Publications by authors named "Kalsi J"
Background: The ovarian cancer (OC) preclinical detectable phase (PCDP), defined as the interval during which cancer is detectable prior to clinical diagnosis, remains poorly characterised. We report exploratory analyses from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
Methods: In UKCTOCS between Apr-2001 and Sep-2005, 101,314 postmenopausal women were randomised to no screening (NS) and 50,625 to annual multimodal screening (MMS) (until Dec-2011) using serum CA-125 interpreted by the Risk of Ovarian Cancer Algorithm (ROCA).
Article Synopsis
- Laparoscopic cholecystectomy (LC) is a common surgical method for treating gallbladder issues, known for causing less pain and facilitating quicker recovery.
- A study of 200 patients from 2017 to 2022 found significant correlations between the patients' age and complications, with a readmission rate of 10% and an average hospital stay of 3.6 days.
- Findings highlighted various complications, such as a 6% rate of wound infections and 2.5% of bile duct injuries, indicating the need for improved patient assessment and care following LC.
Article Synopsis
- - The study aimed to compare pregnancy outcomes between women with PCOS and a control group, assessing maternal-fetal health and birth outcomes through data collected from 2017 to 2022.
- - Results showed women with PCOS had higher incidences of preeclampsia (12.3% vs. 8.1%) and gestational diabetes (18.7% vs. 9.8%) compared to the control group, highlighting increased risks associated with PCOS.
- - However, there were no significant differences in low birth weight or preterm delivery, indicating the complexity of PCOS's impact on pregnancy and the need for further research to improve health outcomes for mothers and babies.
Background: "Proximal humerus fractures [PHFs]" are common orthopedic injuries, often requiring surgical intervention for optimal outcomes. However, the choice of surgical approach remains controversial, with varying outcomes reported in the literature.
Methods: A retrospective research was overseen among subjects who had surgery for PHFs.
Background: There has been a significant increase in the utilization of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in recent years. Cardiothoracic surgery teams have historically led VA-ECMO care teams, with little data available on alternative care models.
Methods: We performed a retrospective review of a cardiovascular medicine inclusive VA-ECMO service, analyzing patients treated with peripheral VA-ECMO at a large quaternary care center from 2018 to 2022.
Article Synopsis
- * Accurate diagnosis relies on tests like cerebrospinal fluid analysis and neuro-imaging to confirm Alzheimer's pathology, but blood-based biomarkers present a promising, less invasive alternative.
- * Despite the potential of these new diagnostic and therapeutic approaches, healthcare systems may struggle with implementation due to limitations in capacity, finances, and infrastructure.
Introduction: Intravascular ultrasound (IVUS) provides intra-procedural guidance in optimizing percutaneous coronary interventions (PCI) and has been shown to improve clinical outcomes in stent implantation. However, current data on the benefit of IVUS during PCI in ST-elevation myocardial infarction (STEMI) patients is mixed. We performed meta-analysis pooling available data assessing IVUS-guided versus angiography-guided PCI in STEMI patients.
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- The UKCTOCS study aimed to explore the symptoms of preclinical invasive epithelial ovarian cancer (iEOC) in women, particularly by comparing symptoms between those diagnosed through screening (PC) and those diagnosed clinically (CD).
- Out of 1133 women diagnosed with iEOC, those in the PC group were younger at diagnosis and reported fewer symptoms overall compared to the CD group, although abdominal symptoms were common in both groups.
- The research suggests that early signs of tubo-ovarian cancer might be more complex than previously thought, highlighting the need to reassess what symptoms should trigger medical evaluation for better early detection.
Abstract: Randomised controlled trials are challenging to deliver. There is a constant need to review and refine recruitment and implementation strategies if they are to be completed on time and within budget. We present the strategies adopted in the United Kingdom Collaborative Trial of Ovarian Cancer Screening, one of the largest individually randomised controlled trials in the world.
View Article and Find Full Text PDFBackground: In UKCTOCS, there was a decrease in the diagnosis of advanced stage tubo-ovarian cancer but no reduction in deaths in the multimodal screening group compared with the no screening group. Therefore, we did exploratory analyses of patients with high-grade serous ovarian cancer to understand the reason for the discrepancy.
Methods: UKCTOCS was a 13-centre randomised controlled trial of screening postmenopausal women from the general population, aged 50-74 years, with intact ovaries.
Background: Ovarian and tubal cancers are lethal gynaecological cancers, with over 50% of the patients diagnosed at advanced stage.
Trial Design: Randomised controlled trial involving 27 primary care trusts adjacent to 13 trial centres based at NHS Trusts in England, Wales and Northern Ireland.
Methods: Postmenopausal average-risk women, aged 50-74, with intact ovaries and no previous ovarian or current non-ovarian cancer.
Purpose Of Review: Summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2022 scientific session of the American Heart Association (AHA).
Recent Findings: The PROMINENT trial compared pemafibrate to a placebo in patients with type 2 diabetes mellitus (DM) and mild-to-moderate hypertriglyceridemia and high-density lipoprotein cholesterol (HDL-C)<40 mg/dL who were already on guideline-directed statin therapy. The RESPECT-EPA trial compared purified eicosapentaenoic acid (EPA) and statin therapy to statin therapy alone for secondary prevention of atherosclerotic CV disease (ASCVD).
