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Olateju T.,Diabetes Center | Begley J.,Royal Bournemouth Hospital NHS Foundation Trust | Flanagan D.,Derriford Hospital | Kerr D.,Bournemouth Diabetes and Endocrine Center | Kerr D.,Bournemouth University
Journal of Diabetes Science and Technology | Year: 2012

Background: Most manufacturers of blood glucose monitoring equipment do not give advice regarding the use of their meters and strips onboard aircraft, and some airlines have blood glucose testing equipment in the aircraft cabin medical bag. Previous studies using older blood glucose meters (BGMs) have shown conflicting results on the performance of both glucose oxidase (GOX)- and glucose dehydrogenase (GDH)-based meters at high altitude. The aim of our study was to evaluate the performance of four new-generation BGMs at sea level and at a simulated altitude equivalent to that used in the cabin of commercial aircrafts. Methodology/Principal Findings: Blood glucose measurements obtained by two GDH and two GOX BGMs at sea level and simulated altitude of 8000 feet in a hypobaric chamber were compared with measurements obtained using a YSI 2300 blood glucose analyzer as a reference method. Spiked venous blood samples of three diferent glucose levels were used. The accuracy of each meter was determined by calculating percentage error of each meter compared with the YSI reference and was also assessed against standard International Organization for Standardization (ISO) criteria. Clinical accuracy was evaluated using the consensus error grid method. The percentage (standard deviation) error for GDH meters at sea level and altitude was 13.36% (8.83%; for meter 1) and 12.97% (8.03%; for meter 2) with p = .784, and for GOX meters was 5.88% (7.35%; for meter 3) and 7.38% (6.20%; for meter 4) with p = .187. There was variation in the number of time individual meters met the standard ISO criteria ranging from 72-100%. Results from all four meters at both sea level and simulated altitude fell within zones A and B of the consensus error grid, using YSI as the reference. Conclusions: Overall, at simulated altitude, no diferences were observed between the performance of GDH and GOX meters. Overestimation of blood glucose concentration was seen among individual meters evaluated, but none of the results obtained would have resulted in dangerous failure to detect and treat blood glucose errors or in giving treatment that was actually contradictory to that required. © Diabetes Technology Society. Source

Pratt G.,NHS England | Thomas P.,Bournemouth University | Marden N.,Royal Bournemouth Hospital NHS Foundation Trust | Alexander D.,Belfast City Hospital | And 7 more authors.
Leukemia and Lymphoma | Year: 2016

Chronic lymphocytic leukemia (CLL) is characterized by heterogeneous clinical behavior and there is a need for improved biomarkers. The current study evaluated the prognostic significance of serum free light chains (sFLC, kappa, and lambda) and other serum markers (bar, serum thymidine kinase (sTK), soluble CD23, and LDH) together with established biomarkers in 289 patients enrolled into the LRF CLL4 trial. In a multivariable analysis of serum markers alone, higher big and kappa light chains were statistically significant in predicting disease progression and higher blg, and sTK in predicting mortality. In multivariable analysis for overall survival the following were independently significant: β2M levels, immunoglobulin gene (IGHV) mutational status (>98% homology), age, 17p13 deletions (>10%), and CD38 expression. β2M is the only serum marker that retained clear independent value as a biomarker in the LRF CLL4 trial and remains powerfully prognostic requiring evaluation in any future method of risk stratifying patients. © 2016 Taylor & Francis Source

Cidon E.U.,Royal Bournemouth Hospital NHS Foundation Trust
Clinical Medicine Insights: Oncology | Year: 2016

Cholangiocarcinoma is a very heterogeneous and rare group of neoplasms originating from the perihilar, intra-, or extrahepatic bile duct epithelium. It represents only 3% of gastrointestinal cancers, although their incidence is increasing as its mortality increases. Surgical resection is the only potentially curative option, but unfortunately the resectability rate is low. Overall, these malignancies have got a very poor prognosis with a five-year survival rate of 5-10%. Although the five-year survival rate increases to 25-30% in the cases amenable to surgery, only 10-40% of patients present with resectable disease. Therefore, it is necessary to optimize the benefit of adjuvant strategies after surgery to increase the rate of curability. This study reviewed the role of adjuvant chemotherapy in resectable bile duct cancers. © the authors, publisher and licensee Libertas Academica Limited. Source

Olateju T.,LMC Diabetes & Endocrinology | Begley J.,Royal Bournemouth Hospital NHS Foundation Trust | Green D.J.,Keele University | Kerr D.,Bournemouth University
Canadian Journal of Diabetes | Year: 2015

Objective: To determine the physiologic and glycemic responses to energy drinks by people with type 1 diabetes. Methods: In a double-blind randomized comparison of Red Bull, Red Bull Light and a control drink, 16 adults (11 females; average age 31.5 years) with type 1 diabetes and an average glycated hemoglobin (A1C) of 68 mmol/mol were given 750 mL of Red Bull, Red Bull Light and Suso Orange in a random order. During 3 hours, comparisons were made of blood pressure and blood glucose and caffeine levels; 4-choice reaction time (4CRT) and a digit symbol substitution test were used to assess cognitive performance. Mood was measured using the University of Wales Institute of Science and Technology mood adjective checklist. Results: Consumption of Red Bull and Suso Orange were associated with an early sustained rise in blood glucose, which was augmented by Red Bull (p=0.02). A transient rise in systolic blood pressure (115.9mm Hg to 124.5 mm Hg and 115.8 mm Hg to 125.9 mm Hg, respectively, both p<0.01) followed consumption of Red Bull and Red Bull Light. There were less consistent changes in diastolic blood pressure and heart rate. Consumption of both energy drinks resulted in modest improvement in performance on the digit substitution test but had no effect on 4CRT. Energy arousal and hedonic tone were influenced transiently only, following the consumption of Suso Orange. Conclusions: Consumption of energy drinks can result in a significant carbohydrate load for people with diabetes, and patients must consider the need to adjust their insulin regimens appropriately. Caffeine-containing energy drinks can cause a rise in blood pressure, which may be an important consideration for individuals at risk for diabetes-related complications. © 2015 Canadian Diabetes Association. Source

Masters B.,Poole Hospital NHS Foundation Trust | Hickish T.,Royal Bournemouth Hospital NHS Foundation Trust | Cidon E.U.,Royal Bournemouth Hospital NHS Foundation Trust
BMJ Case Reports | Year: 2014

Oxaliplatin is a platinum compound mainly used in the treatment of colorectal cancer. According to its manufacturer it is not considered vesicant agent though it has been shown to cause severe tissue damage if extravasation occurs in large doses. Several cases of extravasation have been reported; most of them from incorrectly placed peripheral cannula or incorrect use of central venous access devices. To reduce these risks, peripherally inserted central catheters and midline catheters have been increasingly used and are especially helpful if poor peripheral venous access. Midlines are mainly used for patients not receiving vesicant drugs, and are generally inserted without radiological guidance. They are believed to be safe, but we present the first ever-documented oxaliplatin extravasation injury from a midline catheter. Copyright 2014 BMJ Publishing Group. All rights reserved. Source

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