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Rejjal L, Aldibasi O, Sidhu S, Ware S, Canales K, Vasquez R, Dumas-Hicks D, Desai S, Ventura H, Krim S. Use of Gene Expression Profiling Score Variability to Predict Cardiac Allograft Vasculopathy: A Single Center Experience. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sidhu SS, Malhi NS, Goyal O, Singh R, Dutta U, Grover R, Sidhu JS, Nanda V, Saluja H, Bansal A, Singh G, Sehgal A, Kishore H, Sidhu S. Treatment of chronic hepatitis C genotype 3 with Sofosbuvir-based therpy: a real-life study. Hepatol Int 2017; 11:277-285. [PMID: 28361300 DOI: 10.1007/s12072-017-9794-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/14/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Recently, Sofosbuvir was launched in India at affordable cost. We conducted a real-life study to determine the efficacy and safety of Sofosbuvir plus Ribavirin, with and without peginterferon-alfa 2a, in patients with chronic hepatitis C (CHC) genotype 3, the commonest genotype in South Asia. METHODS This study included data of CHC patients from 11 sites in northern India between March 2015 and December 2015 (n = 1203). Patients with CHC genotype 3 (n = 931), who were treated with either Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×24 weeks (n = 432) (dual therapy), or Peginterferon-α2a 180 mcg weekly, Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×12 weeks (n = 499) (triple therapy) were included for analysis. Primary outcome was the proportion of patients achieving sustained viral response at 12 weeks post-therapy. RESULTS The overall SVR rates were 91 and 92% in the dual and triple therapy arms, respectively. The SVR rates in treatment experienced were 67 and 74% versus 93 and 96% in naïve patients, on the dual and triple therapy arms, respectively. The SVR rates of cirrhotics were 73 and 75% on the dual and triple treatment arms, respectively. The SVR rates were low in the experienced cirrhotic patients: 44% (dual therapy) and 58% (triple therapy). Common adverse events were fatigue, headache, and myalgia. CONCLUSION Both dual and triple therapy regimes resulted in SVR rates of >95% in CHC genotype 3 who were naive non-cirrhotics. However, the SVR rates were low in treatment-experienced cirrhotics.
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Sidhu SS, Goyal O, Kishore H, Sidhu S. New paradigms in management of alcoholic hepatitis: a review. Hepatol Int 2017; 11:255-267. [PMID: 28247264 DOI: 10.1007/s12072-017-9790-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/08/2017] [Indexed: 12/12/2022]
Abstract
Severe alcoholic hepatitis (SAH) is defined by modified Maddrey discriminant function ≥32 or Model for End-Stage Liver Disease (MELD) >21 and/or hepatic encephalopathy. It has a 3-month mortality rate ≥30-70 %. Patients with severe alcoholic hepatitis need combined, i.e., static (MELD score) and dynamic (Lille's score), prognostication. Systemic inflammation and poor regeneration are hallmarks of SAH, rather than intrahepatic inflammation. SAH is characterized by dysregulated and uncontrolled systemic inflammatory response followed by weak compensatory antiinflammatory response that leads to increased susceptibility to infection and multiple organ failure. Massive necrosis of hepatocytes exceeds the proliferative capacity of hepatocytes. Liver progenitor cells proliferate to form narrow ductules which radiate out into the damaged liver parenchyma. Corticosteroids have been the standard-of-care therapy, albeit controversial. However, the recent Steroids or Pentoxifylline for Alcoholic Hepatitis (STOPAH) trial revealed that prednisolone was not associated with a significant reduction in 28-day mortality, with no improvement in outcomes at 90 days or 1 year. A paradigm shift from antiinflammatory therapy such as corticosteroids to liver regeneration treatment, e.g., granulocyte-colony stimulating factor, molecular targeted treatments, and fecal microbiota transplantation, for severe alcoholic hepatitis is taking place. Liver transplantation should be offered to select patients with severe alcoholic hepatitis who are nonresponsive to medical treatment.
