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Javanmardi K, Segall-Shapiro TH, Chou CW, Boutz DR, Olsen RJ, Xie X, Xia H, Shi PY, Johnson CD, Annapareddy A, Weaver S, Musser JM, Ellington AD, Finkelstein IJ, Gollihar JD. Antibody escape and cryptic cross-domain stabilization in the SARS-CoV-2 Omicron spike protein. Cell Host Microbe 2022; 30:1242-1254.e6. [PMID: 35988543 PMCID: PMC9350683 DOI: 10.1016/j.chom.2022.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/17/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022]
Abstract
The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the repeated emergence of variants of concern. For the Omicron variant, sub-lineages BA.1 and BA.2, respectively, contain 33 and 29 nonsynonymous and indel spike protein mutations. These amino acid substitutions and indels are implicated in increased transmissibility and enhanced immune evasion. By reverting individual spike mutations of BA.1 or BA.2, we characterize the molecular effects of the Omicron spike mutations on expression, ACE2 receptor affinity, and neutralizing antibody recognition. We identified key mutations enabling escape from neutralizing antibodies at a variety of epitopes. Stabilizing mutations in the N-terminal and S2 domains of the spike protein can compensate for destabilizing mutations in the receptor binding domain, enabling the record number of mutations in Omicron. Our results provide a comprehensive account of the mutational effects in the Omicron spike protein and illustrate previously uncharacterized mechanisms of host evasion.
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Affiliation(s)
- Kamyab Javanmardi
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA.
| | - Thomas H Segall-Shapiro
- Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Chia-Wei Chou
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA
| | - Daniel R Boutz
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Randall J Olsen
- Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA; Laboratory of Molecular and Translational Human Infectious Diseases Research, Center for Infectious Diseases, HMRI and Department of Pathology and Genomic Medicine, HMH, Houston, TX, USA; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Xuping Xie
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Hongjie Xia
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Pei-Yong Shi
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Charlie D Johnson
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Ankur Annapareddy
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA
| | - Scott Weaver
- University of Texas Medical Branch, World Reference Center for Emerging Viruses and Arboviruses, Galveston, TX, USA
| | - James M Musser
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Center for Infectious Diseases, HMRI and Department of Pathology and Genomic Medicine, HMH, Houston, TX, USA; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Andrew D Ellington
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; Center for Systems and Synthetic Biology, The University of Texas at Austin, Austin, TX, USA
| | - Ilya J Finkelstein
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; Center for Systems and Synthetic Biology, The University of Texas at Austin, Austin, TX, USA.
| | - Jimmy D Gollihar
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA.
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Gupta N, Thiele CM, Daum JI, Egbert LK, Chiang JS, Kilgore AE, Johnson CD. Building Patient-Physician Trust: A Medical Student Perspective. Acad Med 2020; 95:980-983. [PMID: 32079958 DOI: 10.1097/acm.0000000000003201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Public trust in physicians has declined over the last 50 years. Future physicians will need to mend the patient-physician trust relationship. In conjunction with the American Medical Association's Accelerating Change in Medical Education initiative, the Mayo Clinic Alix School of Medicine implemented the Science of Health Care Delivery (SHCD) curriculum-a 4-year curriculum that emphasizes interdisciplinary training across population-centered care; person-centered care; team-based care; high-value care; leadership; and health policy, economics, and technology-in 2015. In this medical student perspective, the authors highlight how the SHCD curriculum has the potential to address issues that have eroded patient-physician trust. The curriculum reaches this aim through didactic and/or experiential teachings in health equity, cultural humility and competence, shared decision making, patient advocacy, and safety and quality of care. It is the authors' hope that novel medical education programs such as the SHCD curriculum will allow the nation's future physicians to own their role in rebuilding and fostering public trust in physicians and the health care system.
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Affiliation(s)
- Nikita Gupta
- N. Gupta is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. C.M. Thiele is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. J.I. Daum is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. L.K. Egbert is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. J.S. Chiang is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. A.E. Kilgore Jr is a second-year medical student, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona. C.D. Johnson is a consultant, Department of Radiology, Mayo Clinic Hospital, Scottsdale, Arizona
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Nolte S, Liegl G, Petersen MA, Aaronson NK, Costantini A, Fayers PM, Groenvold M, Holzner B, Johnson CD, Kemmler G, Tomaszewski KA, Waldmann A, Young TE, Rose M. General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. Eur J Cancer 2018; 107:153-163. [PMID: 30576971 DOI: 10.1016/j.ejca.2018.11.024] [Citation(s) in RCA: 237] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/10/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 health-related quality of life questionnaire is one of the most widely used cancer-specific health-related quality of life questionnaires worldwide. General population norm data can facilitate the interpretation of QLQ-C30 data obtained from cancer patients. This study aimed at systematically collecting norm data from the general population to develop European QLQ-C30 norm scores and to generate comparable norm data for individual countries in Europe and North America. METHODS We collected QLQ-C30 data from the general population across 11 European Union (EU) countries, Russia, Turkey, Canada and United States (n ≥ 1000/country). Representative samples were stratified by sex and age groups (18-39, 40-49, 50-59, 60-69 and ≥ 70 years). After applying weights based on the United Nations population distribution statistics, we calculated QLQ-C30 domain scores to generate a 'European QLQ-C30 Norm' based on the EU countries. Further, we calculated QLQ-C30 norm scores for all 15 individual countries. RESULTS A total of 15,386 respondents completed the online survey. For the EU sample, most QLQ-C30 domains showed differences by sex/age, with men scoring somewhat better health than women, while age effects varied across domains. Substantially larger differences were seen in inter-country comparisons, with Austrian and Dutch respondents reporting consistently better health compared with British and Polish respondents. CONCLUSIONS This study is the first to systematically collect EORTC QLQ-C30 general population norm data across Europe and North America applying a consistent data collection method across 15 countries. These new norm data facilitate valid intra-country as well as inter-country comparisons and QLQ-C30 score interpretation.
