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Keegan C, Connolly S, Wren MA. Measuring healthcare expenditure: different methods, different results. Ir J Med Sci 2017; 187:13-23. [DOI: 10.1007/s11845-017-1623-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
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Browne E, O'Malley K, Connolly S, O'Kelly F, Lundon D, Daly P, Galvin D, Hegarty N. The Hidden Burden of Outpatient Repeat PSA Testing in a Prospective Cohort. IRISH MEDICAL JOURNAL 2017; 110:564. [PMID: 28737305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PSA testing is widespread throughout Europe for diagnostic purposes and follow up. We performed a prospective outpatient cohort study of 250 men (2013-2015) in two hospital sites. Included were those men being followed up by urology with PSA blood testing. First appointments and those men in whom non-PSA tests were ordered by urology were excluded. The median age was 67.2yrs (46-88). Eighty-one point two percent of samples had a combination of 21 different serology tests at an added cost of >€18,000. Abnormal serology resulted in 53 referrals. Twenty-six-six percent of correspondence referenced abnormal serology other than PSA. Follow up of non-PSA test results poses a challenge in an outpatient setting with failure to appropriately follow-up on abnormal results, increased costs, and medico-legal implications. There is currently no Irish legislature in place to safeguard hospital physicians. This study quantifies the levels of expenditure, resources and risk associated with ambulant PSA testing.
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Freedman B, Camm J, Calkins H, Healey JS, Rosenqvist M, Wang J, Albert CM, Anderson CS, Antoniou S, Benjamin EJ, Boriani G, Brachmann J, Brandes A, Chao TF, Conen D, Engdahl J, Fauchier L, Fitzmaurice DA, Friberg L, Gersh BJ, Gladstone DJ, Glotzer TV, Gwynne K, Hankey GJ, Harbison J, Hillis GS, Hills MT, Kamel H, Kirchhof P, Kowey PR, Krieger D, Lee VWY, Levin LÅ, Lip GYH, Lobban T, Lowres N, Mairesse GH, Martinez C, Neubeck L, Orchard J, Piccini JP, Poppe K, Potpara TS, Puererfellner H, Rienstra M, Sandhu RK, Schnabel RB, Siu CW, Steinhubl S, Svendsen JH, Svennberg E, Themistoclakis S, Tieleman RG, Turakhia MP, Tveit A, Uittenbogaart SB, Van Gelder IC, Verma A, Wachter R, Yan BP, Al Awwad A, Al-Kalili F, Berge T, Breithardt G, Bury G, Caorsi WR, Chan NY, Chen SA, Christophersen I, Connolly S, Crijns H, Davis S, Dixen U, Doughty R, Du X, Ezekowitz M, Fay M, Frykman V, Geanta M, Gray H, Grubb N, Guerra A, Halcox J, Hatala R, Heidbuchel H, Jackson R, Johnson L, Kaab S, Keane K, Kim YH, Kollios G, Løchen ML, Ma C, Mant J, Martinek M, Marzona I, Matsumoto K, McManus D, Moran P, Naik N, Ngarmukos T, Prabhakaran D, Reidpath D, Ribeiro A, Rudd A, Savalieva I, Schilling R, Sinner M, Stewart S, Suwanwela N, Takahashi N, Topol E, Ushiyama S, Verbiest van Gurp N, Walker N, Wijeratne T. Screening for Atrial Fibrillation. Circulation 2017; 135:1851-1867. [DOI: 10.1161/circulationaha.116.026693] [Citation(s) in RCA: 369] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country- and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
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Balasubramanian M, Hurst J, Brown S, Bishop NJ, Arundel P, DeVile C, Pollitt RC, Crooks L, Longman D, Caceres JF, Shackley F, Connolly S, Payne JH, Offiah AC, Hughes D, Parker MJ, Hide W, Skerry TM. Compound heterozygous variants in NBAS as a cause of atypical osteogenesis imperfecta. Bone 2017; 94:65-74. [PMID: 27789416 PMCID: PMC6067660 DOI: 10.1016/j.bone.2016.10.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/17/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Osteogenesis imperfecta (OI), the commonest inherited bone fragility disorder, affects 1 in 15,000 live births resulting in frequent fractures and reduced mobility, with significant impact on quality of life. Early diagnosis is important, as therapeutic advances can lead to improved clinical outcome and patient benefit. REPORT Whole exome sequencing in patients with OI identified, in two patients with a multi-system phenotype, compound heterozygous variants in NBAS (neuroblastoma amplified sequence). Patient 1: NBAS c.5741G>A p.