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Senior J, Forsyth K, Walsh E, O'Hara K, Stevenson C, Hayes A, Short V, Webb R, Challis D, Fazel S, Burns A, Shaw J. Health and social care services for older male adults in prison: the identification of current service provision and piloting of an assessment and care planning model. HEALTH SERVICES AND DELIVERY RESEARCH 2013. [DOI: 10.3310/hsdr01050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AbstractBackgroundOlder prisoners are the fastest growing subgroup in the English and Welsh prison estate. Existing research highlights that older prisoners have high health and social care needs and that, currently, these needs routinely remain unmet.Objectives(1) To explore the needs of men entering and leaving prison; (2) to describe current provision of services, including integration between health and social care services; and (3) to develop and pilot an intervention for identifying health and social care needs on reception into prison, ensuring that these are systematically addressed during custody.MethodsThe research programme was a mixed-methods study comprising four parts: (1) a study of all prisons in England and Wales housing older adult men, establishing current availability and degree of integration between health and social care services through a national survey and qualitative interviews; (2) establishing the health and social care needs of older men entering prison, including experiences of reception into custody, through structured (n = 100) and semistructured (n = 27) interviews; (3) the development and implementation of an intervention to identify and manage the health, social care and custodial needs of older men entering prison; and (4) exploration of the health and social care needs of older men released from prison into the community through qualitative interviews with older prisoners prior to and following discharge from prison. Descriptive statistics were produced for all quantitative data, and qualitative data were analysed using the constant comparison method.ResultsThe number of older prisoner leads has increased in recent years but they do not all appear always to be active in their roles, nor in receipt of specialist training. Nearly half (44%) of establishments do not have an older prisoner policy. There is a lack of integration between health and social care services because of ambiguity regarding responsibility for older prisoners' social care. The responsible social service may be located a considerable distance from where the prisoner is held; in such instances, local social services do not co-ordinate their care. The most frequent unmet need on prison entry was the provision of information about care and treatment. Release planning for older prisoners was frequently non-existent.LimitationsThe study used a cut-off age of 60 years as the lower limit for the definition of an older prisoner; evidence has emerged that supports a redefinition of that cut-off to 50 years. Our study examined the care provided for men and this should be considered if contemplating using the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) with older women in prison.ConclusionThe OHSCAP, developed as part of this study, provided a feasible and acceptable means of identifying and systematically addressing older prisoners' health and social care needs. Future work will include the conduct of a randomised controlled trial to examine the impact of the OHSCAP in terms of improving a range of outcomes, including economic impact.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Purandare N, Oude Voshaar RC, Burns A, Velupandian UM, McCollum C. Paradoxical embolization: a potential cause of cerebral damage in Alzheimer's disease? Neurol Res 2013; 28:679-84. [PMID: 16945222 DOI: 10.1179/016164106x130425] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND There are considerable overlaps between vascular dementia and Alzheimer's disease (AD), with a suggestion that cerebrovascular disease (CVD) contributes to the neurodegenerative pathology of AD. Paradoxical embolization of venous emboli into the systemic circulation through a venous to arterial circulation shunt (v-aCS), the most commonly a patent foramen ovale (PFO), is known to cause cryptogenic stroke in younger people. We reviewed the potential role of paradoxical embolization in AD. METHODS A review of the literature on paradoxical embolization in neurological disorders and techniques to detect v-aCS and PFO, supplemented by data from our own studies. RESULTS Before our research, the role of paradoxical embolism in dementia had not been studied. The potential role of embolization in cerebral damage was highlighted by studies in patients undergoing coronary artery bypass or carotid surgery. Paradoxical embolization was found to occur in patients with cryptogenic stroke, migraine, decompression sickles and during hip surgery. The methods for detecting v-aCS or PFO had not been standardized. We found 'significant' v-aCS (equivalent to PFO) in 32% of AD patients compared with 22% of controls, but the study was not sufficiently powered to test the statistic significance of this difference. In AD, there was evidence of an association between 'significant' v-aCS and the severity of white matter hyperintensities on magnetic resonance imaging (MRI). CONCLUSION Paradoxical embolization through a v-aCS may be a potentially preventable or treatable cause of CVD in AD.