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Sidhu S, Sadhwani A, Mittal M, Sharma V, Sharma HB, Manna S. Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension. J Clin Diagn Res 2017. [DOI: 10.7860/jcdr/2017/31792.10867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chong H, Yang G, Sidhu S, Ibbetson J, Kopecki Z, Cowin A. Reducing Flightless I expression decreases severity of psoriasis in an imiquimod-induced murine model of psoriasiform dermatitis. Br J Dermatol 2016; 176:705-712. [DOI: 10.1111/bjd.14842] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 11/29/2022]
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Kashani S, Ito T, Guggenheim A, Sanko S, Sidhu S, Balagna J, Green J, Wong C, Eckstein M. 88 Implementation of a Nurse Practitioner Response Unit in an Urban EMS System. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Clarke S, Sidhu S, Pavlakis N, Brahmbhatt H, Macdiarmid J. The Tailored EDVTM trial: A phase I feasibility study evaluating EGFR-targeted EDVTM nanocells as a therapy platform in patients with refractory advanced solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fraser S, Go C, Aniss A, Sidhu S, Delbridge L, Learoyd D, Clifton-Bligh R, Tacon L, Tsang V, Robinson B, Gill AJ, Sywak M. BRAFV600E Mutation is Associated with Decreased Disease-Free Survival in Papillary Thyroid Cancer. World J Surg 2016; 40:1618-24. [DOI: 10.1007/s00268-016-3534-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hoeppli M, Thurston T, Sidhu S, Mangum T, Weavil J, Hureau T, Tang W, Hughen R, Light A, Amann M, Schweinhardt P. (352) Differences in psychophysical responses to muscle stimulation in young and old healthy adults. THE JOURNAL OF PAIN 2016. [DOI: 10.1016/j.jpain.2016.01.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chong BS, Miller J, Sidhu S. The quality of radiographs accompanying endodontic referrals to a health authority clinic. Br Dent J 2015. [PMID: 26205934 DOI: 10.1038/sj.bdj.2015.557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM To assess the quality of radiographs accompanying endodontic referrals, from general dental practitioners, to a health authority clinic. METHODS A total of 200 conventional film and digital radiographs accompanying referrals were assessed and rated as 'excellent', 'diagnostically acceptable' or 'unacceptable' according to the National Radiographic Protection Board (NRPB) guidelines. Statistical analyses of the results included inter- and intra-observer agreement to achieve a kappa score and the chi-squared test. RESULTS Out of the 200 radiographs assessed, 38 (19%) were conventional film and 162 (81%) were digital. Of the conventional film radiographs, 55% were rated 'excellent' and 37% were 'diagnostically acceptable', whilst 27% of digital radiographs were rated 'excellent' and 40% were 'diagnostically acceptable'. In the 'unacceptable' category, 33% were digital and 8% were conventional film radiographs (p <0.001). CONCLUSIONS The quality of digital radiographs was significantly lower compared with conventional film radiographs. The percentage of 'unacceptable' digital radiographs was above the target according to the NRPB guidelines. Hence, there is a need for improvement in quality to avoid repeat radiographs and unnecessary ionising radiation exposure. Instead of hard, printed copies, digital radiographs accompanying referrals should, within the parameters of information governance, be supplied electronically so that they may be optimised, if necessary, for better diagnostic value.
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Britton EJ, Sidhu S, Geraghty J, Psarelli E, Sarkar S. The 5-year outcome of patients having incomplete colonoscopy. Colorectal Dis 2015; 17:298-303. [PMID: 25605376 DOI: 10.1111/codi.12901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 09/06/2014] [Indexed: 12/16/2022]
Abstract
AIM Incomplete colonoscopy indicated for the detection of neoplasia occurs in 2-23% of patients, but there is little information on the long-term outcome of such patients. METHOD All patients who underwent colonoscopy over 5 years at the Royal Liverpool University Hospital with a follow-up of up to 5 years were identified. RESULTS The risk of colorectal cancer (CRC) was 2.9% (312/10 580) for all patients undergoing colonoscopy. For a failed colonoscopy, the risk was five-fold higher [14.3% (99/693)]. The mean age of the patients was 61 years and 58% were female. Following incomplete colonoscopy the risk of finding additional CRC, advanced colonic neoplasia and extracolonic neoplasia on subsequent investigation was 6.2%, 3.2% and 1.9%. The diagnostic yield on subsequent investigation for CRC or colonic polyps was 7% for repeat colonoscopy, 13.4% for computed tomography colonography, 10.3% for standard computed tomography and 1.8% for barium enema. In the 363 patients who were not offered a subsequent investigation, there was no further instance of CRC or CRC-related mortality over a 36-month period. CONCLUSION Although the risk of CRC is higher in patients who have had a failed colonoscopy, a protocol approach of subsequent investigation should not replace clinical assessment on whether another test is necessary in the light of the good outcome of patients who were not subsequently investigated.