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Affiliation(s)
- S Nolte
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, VIC, Australia.
| | - G Liegl
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M A Petersen
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - N K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - A Costantini
- Psycho-Oncology Unit, Sant'Andrea Hospital Sapienza, University of Rome, Rome, Italy
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - M Groenvold
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - C D Johnson
- University of Southampton, Southampton, United Kingdom
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - K A Tomaszewski
- Health Outcomes Research Unit, Department of Gerontology, Geriatrics, and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - A Waldmann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany; Ministry for Health and Consumer Protection, Hamburg Cancer Registry, Hamburg, Germany
| | - T E Young
- East & North Hertfordshire NHS Trust Including Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom
| | - M Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, MA, USA
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Johnson CD. Book Review: Pathology of the Pancreas. J R Soc Med 2018. [DOI: 10.1177/014107688708001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
To date, there have been no clinical investigations of the usefulness of drains following colonic anastomosis in elective operations. We report a prospective study in which 49 patients were randomized to have a corrugated silastic drain (Portex) placed next to the colonic anastomosis. These patients were compared with a control group of 57 patients who had no drain. The two groups were similar in age, sex, diagnosis and site of anastomosis. There was no difference in outcome between the two groups. Anastomotic leakage occurred in six patients in each group. Wound infections were noted in 10 patients in each group. Two patients with a drain and one patient without a drain died from leakage at the anastomosis. This study provides no evidence to support the use of a corrugated drain after anastomosis of the colon.
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Abstract
We have studied the outcome of 140 general surgical procedures in 112 patients known or suspected to be infected with human immunodeficiency virus (HIV) or hepatitis B virus. Forty patients had antibodies to HIV. A wide range of surgical procedures was performed, with an overall complication rate of 5.7%. Wound infection, wound haematoma and one unexplained pyrexia were the only complications seen. Some anorectal wounds in patients with HIV antibodies were noted to heal extremely slowly, but the aggressive anorectal sepsis reported by others was not seen. The postoperative course after general surgical procedures was unremarkable in patients with HIV antibodies, and in those suspected of HIV infection, but because anorectal wounds were found to heal slowly, we recommend that anorectal surgery be conservative in patients with HIV antibodies.
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Affiliation(s)
- R Wakeman
- Professorial Surgical Unit, St Stephen's Hospital, London
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Affiliation(s)
- C D Johnson
- Department of Surgery, Westminster Hospital, London
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Affiliation(s)
- S F Journeaux
- Academic Surgical Unit, St Stephens Hospital, London
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Affiliation(s)
- N Davies
- University Surgical Unit, Royal South Hants Hospital, Southampton
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Ziwary SR, Samad D, Johnson CD, Edwards RT. Impact of place of residence on place of death in Wales: an observational study. BMC Palliat Care 2017; 16:72. [PMID: 29233123 PMCID: PMC5727930 DOI: 10.1186/s12904-017-0261-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/05/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Previous research in England showed that deprivation level of a person's place of residence affects the place of death and quality of care received at the end of life. People dying in their preferred place of death has also been shown to act as an indication for high quality of end of life care services and social equality. This study expands on current research to explore the effects of deprivation and place of residence on health related choices and place of death in Wales. METHODS We used ten years combined mortality statistics from 2005 to 2014 and Welsh Index of Multiple Deprivation rankings for each lower super output area. After accounting for the population's age, the number of deaths in Hospital, Hospice, Home, Care Home, Psychiatric Units, and Elsewhere were compared across deprivation quintiles. RESULTS Distribution of place of death was found to be concentrated in three places - hospital (60%), home (21%) and care home (13%). Results from this study shows a high number of hospital deaths, especially for more deprived areas, despite being the least preferred place of death. CONCLUSION This is the first Welsh study investigating place of death in relation to deprivation, which could be of major importance to academics, end of life care providers and policy makers interested in to reduce health care inequality in Wales.
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Affiliation(s)
- S R Ziwary
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Ardudwy Building, Bangor, LL57 2PZ, UK.
| | - D Samad
- University Malaya, Kuala Lumpur, Malaysia
| | - C D Johnson
- Speciality registrar in Public Health, Public Health Wales, Mold, UK
| | - R T Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Ardudwy Building, Bangor, LL57 2PZ, UK
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Koller M, Hjermstad MJ, Tomaszewski KA, Tomaszewska IM, Hornslien K, Harle A, Arraras JI, Morag O, Pompili C, Ioannidis G, Georgiou M, Navarra C, Chie WC, Johnson CD, Himpel A, Schulz C, Bohrer T, Janssens A, Kuliś D, Bottomley A. An international study to revise the EORTC questionnaire for assessing quality of life in lung cancer patients. Ann Oncol 2017; 28:2874-2881. [PMID: 28945875 DOI: 10.1093/annonc/mdx453] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The European Organization for Research and Treatment of Cancer (EORTC) QLQ-LC13 was the first module to be used in conjunction with the core questionnaire, the QLQ-C30. Since the publication of the LC13 in 1994, major advances have occurred in the treatment of lung cancer. Given this, an update of the EORTC QLQ-LC13 was undertaken. METHODS The study followed phases I to III of the EORTC Module Development Guidelines. Phase I generated relevant quality-of-life issues using a mix of sources including the involvement of 108 lung cancer patients. Phase II transformed issues into questionnaire items. In an international multicenter study (phase III), patients completed both the EORTC QLQ-C30 and the 48-item provisional lung cancer module generated in phases I and II. Patients rated each of the items regarding relevance, comprehensibility, and acceptance. Patient ratings were assessed against a set of prespecified statistical criteria. Descriptive statistics and basic psychometric analyses were carried out. RESULTS The phase III study enrolled 200 patients with histologically confirmed lung cancer from 12 centers in nine countries (Cyprus, Germany, Italy, Israel, Spain, Norway, Poland, Taiwan, and the UK). Mean age was 64 years (39 - 91), 59% of the patients were male, 82% had non-small-cell lung cancer, and 56% were treated with palliative intent. Twenty-nine of the 48 questions met the criteria for inclusion. CONCLUSIONS The resulting module with 29 questions, thus currently named EORTC QLQ-LC29, retained 12 of the 13 original items, supplemented with 17 items that primarily assess treatment side-effects of traditional and newer therapies.
