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Toogood K, Pike T, Coe P, Everett S, Huggett M, Paranandi B, Bassi V, Toogood G, Smith A. The role of cholecystectomy following endoscopic sphincterotomy and bile duct stone removal. Ann R Coll Surg Engl 2023; 105:607-613. [PMID: 35950513 PMCID: PMC10471440 DOI: 10.1308/rcsann.2022.0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 02/16/2022] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Choledocholithiasis is common, with patients usually treated with endoscopic retrograde cholangiopancreatography (ERCP) and subsequent cholecystectomy to remove the presumed source of common bile duct (CBD) stones. However, previous investigations into the management of patients following ERCP have focused on recurrent CBD stones, negating the risks of cholecystectomy. This article appraises the role of cholecystectomy following successful endoscopic clearance of bile duct stones. METHODS Patients undergoing ERCP and CBD clearance for choledocholithiasis at St James's University Hospital January 2015-December 2018 were included. Patients were divided into those who received cholecystectomy and those managed non-operatively. Readmissions, operative morbidity, mortality and treatment costs were investigated. RESULTS Eight hundred and forty-four patients received ERCP and CBD clearance with 3.9 years follow-up. Two hundred and nine patients underwent cholecystectomy with 15% requiring complex surgery. Three hundred and seventy-three patients were non-operatively managed. Unplanned readmissions occurred in 15% following ERCP, mostly within two years. There was no difference in readmissions between the two groups. Accounting for the entire patient pathway, non-operative management was less expensive. CONCLUSIONS The majority of patients do not require readmission following ERCP for CBD stones, and cholecystectomy did not reduce the risk of readmission. Few patients have recurrent CBD stones, but complex biliary surgery is frequently required. Routine cholecystectomy following ERCP needs to be re-evaluated and a more stratified approach to future risk developed.
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Affiliation(s)
| | | | - P Coe
- St James’s University Hospital, UK
| | | | | | | | - V Bassi
- St James’s University Hospital, UK
| | | | - A Smith
- St James’s University Hospital, UK
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Wood T, Faircloth DC, Lawrie SR, Letchford AP, Whitehead MO, Pike T, Perkins M. The ISIS pre-injector reconfiguration. Rev Sci Instrum 2016; 87:02B121. [PMID: 26932003 DOI: 10.1063/1.4934658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
With the introduction of a new "low energy beams" group at ISIS, the decision was taken to expand the ion source area. This paper will explain what actions were taken, how this has improved the present working environment and how the space will be used to accommodate a medium energy beam transport (MEBT) section after the existing radio-frequency quadrupole. The MEBT will incorporate three 202.5 MHz re-bunching cavities and will achieve a transmission of 96% with minimal emittance growth.
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Affiliation(s)
- T Wood
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - D C Faircloth
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - S R Lawrie
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - A P Letchford
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - M O Whitehead
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - T Pike
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
| | - M Perkins
- ISIS Pulsed Spallation Neutron and Muon Facility, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Harwell Oxford, Oxfordshire, United Kingdom
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Sloboda R, Ballester F, Tedgren AC, Culberson W, Esthappan J, Haworth A, Lowenstein J, Ma Y, Mourtada F, Papagiannis P, Pike T, Rivard M, Siebert F, Smith R, Spadinger I, Taylor P, Verhaegen F, Vijande J, Beaulieu L. TH-AB-BRA-05: Infrastructure and Process for Model-Based Dose Calculation Software Commissioning in Brachytherapy. Med Phys 2015. [DOI: 10.1118/1.4926148] [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] Open
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Farid SG, Shah N, Longbotham D, Pike T. Re: Ratios derived from an array of standard haematological indices predict the oncological outcome in colon cancer. Colorectal Dis 2014; 16:926. [PMID: 25040428 DOI: 10.1111/codi.12723] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 05/28/2014] [Indexed: 02/08/2023]
Affiliation(s)
- S G Farid
- Department of General Surgery, St James' Institute of Oncology, St James University Hospital, Beckett Street, Leeds, LS9 7T, UK.
