Publications by authors named "Millward C"
Cranioplasty is an operation that aims to repair a defect in the skull. Indications commonly include Traumatic Brain Injury (TBI), tumours, and infections. It carries a high rate of postoperative morbidity.
View Article and Find Full Text PDFArticle Synopsis
- Comprehensive reporting of clinical trial activity is essential, guided by the SPIRIT 2013 and CONSORT 2010 statements, which outline what should be included in protocols and result articles.
- A review analyzed the reporting quality of 9 trial protocols and 76 trial result articles related to pediatric brain tumors, revealing an average adherence of 76.8% for protocols and around 67-71% for result articles to established reporting standards.
- The findings suggest a need for improved reporting quality in pediatric neuro-oncology, especially regarding randomization and blinding, echoing similar issues previously identified in adult trials.
Aims: WHO Grade 3 (G3) meningiomas are rare tumours with limited data to guide management. This retrospective study documents UK management approaches across 14 centres over 11 years.
Materials And Methods: Patients with WHO G3 meningioma between 01/01/2008 and 31/12/2018 were identified.
Article Synopsis
- A systematic review was conducted to analyze how outcomes of meningioma clinical trials are measured and reported, addressing the lack of agreement on these measures.
- The study reviewed 30 published articles and 18 ongoing trials, resulting in 47 clinical trials and 659 reported outcomes, which were grouped into unique terms using a standardized classification system.
- The findings highlight the need for a more consistent approach to outcome measurement, leading to plans for a consensus meeting to create a core outcome set to guide future trials.
Article Synopsis
- A systematic review was conducted to analyze how outcomes are measured in studies of patients with incidental intracranial meningioma, as inconsistent practices have hindered comparative research.
- The review included 33 published articles, resulting in 268 reported outcomes, which were refined to 178 unique outcomes categorized into 53 standardized terms and classified into 9 outcome domains.
- The goal is to create a Core Outcome Set through stakeholder consensus, improving the consistency of outcome measurements in future studies.
Article Synopsis
- This study is a systematic review focusing on patient-reported outcomes (PROs) in patients with Primary Spinal Intradural Tumours (PSITs), which are rare but can greatly affect quality of life.
- It analyzed 11 studies involving 737 patients, mainly assessing results from surgeries, highlighting that patients reported lower quality of life than healthy individuals, with some improvements noted after surgery for extramedullary tumors.
- The review identified inconsistencies in measuring PROs due to diverse tools used across studies, suggesting a need for standardized measurements and registries for better evaluation of these outcomes in PSIT patients.
Article Synopsis
- This study is a systematic review analyzing outcome measurement instruments used in research focused on surgically managed Cauda Equina Syndrome (CES).
- The objective was to establish a core outcome set (COS), identifying essential outcomes that should be consistently reported in CES studies, and to compare identified instruments with established metrics.
- The results showed significant variability in the measurement instruments, emphasizing the need for a standardized approach to metrics to improve the comparability and quality of CES surgical outcome research.
Article Synopsis
- The study aimed to explore the link between blood inflammatory markers and seizure occurrence in patients after meningioma surgery.
- Researchers analyzed blood data from patients who had undergone meningioma resection from 2012 to 2020, excluding those with pre-existing inflammatory conditions or complications.
- Findings revealed that patients with new seizures post-surgery had higher white cell counts, and a specific blood marker (dNLR) was notably predictive of seizure occurrence one year after surgery.
Article Synopsis
- * Recent research is focusing on the molecular biology of meningiomas, using various profiling techniques to improve how these tumors are understood and predicted in terms of prognosis.
- * While detailed molecular analysis of tumors is not yet routine in clinical practice, its increasing availability may lead to better treatment options and overall patient care in the future.
Article Synopsis
- Many undergraduate medical programs lack formal education in oncology, leading to a gap that mentorship schemes can help fill by offering targeted exposure to the field.
- The National Oncology Mentorship Scheme (NOMS) paired 86 mentors with 112 mentees to provide structured mentoring over six months, encouraging regular meetings and feedback through questionnaires.
- Mentees primarily joined to expand their networking opportunities, while the study aimed to identify motivations and assess the benefits and drawbacks of the mentorship experience for both mentors and mentees.
Article Synopsis
- - The review evaluated the quality of reporting in adult neuro-oncology clinical trial protocols and result articles, using the SPIRIT 2013 and CONSORT 2010 guidelines as benchmarks.
- - Researchers identified 7 trial protocols and 36 result articles, finding that trial protocols adhered to SPIRIT guidelines by an average of 79.4%, while trial abstracts and articles followed CONSORT guidelines at 75.3% and 74.5%, respectively.
- - The study concluded that there is a need for better reporting practices in neuro-oncology trials, suggesting that improved awareness among researchers and journal requirements could enhance the transparency and communication of trial results.
Article Synopsis
- Over the last 30 years, care for meningioma patients has improved due to advancements in understanding the tumors' biology, history, and classification, leading to better management options and outcomes.
- The growing body of research has enhanced our knowledge of molecular factors, paving the way for personalized treatment strategies for patients.
- There is a shift towards more patient-centered measures in evaluating treatment outcomes, recognizing the significant impact even mild symptoms of meningiomas can have on a patient’s quality of life.
Article Synopsis
- More people are finding out they have small brain tumors called meningiomas because of advanced imaging technology like MRIs and CT scans.