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Al Bukhary R, Wassell R, Sidhu S, Al Naimi O, Meechan J. The local anaesthetic effect of a dental laser prior to cavity preparation: a pilot volunteer study. Oper Dent 2014; 40:129-33. [PMID: 25216939 DOI: 10.2341/13-101-c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES It has been suggested that laser preconditioning can produce dental anaesthesia. This study aimed to assess the response of the dental pulp to laser preconditioning. METHODS The effects of laser preconditioning, sham laser (negative control), and composite curing light (positive control) on the response of the dental pulp to electric pulp testing was investigated in this double-blind crossover trial with six volunteers. The Er,Cr:YSGG laser or curing light was shone on a premolar tooth in a sweeping motion for 30 seconds (in the sham treatment, the laser was not activated) in blindfolded volunteers subjected to a consistent aural stimulus. Treatment method at each visit was randomized and performed by a researcher not involved in pulp testing. Teeth were pulp tested twice initially by another member of the research team to get baseline readings, immediately following the treatment, and thereafter every two minutes for 10 minutes. Results were analyzed using analysis of variance and an independent-sample t-test. RESULTS There were no significant differences in pulpal response between treatments (p>0.05). CONCLUSION Laser preconditioning did not affect pulpal response as measured by an electronic pulp tester. Laser preconditioning did not result in any pain or noticeable symptoms for both teeth and soft tissues.
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Allan P, Nixon E, Sidhu S, Teubner A, Abraham A, Carlson G, Lal S. PP152-SUN: Development and Outcome of Intestinal Failure in Crohn’s Disease: 3 Decades of Experience. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Norlén O, Sidhu S, Sywak M, Delbridge L. Long-term outcome after parathyroidectomy for lithium-induced hyperparathyroidism. Br J Surg 2014; 101:1252-6. [PMID: 25043401 DOI: 10.1002/bjs.9589] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 03/27/2014] [Accepted: 05/09/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND The accepted management of lithium-associated hyperparathyroidism (LiHPT) is open four-gland parathyroid exploration (OPTX). This approach has recently been the subject of controversy. A recent study has shown very high long-term recurrence rates after OPTX, whereas some have promoted unilateral focused parathyroidectomy as appropriate management. The aim was to evaluate long-term outcomes after surgery for LiHPT and to assess the accuracy of preoperative imaging. METHODS This was a retrospective cohort study that comprised all patients undergoing initial surgery for LiHPT between 1990 and 2013. The cumulative recurrence rate was calculated by the Kaplan-Meier method. The sensitivity and specificity of sestamibi scintigraphy and ultrasound imaging for identification of single-gland versus multigland disease was investigated using intraoperative assessment as reference. RESULTS Of 48 patients, 45 had OPTX and three underwent focused parathyroidectomy. Multiglandular disease was documented in 27 patients and 21 had a single adenoma. The median follow-up was 5·9 (range 0·3-22) years and 16 patients died during follow-up. The 10-year cumulative recurrence rate was 16 (95 per cent confidence interval 2 to 29) per cent. No permanent complications occurred after primary surgery for LiHPT. Twenty-four patients had at least one preoperative ultrasound or sestamibi scan. For concordant sestamibi scintigraphy and ultrasound imaging, the sensitivity and specificity for identifying single-gland versus multigland disease was five of nine and five of eight respectively. CONCLUSION Surgery provided a safe and effective management option for patients with LiHPT in this series, with a long-term cure rate of well over 80 per cent.
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Tsang VHM, Dwight T, Benn DE, Meyer-Rochow GY, Gill AJ, Sywak M, Sidhu S, Veivers D, Sue CM, Robinson BG, Clifton-Bligh RJ, Parker NR. Overexpression of miR-210 is associated with SDH-related pheochromocytomas, paragangliomas, and gastrointestinal stromal tumours. Endocr Relat Cancer 2014; 21:415-26. [PMID: 24623741 DOI: 10.1530/erc-13-0519] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
miR-210 is a key regulator of response to hypoxia. Pheochromocytomas (PCs) and paragangliomas (PGLs) with germline SDHx or VHL mutations have pseudohypoxic gene expression signatures. We hypothesised that PC/PGLs containing SDHx or VHL mutations, and succinate dehydrogenase (SDH)-deficient gastrointestinal stromal tumours (GISTs), would overexpress miR-210 relative to non-SDH or -VHL-mutated counterparts. miR-210 was analysed by quantitative PCR in i) 39 PC/PGLs, according to genotype (one SDHA, five SDHB, seven VHL, three NF1, seven RET, 15 sporadic, one unknown) and pathology (18 benign, eight atypical, 11 malignant, two unknown); ii) 18 GISTs, according to SDHB immunoreactivity (nine SDH-deficient and nine SDH-proficient) and iii) two novel SDHB-mutant neurosphere cell lines. miR-210 was higher in SDHx- or VHL-mutated PC/PGLs (7.6-fold) compared with tumours without SDHx or VHL mutations (P=0.0016). miR-210 was higher in malignant than in unequivocally benign PC/PGLs (P=0.05), but significance was lost when benign and atypical tumours were combined (P=0.08). In multivariate analysis, elevated miR-210 was significantly associated with SDHx or VHL mutation, but not with malignancy. In GISTs, miR-210 was higher in SDH-deficient (median 2.58) compared with SDH-proficient tumours (median 0.60; P=0.0078). miR-210 was higher in patient-derived neurosphere cell lines containing SDHB mutations (6.5-fold increase) compared with normal controls, in normoxic conditions (P<0.01). Furthermore, siRNA-knockdown of SDHB in HEK293 cells increased miR-210 by 2.7-fold (P=0.001) under normoxia. Overall, our results suggest that SDH deficiency in PC, PGL and GISTs induces miR-210 expression and substantiates the role of aberrant hypoxic-type cellular responses in the development of these tumours.