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Affiliation(s)
- M Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
| | - M J Hjermstad
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, and European Palliative Care Research Center (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology and St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K A Tomaszewski
- Health Outcomes Research Unit, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - I M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - K Hornslien
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - A Harle
- Poole Hospital NHS Foundation Trust, and The Christie NHS Foundation Trust, Manchester, UK
| | - J I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - O Morag
- Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - C Pompili
- St.James's University Hospital, Leeds, UK
| | - G Ioannidis
- Oncology Department, Nicosia General Hospital Cyprus, Nicosia, Cyprus
| | - M Georgiou
- Bank of Cyprus Oncology Center, Nicosia, Cyprus
| | - C Navarra
- Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - W-C Chie
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Republic of Taiwan
| | - C D Johnson
- Surgical Unit, University of Southampton, Southampton, UK
| | - A Himpel
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Schulz
- Department of Internal Medicine, University Hospital Regensburg, Regensburg
| | - T Bohrer
- Department of Thoracic Surgery, Bamberg, Germany
| | - A Janssens
- Thoracic Oncology, MOCA, Antwerp University Hospital, Edegem
| | - D Kuliś
- Quality of Life Department, EORTC, Brussels, Belgium
| | - A Bottomley
- Quality of Life Department, EORTC, Brussels, Belgium
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Kaupp-Roberts SD, Yadegarfar G, Friend E, O'Donnell CM, Valle JW, Byrne C, Bahar I, Finch-Jones M, Gillmore R, Johnson CD, Pereira SP, Wiggers JK, Pinto M, Al-Sarireh B, Ramage JK. Validation of the EORTC QLQ-BIL21 questionnaire for measuring quality of life in patients with cholangiocarcinoma and cancer of the gallbladder. Br J Cancer 2016; 115:1032-1038. [PMID: 27673364 PMCID: PMC5117782 DOI: 10.1038/bjc.2016.284] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 07/10/2016] [Accepted: 08/15/2016] [Indexed: 01/04/2023] Open
Abstract
Background: There is no specific quality of life (QoL) measurement tool to quantify QoL in patients with biliary tract cancer. Quality of life measurement is an increasingly crucial trial end point and is now being incorporated into clinical practice. Methods: This International Multicentre Phase IV Validation Study assessed the QLQ-BIL21 module in 172 patients with cholangiocarcinoma and 91 patients with cancer of the gallbladder. Patients completed the questionnaire at baseline pretherapy and subsequently at 2 months. Following this, the psychometric properties of reliability, validity, scale structure and responsiveness to change were analysed. Results: Analysis of the QLQ-BIL21 scales showed appropriate reliability with Cronbach's α-coefficients >0.70 for all scales overall. Intraclass correlations exceeded 0.80 for all scales. Convergent validity >0.40 was demonstrated for all items within scales, and discriminant validity was confirmed with values <0.70 for all scales compared with each other. Scale scores changed in accordance with Karnofsky performance status and in response to clinical change. Conclusions: The QLQ-BIL21 is a valid tool for the assessment of QoL in patients with cholangiocarcinoma and cancer of the gallbladder.
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Affiliation(s)
- S D Kaupp-Roberts
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, UK.,Faculty of Humanities and Social Sciences, University of Winchester, Sparkford Road, Winchester SO22 4NR, UK
| | - G Yadegarfar
- School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - E Friend
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, UK
| | - C M O'Donnell
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, UK
| | - J W Valle
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
| | - C Byrne
- Hepatobiliary Cancer Services, Aintree University Hospital, Longmoor Lane, Liverpool, Merseyside L9 7AL, UK
| | - I Bahar
- Cachar Cancer Hospital and Research Centre, Meherpur, Silchar, Assam, India
| | - M Finch-Jones
- Department of Surgery, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - R Gillmore
- Department of Medical Oncology, Royal Free Hospital, Pond Street, London NW3 2QG, UK
| | - C D Johnson
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - S P Pereira
- UCL Institute for Liver and Digestive Health, Royal Free Hospital Campus, London NW3 2QG, UK
| | - J K Wiggers
- Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
| | - M Pinto
- National Cancer Institute and G. Pascale Foundation of Naples, Naples, Italy
| | - B Al-Sarireh
- Morriston Hospital, ABM University Health Board, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK
| | - J K Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, UK.,Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, UK
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Quinn JG, Tansey EA, Johnson CD, Roe SM, Montgomery LEA. Blood: tests used to assess the physiological and immunological properties of blood. Adv Physiol Educ 2016; 40:165-175. [PMID: 27068991 DOI: 10.1152/advan.00079.2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
The properties of blood and the relative ease of access to which it can be retrieved make it an ideal source to gauge different aspects of homeostasis within an individual, form an accurate diagnosis, and formulate an appropriate treatment regime. Tests used to determine blood parameters such as the erythrocyte sedimentation rate, hemoglobin concentration, hematocrit, bleeding and clotting times, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean cell volume, and determination of blood groups are routinely used clinically, and deviations outside the normal range can indicate a range of conditions such as anemia, pregnancy, dehydration, overhydration, infectious disease, cancer, thyroid disease, and autoimmune conditions, to mention a few. As these tests can be performed relatively inexpensively and do not require high levels of technical expertise, they are ideally suited for use in the teaching laboratory, enabling undergraduate students to link theory to practice. The practicals described here permit students to examine their own blood and that of their peers and compare these with clinically accepted normal ranges. At the end of the practicals, students are required to answer a number of questions about their findings and to link abnormal values to possible pathological conditions by answering a series of questions based on their findings.
