Ryan Mathew - Academia.edu (original) (raw)
Papers by Ryan Mathew
Ethics & medicine: a Christian perspective on issues in bioethics
Acta radiologica open, 2015
Percutaneous vertebroplasty is a minimally invasive procedure that can be performed to treat pain... more Percutaneous vertebroplasty is a minimally invasive procedure that can be performed to treat pain and immobility associated with vertebral compression fractures. Previous studies have shown that a single injection can achieve adequate fill across the midline of the vertebral body. To compare the radiological outcomes of using a novel steerable needle with using a conventional, straight needle in unipedicular vertebroplasty. Data were collected from 19 patients who were operated at our institute between 1 September 2010 and 31 March 2011. Outcomes were measured in terms of radiological evidence of midline crossing of cement. The available pre- and postoperative pain scores and complications were reviewed. Student's t-test was used to compare mean cement projection across the midline in both groups with P < 0.05 considered to be statistically significant. Mean fill across the midline was significantly greater with the steerable needle (58%) compared with the straight needle (35...
Neuro-oncology, 2014
We report a population-based study examining long-term outcomes for common pediatric CNS tumors c... more We report a population-based study examining long-term outcomes for common pediatric CNS tumors comparing results from the UK with the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data set and with the literature. No such international study has previously been reported. Data between 1996 and 2005 from the UK National Registry of Childhood Tumours (NRCT) and the SEER registry were analyzed. We calculated actuarial survival at each time point from histological diagnosis, with death from any cause as the endpoint. Kaplan-Meier estimation and log-rank testing (Cox proportional hazards regression analysis) were used to calculate survival differences among tumor subtypes, adjusting for age at diagnosis. Population-based outcomes for each tumor type are presented. Overall age-adjusted survival, stratifying for histology (combining pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, primitive neuroectodermal tumor, medulloblastoma, and ependym...
Ethics & medicine : a Christian perspective on issues in bioethics, 2003
The first successful human-to-human organ transplant was performed in 1954 when a kidney was tran... more The first successful human-to-human organ transplant was performed in 1954 when a kidney was transferred between two identical twins. In the years since this groundbreaking operation improvements in transplant surgery and an increasing ability to control organ rejection using imunosupressive medication has made transplantation the treatment of choice for a new generation. Unfortunately, these advancements have resulted in transplantation becoming a victim of its own success, as waiting lists have increased along with the waiting time for donor organs. For these reasons the use of animal organs for human transplantation is seriously being considered. Two groups of animals have been considered as donors: non-human primates and large non-primates such as pigs. Whilst many researchers in this field are very optimistic about the future, many opponents are concerned about the effects on public health and the environment. The primary barrier to transplantation is immunological rejection. W...
In an increasing culture of medical accountability, 30-day operative mortality rates remain one o... more In an increasing culture of medical accountability, 30-day operative mortality rates remain one of the most objective measurements reported for the surgical field. The authors report population-based 30-day postoperative mortality rates among children who had undergone CNS tumor surgery in the United Kingdom. To determine overall 30-day operative mortality rates, the authors analyzed the National Registry of Childhood Tumors for CNS tumors for the period 2004-2007. The operative mortality rate for each tumor category was derived. In addition, comparison was made with the 30-day operative mortality rates after CNS tumor surgery reported in the contemporary literature. Finally, by use of a funnel plot, institutional performance for 30-day operative mortality was compared for all units across the United Kingdom. The overall 30-day operative mortality rate for children undergoing CNS tumor surgery in the United Kingdom during the study period was 2.7%. When only malignant CNS tumors were analyzed, the rate increased to 3.5%. One third of the deaths occurred after discharge from the hospital in which the surgery had been performed. The highest 30-day operative mortality rate (19%) was for patients with choroid plexus carcinomas. A total of 20 institutions performed CNS tumor surgery during the study period. Rates for all institutions fell within 2 SDs. No trend associating operative mortality rates and institutional volume was found. In comparison, review of the contemporary literature suggests that the postoperative mortality rate should be approximately 1%. The authors believe this to be the first report of national 30-day surgical mortality rates specifically for children with CNS tumors. The study raises questions about the 30-day mortality rate among children undergoing surgery for CNS tumors. International consensus should be reached on a minimum data set for outcomes and should include 30-day operative mortality rates.
British journal of neurosurgery, Jan 20, 2015
We report a 20-year-old woman with a diagnosis of spinal neuroschistosomiasis that was confirmed ... more We report a 20-year-old woman with a diagnosis of spinal neuroschistosomiasis that was confirmed histologically. Magnetic resonance imaging demonstrated an expanded, oedematous conus with intrinsic heterogeneous enhancement, which was initially thought to be a neoplastic lesion. This case demonstrates an alternative diagnosis to oncological lesions of the spinal cord which should be considered in patients who have recently travelled to endemic areas.
