Queen's Medical Centre Research Articles

Ovarian needle aspiration in the diagnosis and management of ovarian masses.

ObjectiveOvarian needle aspiration and biopsy (ONAB) may be employed for pretreatment diagnosis of ovarian malignancies or intraoperatively to facilitate removal of ovarian masses. However, there is reluctance to utilize this procedure due to potential cyst rupture or seeding of malignant cells. The objective of this study was to examine the efficacy of ONAB over a 13-year period at our institution.MethodsBetween 2000 and 2013, all ONAB specimens were identified from the Queen's Medical Center Pathology Department database. All cytologic specimens were reviewed and correlated with histopathologic findings. A retrospective chart review was conducted to retrieve data on clinical course and treatment.ResultsThis study identified 144 cases of ovarian masses sampled by aspiration or needle biopsy between 2000 and 2013. Ninety-two (64%) cases had corresponding histopathology, 84 (91%) of which were obtained concomitantly. On histology, 12 (13%) cases were malignant and 80 (87%) benign. Three false negative cases were noted; 2 serous borderline tumors and 1 mucinous cystadenocarcinoma. These were sampling errors; no diagnostic tumor cells were present in the aspirates. Sensitivity and specificity of ONAB in the detection of malignancy were 75% and 100%, respectively. The positive and negative predictive values were 100% and 96%, respectively.ConclusionONAB represents a valuable tool in the diagnosis of malignancy and treatment of ovarian masses. In our study, it was highly specific, with excellent positive and negative predictive value.

Cardio-Pulmonary Stethoscope: Clinical Validation With Heart Failure and Hemodialysis Patients.

The purpose of this study is to evaluate the accuracy of a noninvasive radiofrequency-based device, the Cardio-Pulmonary Stethoscope (CPS), to monitor heart and respiration rates, and detect changes in lung water content in human experiments and clinical trials. Three human populations (healthy subjects ( ), heart failure (), and hemodialysis () patients) were enrolled in this study. The study was conducted at the University of Hawaii and the Queen's Medical Center in Honolulu, HI, USA. Measurement of heart and respiration rates for all patients was compared with standard FDA - approved monitoring methods. For lung water measurements, CPS data were compared with simultaneous pulmonary capillary wedge pressure (PCWP) measurements for heart failure patients, and with change in weight of extracted fluid for hemodialysis patients. Statistical correlation methods (Pearson, mixed, and intraclass) were used to compare the data and examine accuracy of CPS results. Results show that heart and respiration rates of all patients have excellent correlation factors, r≥0.9. Comparisons with fluid removed during hemodialysis treatment showed correlation factor of to 1, while PCWP measurements of heart failure patients had correlation factor of to 0.97. These results suggest that CPS technology accurately quantifies heart and respiration rates and measure fluid changes in the lungs. The CPS has the potential to accurately monitor lung fluid status noninvasively and continuously in a clinical and outpatient setting. Early and efficient management of lung fluid status is key in managing chronic conditions such heart failure, pulmonary hypertension, and acute respiration distress syndrome.

Building a safe unit culture with CUSP

Jill Slade is a nurse manager and Rose Hata is a clinical nurse specialist for the surgical intensive care unit at The Queen's Medical Center in Honolulu, Hawaii. The authors would like to acknowledge the SICU RNs, SICU intensivists, Cindy Kamikawa, the Hawaii CUSP initiative, the Hawaii State Center for Nursing, and The Queen's Medical Center's Queen Emma Nursing Institute for partnering with them on this important improvement project. The authors have disclosed no financial relationships related to this article.