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Affiliation(s)
- J G Quinn
- Centre for Biomedical Sciences Education, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - E A Tansey
- Centre for Biomedical Sciences Education, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - C D Johnson
- Centre for Biomedical Sciences Education, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - S M Roe
- Centre for Biomedical Sciences Education, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - L E A Montgomery
- Centre for Biomedical Sciences Education, School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
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Day-Lewis FD, Johnson CD, Slater LD, Robinson JL, Williams JH, Boyden CL, Werkema D, Lane JW. A Fractured Rock Geophysical Toolbox Method Selection Tool. Ground Water 2016; 54:315-6. [PMID: 26743439 DOI: 10.1111/gwat.12397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- F D Day-Lewis
- Office of Groundwater, Branch of Geophysics, U.S. Geological Survey, Storrs, CT 06269
| | - C D Johnson
- Office of Groundwater, Branch of Geophysics, U.S. Geological Survey, Storrs, CT 06269
| | - L D Slater
- Department of Earth & Environmental Sciences, Rutgers University Newark, Newark, NJ 07102
| | - J L Robinson
- Department of Earth & Environmental Sciences, Rutgers University Newark, Newark, NJ 07102
| | - J H Williams
- New York Water Science Center, U.S. Geological Survey, Troy, NY 12180
| | - C L Boyden
- Office of Groundwater, Branch of Geophysics, U.S. Geological Survey, Storrs, CT 06269
| | - D Werkema
- Environmental Sciences Division, Characterization and Monitoring Branch, U.S. Environmental Protection Agency, Office of Research and Development, Las Vegas, NV 89119
| | - J W Lane
- Office of Groundwater, Branch of Geophysics, U.S. Geological Survey, Storrs, CT 06269
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Windsor JA, Johnson CD, Petrov MS, Layer P, Garg PK, Papachristou GI. Classifying the severity of acute pancreatitis: towards a way forward. Pancreatology 2015; 15:101-4. [PMID: 25683639 DOI: 10.1016/j.pan.2015.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The recent development of two different severity classifications for acute pancreatitis has appropriately raised questions about which should be used. The aim of this paper is to review the two new severity classifications, outline their differences, review validation studies, and identify gaps in knowledge to suggest a way forward. METHODS A literature review was performed to identify the purposes and differences between the classifications. Validation studies and those comparing the two different classifications were also reviewed. RESULTS The Revised Atlanta Classification (RAC) and the Determinants Based Classification (DBC) both rely on assessment of local and systemic factors. The differences between the classifications provides opportunities for further research to improve the accuracy and utility of severity classification. This includes understanding how best to tailor severity classification to setting (e.g. secondary or tertiary hospital) and purpose (e.g. clinical management or research). A key difference is that the RAC does not consider infected pancreatic necrosis an indicator of severe disease. There is also the need to develop methods for the accurate non-invasive diagnosis of infected necrosis and evaluation of the characteristics of organ dysfunction in relation to severity and outcome. CONCLUSION Further improvement in severity classification is possible and research priorities have been identified. For now, the decision as to which classification to use should be on the basis of setting, validity, accuracy, and ease of use.
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Affiliation(s)
- J A Windsor
- Department of Surgery, University of Auckland, New Zealand.
| | - C D Johnson
- Department of Surgery, University of Auckland, New Zealand
| | - M S Petrov
- Department of Surgery, University of Auckland, New Zealand
| | - P Layer
- Department of Surgery, University of Auckland, New Zealand
| | - P K Garg
- Department of Surgery, University of Auckland, New Zealand
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Gareen IF, Siewert B, Vanness DJ, Herman B, Johnson CD, Gatsonis C. Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial. Patient Prefer Adherence 2015; 9:1043-51. [PMID: 26229451 PMCID: PMC4516344 DOI: 10.2147/ppa.s81901] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC) every 5 years. Bowel preparation (BP) is currently required for both screening modalities. PURPOSE To compare ACRIN 6664: the National CT Colonography Trial (NCTCT) participant experiences with CTC and optical colonoscopy (OC), procedure preference, and willingness to return for each procedure. MATERIALS AND METHODS Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals. RESULTS A total of 2,310 of 2,600 patients (89%) returned their questionnaires. Of patients reporting a preference, 1,058 (46.6%) preferred CTC, 569 (25.0%) preferred OC, and 626 (27.6%) reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9%) and OC (5.0%) (P<0.001). About 79.3% were willing to be screened again with CTC in 5 years, and 96.6% with OC in 10 years. Discomfort and embarrassment worse than expected with OC were associated with increased intention to adhere with CTC in the future. Conversely, embarrassment experienced during CTC and discomfort worse than expected on CTC were associated with increased intention to adhere with OC in the future. CONCLUSION While a larger proportion of participants indicated that they preferred CTC to OC, willingness to undergo repeat CTC compared to OC was limited by unanticipated exam discomfort and embarrassment and CTC's shorter screening interval.
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Affiliation(s)
- Ilana F Gareen
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
- Correspondence: Ilana F Gareen, Center for Statistical Sciences, Brown University School of Public Health, Box G-S121-7, Providence, RI 02912, USA, Tel +1 401 863 1758, Fax +1 401 863 9182, Email
| | - Bettina Siewert
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David J Vanness
- Population Health Sciences, University of Wisconsin, Madison, WI, USA
| | - Benjamin Herman
- Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
| | | | - Constantine Gatsonis
- Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
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17
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Affiliation(s)
- C D Johnson
- University Surgery, University Hospital Southampton, SO16 6YD, UK
| | - M G Besselink
- Dutch Pancreatitis Study Group, Academic Medical Center Amsterdam, Netherlands
| | - R Carter
- West of Scotland Pancreatic Unit, Glasgow Royal infirmary, Glasgow, UK
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Wheelwright SJ, Darlington AS, Hopkinson JB, Fitzsimmons D, White A, Johnson CD. A systematic review to establish health-related quality-of-life domains for intervention targets in cancer cachexia. BMJ Support Palliat Care 2014; 6:307-14. [PMID: 24943495 DOI: 10.1136/bmjspcare-2014-000680] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 05/25/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To develop a model of the impact of cancer cachexia on patients by identifying the relevant health-related quality-of-life (HRQOL) issues, and to use the model to identify opportunities for intervention. METHODS Standard systematic review methods were followed to identify papers which included direct quotes from cancer patients with cachexia or problems with eating or weight loss. Following thematic synthesis methodology, the quotes were coded, and themes and metathemes were extracted. The metathemes were used to develop a model of the patient's experience of cachexia. RESULTS 18 relevant papers were identified which, in total, contained interviews with more than 250 patients. 226 patient quotes were extracted from the papers and 171 codes. 26 themes and 8 metathemes were formulated. The model developed from the metathemes demonstrated a direct link between eating and food problems and negative emotions and also a link mediated by the associated physical decline. These links provide opportunities for interventions. CONCLUSIONS There are a vast number of HRQOL issues associated with cancer cachexia as identified from patients' own words. The model generated from these issues indicates that relationships, coping and knowledge of the condition are important components of new psychosocial interventions.