Ethics & medicine: a Christian perspective on issues in bioethics
Acta radiologica open, 2015
Percutaneous vertebroplasty is a minimally invasive procedure that can be performed to treat pain... more Percutaneous vertebroplasty is a minimally invasive procedure that can be performed to treat pain and immobility associated with vertebral compression fractures. Previous studies have shown that a single injection can achieve adequate fill across the midline of the vertebral body. To compare the radiological outcomes of using a novel steerable needle with using a conventional, straight needle in unipedicular vertebroplasty. Data were collected from 19 patients who were operated at our institute between 1 September 2010 and 31 March 2011. Outcomes were measured in terms of radiological evidence of midline crossing of cement. The available pre- and postoperative pain scores and complications were reviewed. Student's t-test was used to compare mean cement projection across the midline in both groups with P < 0.05 considered to be statistically significant. Mean fill across the midline was significantly greater with the steerable needle (58%) compared with the straight needle (35...
Neuro-oncology, 2014
We report a population-based study examining long-term outcomes for common pediatric CNS tumors c... more We report a population-based study examining long-term outcomes for common pediatric CNS tumors comparing results from the UK with the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data set and with the literature. No such international study has previously been reported. Data between 1996 and 2005 from the UK National Registry of Childhood Tumours (NRCT) and the SEER registry were analyzed. We calculated actuarial survival at each time point from histological diagnosis, with death from any cause as the endpoint. Kaplan-Meier estimation and log-rank testing (Cox proportional hazards regression analysis) were used to calculate survival differences among tumor subtypes, adjusting for age at diagnosis. Population-based outcomes for each tumor type are presented. Overall age-adjusted survival, stratifying for histology (combining pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, primitive neuroectodermal tumor, medulloblastoma, and ependym...
Ethics & medicine : a Christian perspective on issues in bioethics, 2003
The first successful human-to-human organ transplant was performed in 1954 when a kidney was tran... more The first successful human-to-human organ transplant was performed in 1954 when a kidney was transferred between two identical twins. In the years since this groundbreaking operation improvements in transplant surgery and an increasing ability to control organ rejection using imunosupressive medication has made transplantation the treatment of choice for a new generation. Unfortunately, these advancements have resulted in transplantation becoming a victim of its own success, as waiting lists have increased along with the waiting time for donor organs. For these reasons the use of animal organs for human transplantation is seriously being considered. Two groups of animals have been considered as donors: non-human primates and large non-primates such as pigs. Whilst many researchers in this field are very optimistic about the future, many opponents are concerned about the effects on public health and the environment. The primary barrier to transplantation is immunological rejection. W...
In an increasing culture of medical accountability, 30-day operative mortality rates remain one o... more In an increasing culture of medical accountability, 30-day operative mortality rates remain one of the most objective measurements reported for the surgical field. The authors report population-based 30-day postoperative mortality rates among children who had undergone CNS tumor surgery in the United Kingdom. To determine overall 30-day operative mortality rates, the authors analyzed the National Registry of Childhood Tumors for CNS tumors for the period 2004-2007. The operative mortality rate for each tumor category was derived. In addition, comparison was made with the 30-day operative mortality rates after CNS tumor surgery reported in the contemporary literature. Finally, by use of a funnel plot, institutional performance for 30-day operative mortality was compared for all units across the United Kingdom. The overall 30-day operative mortality rate for children undergoing CNS tumor surgery in the United Kingdom during the study period was 2.7%. When only malignant CNS tumors were analyzed, the rate increased to 3.5%. One third of the deaths occurred after discharge from the hospital in which the surgery had been performed. The highest 30-day operative mortality rate (19%) was for patients with choroid plexus carcinomas. A total of 20 institutions performed CNS tumor surgery during the study period. Rates for all institutions fell within 2 SDs. No trend associating operative mortality rates and institutional volume was found. In comparison, review of the contemporary literature suggests that the postoperative mortality rate should be approximately 1%. The authors believe this to be the first report of national 30-day surgical mortality rates specifically for children with CNS tumors. The study raises questions about the 30-day mortality rate among children undergoing surgery for CNS tumors. International consensus should be reached on a minimum data set for outcomes and should include 30-day operative mortality rates.
British journal of neurosurgery, Jan 20, 2015
We report a 20-year-old woman with a diagnosis of spinal neuroschistosomiasis that was confirmed ... more We report a 20-year-old woman with a diagnosis of spinal neuroschistosomiasis that was confirmed histologically. Magnetic resonance imaging demonstrated an expanded, oedematous conus with intrinsic heterogeneous enhancement, which was initially thought to be a neoplastic lesion. This case demonstrates an alternative diagnosis to oncological lesions of the spinal cord which should be considered in patients who have recently travelled to endemic areas.