Increased tumor response to neoadjuvant therapy among rectal cancer patients taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly used antihypertensive medications that have been reported to affect aberrant angiogenesis and the dysregulated inflammatory response. Because of such mechanisms, it was hypothesized that these medications might affect the tumor response to neoadjuvant radiation in patients with rectal cancer. One hundred fifteen patients who were treated with neoadjuvant radiation at the University of Wisconsin (UW) between 1999 and 2012 were identified. Univariate analyses were performed with anonymized patient data. In a second independent data set, 186 patients with rectal cancer who were treated with neoadjuvant radiation at the Queen's Medical Center of the University of Hawaii (UH) between 1995 and 2010 were identified. These data were independently analyzed as before. Multivariate analyses were performed with aggregate data. Among patients taking ACEIs/ARBs in the UW data set, a significant 3-fold increase in the rate of pathologic complete response (pCR) to neoadjuvant therapy (52% vs 17%, P = .001) was observed. This finding was confirmed in the UH data set, in which a significant 2-fold-increased pCR rate (24% vs 12%, P = .03) was observed. Identified patient and treatment characteristics were otherwise balanced between patients taking and not taking ACEIs/ARBs. No significant effect was observed on pCR rates with other medications, including statins, metformin, and aspirin. Multivariate analyses of aggregate data identified ACEI/ARB use as a strong predictor of pCR (odds ratio, 4.02; 95% confidence interval, 2.06-7.82; P < .001). The incidental use of ACEIs/ARBs among patients with rectal cancer is associated with a significantly increased rate of pCR after neoadjuvant treatment. Cancer 2016;122:2487-95. © 2016 American Cancer Society.

Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy

AimsHelicobacter pylori infection is the major cause of peptic ulceration and gastric cancer, and an important virulence determinant is its vacuolating cytotoxin vacA. Previously, we have described allelic variation in...

The Honolulu Liver Disease Cluster at the Medical Center: Its Mysteries and Challenges.

In 2013, physicians at the Honolulu Queen’s Medical Center (QMC) noticed that seven liver disease patients reported the use of OxyELITE Pro (OEP), a widely consumed dietary supplement (DS). Assuming a temporal association between OEP use and disease, they argued that OEP was the cause of this mysterious cluster. Subsequent reexamination, however, has revealed that this QMC cohort is heterogeneous and not a cluster with a single agent causing a single disease. It is heterogeneous because patients used multiple DS’s and drugs and because patients appeared to have suffered from multiple liver diseases: liver cirrhosis, liver failure by acetaminophen, hepatotoxicity by non-steroidal antiinflammatory drugs (NSAIDs), resolving acute viral hepatitis by hepatitis B virus (HBV), herpes simplex virus (HSV), and varicella zoster virus (VZV), and suspected hepatitis E virus (HEV). Failing to exclude these confounders and to consider more viable diagnoses, the QMC physicians may have missed specific treatment options in some of their patients. The QMC physicians unjustifiably upgraded their Roussel Uclaf Causality Assessment Method (RUCAM) causality scores so that all patients would appear to be “probable” for OEP. However, subsequent RUCAM reassessments by our group demonstrated a lack of causality for OEP in the evaluated QMC cases. The QMC’s questionable approaches explain the extraordinary accumulation of suspected OEP cases at the QMC in Hawaii as single place, whereas similar cohorts were not published by any larger US liver center, substantiating that the problem is with the QMC. In this review article, we present and discuss new case data and critically evaluate upcoming developments of problematic regulatory assessments by the US Centers for Disease Control and Prevention (CDC), the Hawaii Department of Health (HDOH), and the Food and Drug Administration (FDA), as based on invalid QMC conclusions, clarifying now also basic facts and facilitating constructive discussions.

PWE-281 Are patients with cancers ‘missed’ on faecal occult blood (FOB) testing truly asymptomatic? – a multicentre analysis

