Influence of TNFalpha and LTalpha single nucleotide polymorphisms on susceptibility to and prognosis in cutaneous malignant melanoma in the British population.
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Felín Mariangela Soberón, Wang Kanix, Moreira Aliya, Grose Andrew, Leahy Karen, Zhou Ying, Clouser Fatima Alibana, Siddiqui Maryam, Leong Nicole, Goodall Perpetua, Michalowski Morgan, Ismail Mahmoud, Christmas Monica, Schrantz Stephen, Caballero Zuleima, Norero Ximena, Estripeaut Dora, Ellis David, Raggi Catalina, Castro Catherine, Moossazadeh Davina, Ramirez Margarita, Pandey Abhinav, Ashi Kevin, Dovgin Samantha, Dixon Ashtyn, Li Xuan, Begeman Ian, Heichman Sharon, Lykins Joseph, Villalobos-Cerrud Delba, Fabrega Lorena, Montalvo José Luis Sanchez, Mendivil Connie, Quijada Mario R, Fernández-Pirla Silvia, de La Guardia Valli, Wong Digna, de Guevara Mayrene Ladrón, Flores Carlos, Borace Jovanna, García Anabel, Caballero Natividad, Rengifo-Herrera Claudia, de Saez Maria Theresa Moreno, Politis Michael, Wroblewski Kristen, Karrison Theodore, Ross Stephanie, Dogra Mimansa, Dhamsania Vishan, Graves Nicholas, Kirchberg Marci, Mathur Kopal, Aue Ashley, Restrepo Carlos M, Llanes Alejandro, Guzman German, Rebellon Arturo, Boyer Kenneth, Heydemann Peter, Noble A Gwendolyn, Swisher Charles, Rabiah Peter, Withers Shawn, Hull Teri, Su Chunlei, Blair Michael, Latkany Paul, Mui Ernest, Vasconcelos-Santos Daniel Vitor, Villareal Alcibiades, Perez Ambar, Galvis Carlos Andrés Naranjo, Montes Mónica Vargas, Perez Nestor Ivan Cardona, Ramirez Morgan, Chittenden Cy, Wang Edward, Garcia-López Laura Lorena, Muñoz-Ortiz Juliana, Rivera-Valdivia Nicolás, Bohorquez-Granados María Cristina, de-la-Torre Gabriela Castaño, Padrieu Guillermo, Hernandez Juan David Valencia, Celis-Giraldo Daniel, Dávila Juan Alejandro Acosta, Torres Elizabeth, Oquendo Manuela Mejia, Arteaga-Rivera José Y, Nicolae Dan L, Rzhetsky Andrey, Roizen Nancy, Stillwaggon Eileen, Sawers Larry, Peyron Francois, Wallon Martine, Chapey Emanuelle, Levigne Pauline, Charter Carmen, De Frias Migdalia, Montoya Jose, Press Cindy, Ramirez Raymund, Contopoulos-Ioannidis Despina, Maldonado Yvonne, Liesenfeld Oliver, Gomez Carlos, Wheeler Kelsey, Holfels Ellen, Frim David, McLone David, Penn Richard, Cohen William, Zehar Samantha, McAuley James, Limonne Denis, Houze Sandrine, Abraham Sylvie, Piarroux Raphael, Tesic Vera, Beavis Kathleen, Abeleda Ana, Sautter Mari, El Mansouri Bouchra, El Bachir Adlaoui, Amarir Fatima, El Bissati Kamal, de-la-Torre Alejandra, Britton Gabrielle, Motta Jorge, Ortega-Barria Eduardo, Romero Isabel Luz, Meier Paul, Grigg Michael, Gómez-Marín Jorge, Kosagisharaf Jagannatha Rao, Llorens Xavier Sáez, Reyes Osvaldo, McLeod Rima
Аннотация
METHOD: We describe the clinical and patient-centred outcomes of patients attending a podiatry-led integrated care pathway in a multi-use clinic situated in a venue supported by the National Centre for Sports and Exercise Medicine in the UK. At the baseline appointment, patients were given a full assessment where symptoms of intermittent claudication using the Edinburgh Intermittent Claudication Questionnaire, foot pulses, Doppler sounds, Ankle Brachial Pressure Indices, glycated haemoglobin (HbA1c) and cholesterol levels, and smoking status were recorded. A tailored treatment plan was devised, including referral to an exercise referral service, smoking cessation programmes (if applicable) and each participant was also seen by a dietician for nutritional advice. Participants were followed up at 3 and 6 months to assess any improvement in vascular status and with each completing the EQ-5D quality of life questionnaire and a simple satisfaction questionnaire at the end of the study. As this was a complex intervention a pilot study design was adopted to evaluate if the method and outcomes were suitable and acceptable to participants the results of which will then inform the design of a larger study.
RESULTS: Data was collected on 21 individuals; 15 men (71.4%) and 6 women (28.6%) across the 6-month study period. Eleven participants were referred onto the exercise referral service; 16 participants saw the dietician for nutritional advice at baseline and had one-to-one or telephone follow-up at 3 months. Five out of 14 participants had reduced scores from baseline of intermittent claudication during the study period. No evidence for substantive changes in Doppler sounds or ABPI measurements was revealed. Quality of life scores with the EQ-5D improved in 15 participants; this was statistically significant (p = 0.007) with 14 participants who completed the simple satisfaction questionnaire expressing a positive view of the programme. Of the four people who were smokers, two stopped smoking cigarettes and moved to e-cigarettes as part of smoking cessation advice.
CONCLUSION: As this was a pilot study the sample size was low, but some statistically significant improvements with some measures were observed over the 6-month study. Podiatrists are able to provide a comprehensive vascular assessment of the lower limb and accompanying tailored advice on lifestyle changes including smoking cessation and exercise. Locating clinics in National Centres for Sports and Exercise Medicine enables easy access to exercise facilities to encourage the adoption of increased activity levels, though the long term sustainability of exercise programmes still requires evaluation.This study was reviewed and approved by London Brent Ethics Committee IRAS ID 204611 and received research governance approval from the sponsor, Sheffield Teaching Hospitals NHS Foundation Trust Research and Innovation Office STH19410.