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Affiliation(s)
- S J Wheelwright
- Department of Cancer Sciences, University of Southampton, Southampton, UK
| | - A-S Darlington
- Department of Health Sciences, University of Southampton, Southampton, UK
| | - J B Hopkinson
- Cardiff School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - D Fitzsimmons
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - A White
- Department of Cancer Sciences, University of Southampton, Southampton, UK
| | - C D Johnson
- Department of Cancer Sciences, University of Southampton, Southampton, UK
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19
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Clavijo A, Nikooienejad A, Esfahani MS, Metz RP, Schwartz S, Atashpaz-Gargari E, Deliberto TJ, Lutman MW, Pedersen K, Bazan LR, Koster LG, Jenkins-Moore M, Swenson SL, Zhang M, Beckham T, Johnson CD, Bounpheng M. Identification and analysis of the first 2009 pandemic H1N1 influenza virus from U.S. feral swine. Zoonoses Public Health 2012; 60:327-35. [PMID: 22978260 DOI: 10.1111/zph.12006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The first case of pandemic H1N1 influenza (pH1N1) virus in feral swine in the United States was identified in Texas through the United States Department of Agriculture (USDA) Wildlife Services' surveillance program. Two samples were identified as pandemic influenza by reverse transcriptase quantitative PCR (RT-qPCR). Full-genome Sanger sequencing of all eight influenza segments was performed. In addition, Illumina deep sequencing of the original diagnostic samples and their respective virus isolation cultures were performed to assess the feasibility of using an unbiased whole-genome linear target amplification method and multiple sample sequencing in a single Illumina GAIIx lane. Identical sequences were obtained using both techniques. Phylogenetic analysis indicated that all gene segments belonged to the pH1N1 (2009) lineage. In conclusion, we have identified the first pH1N1 isolate in feral swine in the United States and have demonstrated the use of an easy unbiased linear amplification method for deep sequencing of multiple samples.
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Affiliation(s)
- A Clavijo
- Texas Veterinary Medical Diagnostic Laboratory, College Station, TX, USA.
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Abstract
There is mounting recognition that, to aid surgical decision making, treatment efficacy needs to be measured in a variety of ways, with health-related quality of life now widely regarded as an important outcome in pulmonary surgical populations. The aim of this review is to provide a comprehensive overview of the key issues to consider if an investigator wishes to incorporate health-related quality of life assessment into trials and studies of pulmonary surgery, drawing on recent studies of lung cancer surgery as an example.
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Affiliation(s)
- D Fitzsimmons
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, United Kingdom
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21
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Doan R, Cohen ND, Sawyer J, Ghaffari N, Johnson CD, Dindot SV. Whole-genome sequencing and genetic variant analysis of a Quarter Horse mare. BMC Genomics 2012; 13:78. [PMID: 22340285 PMCID: PMC3309927 DOI: 10.1186/1471-2164-13-78] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 02/17/2012] [Indexed: 11/24/2022] Open
Abstract
Background The catalog of genetic variants in the horse genome originates from a few select animals, the majority originating from the Thoroughbred mare used for the equine genome sequencing project. The purpose of this study was to identify genetic variants, including single nucleotide polymorphisms (SNPs), insertion/deletion polymorphisms (INDELs), and copy number variants (CNVs) in the genome of an individual Quarter Horse mare sequenced by next-generation sequencing. Results Using massively parallel paired-end sequencing, we generated 59.6 Gb of DNA sequence from a Quarter Horse mare resulting in an average of 24.7X sequence coverage. Reads were mapped to approximately 97% of the reference Thoroughbred genome. Unmapped reads were de novo assembled resulting in 19.1 Mb of new genomic sequence in the horse. Using a stringent filtering method, we identified 3.1 million SNPs, 193 thousand INDELs, and 282 CNVs. Genetic variants were annotated to determine their impact on gene structure and function. Additionally, we genotyped this Quarter Horse for mutations of known diseases and for variants associated with particular traits. Functional clustering analysis of genetic variants revealed that most of the genetic variation in the horse's genome was enriched in sensory perception, signal transduction, and immunity and defense pathways. Conclusions This is the first sequencing of a horse genome by next-generation sequencing and the first genomic sequence of an individual Quarter Horse mare. We have increased the catalog of genetic variants for use in equine genomics by the addition of novel SNPs, INDELs, and CNVs. The genetic variants described here will be a useful resource for future studies of genetic variation regulating performance traits and diseases in equids.
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Affiliation(s)
- Ryan Doan
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA
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22
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Johnson CD, Fitzsimmons D. Comment on 'differences in the birth-cohort patterns of gastric cancer and peptic ulcer'. Gut 2012; 61:165; author reply 165. [PMID: 21209125 DOI: 10.1136/gut.2010.234682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Pallis AG, Ring A, Fortpied C, Penninckx B, Van Nes MC, Wedding U, Vonminckwitz G, Johnson CD, Wyld L, Timmer-Bonte A, Bonnetain F, Repetto L, Aapro M, Luciani A, Wildiers H. EORTC workshop on clinical trial methodology in older individuals with a diagnosis of solid tumors. Ann Oncol 2011; 22:1922-6. [PMID: 21266517 DOI: 10.1093/annonc/mdq687] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A G Pallis
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece.
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24
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Abstract
Resistance to stretch, electromyographic (EMG) response to stretch, stretch discomfort and maximum range of motion (ROM) were measured during passive hamstring stretches performed in the slump test position (neural tension stretch) and in the upright position (neutral stretch) in eight healthy subjects. Stretches were performed on an isokinetic dynamometer at 5°/s with the test thigh flexed 40° above the horizontal, and the seat back at 90° to the horizontal. Surface EMG signals were recorded from the medial and lateral hamstrings during stretches. Knees were passively extended to maximum stretch tolerance with test order (neural tension vs neutral) alternated between legs. For neural tension stretches, the cervical and thoracic spine were manually flexed. Maximum ROM was 8° less for the neural tension stretch vs the neutral stretch (P<0.01). Resistance to stretch was 14-15% higher for the neural tension stretch vs the neutral stretch (P<0.001) at common joint angles in the final third of ROM. Stretch discomfort and EMG response were unaffected by neural tension. In conclusion, an increased passive resistance to stretch with the addition of neural tension during passive hamstring stretch despite no change in the EMG response indicates that passive extensibility of neural tissues can limit hamstring flexibility.