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Gandhi V, Burns A, Goodship T. A complementary component to atypical haemolytic uraemic syndrome. CASE REPORTS 2013; 2013:bcr-2013-010214. [DOI: 10.1136/bcr-2013-010214] [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] Open
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79
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Tan AL, Tanner SF, Waller ML, Hensor EMA, Burns A, Jeavons AP, Bury RF, Emery P, McGonagle D. High-resolution [18F]fluoride positron emission tomography of the distal interphalangeal joint in psoriatic arthritis--a bone-enthesis-nail complex. Rheumatology (Oxford) 2013; 52:898-904. [DOI: 10.1093/rheumatology/kes384] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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80
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Murch S, Roberts T, La Gerche A, MacIsaac A, Prior D, Burns A. Pulmonary Hypertension is Associated With Right Ventricular Diastolic Dysfunction. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.141] [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]
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81
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Williams P, Palmer S, Judkins C, Burns A, Whitbourn R, MacIsaac A, Wilson A, Costello B, Gutman J. Left and Right Heart Catheterisation via Transradial and Antecubital Fossa Vein Access: A Safe and Effective Approach. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.336] [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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82
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Sahmel J, Devlin K, Burns A, Ferracini T, Ground M, Paustenbach D. An analysis of workplace exposures to benzene over four decades at a petrochemical processing and manufacturing facility (1962-1999). JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:723-746. [PMID: 23980839 DOI: 10.1080/15287394.2013.821393] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Benzene, a known carcinogen, can be generated as a by-product during the use of petroleum-based raw materials in chemical manufacturing. The aim of this study was to analyze a large data set of benzene air concentration measurements collected over nearly 40 years during routine employee exposure monitoring at a petrochemical manufacturing facility. The facility used ethane, propane, and natural gas as raw materials in the production of common commercial materials such as polyethylene, polypropylene, waxes, adhesives, alcohols, and aldehydes. In total, 3607 benzene air samples were collected at the facility from 1962 to 1999. Of these, in total 2359 long-term (>1 h) personal exposure samples for benzene were collected during routine operations at the facility between 1974 and 1999. These samples were analyzed by division, department, and job title to establish employee benzene exposures in different areas of the facility over time. Sampling data were also analyzed by key events over time, including changes in the occupational exposure limits (OELs) for benzene and key equipment process changes at the facility. Although mean benzene concentrations varied according to operation, in nearly all cases measured benzene quantities were below the OEL in place at the time for benzene (10 ppm for 1974-1986 and 1 ppm for 1987-1999). Decreases in mean benzene air concentrations were also found when data were evaluated according to 7- to 10-yr periods following key equipment process changes. Further, an evaluation of mortality rates for a retrospective employee cohort (n = 3938) demonstrated that the average personal benzene exposures at this facility (0.89 ppm for the period 1974-1986 and 0.125 ppm for the period 1987-1999) did not result in increased standardized mortality ratio (SMRs) for diseases or malignancies of the lymphatic system. The robust nature of this data set provides comprehensive exposure information that may be useful for assessing human benzene exposures at similar facilities. The data also provide a basis for comparable measured exposure levels and the potential for adverse health effects. These data may also prove beneficial for comparing relative exposure potential for production versus nonproduction operations and the relationship between area and personal breathing zone samples.