- Most of these meningiomas don’t grow fast or cause problems, so they might not need treatment.
- Doctors are trying to figure out the best way to manage these tumors since sometimes they can grow and cause issues, but deciding when to treat can be tricky.*
Article Synopsis
- * A systematic review was conducted to analyze patient-reported outcomes and health-related quality of life (HRQoL) after cranioplasty, with 25 studies included in the review.
- * Results showed improvements in physical and social functioning, cosmetic outcomes, and overall HRQoL, highlighting the need for more longitudinal studies using validated tools to better assess these effects.
Article Synopsis
- Tranexamic Acid (TXA) is used to reduce bleeding during meningioma surgery, with a systematic review showing it significantly decreases intraoperative blood loss by about 316 mls.
- The analysis included four studies with 281 patients, but found no significant impact of TXA on transfusion needs, operation time, postoperative seizures, hospital stay duration, or long-term disability outcomes.
- Limitations of the review include a small sample size, insufficient data on secondary outcomes, and lack of a standardized blood loss measurement method, suggesting the need for larger trials to assess the full impact of TXA.
Article Synopsis
- After meningioma surgery, about one-third of patients have leftover tumors that need regular monitoring, but their growth rates are not well understood.
- The study focused on measuring the volumetric growth rates of these residual tumors in patients treated at a neurosurgery center from 2004 to 2020, using MRI scans and specific growth models.
- Results showed that most tumors grew slowly over time, with factors like tumor location and Ki-67 index helping to predict the likelihood of progression, which is important for determining treatment strategies.
Article Synopsis
- Gender-affirming hormone therapy is important for managing transgender individuals, particularly with the use of cyproterone acetate (CPA) in transgender women, but high doses of CPA have been linked to the development of intracranial meningiomas.
- A systematic review identified 12 case reports involving 35 meningiomas in patients who had utilized CPA, noting a median patient age of 48 years and common daily doses of 50mg and 100mg.
- Most cases were managed surgically, although some improved with cessation of CPA, highlighting the need for alternative hormone treatments when necessary.
Article Synopsis
- * A total of 23 patients participated, with data showing significant challenges in social and cognitive functioning compared to the general population, as well as increased rates of loss of appetite and nausea.
- * The findings emphasize the importance of early healthcare interventions and specialized services for young adults transitioning from paediatric care to improve education and overall quality of life among childhood brain tumour survivors.
Article Synopsis
- The study investigates long-term health-related quality of life (HRQoL) in meningioma patients, particularly those with tumors that are monitored but not surgically treated.
- Using patient-reported outcome measures, significant HRQoL impairments were found in various areas, especially for those with lower education levels, unemployment, or who faced postoperative complications.
- The findings emphasize the ongoing burden meningioma has on patients nearly a decade post-diagnosis, suggesting healthcare providers should pay attention to HRQoL and offer support resources accordingly.
Improving droplet microfluidic systems for studying single bacteria growth.
Anal Bioanal Chem
February 2023
Antimicrobial resistance remains a global threat with ~ 5 million deaths in 2019 alone and 10 million deaths projected every year by 2050. Current tools employed in the analysis of bacteria can be time inefficient, leading to delayed diagnosis and treatment. In this work, we develop a microfluidic setup capable of bacteria incubation and detection of growth in ~ 2 h.
View Article and Find Full Text PDFArticle Synopsis
- Sporadic multiple meningiomas are rare and associated with lower overall survival compared to solitary meningiomas, but this study explores their clinical outcomes.
- A matched cohort study analyzed 34 patients with multiple meningiomas and found similar intervention rates, recurrence-free survival, and overall survival when compared to those with solitary meningiomas.
- The findings suggest that sporadic multiple meningiomas may not lead to worse outcomes, indicating that treatment should focus on symptomatic or high-risk asymptomatic cases.
Article Synopsis
- Systematic reviews (SR) and systematic reviews with meta-analysis (SRMA) are vital for guiding clinical practice related to meningioma, yet their overall quality and reporting standards were found to be lacking.
- A search of eight databases identified 116 eligible SRs published between 1990 and 2020, with most studies scoring low on various quality assessment tools like PRISMA and AMSTAR 2.
- The findings suggest that improvements in methodological practices and adherence to established guidelines are necessary to enhance the validity and transparency of research in this area.
Article Synopsis
- This study analyzed outcomes of first alloplastic cranioplasty in 287 patients, focusing on post-surgery complications and factors influencing the need for explantation, which is the removal of the implanted material.* -
- Most patients were around 43 years old, with traumatic brain injury being the leading reason for prior craniectomy; various materials, such as titanium and hydroxyapatite, were used for the cranioplasty.* -
- Results showed a 12.2% rate of all-cause explantation, with certain materials like hydroxyapatite and acrylic significantly lowering the risk of complications, while age and certain conditions increased the risk.*
Article Synopsis
- Meningiomas are the most common type of primary brain tumor in adults, mostly non-cancerous, but some can be aggressive, requiring different management strategies depending on symptoms and growth.
- Two specialized sets of outcomes (COS: Intervention and COS: Observation) will be created to standardize how results are measured in clinical trials and studies of incidental meningiomas.
- The study will utilize systematic literature reviews and focus group surveys to identify, categorize, and prioritize outcomes, with ethical approval and consent processes in place for participant involvement.