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Ngo W, Srinivasan S, Keech A, Keir N, Jones L. Self versus examiner administration of the Ocular Surface Disease Index ©. JOURNAL OF OPTOMETRY 2017; 10:34-42. [PMID: 27233156 PMCID: PMC5219841 DOI: 10.1016/j.optom.2016.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/06/2016] [Accepted: 04/23/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE To compare the difference in Ocular Surface Disease Index© (OSDI) scores when participants were given the OSDI to complete on their own (self-guided, SG), versus under the guidance of the examiner (examiner-guided, EG). METHODS 100 participants enrolled in this prospective two-visit study (fifty under-45 years old, 38F/12M; and fifty 45 years-and-older, 42F/8M). Participants who scored ≥1 on the Subjective Evaluation of Symptoms of Dryness (SESoD) were included in this study. Participants completed the OSDI SG during the first visit. Participants returned the next day and repeated the OSDI, but with EG (with standardized instructions). Participants were under deception and believed that they were comparing the OSDI to the SESoD. RESULTS The mean OSDI score of the SG and EG administration was 32.0±17.3 and 33.8±19.6 respectively (p>0.05) with 95% limits of agreement between -20.6 and +24.2. The correlation between SG and EG administration was Spearman's r=0.81, p<0.01. The mean difference between SG and EG was not significant (p>0.05) for both the under-45 group, and 45-and-older group. The 95% limits of agreement for the under-45 group were smaller than the 45-and-older group (under-45: [-15.5, +13.1,], 45-and-older: [-23.3, +32.2]). A significant difference was found between 8 of the 12 questions items (all p≤0.01). However, the mean difference for each was <0.6 and was not considered to be clinically significant. CONCLUSION There was no clinically significant difference in OSDI score between SG and EG administration, however having instructions provided with EG administration affected variability of scores in the older group more than the younger group.
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Tan A, Greenberg B, Keech A, Plumb P, Hughes S, Harder L. A-59Neuropsychological Functioning in Pediatric Demyelinating Diseases: A Comparison Between Multiple Sclerosis (MS) and Acute Disseminated Encephalomyelitis (ADEM). Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tan A, Greenberg B, Keech A, Plumb P, Hughes S, Harder L. A-57Assessing Executive Functioning Deficits in Pediatric Multiple Sclerosis: Association Between Objective Measures and Subjective Rating Scales. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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King E, Yuan J, Kong S, Dunn L, Stocker R, Keech A, Jenkins A, Ng M. Hypoxia Tolerance in Diabetes Mellitus: The Role of Fenofibrate in Facilitating Protective Metabolic Reprogramming. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chia N, Fulcher J, Keech A. Beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, nitrate-hydralazine, diuretics, aldosterone antagonist, ivabradine, devices and digoxin (BANDAID(2) ): an evidence-based mnemonic for the treatment of systolic heart failure. Intern Med J 2016; 46:653-62. [PMID: 26109136 DOI: 10.1111/imj.12839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Heart failure causes significant morbidity and mortality, with recognised underutilisation rates of guideline-based therapies. Our aim was to review current evidence for heart failure treatments and derive a mnemonic summarising best practice, which might assist physicians in patient care. Treatments were identified for review from multinational society guidelines and recent randomised trials, with a primary aim of examining their effects in systolic heart failure patients on mortality, hospitalisation rates and symptoms. Secondary aims were to consider other clinical benefits. MEDLINE and EMBASE were searched using a structured keyword strategy and the retrieved articles were evaluated methodically to produce an optimised reference list for each treatment. We devised the mnemonic BANDAID (2) , standing for beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, nitrate-hydralazine (or potentially neprilysin inhibitor), diuretics, aldosterone antagonist, ivabradine, devices (automatic implantable cardioverter defibrillator, cardiac resynchronisation therapy or both) and digoxin as a representation of treatments with strong evidence for their use in systolic heart failure. Treatment with omega-3 fatty acids, statins or anti-thrombotic therapies has limited benefits in a general heart failure population. Adoption of this mnemonic for current evidence-based treatments for heart failure may help improve prescribing rates and patient outcomes in this debilitating, high mortality condition.