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Farid SG, Shah N, Pike T, Wijetunga I. Re: 'Predicting postoperative mortality after colorectal surgery: a novel clinical model'. Colorectal Dis 2014; 16:926-7. [PMID: 25155406 DOI: 10.1111/codi.12750] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/04/2014] [Indexed: 02/08/2023]
Affiliation(s)
- S G Farid
- Department of Surgery, St James' University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
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Simiele S, Pike T, Micka J, DeWerd L. WE-A-108-05: Experimental and Computational Dosimetric Characterization of the Xoft AxxentTM Electronic Brachytherapy Source Within a Titanium Cervical Applicator. Med Phys 2013. [DOI: 10.1118/1.4815498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Li X, Flynn R, Pike T. SU-D-108-07: Experimental Verification of a Compensator-Based Brachytherapy System. Med Phys 2013. [DOI: 10.1118/1.4814017] [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] Open
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Pike T, Davis S, Micka J, DeWerd L. SU-E-T-85: Ionization Chamber Measured Dose-Rate Constant of the Xoft Axxent Electronic Brachytherapy Source. Med Phys 2011. [DOI: 10.1118/1.3612036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pike T, Moga J, Davis S, DeWerd L. WE-D-BRB-05: Dose-Rate Constant Determination of the Xoft Axxent Electronic Brachytherapy Source Using Spectroscopic Methods. Med Phys 2010. [DOI: 10.1118/1.3469393] [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] Open
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Kennedy R, Pike T, Davis S, DeWerd L. SU-GG-T-276: Dosimetric Characterization of a Set of Surface Applicators from Xoft Inc. Med Phys 2010. [DOI: 10.1118/1.3468668] [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] Open
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Pike T, Raffi J, Davis S, DeWerd L. SU-FF-T-273: Energy Dependence of TLD-100 Chips and Microcubes for the Xoft Axxent® 50 KV Miniature X-Ray Source and Cs-137 Relative to Co-60. Med Phys 2009. [DOI: 10.1118/1.3181750] [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] Open
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Pike T, Davis S, Palmer B, DeWerd L. WE-E-AUD-02: Dose Rate Measurements of An Electronic Brachytherapy Source Using Thermoluminescent Dosimeters in Water. Med Phys 2007. [DOI: 10.1118/1.2761594] [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] Open
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Chassefière E, Bertaux JL, Berthelier JJ, Cabane M, Ciarletti V, Durry G, Forget F, Hamelin M, Leblanc F, Menvielle M, Gerasimov M, Korablev O, Linkin S, Managadze G, Jambon A, Manhès G, Lognonné P, Agrinier P, Cartigny P, Giardini D, Pike T, Kofman W, Herique A, Coll P, Person A, Costard F, Sarda P, Paillou P, Chaussidon M, Marty B, Robert F, Maurice S, Blanc M, d'Uston C, Sabroux JC, Pineau JF, Rochette P. MEP (Mars Environment Package): toward a package for studying environmental conditions at the surface of Mars from future lander/rover missions. Adv Space Res 2004; 34:1702-9. [PMID: 15934176 DOI: 10.1016/j.asr.2003.08.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In view to prepare Mars human exploration, it is necessary to promote and lead, at the international level, a highly interdisciplinary program, involving specialists of geochemistry, geophysics, atmospheric science, space weather, and biology. The goal of this program will be to elaborate concepts of individual instruments, then of integrated instrumental packages, able to collect exhaustive data sets of environmental parameters from future landers and rovers of Mars, and to favour the conditions of their implementation. Such a program is one of the most urgent need for preparing human exploration, in order to develop mitigation strategies aimed at ensuring the safety of human explorers, and minimizing risk for surface operations. A few main areas of investigation may be listed: particle and radiation environment, chemical composition of atmosphere, meteorology, chemical composition of dust, surface and subsurface material, water in the subsurface, physical properties of the soil, search for an hypothesized microbial activity, characterization of radio-electric properties of the Martian ionosphere. Scientists at the origin of the present paper, already involved at a high degree of responsibility in several Mars missions, and actively preparing in situ instrumentation for future landed platforms (Netlander--now cancelled, MSL-09), express their readiness to participate in both ESA/AURORA and NASA programs of Mars human exploration. They think that the formation of a Mars Environment working group at ESA, in the course of the AURORA definition phase, could act positively in favour of the program, by increasing its scientific cross-section and making it still more focused on human exploration.
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Affiliation(s)
- E Chassefière
- Pôle de Planétologie de l'IPSL, Université Pierre et Marie Curie, Paris, France.
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Diakoumis K, Dequet C, Pike T, Uphues M, Davison D. 958 CORRELATION BETWEEN INTERNAL ROTATION AND PAIN IN THE SUPRASPINATUS MUSCLE IN ADOLESCENT SWIMMERS. Med Sci Sports Exerc 1993. [DOI: 10.1249/00005768-199305001-00961] [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: 11/21/2022]
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Abstract
A data acquisition system that automatically discards corrupted or undesirable signals would save untold hours of drudgery for researchers. Continuous recording of variables to provide detailed behavior patterns generates huge amounts of raw data. Unfortunately waveforms usually require visual inspection for isolating desired behavior or validating signal integrity. This tedious and time-consuming step can potentially be eliminated using a novel computer science technique. We have trained a simulated neural network to recognize corrupted arterial pressure waveforms. Our system can now evaluate the validity of the arterial waveform without human intervention with an average false positive error rate of 2.2% and an average false negative error rate of 12.6%.
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Affiliation(s)
- T Pike
- Department of Surgery, Wellesley Hospital, University of Toronto, Ontario, Canada
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Abstract
A personal computer based system for data acquisition and analysis appropriate to physiological experiments is described in detail. The system is independent of the details of the analog signal generation. The software, written in C, is modular and easily portable to other PC systems. The system is capable of: (a) sampling many analog signals at an appropriate rate (100 Hz), (b) storing large quantities of digitized data, (c) analysing digitized waveforms to obtain signal parameters, and (d) storing signal parameters in a format suitable for statistical analysis. Computer processed cardiopulmonary data are compared with data derived from standard ICU equipment.
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Affiliation(s)
- R A Mustard
- Department of Surgery, Wellesley Hospital, University of Toronto, Ontario, Canada
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