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Affiliation(s)
- M P McHugh
- Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York, USA.
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25
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Abstract
1. From four out of six specimens of saliva from six cases of mumps in the early stages of the disease, a filterable cytotropic virus has been obtained which induces in M. rhesus monkeys, following inoculation of the parotid glands through Stensen's duct, an acute, non-suppurative parotitis analogous to mumps. 2. This virus has not been found in normal saliva, nor does it correspond to any known virus with which we are familiar. 3. The virus is free of demonstrable microorganisms including spirochetes. 4. It is judged that this virus is the causative agent of mumps.
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Affiliation(s)
- C D Johnson
- Department of Pathology, Vanderbilt University Medical School, Nashville
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26
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Mokrowiecka A, Pinkowski D, Malecka-Panas E, Johnson CD. Clinical, emotional and social factors associated with quality of life in chronic pancreatitis. Pancreatology 2010; 10:39-46. [PMID: 20332660 DOI: 10.1159/000225920] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 05/31/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND In chronic pancreatitis (CP), a debilitating, progressive and incurable disease, patients' wellbeing is considerably impaired, but the different factors affecting quality of life (QoL), have not been identified yet. METHODS 69 patients with CP were evaluated (M/F 55/14; mean age 46.6 +/- 10.05 years). Different degrees of pancreatic damage were defined using the Cambridge classification; pain intensity and frequency were assessed using pain index. QoL was measured using EORTC QLQ-C30 and the PAN26 questionnaire. Although developed for pancreatic cancer, the C30/PAN26 has been validated for chronic pancreatitis. RESULTS Digestive symptoms, financial difficulties, fear of future health and general pain scales showed considerable effects of CP on QoL. We observed significant negative correlation between mean QoL scores and pain index in almost all domains (p < 0.001, p < 0.05). Pain intensity affects QoL scales more often than pain frequency. BMI correlated positively with QoL in global health status, altered bowel habits, body image and satisfaction with health care domains (p < 0.01, p < 0.05). CONCLUSION Pain index, BMI, Cambridge classification and disease duration are the most important factors adversely affecting QoL in CP. Measurement of QoL is essential in the disease management and improves the knowledge of psychosocial functioning of these patients. and IAP.
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Affiliation(s)
- A Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland.
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27
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Kizub IV, Pavlova OO, Johnson CD, Soloviev AI, Zholos AV. Rho kinase and protein kinase C involvement in vascular smooth muscle myofilament calcium sensitization in arteries from diabetic rats. Br J Pharmacol 2010; 159:1724-31. [PMID: 20218979 DOI: 10.1111/j.1476-5381.2010.00666.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Diabetes mellitus (DM) causes multiple dysfunctions including circulatory disorders such as cardiomyopathy, angiopathy, atherosclerosis and arterial hypertension. Rho kinase (ROCK) and protein kinase C (PKC) regulate vascular smooth muscle (VSM) Ca(2+) sensitivity, thus enhancing VSM contraction, and up-regulation of both enzymes in DM is well known. We postulated that in DM, Ca(2+) sensitization occurs in diabetic arteries due to increased ROCK and/or PKC activity. EXPERIMENTAL APPROACH Rats were rendered hyperglycaemic by i.p. injection of streptozotocin. Age-matched control tissues were used for comparison. Contractile responses to phenylephrine (Phe) and different Ca(2+) concentrations were recorded, respectively, from intact and chemically permeabilized vascular rings from aorta, tail and mesenteric arteries. KEY RESULTS Diabetic tail and mesenteric arteries demonstrated markedly enhanced sensitivity to Phe while these changes were not observed in aorta. The ROCK inhibitor HA1077, but not the PKC inhibitor chelerythrine, caused significant reduction in sensitivity to agonist in diabetic vessels. Similar changes were observed for myofilament Ca(2+) sensitivity, which was again enhanced in DM in tail and mesenteric arteries, but not in aorta, and could be reduced by both the ROCK and PKC blockers. CONCLUSIONS AND IMPLICATIONS We conclude that in DM enhanced myofilament Ca(2+) sensitivity is mainly manifested in muscular-type blood vessels and thus likely to contribute to the development of hypertension. Both PKC and, in particular, ROCK are involved in this phenomenon. This highlights their potential usefulness as drug targets in the pharmacological management of DM-associated vascular dysfunction.
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Affiliation(s)
- I V Kizub
- Institute of Pharmacology and Toxicology, Academy of Medical Sciences of Ukraine, Kiev, Ukraine
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28
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Booya F, Akram S, Fletcher JG, Huprich JE, Johnson CD, Fidler JL, Barlow JM, Solem CA, Sandborn WJ, Loftus EV. CT enterography and fistulizing Crohn's disease: clinical benefit and radiographic findings. ACTA ACUST UNITED AC 2009; 34:467-75. [PMID: 18551336 DOI: 10.1007/s00261-008-9419-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND To estimate the clinical benefit of CT enterography (CTE) in patients with fistulizing Crohn's disease and describe the appearance of fistulas at CTE. METHODS Crohn's patients who had undergone CTE, which diagnosed an abscess or fistula, were identified. A gastroenterologist reviewed clinical notes prior to and following CTE to assess the pre-CTE clinical suspicion for fistula/abscess, and post-CTE alteration in patient management. A radiologist reassessed all fistula-positive cases, which were confirmed by a non-CT reference standard, to describe their radiologic appearance. RESULTS Fifty-six patients had CT exams identifying 19 abscesses and 56 fistulas. There was no or remote suspicion of fistula or abscess at pre-imaging clinical assessment in 50% of patients. Thirty-four patients (61%) required a change in or initiation of medical therapy and another 10 (18%) underwent an interventional procedure based on CT enterography findings. Among 37 fistulas with reference standard confirmation, 30 (81%) were extraenteric tracts, and 32 (86%) were hyperenhancing compared to adjacent bowel loops. Most fistulas (68%) contained no internal air or fluid. CONCLUSION CTE detects clinically occult fistulas and abscesses, resulting in changes in medical management and radiologic or surgical intervention. Most fistulas appear as hyperenhancing, extraenteric tracts, usually without internal air or fluid.