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Dickson J, Burns A. 136 Meeting the information needs of lung cancer patients and carers. Review and update of Lung Cancer – Answering your Questions booklet. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70136-3] [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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Murch S, Roberts T, La Gerche A, MacIsaac A, Prior D, Burns A. Pulmonary Wave Reflection: Observations in Pulmonary Hypertension. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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85
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Palmer S, Layland J, Judkins C, Williams P, Whitbourn R, MacIsaac A, Wilson A, Costello B, Burns A. Coronary Artery Augmentation Index: A Marker and Predictor of Periprocedural Myocardial Infarction. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.315] [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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Roberts T, Murch S, La Gerche A, Stevens W, Conron M, MacIsaac A, Prior D, Burns A. Pulmonary Index of Microvascular Resistance (PIMR) using PressureWire: First Report in 38 Human Subjects. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sunny SS, Burns A, Jary H, Aspray T, Soyza AD. P90 Osteoporosis in Non-Cystic Fibrosis Bronchiectasis (NCFBr) Adults: Abstract P90 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gibbons JF, Markey BK, Jahns H, Boland F, Abbott Y, Burns A, Egan J, Fanning S, Gutierrez M, Leonard FC. Investigation of the persistence and transmission of MRSA CC 5 in pigs following intra-nasal inoculation. Vet Microbiol 2012; 162:771-778. [PMID: 23116587 DOI: 10.1016/j.vetmic.2012.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 09/29/2012] [Accepted: 10/01/2012] [Indexed: 12/15/2022]
Abstract
MRSA CC5 spa type t002 appears to have a broad host range, has been isolated from animals and in-contact humans in Ireland and could potentially become established in pigs in Ireland. The aims of this study were to determine if MRSA CC5 spa type t002 could persist in the tissues of the porcine upper respiratory tract following intra-nasal inoculation; to determine the relative importance of environmental and animal sources of the bacterium in the transmission cycle and to determine the importance of the pharynx as a carriage site of Staphylococcus aureus and MRSA. Twelve pigs were inoculated intra-nasally with MRSA CC5 t002. After 1 or 6 days, the inoculated pigs were removed from the contaminated environment, were washed in an antiseptic solution and placed in a clean house with a group of naive pigs (in-contact group). Another group of naive pigs was placed in the contaminated environment to assess transmission from the environment (environmental group). Nasal swabs, environmental swabs and tissue samples from the upper respiratory tract were taken for MRSA culture. Infection rates were calculated for each group of exposed pigs. MRSA persisted in the pharyngeal tissues of 6 inoculated pigs for at least 30 days and higher counts of S. aureus were found in pharyngeal tissues than in other sites. In this study we were able to demonstrate the establishment of colonisation by MRSA CC5 spa type t002 in commercially sourced pigs already colonised by S. aureus; however, colonisation was sporadic despite the inoculation of large doses. Onward transmission via pig-to-pig contact or environmental contamination was possible and a significant difference was found between the proportion of pigs infected in the environmental group and the proportion infected in the in-contact group during the first 5 days. However, no significant difference was detected in overall infection rates between the 2 groups. The tissues of the pharynx were found to carry greater numbers of S. aureus than other tissues of the upper respiratory tract; therefore, pharyngeal carriage of MRSA and S. aureus in pigs may be more significant than previously thought.
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Knight SJL, Yau C, Clifford R, Timbs AT, Sadighi Akha E, Dréau HM, Burns A, Ciria C, Oscier DG, Pettitt AR, Dutton S, Holmes CC, Taylor J, Cazier JB, Schuh A. Quantification of subclonal distributions of recurrent genomic aberrations in paired pre-treatment and relapse samples from patients with B-cell chronic lymphocytic leukemia. Leukemia 2012; 26:1564-75. [PMID: 22258401 PMCID: PMC3505832 DOI: 10.1038/leu.2012.13] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Genome-wide array approaches and sequencing analyses are powerful tools for identifying genetic aberrations in cancers, including leukemias and lymphomas. However, the clinical and biological significance of such aberrations and their subclonal distribution are poorly understood. Here, we present the first genome-wide array based study of pre-treatment and relapse samples from patients with B-cell chronic lymphocytic leukemia (B-CLL) that uses the computational statistical tool OncoSNP. We show that quantification of the proportion of copy number alterations (CNAs) and copy neutral loss of heterozygosity regions (cnLOHs) in each sample is feasible. Furthermore, we (i) reveal complex changes in the subclonal architecture of paired samples at relapse compared with pre-treatment, (ii) provide evidence supporting an association between increased genomic complexity and poor clinical outcome (iii) report previously undefined, recurrent CNA/cnLOH regions that expand or newly occur at relapse and therefore might harbor candidate driver genes of relapse and/or chemotherapy resistance. Our findings are likely to impact on future therapeutic strategies aimed towards selecting effective and individually tailored targeted therapies.