Introduction We aimed to identify the symptomatology of patients who develop interval cancers (cancers diagnosed within 2 years of a negative FOBT screening) in the eligible population of the East Midlands region. Method Data from the National Bowel Cancer Audit Programme from three tertiary colorectal centres (Queens Medical Centre, Nottingham; Royal Derby Hospital and Sherwood Forest Hospitals ll) in the FOB testing age group (60–74 years) over 2 years (August 2011 to August 2013) were analysed and linked to the regional FOB hub to identify patients who had developed colorectal cancer after a negative FOBT in the screening interval (2 years) status. Tumours from and distal to the splenic flexure were classed as left sided tumours. Dukes C/D tumours were classed as advanced tumours. All three centres were in incident rounds of screening. Results The study covered a population of 2 million of which 200,000 were eligible for screening. 521 colorectal cancers were diagnosed in the above population (0.11%). Of these, 231 cancers (44%) were in patients who had declined screening,162 (31%) were picked up following on from a positive FOBT and 128 (25%) were picked up in patients who had a negative FOBT. Of these 128 patients (M: F; 84:44),median age 67 years (SD:3.8) the commonest presenting symptoms for these patients were change in bowel habits in 50(39%). Other presentations included bleeding per-rectum in 44 patients (34%), abdominal pain in 38 (30%) patients, anaemia in 36(28%) patients, loss of weight in14 (11%)patients, bowel obstruction in 13 (10%) patients, bowel perforation in 3(2%) patients. Only two patients were truly asymptomatic from the bowel cancer with this being identified in one patient during surgery for an ovarian cyst and during a trauma laparotomy in the other patient. In the 28% patients who had anaemia the blood picture included a Hb (mean)of 10.3gm;MCV of 82.4 and;MCH of 26.3. In 61% of anaemic patients, the cancer was located on the right side of the colon with an equal percentage being of advanced Duke’s stage. The median interval between the negative FOB test and the diagnosis of cancer in these patients was 15 months (range 0.5–24 months). Conclusion Our findings suggest that the majority of patients with ‘missed’ interval cancers were symptomatic with ‘red flag symptoms’ inspite of the negative FOB test. We also raise the possibility of a natural bias of subjects volunteering for the FOB test in that some who opt for the test may not be ‘truly’ asymptomatic but may have bowel symptoms not yet discussed with their general practitioner. We highlight the need for improved awareness to reduce delays in symptomatic patients seeking medical advice against a background of a negative FOBT. Disclosure of interest None Declared.

PWE-280 Faecal occult blood testing (FOBT) and interval bowel cancers-results of a multicentre study

<h3>Introduction</h3> We aimed to assess the incidence and demographics of interval cancers (cancers diagnosed within 2 years of a negative FOBT screening) in the eligible population of the East Midlands region. <h3>Method</h3> The National Bowel Cancer Audit Programme data from three centres (Queens Medical Centre, Nottingham; Royal Derby Hospital and Sherwood Forest Hospitals) for all colorectal cancers in the screening age group (60–74 years)over a 2-year period (August 2011–August 2013) were linked for their FOBT screening status (BCSP database/Eastern Hub). Three cancer groups were identified: interval cancers, screen detected (positive FOBT) and those in the non-uptake group (eligible patients who declined screening). Tumours at and distal to the splenic flexure were classed as left sided tumours. Dukes C and D tumours were classed as advanced tumours. All three centres were in incident rounds of screening. <h3>Results</h3> Of the 521 colorectal cancers identified, 128 (25%) were interval cancers, 162(31%) were screen detected and 231 (44%) were from the non-uptake group. Gender, ethnicity and Deprivation index were comparable between the three groups. The mean age in the interval cancer group was greater (67 yrs) compared to the screen detected (66 yrs) (<i>p = 0.005</i>). The interval cancer group had a higher incidence of right sided cancers (38% vs. 25% and 29%; <i>X</i>²=6.59; p = 0.033) compared to the screen-detected and non-uptake groups. Cancers detected in the interval cancer group were of a more advanced stage (Dukes C/D) (70% vs. 34% and 54%; <i>X</i>²=37.2;<i>p &lt; 0.005</i>) in comparison to screen-detected and non-uptake groups. The one year mortality in the interval cancer group (16%) was higher than the non-uptake group (12%) and the screen detected group (3%) (16%vs12% and 3%; X2=13.8;<i>p &lt; 0.005</i>). <h3>Conclusion</h3> A quarter of colorectal cancers identified in our screening-eligible population were interval cancers. We highlight the probability that these cancers were ‘missed’ by the guaiac-based FOBT screening tests. The interval cancer group also had poorer outcomes when compared to the screen-detected group. We highlight the need for a test with a lower false negative rate for population based FOBT screening. <h3>Disclosure of interest</h3> None Declared.

