Publications by authors named "McCluskey S"
Background: The long-acting injectable regimen of cabotegravir plus rilpivirine (CAB/RPV) emerged as an alternative to oral standard of care integrase strand transfer inhibitor (INSTI)-based regimens for individuals with adherence challenges or preference for reduced dosing schedules. Although oral INSTI regimens have a high barrier to emergent resistance, less is known about the potency and durability of CAB/RPV.
Methods: We reviewed clinical trial registries, PubMed, EMBASE, and conference abstract databases to identify published reports of CAB/RPV for HIV therapy.
Objectives: To examine if point-of-care urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC).
Methods: Participants were enrolled from 42 clinics across Namibia. At each monthly medication pick-up, participants completed the point-of-care urine test and received EAC informed by this testing (EAC+).
Background: Postoperative acute kidney injury is associated with an increase in hospital length of stay and mortality. Intraoperative hemodynamics and fluid management may contribute to acute kidney injury. The aim of this study is to evaluate the association between intraoperative duration of hypotension with adverse events after laparoscopic liver resection.
View Article and Find Full Text PDFBackground: Solitary hepatocellular carcinoma measuring ≤3 cm represents approximately 30% of hepatocellular carcinoma cases, yet treatment guidelines lack robust evidence. This study compares oncologic outcomes after ablation, liver resection, and liver transplantation for solitary, small hepatocellular carcinoma.
Methods: We systematically searched databases up to 7 February 2022, for studies including adults with solitary hepatocellular carcinoma ≤3 cm treated by any ablation, liver resection, or liver transplantation.
Purpose: We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service.
Methods: We conducted a pragmatic, nonrandomized feasibility study of surgical prehabilitation. Patients were eligible if they were ≥ 18 yr of age, fluent in English, and referred by a health professional for prehabilitation.
Article Synopsis
- A study investigated the effectiveness of a virtually delivered mind-body program called VDTQM, which combines tai chi, qigong, and meditation, in treating low back pain (LBP) among adults.
- The study involved 350 participants, who were divided into a treatment group receiving 12 weeks of VDTQM classes and a waitlist control group, with outcomes measured primarily by pain-related disability and secondary factors like pain intensity and quality of life.
- Results indicated that the treatment group experienced significant improvements in pain-related disability and other outcomes at various points after treatment, suggesting that VDTQM could be a beneficial option for managing LBP.
Article Synopsis
- - The study investigates how intraoperative hypotension (low blood pressure during surgery) affects kidney function after transplantation, focusing on duration and levels of mean arterial pressure (MAP).
- - Analyzing 1,602 kidney transplants over a decade, researchers found that hypotension (specifically, MAP below 65 mmHg for >5 minutes) is linked to a significant risk of delayed graft function (DGF), where kidney function does not improve promptly post-surgery.
- - While DGF occurred in 33% of patients analyzed, the research suggests that lower MAP levels (especially <55 mmHg) contribute to poorer early kidney function outcomes, but the need for dialysis shortly after transplantation was not tied to intraoperative hypot
Introduction: Acute Kidney Injury (AKI) following Liver Transplantation (LT) is associated with prolonged ICU and hospital stay, increased risk of chronic renal disease, and decreased graft survival. Intraoperative hypotension is a modifiable risk factor associated with postoperative AKI. We aimed to determine in which phase of LT hypotension has the strongest association with AKI: the anhepatic or neohepatic phase.
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- The introduction of direct-acting antivirals (DAAs) offers hope for eliminating hepatitis C virus (HCV) by 2030, but some patients (2%-12%) experience treatment failure, potentially due to existing drug resistance.
- A systematic review of 56 studies found a high prevalence of hepatitis C resistance-associated substitutions (RAS) among patients with virological failure after DAA treatment, ranging from 78% to 100% depending on the specific treatment regimen.
- The findings highlight the importance of monitoring DAA-associated resistance and understanding its implications for future treatment strategies.
Background: Iron-deficiency anaemia, occurring in 30-40% of patients undergoing cardiac surgery, is an independent risk factor for adverse outcomes. Our long-term goal is to assess if postoperative i.v.
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- Tranexamic acid is known to reduce bleeding and blood transfusions in various surgeries, but its effectiveness for patients undergoing liver resection due to cancer is uncertain.
- A multicenter randomized clinical trial involving 1384 patients was conducted to see if tranexamic acid decreases the need for red blood cell transfusions within 7 days after liver surgery.
- The results showed no significant difference in transfusion rates or blood loss between the tranexamic acid group and the placebo group, and those who received tranexamic acid experienced more complications.
Article Synopsis
- Osteogenesis imperfecta (OI) is a genetic bone disorder that causes low bone density and frequent fractures, primarily treated with bisphosphonates in children, while adult treatment options are limited.