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Layland J, Witbourn R, Burns A, Palmer S, Wilson-O’Brien A, Leitl G, MacIsaac A, Wilson A. Impaired Baseline Microcirculatory Function and Diabetes are Associated with Post PCI Coronary Microcirculatory Dysfunction. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.398] [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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Layland J, Carrick D, McGeoch R, Palmer S, Burns A, MacIsaac A, Whitbourn R, Wilson A, Oldroyd K, Berry C. The Index of Microcirculatory Resistance is Less Reproducible in Patients with Acute Coronary Syndromes. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Burns A, O'Connell C, Rathore F. Meeting the challenges of spinal cord injury care following sudden onset disaster: lessons learned. J Rehabil Med 2012; 44:414-20. [DOI: 10.2340/16501977-0974] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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93
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Moneghetti K, Palmer S, Murch S, LaGerche A, Prior D, MacIsaac A, Burns A. Pulmonary Vascular Capacitance Measured Using Pressurewire: A Novel Index of Pulmonary Haemodynamics. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Murch S, McLellan A, Coller J, MacIsaac A, Burns A, Prior D. Tissue Doppler Parameters of Right Ventricular Diastolic Function Do Not Predict Dobutamine-Induced Changes in Pulmonary Haemodynamics in Patients With Scleroderma. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.568] [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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95
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Murch S, Wilson A, LaGerche A, MacIsaac A, Prior D, Burns A. Right Ventricular Tau is an Important Determinant of Right Ventricular End Diastolic Pressure. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.160] [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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96
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Povey A, McNamee R, Stock S, Watkins G, Creed F, Burns A, Neary D. Pesticide exposure and screen-identified neuropsychiatric disease in British sheep farmers. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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97
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Delaney RA, Burns A, Emans JB. Arteriovenous fistula formation after a closed proximal tibial fracture in a child. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2011; 93:1424-6. [PMID: 21969446 DOI: 10.1302/0301-620x.93b10.27352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Arteriovenous fistula formation after a closed extremity fracture is rare. We present the case of an 11-year-old boy who developed an arteriovenous fistula between the anterior tibial artery and popliteal vein after closed fractures of the proximal tibia and fibula. The fractures were treated by closed reduction and casting. A fistula was diagnosed 12 weeks after the injury. It was treated by embolisation with coils. Subsequent angiography and ultrasonography confirmed patency of the popliteal vein and anterior and posterior tibial and peroneal arteries, with no residual shunting through the fistula. The fractures healed uneventfully and he returned to full unrestricted activities 21 weeks after his injury.
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Walker R, James H, Burns A. A qualitative study exploring patients’ perspective of adhering to recommended behaviour change in the predialysis stage of kidney disease. J Hum Nutr Diet 2011. [DOI: 10.1111/j.1365-277x.2011.01177_41.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kuet KP, Goepel J, Mudhar H, Bourne JT, Sykes MP, Riaz I, Borg FA, Everett C, Dasgupta B, Byng-Maddick R, Wincup C, Penn H, Jani M, Bukhari M, Halsey J, Chander S, Marsh J, Hughes R, Chu E, Little J, Bruce I, Soh C, Lee L, Ho P, Ntatsaki E, Vassiliou V, Youngstein T, Mohamed M, Lanham J, Haskard D, Lutalo PM, Scott IC, Sangle S, D'Cruz DP, Scott IC, Garrood T, Mackie SL, Backhouse O, Melsom R, Pease CT, Marzo-Ortega H, Al-Mossawi MH, Wathen CJ, Al-Balushi F, Mahto A, Humby F, Kelly C, Jawad A, Lee M, Haigh RC, Derrett-Smith EC, Nihtyanova S, Parker J, Bunn C, Burns A, Little M, Denton C, Tosounidou S, Harris S, Steventon D, Sheeran T, Baxter D, Field M, Lutalo PM, Sangle S, Davies R, Khamashta MA, D'Cruz D, Wajed J, Kiely P, Srikanth A, Lanyon P. Case reports: 1. IGG4 Related Fibrosis: A Treatable Disease. Four Cases in a District General Hospital. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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100
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Layland J, Whitbourn R, MacIsaac A, Burns A, Somaratne J, Leitl G, Wilson A. Low Coronary Blood Flow Pre-PCI Predicts Microvascular Dysfunction Following PCI in Patients with Stable Angina. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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