(Arg1914His); c.3010C>T p.(Arg1004*) in a 10-year old boy with significant short stature, bone fragility requiring treatment with bisphosphonates, developmental delay and immunodeficiency. Patient 2: NBAS c.5741G>A p.(Arg1914His); c.2032C>T p.(Gln678*) in a 5-year old boy with similar presenting features, bone fragility, mild developmental delay, abnormal liver function tests and immunodeficiency. DISCUSSION Homozygous missense NBAS variants cause SOPH syndrome (short stature; optic atrophy; Pelger-Huet anomaly), the same missense variant was found in our patients on one allele and a nonsense variant in the other allele. Recent literature suggests a multi-system phenotype. In this study, patient fibroblasts have shown reduced collagen expression, compared to control cells and RNAseq studies, in bone cells show that NBAS is expressed in osteoblasts and osteocytes of rodents and primates. These findings provide proof-of-concept that NBAS mutations have mechanistic effects in bone, and that NBAS variants are a novel cause of bone fragility, which is distinguishable from 'Classical' OI. CONCLUSIONS Here we report on variants in NBAS, as a cause of bone fragility in humans, and expand the phenotypic spectrum associated with NBAS. We explore the mechanism underlying NBAS and the striking skeletal phenotype in our patients.
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Foran A, Lundon D, Kelly B, Hegarty N, O'Reilly E, Connolly S, O'Malley K. Correlation between neutrophil count and positive prostate biopsy. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Doyle K, Lönn H, Käck H, Van de Poël A, Swallow S, Gardiner P, Connolly S, Root J, Wikell C, Dahl G, Stenvall K, Johannesson P. Discovery of Second Generation Reversible Covalent DPP1 Inhibitors Leading to an Oxazepane Amidoacetonitrile Based Clinical Candidate (AZD7986). J Med Chem 2016; 59:9457-9472. [PMID: 27690432 DOI: 10.1021/acs.jmedchem.6b01127] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A novel series of second generation DPP1 inhibitors free from aorta binding liabilities found for earlier compound series was discovered. This work culminated in the identification of compound 30 (AZD7986) as a highly potent, reversible, and selective clinical candidate for COPD, with predicted human PK properties suitable for once daily human dosing.
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Connolly S, Wren MA. P94 Variations in unmet need for medical and dental services in Ireland. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.192] [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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58
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Jones J, Flaherty G, Gibson I, Walsh A, Kerins C, Costello C, Connolly S, Wood D. PT037 Health Economic Evaluation of a Preventive Cardiology Programme in Ireland. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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59
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Rutledge S, Chalissery A, O'Connor R, Mahon S, Connolly S, Farrell M, Crowley P, MacSweeney F, Tubridy N. Anti-NMDA-receptor antibody-mediated cortical blindness: a case report. QJM 2016; 109:127-8. [PMID: 26319702 DOI: 10.1093/qjmed/hcv151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Floyd MS, Abbas G, Connolly S, Gana HB, McCabe JE. An unusual presentation of a vesicouterine fistula. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415815584718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 26-year-old female presented with a history of cyclical incontinence following a ventouse assisted delivery. Initial investigations revealed an endometrial deposit in her bladder, which following further investigations revealed a vesicouterine fistula necessitating formal open repair.