Report from the 2014 Scoliosis Research Society Travelling Fellowship

The Scoliosis Research Society traveling fellowship was conceptualized in 1970, repeated in 1972, and, after a pause, restarted in 1993. International traveling fellows visiting North America first commenced in 2000 and have since alternated annually with the North American fellows. Although a senior fellow had always traveled with them, in 2012 the first senior international fellow traveled with the group. This year, the senior fellow was Daniel Chopin from the Neuro-Orthopedic Spine Unit, Lille University Hospital, France, and past Director of the Spine Center, Institut Calot Berck sur Mer (succeeding Dr. Cotrel). The junior fellows were Meric Enercan from the Florence Nightingale Hospital, Istanbul Spine Center, Turkey; J. Naresh-Babu from Mallika Spine Centre, Guntur, Andhra Pradesh, India; and Nasir A. Quraishi from the Centre for Spine Studies and Surgery, Queen's Medical Centre, Nottingham, UK. The host centers were initially suggested by Dr. Chopin, the senior fellow; after some minor tweaking and extensive planning from the Scoliosis Research Society office, the itinerary was confirmed. The researchers were to visit 7 centers in just over 3 weeks. All of the international fellows were going to have an extraordinary adventure although they had not met each other previously. As it turned out, the trip was indeed sensational—professionally stimulating and socially endearing. The following is a short report on this unforgettable experience.

Use of HIDA scans and laparoscopic cholecystectomy for acalculous biliary symptoms – A 4 year experience in a district general hospital

Use of HIDA scans and laparoscopic cholecystectomy for acalculous biliary symptoms – A 4 year experience in a district general hospital

Stapled anopexy: An effective treatment for symptomatic haemorrhoidal disease – A district general hospital experience

Stapled anopexy: An effective treatment for symptomatic haemorrhoidal disease – A district general hospital experience

Advances in training: A high fidelity practical course on cadavers for complex cardiac procedures

s / International Journal of Surgery 12 (2014) S13eS117 S76 0313: ADVANCES IN TRAINING: A HIGH FIDELITY PRACTICAL COURSE ON CADAVERS FOR COMPLEX CARDIAC PROCEDURES John Massey, Jasmine Winter-Beatty , Nigel Drury, Jitendra Parmar. University Hospital Coventry and Warwickshire, Coventry, UK. Introduction: Surgical education is changing owing to implementation of European Working time Directive. Cadaveric-based educational programs have had positive feedback from surgical trainees. Our training centre allows trainees to gain experience in complex cardiac procedures in a safe, non-time pressurised environment.We look at how trainees benefit from a high fidelity course-training surgeons to perform two complex cardiac procedures. Methods: Cadavers had been prepared through a midline sternotomy, pericardium opened with heart and great vessels exposed. Trainees performed a stentless aortic valve replacement and an aortic root replacement. Faculty surgeons facilitated learning as required. Results: There was a 100% response for a post course feedback form. Knowledge survey revealed an increase in perception of knowledge. There was an increase in trainees' confidence to assist these procedures in future. 100% of attendees would recommend it to their peers. Trainees stated that they felt more comfortable assisting and performing the procedures having practiced on cadavers. Conclusions: Simulated training using fresh frozen human cadavers can be incorporated into surgical training of cardiothoracic trainees. Such a course can have high face validity and significantly improve trainees' perception of technical knowledge as well as increasing confidence to assist and perform complex cardiac procedures. 0320: THE LESSER-SPOTTED MEDICAL STUDENT: UNDERSTANDING AND FACILITATING STUDENT PRESENCE ON WARDS Ian Henderson, Jessika Voll , Damian Bragg. Queen's Medical Centre (NUH),

Abstract PL02-03: Overcoming cultural and geographic barriers to participation in clinical trials among Native Hawaiians