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Reith C, Blackwell L, Emberson J, Mihaylova B, Armitage J, Fulcher J, Keech A, Simes J, Baigent C, Collins R. Protocol for analyses of adverse event data from randomized controlled trials of statin therapy. Am Heart J 2016; 176:63-9. [PMID: 27264221 PMCID: PMC4906243 DOI: 10.1016/j.ahj.2016.01.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/16/2016] [Indexed: 01/14/2023]
Abstract
The Cholesterol Treatment Trialists' (CTT) Collaboration was originally established to conduct individual participant data meta-analyses of major vascular events, cause-specific mortality, and site-specific cancers in large, long-term, randomized trials of statin therapy (and other cholesterol-modifying treatments). The results of the trials of statin therapy and their associated meta-analyses have shown that statins significantly reduce the risk of major vascular events without any increase in the risk of nonvascular causes of death or of site-specific cancer, but do produce small increases in the incidence of myopathy, diabetes, and, probably, hemorrhagic stroke. The CTT Collaboration has not previously sought data on other outcomes, and so a comprehensive meta-analysis of all adverse events recorded in each of the eligible trials has not been conducted. This protocol prospectively describes plans to extend the CTT meta-analysis data set so as to provide a more complete understanding of the nature and magnitude of any other effects of statin therapy.
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Sullivan DR, Watts GF, Nicholls SJ, Barter P, Grenfell R, Chow CK, Tonkin A, Keech A. Clinical guidelines on hyperlipidaemia: recent developments, future challenges and the need for an Australian review. Heart Lung Circ 2015; 24:495-502. [PMID: 25676115 DOI: 10.1016/j.hlc.2014.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 12/11/2022]
Abstract
Large reductions in cardiovascular disease (CVD) mortality have been achieved over the last 50 years in developed countries. The health policies that have contributed so much to this success have largely been coordinated by means of expert guidelines for the management of the classic modifiable risk factors such as blood pressure, diabetes and blood lipids. National and international guidelines for lipid management have demonstrated a high degree of consistency between numerous sets of recommendations. It has been argued that some important components of the consensus that has been established over the past decade have been challenged by the latest guidelines of the American Heart Association - American College of Cardiologists (AHA-ACC). Clinicians can be reassured that continued reliance on extensive scientific evidence has reaffirmed the importance of lipid metabolism as a modifiable risk factor for atherosclerotic cardiovascular disease. On the other hand, the recent AHA-ACC guidelines suggest changes in the strategies by which metabolic risk factors may be modified. This small number of important changes should not be sensationalised because these differences usefully reflect the need for guidelines to evolve to accommodate different contexts and changing perspectives as well as emerging issues and new information for which clinical trial evidence is incomplete. This article will consider the recent policies and responses of national and supranational organisations on topics including components of CVD risk assessment, sources of CVD risk information and re-appraisal of lipid-lowering interventions. Timely review of Australian lipid management guidelines will require consideration of these issues because they are creating a new context within which new guidelines must evolve.