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Shurrab M, Botto G, Connolly S, Kaoutskaia A, Arouny B, Newman D, Boriani G, Padeletti L, Healey J, Crystal E. REDUCTION IN UNNECESSARY VENTRICULAR PACING FAILS TO AFFECT HARD CLINICAL OUTCOMES: A META-ANALYSIS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jennings CS, Jones J, Mead A, Connolly S, Kotseva K, Holden A, Fiumicelli G, Stevenson J, Hunjan M, Turner E, Wood DA. 025 Lifestyle and health related quality of life changes in coronary and high CVD risk patients and their partners attending the MYACTION integrated vascular prevention programme in the community. Heart 2015. [DOI: 10.1136/hrt.2010.195941.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mirsadraee S, Weir N, Connolly S, Murchison J, Reid J, Hirani N, Connell M, van Beek E. Feasibility of radiation dose reduction using AIDR-3D in dynamic pulmonary CT perfusion. Clin Radiol 2015; 70:844-51. [DOI: 10.1016/j.crad.2015.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/20/2015] [Accepted: 04/17/2015] [Indexed: 01/05/2023]
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Harden R, Connolly S, Kirsling A, Saracoglu M, Thilges S, Mattson M, Burns J. (462) Placebo effects in analgesic medication trials in two chronic pain models: gender and pain disorder moderators. THE JOURNAL OF PAIN 2015. [DOI: 10.1016/j.jpain.2015.01.381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Harden R, Burns J, Connolly S, Kirsling A, Abousaad E, Khoury A, Walega D. (420) Implications of Opioid Induced Hyperalgesia (OIH) in lower back pain patients. THE JOURNAL OF PAIN 2015. [DOI: 10.1016/j.jpain.2015.01.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ghaith ES, Connolly S. Evaluation of mesoporous SBA-15 for the controlled delivery of ciprofloxacin hydrochloride. BIOINSPIRED BIOMIMETIC AND NANOBIOMATERIALS 2014. [DOI: 10.1680/bbn.14.00002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Controlled drug release of ciprofloxacin hydrochloride monohydrate has been investigated by loading into the channels of SBA-15 mesoporous silica. Three categories of SBA-15 were prepared by a sol-gel process according to blank SBA-15, calcined SBA-15 and SBA-15 functionalised with 3-aminopropyltriethoxysilane (APTS) in a 1:1 ratio prior to drug loading. The carrier and drug samples were characterised by small-angle X-ray diffraction (SAXRD), N2 adsorption–desorption isotherm measurements, fourier transform infrared spectroscopy (FT-IR) and ultraviolet (UV) spectrophotometry. Controlled drug release was conducted in buffered neutral conditions at room temperature for 24, 48 and 120 h. Maximum desorption was observed in the case of the amino-functionalised SBA-15 after 120 h corresponding to 72·16%, whereas for calcined SBA-15 this amounted to 71·35% and in the case of blank SBA-15 48·34% of the total amount of loaded drug was liberated demonstrating the slow release effect of mesoporous silica.
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Ahmadi A, Parsa A, Swampillai J, Connolly S, Dorian P, Green M, Humphries K, Klein G, Qian H, Talajic M, Kerr C. PREDICTORS OF DEATH AND STROKE IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION: Results FROM THE CANADIAN REGISTRY OF ATRIAL FIBRILLATION. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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68
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Kaier TE, Morgan D, Grapsa J, Demir OM, Paschou SA, Sundar S, Hakky S, Purkayastha S, Connolly S, Fox KF, Ahmed A, Cousins J, Nihoyannopoulos P. Ventricular remodelling post-bariatric surgery: is the type of surgery relevant? A prospective study with 3D speckle tracking. Eur Heart J Cardiovasc Imaging 2014; 15:1256-62. [DOI: 10.1093/ehjci/jeu116] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Connolly S, Maldonado M, Schiff M, Weinblatt M, Fleischmann R, Robinson W, Sokolove J. FRI0039 Modulation of the ACPA Fine Specificity in Patients with RA Treated with Either Abatacept or Adalimumab in the AMPLE Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shapiro F, Connolly S, Zurakowski D, Flynn E, Jaramillo D. Acetabular changes associated with avascularnecrosis of the femoral head in a piglet model. Bone Joint Res 2014; 3:130-8. [PMID: 24782477 PMCID: PMC4036434 DOI: 10.1302/2046-3758.34.2000267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives An experimental piglet model induces avascular necrosis (AVN)
and deformation of the femoral head but its secondary effects on
the developing acetabulum have not been studied. The aim of this
study was to assess the development of secondary acetabular deformation
following femoral head ischemia. Methods Intracapsular circumferential ligation at the base of the femoral
neck and sectioning of the ligamentum teres were performed in three
week old piglets. MRI was then used for qualitative and quantitative
studies of the acetabula in operated and non-operated hips in eight
piglets from 48 hours to eight weeks post-surgery. Specimen photographs and
histological sections of the acetabula were done at the end of the
study. Results The operated-side acetabula were wider, shallower and misshapen,
with flattened labral edges. At eight weeks, increased acetabular
cartilage thickness characterised the operated sides compared with
non-operated sides (p < 0.001, ANOVA). The mean acetabular width
on the operated side was increased (p = 0.015) while acetabular depth
was decreased anteriorly (p = 0.007) and posteriorly (p = 0.44).