Abstract The Native Hawaiian population of Hawaii has disproportionately high cancer incidence and mortality rates. Native Hawaiian women with breast cancer present at an advanced stage and have death rates that are 52 % above the state average. Prostate cancer among Native Hawaiian men is diagnosed at more advanced stage. Native Hawaiian participation in cancer clinical trials was historically low. Reasons for this were varied including access, health literacy, lack of primary and referring physician awareness/time constraints and cultural barriers. Since the establishment of the University of Hawaii Minority Based Clinical Oncology Program (UHMBCCOP) participation in cancer clinical trials has definitely increased. MBCCOP provided clinical trial promotion, increased access and clinical trial support for a group of hospital and office based oncologists across the islands of Oahu and Kauai have all contributed to the increase. Education programs in Hawaii by multiple organizations, in particular, Imi Hale, the Native Hawaiian Cancer Network Program have enhanced knowledge of cancer and clinical trials in the Native Hawaiian community. Imi Hale's emphasis has focused on community based patient training, patient navigation and referring physician cancer clinical trial training. In fact, a recent program was recently initiated in conjunction with Education Network to Advance Clinical Trials (ENNACT) and Queens Medical Center. Review of Native Hawaiian participation in both cancer prevention and treatment trials through the UHMBCCOP over the last 20 years shows a significant gender difference with more women participating in both prevention and treatment trials. The reasons for this are not well understood but are under investigation. In summary, increased focused access and community based education have improved Native Hawaiian participation in cancer clinical trials but challenges persist including gender disparities in enrollment onto clinical trials and lack of access outside of Oahu and Kauai islands. Citation Format: Jeffrey L. Berenberg. Overcoming cultural and geographic barriers to participation in clinical trials among Native Hawaiians. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PL02-03. doi:10.1158/1538-7755.DISP13-PL02-03

Process outcome measures of patients with head/neck, thoracic, and gynecologic malignancies in the MDC clinic.

61 Background: Queen’s Medical Center (QMC) was selected as one of 14 sites nationwide to participate in the expansion of the National Cancer Institute’s Community Cancer Centers program in 2010. In 2011, QMC implemented Multidisciplinary Clinics (MDC) to make the treatment of patients with head and neck (H&amp;N), thyroid, thoracic, and GYN malignancies more efficient and seamless. The purpose of this study was to examine the following process outcomes: timeliness of care, adherence to MDC treatment plans and national guidelines, and utilization of ancillary services in H&amp;N, thyroid, thoracic, and GYN MDC. Methods: Retrospective, chart review of patients with H&amp;N, thyroid, thoracic, and GYN malignancies who were seen at the MDC from Jan 2012 to Dec 2012 was conducted. Variables collected were patient demographics, initial date of referral to the MDC, date of first cancer treatment, clinical variables (e.g. cancer diagnosis, co-morbidities, social habits [smoking, drinking, drug use]), and hospital process variables (e.g. reasons for delay in treatment, adherence to national guidelines, and use of ancillary services [e.g. navigation, dietary, survivorship, social work, chaplain, genetic counseling]). Results: 222 charts were reviewed (H&amp;N = 69, Thyroid = 54, Thoracic = 48, Gyn = 51). Ethnic minorities represented over 50% of the sample. For all cancers combined, average time to referral to first treatment was 32 days. Post-hoc analysis showed that patients seen in GYN MDC (mean = 17.5 + 12.3 days) had significantly fewer days from referral to first cancer treatment compared to patients seen in the H&amp;N MDC (mean = 41.3 + 25.6 days), F = 4.3, p = 0.003. For all sites combined, there was 99.5% adherence to the MDC recommended treatment plans, and 100% adherence to NCCN guidelines in the treatment received. Most patients with GYN malignancy (96.1%) were referred to one or more ancillary services followed by H&amp;N (88.4%), thoracic (85.4%), and thyroid (46.3%). Conclusions: Study provided baseline process outcomes for MDC of disease sites which are often less studied in literature. MDC nurse coordinator played a critical role in ensuring efficient and quality patient care. Results can serve as basis for further quality improvement.

Improving outcomes for patients with proximal femoral fractures.

A peri-operative bay was created to treat all patients with proximal femoral fractures admitted to one trauma ward at the Queen's Medical Centre, Nottingham. All patients had urinary catheterisation and their fluid intake and output was recorded; patients had daily blood tests and were cared for on pressure-relieving mattresses. In addition, a study day was provided for all nursing staff on the management of patients with proximal femoral fractures. These measures resulted in a significant decrease in the incidence of acute kidney injury, reduced the length of hospital stay for patients on this ward and reduced the numbers of falls and pressure-related injuries for these patients.

Psoriasis and uveitis - should we be asking about eye symptoms?