Article Synopsis
- - The study by the International Cancer Benchmarking Partnership analyzed breast cancer diagnostic pathways across 10 regions in Australia, Canada, and Europe to understand the impact of delayed treatment on prognosis.
- - Data were collected from 3,471 women diagnosed with breast cancer and included input from primary care physicians and cancer specialists, revealing that a significant number sought care due to symptoms, primarily lumps or changes in their breasts.
- - Results showed considerable variation in the time taken for diagnosis and treatment between regions, with some areas demonstrating longer waiting periods, suggesting the need for improved strategies to reduce these delays and improve patient outcomes.
Unselected population-based personalised ovarian cancer (OC) risk assessments combining genetic, epidemiological and hormonal data have not previously been undertaken. We aimed to understand the attitudes, experiences and impact on the emotional well-being of women from the general population who underwent unselected population genetic testing (PGT) for personalised OC risk prediction and who received low-risk (<5% lifetime risk) results. This qualitative study was set within recruitment to a pilot PGT study using an OC risk tool and telephone helpline.
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- The International Cancer Benchmarking Partnership studied how ovarian cancer is diagnosed and the time from symptom onset to treatment across five countries, analyzing data from over 1,100 patients.
- Key findings revealed no significant differences in initial diagnosis symptoms, but there were notable inconsistencies in urgent referral rates and intervals from diagnosis to treatment, particularly when compared to Denmark.
- The research emphasizes the need for improvements in the diagnostic process and encourages learning from different healthcare systems to enhance timely ovarian cancer diagnosis and treatment.
Background: Epithelial tubo-ovarian cancer (EOC) has high mortality partly due to late diagnosis. Prevention is available but may be associated with adverse effects. A multifactorial risk model based on known genetic and epidemiological risk factors (RFs) for EOC can help identify women at higher risk who could benefit from targeted screening and prevention.
View Article and Find Full Text PDFObjective: To investigate the association between hysterectomy with conservation of one or both adnexa and ovarian and tubal cancer.
Design: Prospective cohort study.
Setting: Thirteen NHS Trusts in England, Wales and Northern Ireland.
Objectives: To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.
Design: Multicohort study with three sets of analyses.
Setting: United Kingdom, Europe, and the United States.
Article Synopsis
- Ovarian cancer remains a serious health issue, particularly for postmenopausal women; the UKCTOCS trial was initiated to evaluate if screening could lower mortality rates associated with the disease.
- The study involved over 202,000 postmenopausal women who were randomly assigned to one of three groups: multimodal screening, transvaginal ultrasound screening, or no screening, and data was collected over a median follow-up period of 16.3 years.
- Results showed that the detection rates of ovarian and tubal cancer were similar across all groups, indicating that neither type of screening significantly impacted the mortality from these cancers.
Article Synopsis
- Randomized trials for ovarian cancer screening haven't shown a reduction in mortality, but they provide useful data on screening effectiveness.
- In the UKCTOCS trial, 44,799 women were screened annually with transvaginal ultrasound over nearly a decade, leading to 280,534 screenings and 960 surgeries from positive results.
- Out of detected cancers, 37.5% of invasive epithelial cases were at Stage I/II, but the overall sensitivity of the ultrasound was low (68.5%) suggesting it may not be effective as a first line screening method in the general population.
Article Synopsis
- The study revisits the analysis methods for long-term mortality outcomes in a cancer screening trial, due to advancements in statistical methods and new evidence regarding delayed effects.
- In consultation with experts, three analysis options were considered, with most advocating for a new method that accounts for delayed mortality effects.
- The final decision was to use the Versatile test for better accuracy, highlighting the need for improved consensus on mortality outcome reporting in cancer trials.
Background: There is a trend to increasing use of routinely collected health data to ascertain outcome measures in trials. We report on the completeness and accuracy of national ovarian cancer and death registration in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
Methods: Of the 202,638 participants, 202,632 were successfully linked and followed through national cancer and death registries of Northern Ireland, Wales and England.
Assessment of driving fitness among patients with alcohol-related visits to two hospitals in eastern Finland.
Nordisk Alkohol Nark
October 2019
Objective: The aim of the present study was twofold. The first aim was to explore how frequently physicians evaluate driving fitness when a patient has a serious alcohol problem, which is accomplished by examining differences in physicians' compliance with their intervention/notification obligation among different alcohol-related ICD-10 diagnoses. The second aim was to explore how many heavy alcohol users have a valid driving license.
View Article and Find Full Text PDFPurpose: To evaluate the significance of vision-related problems in fatal motor vehicle accidents (FMVAs) based on a systematic investigation process by multidisciplinary road accident investigation teams (RAITs).
Methods: Retrospective registry-based study of all FMVAs during the years 2012-2016 in Finland in which driver causing the accident had a valid Finnish driving licence and the operated motor vehicle required having a driving licence.
Results: There were a total of 968 FMVAs.