The cartilage was thicker, with delayed acetabular bone formation,
and showed increased vascularisation with fibrosis laterally and
focal degenerative changes involving chondrocyte hypocellularity,
chondrocyte cloning, peripheral pannus formation and surface fibrillation. Conclusions We demonstrate that femoral head AVN in the young growing piglet
also induced, and was coupled with, secondary malformation in acetabular
shape affecting both articular and adjacent pelvic cartilage structure,
and acetabular bone. The femoral head model inducing AVN can also
be applied to studies of acetabular maldevelopment, which is less
well understood in terms of developing hip malformation. Cite this article: Bone Joint Res 2014;3:130–8.
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Stocks MJ, Alcaraz L, Bailey A, Bonnert R, Cadogan E, Christie J, Dixon J, Connolly S, Cook A, Fisher A, Flaherty A, Humphries A, Ingall A, Jordan S, Lawson M, Mullen A, Nicholls D, Paine S, Pairaudeau G, Young A. Discovery of AZD3199, An Inhaled Ultralong Acting β2 Receptor Agonist with Rapid Onset of Action. ACS Med Chem Lett 2014; 5:416-21. [PMID: 24900851 DOI: 10.1021/ml4005232] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/08/2014] [Indexed: 11/28/2022] Open
Abstract
A series of dibasic des-hydroxy β2 receptor agonists has been prepared and evaluated for potential as inhaled ultralong acting bronchodilators. Determination of activities at the human β-adrenoreceptors demonstrated a series of highly potent and selective β2 receptor agonists that were progressed to further study in a guinea pig histamine-induced bronchoconstriction model. Following further assessment by onset studies in guinea pig tracheal rings and human bronchial rings contracted with methacholine (guinea pigs) or carbachol (humans), duration of action studies in guinea pigs after intratracheal (i.t.) administration and further selectivity and safety profiling AZD3199 was shown to have an excellent over all profile and was progressed into clinical evaluation as a new ultralong acting inhaled β2 receptor agonist with rapid onset of action.
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Appelboom G, Piazza M, Bruce S, Hwang B, Badjatia N, Drogba L, De Witte O, Connolly S. A Common Single Nucleotide Polymorphism Within Hemostasis Pathways Is Associated with Hematoma Expansion After Intracerebral Hemorrhage. World Neurosurg 2013. [DOI: 10.1016/j.wneu.2013.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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73
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Nieuwlaat R, Healey JS, Ezekowitz M, Reilly P, Formella S, Wallentin L, Yusuf S, Connolly S. Management of dyspepsia symptoms on dabigatran during RELY-ABLE: long-term follow up study after RE-LY. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lip G, Clemens A, Noack H, Ferreira J, Connolly S, Yusuf S. Guidance adherent dabigatran etexilate treatment versus warfarin in the RE-LY population: an analysis on the basis of the European label recommendations for dabigatran etexilate. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Berge E, Atar D, Le Heuzey JY, Connolly S, Fitzmaurice DA, Camm AJ, Jansky P, Rushton-Smith SK, Kayani G, Kakkar AK. Outcomes after rhythm versus rate control in patients with atrial fibrillation: the international prospective GARFIELD registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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