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Affiliation(s)
- Fargol Booya
- Department of Radiology, Mayo Clinic Rochester, Rochester, MN 55905, USA
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29
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Aapro M, Johnson CD. The Elderly: Geriatric oncology finally deserving adequate attention. Eur J Cancer 2007; 43:2312-4. [PMID: 17826978 DOI: 10.1016/j.ejca.2007.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Accepted: 06/27/2007] [Indexed: 12/27/2022]
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30
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Abstract
Antioxidant supplements may be ineffective for the treatment or prevention of organ failure in predicted severe acute pancreatitis
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Affiliation(s)
- C D Johnson
- University Surgical Unit, Mail Point 816, Southampton General Hospital, Southampton SO16 6YD, UK.
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31
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Abstract
Abstract
Background
The aim of this study was to describe period and cohort effects in incidence and mortality of stomach and pancreatic cancer in England and Wales.
Methods
National figures for mortality (1951–2000) and incidence (1971–2000) were analysed using log-linear Poisson regression models to obtain relative risks (RR) for period (year of incidence or death) and cohort (year of birth).
Results
Stomach cancer shows a pronounced cohort effect in mortality with a decline in RR in men from 2·20 (1876) to 0·47 (1946) and a reduction from 2·79 to 0·41 for women. Mortality to incidence ratios are now less than 0·70. Pancreatic cancer mortality (men) RR rose from 0·91 (1951–1955) to a peak 1·11 (1976–1980) and then declined to 0·90 (1996–2000). Women showed a similar pattern. Cohort RR (men) increased to a peak of 1·14 in 1916 and declined to 1·01 in 1946, and continued to fall; the peak occurred slightly later in women. Mortality to incidence ratios were near 1 in the first 20 years, declining to 0·95 in the last 10 years.
Conclusion
Stomach cancer incidence has fallen continuously from 19th century birth cohorts onwards. Incidence of pancreatic cancer has fallen in successive birth cohorts after 1920; peak period risk was 1976–1990. Age-standardized mortality and case mortality for pancreatic cancer are declining.
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Affiliation(s)
- D Fitzsimmons
- School of Health Science, University of Wales-Swansea, Swansea, UK
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32
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Armstrong T, Strommer L, Ruiz-Jasbon F, Shek FW, Harris SF, Permert J, Johnson CD. Pancreaticoduodenectomy for peri-ampullary neoplasia leads to specific micronutrient deficiencies. Pancreatology 2007; 7:37-44. [PMID: 17449964 DOI: 10.1159/000101876] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Accepted: 09/20/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS After pancreaticoduodenectomy (PD) patients may be deficient in essential micronutrients. This study was designed to determine if this is a consequence of surgery. METHODS Long-term survivors (>6 months) of PD for peri-ampullary neoplasia and healthy controls (patients' spouse/partner) were enrolled in the study. Specific clinical parameters were recorded, serum micronutrient levels were measured and subjects completed 7-day food diaries. RESULTS Thirty-seven patients were studied, 25 with paired controls. All were well nourished, as defined by body mass index and food diary analysis. Patients with paired controls were representative of all patients studied. Patients had raised transferrin (median 2.60 vs. 2.16 g/l, p = 0.001) and low ferritin levels (34.9 vs. 119.0 g/l, p < 0.001) indicating relative iron deficiency. Patients also demonstrated lower levels of the anti-oxidants selenium (0.77 vs. 0.93 micromol/l, p < 0.001) and vitamin E (23.2 vs. 35.7 micromol/l, p < 0.001) with 57% of patients having frank selenium deficiencies. Patients had lower levels of vitamin D than controls (15.7 vs. 19.6 micromol/l, p = 0.001) and 30% of patients had a raised parathyroid hormone level, suggesting compensatory mechanisms operate to maintain normocalcaemia. CONCLUSIONS Long-term survivors of PD are relatively deficient in several micronutrients compared to non-operated controls taking the same diet. We recommend that micronutrient status should be regularly checked in these patients and treated where necessary.
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Affiliation(s)
- T Armstrong
- University Department of Surgery, Southampton General Hospital, Southampton, UK.
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Clark DL, Handa RK, Johnson CD, Connors BA, Evan AP, Willis LR. Interleukin‐6 response to shock wave lithotripsy‐induced renal injury. FASEB J 2007. [DOI: 10.1096/fasebj.21.6.lb123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - L R Willis
- Pharmacology & ToxicologyIndiana University School of Medicine635 Barnhill DriveIndianapolisIN46202
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35
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McPhail MJW, Abu-Hilal M, Johnson CD. A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery. Br J Surg 2006; 93:1038-44. [PMID: 16804872 DOI: 10.1002/bjs.5424] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although bladder drainage is widely used for general surgical patients undergoing laparotomy, there is little consensus on whether suprapubic or transurethral catheterization is better. METHOD A systematic database search was undertaken to find all studies of suprapubic catheterization. Randomized controlled trials were identified for inclusion. Endpoints for analysis were bacteriuria, patient satisfaction and recatheterization rates. A meta-analysis was performed using fixed-effect or random-effect models as appropriate, depending on heterogeneity. RESULTS After abdominal surgery, transurethral catheterization is associated with significant bacteriuria (relative risk (RR)=2.02, P<0.001, 95 percent confidence interval (c.i.) 1.34 to 3.04) and pain or discomfort (RR=2.94, P=0.004, 95 percent c.i. 1.41 to 6.14). Recatheterization rates using the transurethral method were not increased significantly (RR=1.97, P=0.213, 95 percent c.i. 0.68 to 5.74) with heterogeneity between studies. CONCLUSION The suprapubic route for bladder drainage in general surgery is more acceptable to patients and reduces microbiological morbidity.
