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  1. Article ; Online: Antibiotics versus no antibiotics in the treatment of acute uncomplicated diverticulitis - a systematic review and meta-analysis.

    Tandon, Ashutosh / Fretwell, Victoria L / Nunes, Quentin M / Rooney, Paul S

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2018  

    Abstract: Background: Acute uncomplicated diverticulitis (AUD) is common and antibiotics are the cornerstone of traditional conservative management. This approach lacks clear evidence base and studies have recently suggested that avoidance of antibiotics is a ... ...

    Abstract Background: Acute uncomplicated diverticulitis (AUD) is common and antibiotics are the cornerstone of traditional conservative management. This approach lacks clear evidence base and studies have recently suggested that avoidance of antibiotics is a safe and efficacious way to manage AUD. The aim of this systematic review is to determine the safety and efficacy of treating AUD without antibiotics.
    Methods: A systematic search of Embase, Cochrane library, MEDLINE, Science Citation Index Expanded, and ClinicalTrials. gov was performed. Studies comparing antibiotics versus no antibiotics in the treatment of AUD were included. Meta-analysis was performed using the random effects model with the primary outcome measure being diverticulitis-associated complications. Secondary outcomes were readmission rate, diverticulitis recurrence, mean hospital stay, requirement for surgery and requirement for percutaneous drainage.
    Results: Eight studies were included involving 2469 patients; 1626 in the non-antibiotic group (NAb) and 843 in the antibiotic group (Ab). There was a higher complication rate in the Ab group however this was not significant (1.9% versus 2.6%) with a combined risk ratio (RR) of 0.63 (95% CI, 0.25 to 1.57, p=0.32). There was a shorter mean length of hospital stay in the Nab group (standard mean difference of -1.18 (95% CI, -2.34 to -0.03 p= 0.04). There was no significant difference in readmission, recurrence and surgical intervention rate or requirement for percutaneous drainage.
    Conclusion: Treatment of AUD without antibiotics may be feasible with outcomes that are comparable to antibiotic treatment and with potential benefits for patients and the NHS. Large scale randomised multicentre studies are needed. This article is protected by copyright. All rights reserved.
    Language English
    Publishing date 2018-01-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.14013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: In silico analyses of heparin binding proteins expression in human periodontal tissues.

    Lackey, Bernadette / Nunes, Quentin M / Higham, Susan M / Fernig, David G / Valappil, Sabeel P

    BMC research notes

    2016  Volume 9, Page(s) 53

    Abstract: Background: Periodontitis is described as a group of inflammatory diseases of the gingiva and supporting structures of the periodontium. The accumulation of plaque bacteria, which include putative periodontal pathogens, is known to initiate the disease ... ...

    Abstract Background: Periodontitis is described as a group of inflammatory diseases of the gingiva and supporting structures of the periodontium. The accumulation of plaque bacteria, which include putative periodontal pathogens, is known to initiate the disease but the host immune response is the major contributing factor for destruction of periodontal tissues. Proteins that bind to heparin heparin-binding protein (HBPs) play important roles in health and disease and interact with each other via networks known as 'heparin interactomes'. This study aimed at evaluating published datasets of HBPs and its role in periodontitis.
    Methods: To elucidate the role of HBPs in periodontitis, bioinformatics analyses of published data was used. In silico analyses of published datasets were used to construct a putative HBPs interactome using an online database resource, 'STRING' (Search Tool for the Retrieval of Interacting Genes).
    Results: PubMed searches identified 249 genes that were up regulated and 146 genes that were down regulated in periodontal disease, compared with periodontal disease-free gingival samples. In silico analyses using published datasets revealed 25 up-regulated and 23 down-regulated HBPs in periodontitis. Of these HBPs; chemokines, such as CXCL12 was up regulated where as some of the matrixmetalloproteinases (MMPs; MMP-2 and MMP9) were up-regulated while MMP-14 was down regulated.
    Conclusions: The results indicate that HBP analyses will provide multiple targets for the biological mechanisms underlying periodontal disease (such as MMPs, cytokines and chemokines) that will have important clinical implications in the future drug design and management of periodontal disease.
    MeSH term(s) Antimicrobial Cationic Peptides/metabolism ; Blood Proteins/metabolism ; Carrier Proteins/metabolism ; Cluster Analysis ; Computer Simulation ; Humans ; Periodontitis/metabolism ; Periodontium/metabolism ; Protein Interaction Mapping
    Chemical Substances AZU1 protein, human ; Antimicrobial Cationic Peptides ; Blood Proteins ; Carrier Proteins
    Language English
    Publishing date 2016-01-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2413336-X
    ISSN 1756-0500 ; 1756-0500
    ISSN (online) 1756-0500
    ISSN 1756-0500
    DOI 10.1186/s13104-016-1857-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Fibroblast growth factors as tissue repair and regeneration therapeutics.

    Nunes, Quentin M / Li, Yong / Sun, Changye / Kinnunen, Tarja K / Fernig, David G

    PeerJ

    2016  Volume 4, Page(s) e1535

    Abstract: Cell communication is central to the integration of cell function required for the development and homeostasis of multicellular animals. Proteins are an important currency of cell communication, acting locally (auto-, juxta-, or paracrine) or ... ...