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Manlhiot C, Stenyk L, Sidhu S, McCrindle B. 435 Evidence of Seasonality in Births of Patients With Congenital Heart Disease Who Require Subsequent Surgical Repair. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Collins J, Sidhu S, Katugampola R. Assoc Med J 2012; 344:e2693-e2693. [DOI: 10.1136/bmj.e2693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sidhu S, Katugampola R. . West J Med 2011; 343:d7877-d7877. [DOI: 10.1136/bmj.d7877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sidhu S, Bodger O, Williams N, Roberts DL. The number of benign moles excised for each malignant melanoma: the number needed to treat. Clin Exp Dermatol 2011; 37:6-9. [PMID: 21981313 DOI: 10.1111/j.1365-2230.2011.04148.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The ratio of benign moles excised for each malignant melanoma (MM) diagnosed, i.e. the number needed to treat (NNT), may be a useful indicator of diagnostic accuracy and the efficient use of healthcare resources, and may have personal implications for the patient. AIM To assess the NNT for a group of consultant dermatologists serving a population of 600,000, and to compare this with similar studies from other countries. METHODS This was a retrospective analysis of data on pigmented lesions excised over a 5-year period (2005-2009). The lesions were divided into three groups: benign naevi (BN), dysplastic naevi (DN) and MM. The NNT ratio was calculated as (BN + DN + MM)/MM. RESULTS In total, 4691 lesions were examined. The overall mean NNT was 6.3, with a range of 4.9-11.3 for each of nine consultant dermatologists. The mean NNT was 7.6 for female and 4.8 for male patients. There were more patients with BN (n = 3534; 75%) than with DN (n = 407; 9%) or MM (n = 750; 16%). The gender representation was similar in the DN and MM groups, but had a disproportionately female bias in the BN group (67% female, 33% male patients). Overall, there were more female patients in all three groups [2962 female patients (63%) and 1729 male patients (37%)]. CONCLUSIONS The NNT of 6.3 in this study compares favourably with NNT ratios from studies of dermatologists from other countries. This study may encourage other countries and individual doctors to assess their NNT ratios, as it may be an important indicator of the efficient use of resources and the avoidance of unnecessary surgery for patients.
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Sidhu S, Falzon G, Hart SA, Fox JG, Lewis RA, Siu KKW. Classification of breast tissue using a laboratory system for small-angle x-ray scattering (SAXS). Phys Med Biol 2011; 56:6779-91. [DOI: 10.1088/0031-9155/56/21/002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Willis JR, Kumar V, Mohanty S, Kumar A, Singh JV, Ahuja RC, Misra RP, Singh P, Singh V, Baqui AH, Sidhu S, Santosham M, Darmstadt GL. Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India. Int J Qual Health Care 2011; 23:487-94. [DOI: 10.1093/intqhc/mzr030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hussein M, Sidhu S, Clark C, Adams E, Jordan T. 1433 poster CRITICAL EVALUATION BETWEEN THE PTW SEVEN29 2D ARRAY(tm) AND SCANDIDOS DELTA4(tm) FOR DYNAMIC IMRT AND RAPIDARC(tm) VERIFICATION. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71555-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sidhu S, Morris AD. . West J Med 2011; 342:d1133-d1133. [DOI: 10.1136/bmj.d1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yao M, Rosenfeld J, Attridge S, Sidhu S, Aksenov V, Rollo CD. The Ancient Chemistry of Avoiding Risks of Predation and Disease. Evol Biol 2009. [DOI: 10.1007/s11692-009-9069-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chang LY, Suliburk J, Sidhu S, Delbridge L, Sywak M. ES17�*RESULTS OF SUTURELESS TECHNIQUES VS CONVENTIONAL VESSEL LIGATION FOR TOTAL THYROIDECTOMY. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04916_17.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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