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Affiliation(s)
- M J W McPhail
- University Surgical Unit, Mail Point 816, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
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Abstract
OBJECTIVE To quantify the performance demands in professional male tennis. METHODS Games from three grand slam tournaments were analysed by an elite tennis player from video recordings. Game related data were collected on 22 players (French Open, 8 (186 games); Wimbledon, 11 (206 games); US Open, 9 (224 games)). Total number of strokes per game was quantified separately for service and return games. Strokes were categorised by type and designated as forehand or backhand. Differences in the types of strokes in a game were analysed using one factor (type of stroke) repeated measures analysis of variance. Differences in total strokes and stroke distributions between playing surfaces were analysed by analysis of variance (surface type) with Tukey's post hoc pairwise comparisons. RESULTS For service games there were more serves per game than any other type of stroke (p<0.001), with topspin forehand and topspin backhand the only other strokes averaging more than one per service game. For return games there were more forehand and backhand returns and topspin forehands and backhands than other types of stroke (p<0.01). Total number of strokes per game was greater in the French Open than Wimbledon (p<0.01), with more topspin forehands (p<0.01) and more topspin backhands (p<0.01). Total strokes per game in the US Open were not different from the other two tournaments. CONCLUSIONS The serve was the predominant stroke accounting for 45% (French Open) to 60% (Wimbledon) of strokes during service games. The greater number of strokes per game on clay v grass may contribute to earlier fatigue.
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Affiliation(s)
- C D Johnson
- Nicholas Institute of Sports Medicine and Athletic Trauma, Lennox Hill Hospital, 100 East 77th Street, New York, NY10021, USA.
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Martínez J, Johnson CD, Sánchez-Payá J, de Madaria E, Robles-Díaz G, Pérez-Mateo M. Obesity is a definitive risk factor of severity and mortality in acute pancreatitis: an updated meta-analysis. Pancreatology 2006; 6:206-9. [PMID: 16549939 DOI: 10.1159/000092104] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Accepted: 10/26/2005] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Obesity is considered a risk factor in patients with acute pancreatitis. However, the relationship between obesity and mortality in this disease has not been confirmed definitively even in a previous meta-analysis. Since the publication of our previous meta-analysis, one study has been reported about the prognostic value of obesity in acute pancreatitis. We have performed a new meta-analysis to confirm the relationship between obesity and the outcome of acute pancreatitis. DATA SOURCES A MEDLINE search using 'pancreatitis', 'obesity' and 'body mass index' as search terms. REVIEW METHODS Clinical studies which investigated the prognostic value of obesity in acute pancreatitis with the following criteria: (a) inclusion of mild and severe acute pancreatitis; (b) use of body mass index (BMI) as the measure of obesity; (c) definition of obesity as BMI >or=30 kg/m(2); (d) definition of severity of acute pancreatitis according to the criteria established in the Atlanta Symposium. Five studies including patients with mild and severe acute pancreatitis and obesity measured by BMI were analyzed. The end points of the meta-analysis were the severity of acute pancreatitis, local complications, systemic complications and mortality. Pooled odds ratio (OR) and confidence intervals (CI) were calculated according to the Mantel-Haenszel method, and heterogeneity was assessed by the multiplicative inverse variance method. RESULTS Seven hundred and thirty-nine patients were included. There was no heterogeneity for the variables severity, systemic complications, local complications and mortality among the included studies. Severe acute pancreatitis was significantly more frequent in obese patients (OR 2.9, 95% CI 1.8-4.6). Furthermore, those patients developed significantly more systemic (OR 2.3, 95% CI 1.4-3.8) and especially local complications (OR 3.8, 95% CI 2.4-6.6). In this new analysis, mortality was also higher in obese patients (OR 2.1, 95% CI 1.0-4.8). CONCLUSION Obesity is not only a risk factor for the development of local and systemic complications in acute pancreatitis: it also increases the mortality of this disease.
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Affiliation(s)
- J Martínez
- Department of Gastroenterology, Hospital General Universitario de Alicante, Alicante, Spain.
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Williamson RCN, Farndon JR, Murie JA, Johnson CD. Editors' announcement. Br J Surg 2006. [DOI: 10.1002/bjs.1800811206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Williamson RCN, Farndon JR, Murie JA, Johnson CD. Editors' announcement. Br J Surg 2006. [DOI: 10.1002/bjs.1800811208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Johnson CD. Practical gastrointestinal endoscopy. 4th ed. P. B. Cotton and C. B. Williams (eds). 250 × 175 mm. Pp, 338. Illustrated. 1996. Oxford: Blackwell Science. £45. Br J Surg 2005. [DOI: 10.1002/bjs.1800840462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C D Johnson
- Southampton General Hospital, Trernona Road, Southampton SO16 6YE, UK
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Murie JA, Farndon JR, Johnson CD, Earnshaw JJ, Guillou PJ. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800840403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Murie JA, Farndon JR, Johnson CD, Earnshaw JJ, Guillou PJ. British Journal of Surgery on CD-Rom. Br J Surg 2005. [DOI: 10.1002/bjs.1800840504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Williamson RCN, Farndon JR, Murie JA, Johnson CD. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800811112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Williamson RCN, Farndon JR, Murie JA, Johnson CD. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800811121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Williamson RCN, Farndon JR, Murie JA, Johnson CD, Earnshaw JJ. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800820706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Williamson RCN, Murie JA, Johnson CD, Earnshaw JJ, Guillou PJ. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800831203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Murie JA, Farndon JR, Johnson CD, Earnshaw JJ, Guillou PJ. Editors' announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800840105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Johnson CD. Medical and surgical diseases of the pancreas. J. E. Valenzuela, H. A. Reber and A. Ribet (eds). 260 × 180mm. Pp. 184. Illustrated. 1991. New York: Igaku-Shoin. Br J Surg 2005. [DOI: 10.1002/bjs.1800790862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C D Johnson
- Southampton General Hospital, Southampton SO9 4XY, UK
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Williamson RCN, Murie JA, Johnson CD, Earnshaw JJ, Guillou PJ. Editor's Announcement. Br J Surg 2005. [DOI: 10.1002/bjs.1800830415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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