- The ASTEROID trial tested a new treatment, setrusumab, which showed improvements in bone density and strength for adults with OI types I, III, and IV.
- Analysis of bone biopsies revealed that while treatment with setrusumab did not significantly change the bone matrix properties, it did increase bone mass, suggesting that the fragility associated with OI may be due to other factors beyond just mineral content and matrix structure.
Article Synopsis
- Intraoperative dialysis during liver transplant surgeries is debated, especially for patients with certain kidney and lung issues, as it helps reduce stress on the heart.
- A 54-year-old woman who had serious liver problems, needing both a new liver and dialysis, underwent a liver transplant while using two dialysis catheters to manage her condition.
- The doctors removed excess fluid during the surgery, which helped her heart not get overloaded and allowed for a successful liver transplant.
Background: Tenofovir/lamivudine/dolutegravir (TLD) is the preferred first-line antiretroviral therapy (ART) regimen for people with HIV (PWH), including those who were previously virologically suppressed on nonnucleoside reverse transcriptase inhibitors (NNRTIs). We sought to estimate the real-world effectiveness of the TLD transition in Ugandan public-sector clinics.
Methods: We conducted a prospective cohort study of PWH aged ≥18 years who were transitioned from NNRTI-based ART to TLD.
Article Synopsis
- Dolutegravir (DTG) is a highly effective medication in HIV treatment, but there's limited data on the risk of drug-resistance mutations arising in patients taking it.
- A review of 2131 studies showed that in various patient scenarios, the prevalence of drug-resistance mutations was generally low, particularly in trials involving experienced patients or those on monotherapy.
- To better understand drug-resistance risks, more innovative methods need to be applied in real-world studies, as trial data may not fully represent broader patient experiences.
Article Synopsis
- Same day discharge after minimally invasive gynecology oncology surgery is both safe and sustainable, with rates maintaining around 72% one year post-implementation of a quality improvement program.
- The program led to a significant decrease in unnecessary post-operative clinic visits and bowel prep usage, while not increasing complication rates or hospital readmissions.
- Factors identified as significant in influencing same day discharge included the start time of the procedure and the level of narcotic use during hospitalization.
Background: Free flap reconstruction for head and neck cancer is associated with a high risk of perioperative complications. One of the modifiable risk factors associated with perioperative morbidity is intraoperative hypotension (IOH). The main aim of this pilot study is to determine if the intraoperative use of goal-directed hemodynamic therapy (GDHT) is associated with a reduction in the number of IOH events in this population.
View Article and Find Full Text PDFBackground: People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this risk is consistent across settings. We assessed weight change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD).
Design: We conducted a prospective cohort study at public-sector HIV clinics in Uganda and South Africa.
Background MRI-guided focal therapy (FT) allows for accurate targeting of localized clinically significant prostate cancer (csPCa) while preserving healthy prostate tissue, but the long-term outcomes of this approach require more study. Purpose To assess the 2-year oncological and functional outcomes of men with intermediate-risk prostate cancer (PCa) treated with targeted FT. Materials and Methods In this single-center prospective phase II trial, men with localized unifocal intermediate-risk PCa underwent transrectal MRI-guided focused ultrasound between July 2016 and July 2019.
View Article and Find Full Text PDFBackground: Mutations in the epidermal growth factor receptor (EGFR) kinase domain are common in non-small cell lung cancer. Conventional tyrosine kinase inhibitors target the mutation site in the ATP binding pocket, thereby inhibiting the receptor's function. However, subsequent treatment resistance mutations in the ATP binding site are common.
View Article and Find Full Text PDFLiver transplantation (LT) is the second most performed solid organ transplant. Coronary artery disease (CAD) is a critical consideration for LT candidacy, particularly in patients with known CAD or risk factors, including metabolic dysfunction associated with steatotic liver disease. The presence of severe CAD may exclude patients from LT; therefore, precise preoperative evaluation and interventions are necessary to achieve transplant candidacy.
View Article and Find Full Text PDFPurpose: We aimed to evaluate the effect of the 2017 Canadian Cardiovascular Society (CCS) guidelines on troponin surveillance after noncardiac surgery.
Methods: This was a single-centre, retrospective, observational study. Patients aged 40 yr or older undergoing intermediate- to high-risk elective noncardiac surgery between 2016 and 2021 were included.
Background: Myeloid cell metabolic reprogramming is a hallmark of inflammatory disease; however, its role in inflammation-induced hypercoagulability is poorly understood.
Objectives: We aimed to evaluate the role of inflammation-associated metabolic reprogramming in regulating blood coagulation.
Methods: We used novel myeloid cell-based global hemostasis assays and murine models of immunometabolic disease.