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King E, Chen S, Yuan J, Jenkins A, Keech A, Ng M. The role of fenofibrate in metabolic reprogramming in hyperglycaemia and hypoxia. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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van der Linde D, Davies L, Sherrah A, Bannon P, Vallely M, Wilson M, Turner L, Keech A, Jeremy R. Comparative outcomes after acute aortic dissection in genetic aortopathy syndromes. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.732] [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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Chen S, King E, Yuan J, Jenkins A, Keech A, Ng M. Effects of fenofibrate on hypoxia tolerance in diabetes and associated molecular mechanisms. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yuan J, Rajamani K, King E, Bursill C, Lecce L, Jenkins A, Keech A, Ng M. Fenofibrate rescues diabetes-related impairment of ischaemia-mediated angiogenesis by a PPARα independent pathway. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fabritz L, Fortmuller L, Vloumidi E, Yue TY, Syeda F, Kirchhof P, Leube R, Krusche C, Chin SH, Winter J, Brack KE, Ng GA, Ng FS, Holzem KM, Koppel AC, Janks D, Wit AL, Peters NS, Efimov IR, Chowdhury RA, El-Harasis MA, Dupont E, Terracciano CMN, Peters NS, Mellor GJ, Raju H, de Noronha SV, Papadakis M, Sharma S, Behr ER, Sheppard MN, Jamil-Copley S, Bai W, Ariff B, Lim PB, Koa-Wing M, Kyriacou A, Hayat S, Sohaib A, Qureshi N, Sandler B, O'Regan D, Whinnett Z, Davies W, Rueckert D, Kanagaratnam P, Peters N, Lambiase PD, Chow AW, Lowe MD, Segal OR, Ahsan S, de Bono J, Dhaliwal M, Mfuko C, Ng A, Sandilands A, Paisey J, Roberts P, Morgan JM, McCready J, Yue A, Ullah W, Hunter R, Lovell M, Dhinoja M, Sporton S, Earley M, Schilling R, Ghosh J, Martin A, Keech A, Chan KH, Gomes S, Singarayar S, McGuire M, Lee G, Hunter R, Berriman T, Diab I, Kamdar R, Richmond L, Baker V, Goromonzi F, Sawhney V, Duncan E, Unsworth B, Mayet J, Abrams D, Dhinoja M, Sporton S, Earley M, Schilling RJ, Bowers RW, Mulholland V, Balasubramaniam RN, Paisey JR, Sopher SM, Chu GS, Chin SH, Winter J, Armstrong S, Masca N, Almeida TP, Brown PD, Sandilands AJ, Schlindwein FS, Ng GA. ABSTRACTS FOR ORAL PRESENTATION, SESSION 2, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut315] [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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Keech A, Senchyna M, Jones L. Impact of time between collection and collection method on human tear fluid osmolarity. Curr Eye Res 2013; 38:428-36. [PMID: 23402632 DOI: 10.3109/02713683.2013.763987] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To generate data on the variability of tear osmolarity in a control (normal, non-dry eye) and symptomatic dry eye population (Ocular Surface Disease Index: OSDI ≥20). A secondary outcome is the determination of the effect that tear collection technique has on the osmolarity of the sample. MATERIALS AND METHODS This was a two-phase study that recruited 20 subjects (n = 10 normal, n = 10 dry eye) to evaluate the influence of time between measurements (Phase I) and 30 subjects (n = 15 normal, n = 15 dry eye) to evaluate the influence of collection technique (Phase II). As part of Phase I, serial tear osmolarity measurements were performed on each eye; four separated by 15 min followed by four separated by 1 min, at each of three visits. Phase II compared the consecutive measurement of four in vivo tear samples to four in vitro measurements on tears collected and dispensed from a glass capillary tube. RESULTS During Phase I, the dry eye group had a significantly higher maximum osmolarity (334.2 ± 25.6 mOsm/L) compared to the normal group (304.0 ± 8.4 mOsm/L, p = 0.002). No significant differences were observed whether collections were performed at 15 or 1 min intervals. During Phase II, the in vivo osmolarity was equivalent to in vitro measurements from glass capillary tube samples for both the dry eye group (323.0 ± 16.7 mOsm/L versus 317.7 ± 24.8, p = 0.496), and for the normal subjects (301.2 ± 7.2 mOsm/L versus 301.9 ± 16.0 mOsm/L, p = 0.884). CONCLUSION Symptomatic dry eye subjects exhibited a significantly higher tear osmolarity and variation over time than observed in normal subjects, reflecting the inherent tear film instability of dry eye disease. There was no change in the distribution of tear osmolarity measurements whether tears were collected in rapid succession or given time to equilibrate, and collection method had no impact on tear osmolarity.