British Journal of DermatologyVolume 170, Issue 3 p. 756-757 Correspondence Psoriasis and uveitis – should we be asking about eye symptoms? E. Burden-Teh, E. Burden-Teh eburden@doctors.org.uk Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH U.KSearch for more papers by this authorR. Murphy, R. Murphy Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH U.KSearch for more papers by this author E. Burden-Teh, E. Burden-Teh eburden@doctors.org.uk Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH U.KSearch for more papers by this authorR. Murphy, R. Murphy Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH U.KSearch for more papers by this author First published: 09 November 2013 https://doi.org/10.1111/bjd.12731Citations: 18 Funding sources: no external funding. Conflicts of interest: none declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume170, Issue3March 2014Pages 756-757 RelatedInformation

Emergence of well differentiated neuroendocrine (carcinoid) tumours following chemoradiotherapy for rectal adenocarcinoma

Colorectal DiseaseVolume 15, Issue 12 p. 1544-1547 Correspondence Emergence of well differentiated neuroendocrine (carcinoid) tumours following chemoradiotherapy for rectal adenocarcinoma D. Lindsay, D. Lindsay Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorA. Zaitoun, A. Zaitoun Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorP. Kaye, P. Kaye Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorM. Ilyas, M. Ilyas mohammad.ilyas@nottingham.ac.uk Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this author D. Lindsay, D. Lindsay Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorA. Zaitoun, A. Zaitoun Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorP. Kaye, P. Kaye Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this authorM. Ilyas, M. Ilyas mohammad.ilyas@nottingham.ac.uk Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG72UH UKSearch for more papers by this author First published: 27 August 2013 https://doi.org/10.1111/codi.12398Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume15, Issue12December 2013Pages 1544-1547 RelatedInformation

In Memoriam: Bo K Siesjö, 1930–2013

Bo K Siesjo was an outstanding brain researcher and will be remembered as such. He was born in Sweden on 8 January 1930 and died in his home country on the 27 June 2013. He graduated from medical school at the Lund's University in 1958 and defended his PhD thesis at the same university in 1962. His postgraduate training took place in Sweden and Cambridge, and in the late 1980s he was a visiting scientist in Nice. After his graduation from medical school, he had appointments at the Lund's University and University Hospital until his retirement in 1995. In Lund he created the Laboratory for Experimental Brain Research, and the Swedish Research Council established a special professorship for him in 1974. He, subsequently, became the chief of the research department at Lund's University Hospital. After his retirement he went to Hawaii to build up a neuroscience research department at Queens Medical Center in Honolulu. Siesjo's research focus was on cerebral metabolism in the normal and injured brain, and an early important topic of his interest was the regulation of pH in the extra- and intracellular fluids in the brain. He published a textbook on the brain's energy metabolism and authored or co-authored more than 500 publications listed on PubMed. In 1970s his research focused on the ischemic metabolic cascade, the mechanisms of ischemic cell death, and the energy reserves in the brain, work that bore rich fruit. Two classic papers from this period stand out for their influence on the field, ie, his 1981 paper with Astrup and Symon on the concept of the ischemic penumbra,1 and his synthesis paper on the mechanisms of ischemic cell death.2 In his later years of research he also investigated the pathophysiology of chronic brain diseases, such as dementia of the Alzheimer's type. In his research carrier, Siesjo became one of the most highly cited scientists in his field. Bo Siesjo was the main catalyst for the founding in 1981 of the Journal of Cerebral Blood Flow and Metabolism and the organization of its parent professional society, the International Society of Cerebral Blood Flow and Metabolism. He was also the recipient of a number of awards that include the Mihara Award in 1989, the J Allan Taylor International Prize in Medicine in 1992, the KJ Zulch Prize in 1992, and the Lifetime Achievement Award by the International Society for Cerebral Blood Flow and Metabolism in 2003. Siesjo's research in Lund was renowned worldwide, and many young scientists from all over the world came to work with him. Many of them, who got their scientific start in his laboratory, later became well-established researchers in their home countries; more than 20 of them achieved full professorships in institutions worldwide. In addition to his scientific interests, Bo Siesjo had an intense interest in art that led him to establish an art collection concentrated mainly on modern national art. Bo was married with Bodil, and they had three children, Peter, Viveka, and Bjorn. All honor to his name.

Comparing pain and analgesia requirements in different procedures for the treatment of hip fractures

Comparing pain and analgesia requirements in different procedures for the treatment of hip fractures

Management of trauma patients admitted to critical care at queens medical centre: Comparison of two studies

Management of trauma patients admitted to critical care at queens medical centre: Comparison of two studies