN	0047-2425
DOI	10.2134/jeq2014.07.0301
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Zs.A 2958: Show issues

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Article ; Audio / Video: Corn Response to Starter and Seed-Placed Fertilizer in Delaware

Binford, G.D / Hansen, D.J / Tingle, S.C

Mid-Atlantic grain and forage journal. 2002-2003, v. 8

2002

Keywords	Zea mays ; corn ; starter fertilizers ; plant response ; strip cropping ; Delaware
Language	English
Dates of publication	2002-2003
Size	p. 7-23.
Document type	Article ; Audio / Video
Database	NAL-Catalogue (AGRICOLA)

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