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Colquhoun D, Bensoussan A, Braun L, Hill K, Keech A, Kostner K, Rosenfeldt F, Walker R, Watts G. Complementary Medicines in Cardiovascular Disease – Review of the Evidence by the National Institute of Complementary Medicine 2013. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.621] [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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Yong A, Ho M, Shah M, Chawantanpipat C, O’Connell R, Keech A, Kritharides L, Fearon W, Ng M. The Index of Microcirculatory Resistance Predicts Myocardial Infarction Related to Percutaneous Coronary Intervention. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Harmer J, Veillard A, Skilton M, Keech A, Celermajer D. Fenofibrate and Carotid Intima-Media Thickness in Adults with Type 2 Diabetes Mellitus: A FIELD Sub-Study. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Drury PL, Ting R, Zannino D, Ehnholm C, Flack J, Whiting M, Fassett R, Ansquer JC, Dixon P, Davis TME, Pardy C, Colman P, Keech A. Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Diabetologia 2011; 54:32-43. [PMID: 20668832 DOI: 10.1007/s00125-010-1854-1] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 06/18/2010] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS We investigated effects of renal function and albuminuria on cardiovascular outcomes in 9,795 low-risk patients with diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. METHODS Baseline and year 2 renal status were examined in relation to clinical and biochemical characteristics. Outcomes included total cardiovascular disease (CVD), cardiac and non-cardiac death over 5 years. RESULTS Lower estimated GFR (eGFR) vs eGFR ≥90 ml min⁻¹ 1.73 m⁻² was a risk factor for total CVD events: (HR [95% CI] 1.14 [1.01-1.29] for eGFR 60-89 ml min⁻¹ 1.73 m⁻²; 1.59 [1.28-1.98] for eGFR 30-59 ml min⁻¹ 1.73 m⁻²; p < 0.001; adjusted for other characteristics). Albuminuria increased CVD risk, with microalbuminuria and macroalbuminuria increasing total CVD (HR 1.25 [1.01-1.54] and 1.19 [0.76-1.85], respectively; p = 0.001 for trend) when eGFR ≥90 ml min⁻¹ 1.73 m⁻². CVD risk was further modified by renal status changes over the first 2 years. In multivariable analysis, 77% of the effect of eGFR and 81% of the effect of albumin:creatinine ratio were accounted for by other variables, principally low HDL-cholesterol and elevated blood pressure. CONCLUSIONS/INTERPRETATION Reduced eGFR and albuminuria are independent risk factors for cardiovascular events and mortality rates in a low-risk population of mainly European ancestry. While their independent contributions to CVD risk appear small when other risk factors are considered, they remain excellent surrogate markers in clinical practice because they capture risk related to a number of other characteristics. Therefore, both should be considered when assessing prognosis and treatment strategies in patients with diabetes, and both should be included in risk models.
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Rajamani K, Donoghoe M, Li L, Ting RD, Colman P, Scott R, Laakso M, Keech A. MS546 FENOFIBRATE REDUCES PERIPHERAL NEUROPATHY IN TYPE 2 DIABETES: THE FENOFIBRATE INTERVENTION AND EVENT LOWERING IN DIABETES (FIELD) STUDY. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)71046-1] [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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Foucher C, Le Malicot K, Ansquer JC, Gebski V, Keech A. MS520 FENOFIBRATE TREATMENT REDUCES THE OCCURRENCE OF RECURRENT CARDIOVASCULAR EVENTS IN PATIENTS WITH TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)71020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Harmer J, Keech A, Veillard A, Skilton M, Griffiths K, Marwick T, Watts G, Meredith I, Celermajer D. Fenofibrate and Short-Term Improvement in Endothelial Function in Adults with Type 2 Diabetes Mellitus: A FIELD Substudy. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kiat A, Dignan R, Gebski V, Keech A. A Novel Technique of Continuous Parasternal Ropivacaine Infusion after Cardiac Surgery: Background Study to the PAINLESS Trial. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dignan R, Keech A, Powell C, Turner L, Mann K, Hughes C, Gebski V. Is Home Warfarin Self-Management Effective? Results of the Warfarin S.M.A.R.T. Study and Uptake of Self-Management. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Harmer J, Keech A, Veillard A, Skilton M, Griffiiths K, Marwick T, Watts G, Meredith I, Celermajer D. Cigarette Smoking and Albuminuria are Associated with Impaired Arterial Smooth Muscle Function in Patients with Type 2 Diabetes Mellitus: A FIELD Sub-Study. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Glasier MA, Keech A, Sheardown H, Subbaraman LN, Jones L. Conformational and Quantitative Characterization of Lysozyme Extracted from Galyfilcon and Senofilcon Silicone Hydrogel Contact Lenses. Curr Eye Res 2009; 33:1-11. [DOI: 10.1080/02713680701830278] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Keech A. Abstract: 1446 USE OF PPAR AGONISTS IN THE MANAGEMENT AND PREVENTION OF VASCULAR DISEASE IN DIABETES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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