    Abstract Cell communication is central to the integration of cell function required for the development and homeostasis of multicellular animals. Proteins are an important currency of cell communication, acting locally (auto-, juxta-, or paracrine) or systemically (endocrine). The fibroblast growth factor (FGF) family contributes to the regulation of virtually all aspects of development and organogenesis, and after birth to tissue maintenance, as well as particular aspects of organism physiology. In the West, oncology has been the focus of translation of FGF research, whereas in China and to an extent Japan a major focus has been to use FGFs in repair and regeneration settings. These differences have their roots in research history and aims. The Chinese drive into biotechnology and the delivery of engineered clinical grade FGFs by a major Chinese research group were important enablers in this respect. The Chinese language clinical literature is not widely accessible. To put this into context, we provide the essential molecular and functional background to the FGF communication system covering FGF ligands, the heparan sulfate and Klotho co-receptors and FGF receptor (FGFR) tyrosine kinases. We then summarise a selection of clinical reports that demonstrate the efficacy of engineered recombinant FGF ligands in treating a wide range of conditions that require tissue repair/regeneration. Alongside, the functional reasons why application of exogenous FGF ligands does not lead to cancers are described. Together, this highlights that the FGF ligands represent a major opportunity for clinical translation that has been largely overlooked in the West.
    Language English
    Publishing date 2016-01-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703241-3
    ISSN 2167-8359
    ISSN 2167-8359
    DOI 10.7717/peerj.1535
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Earlier surgery improves outcomes from painful chronic pancreatitis.

    Ke, Nengwen / Jia, Dan / Huang, Wei / Nunes, Quentin M / Windsor, John A / Liu, Xubao / Sutton, Robert

    Medicine

    2018  Volume 97, Issue 19, Page(s) e0651

    Abstract: The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 ... ...

    Abstract The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012.The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/- ductal dilatation (47% vs 27%, P < .001), but less frequently abdominal pain alone (73.5% vs 85.9%, P = .009), ductal dilatation alone (31% vs 71%, P < .001), parenchymal calcification (91.8% vs 100%, P < .001) or exocrine insufficiency (60% vs 72%, P = .034); there were no other significant differences. The early group had longer hospital stay (14.4 vs 12.2 days, P = .009), but no difference in complications. Significantly greater pain relief followed early surgery (complete 69% vs 47%, partial 22% vs 37%, none 8% vs 16%, P = .01) with lower rates of exocrine (60% vs 80%, P = .005) and endocrine insufficiency (36% vs 53%, P = .033).Our data indicate that early surgery results in higher rates of pain relief and pancreatic sufficiency than late surgery for chronic pancreatitis patients. Frey and Berne procedures showed better results than other surgical procedures.
    MeSH term(s) Abdominal Pain/etiology ; Abdominal Pain/prevention & control ; Calcinosis ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/methods ; Dilatation, Pathologic ; Female ; Humans ; Intraoperative Complications ; Jaundice/complications ; Male ; Middle Aged ; Pancreas/pathology ; Pancreas/physiology ; Pancreatic Ducts/pathology ; Pancreatitis, Chronic/complications ; Pancreatitis, Chronic/pathology ; Pancreatitis, Chronic/physiopathology ; Pancreatitis, Chronic/surgery ; Postoperative Complications ; Time Factors
    Language English
    Publishing date 2018-04-30
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000010651
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Network based meta-analysis prediction of microenvironmental relays involved in stemness of human embryonic stem cells.

    Mournetas, Virginie / Nunes, Quentin M / Murray, Patricia A / Sanderson, Christopher M / Fernig, David G

    PeerJ

    2014  Volume 2, Page(s) e618

    Abstract: Background. Human embryonic stem cells (hESCs) are pluripotent cells derived from the inner cell mass of in vitro fertilised blastocysts, which can either be maintained in an undifferentiated state or committed into lineages under determined culture ... ...

    Abstract Background. Human embryonic stem cells (hESCs) are pluripotent cells derived from the inner cell mass of in vitro fertilised blastocysts, which can either be maintained in an undifferentiated state or committed into lineages under determined culture conditions. These cells offer great potential for regenerative medicine, but at present, little is known about the mechanisms that regulate hESC stemness; in particular, the role of cell-cell and cell-extracellular matrix interactions remain relatively unexplored. Methods and Results. In this study we have performed an in silico analysis of cell-microenvironment interactions to identify novel proteins that may be responsible for the maintenance of hESC stemness. A hESC transcriptome of 8,934 mRNAs was assembled using a meta-analysis approach combining the analysis of microarrays and the use of databases for annotation. The STRING database was utilised to construct a protein-protein interaction network focused on extracellular and transcription factor components contained within the assembled transcriptome. This interactome was structurally studied and filtered to identify a short list of 92 candidate proteins, which may regulate hESC stemness. Conclusion. We hypothesise that this list of proteins, either connecting extracellular components with transcriptional networks, or with hub or bottleneck properties, may contain proteins likely to be involved in determining stemness.
    Language English
    Publishing date 2014-10-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703241-3
    ISSN 2167-8359
    ISSN 2167-8359
    DOI 10.7717/peerj.618
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The heparin-binding proteome in normal pancreas and murine experimental acute pancreatitis.

    Nunes, Quentin M / Su, Dunhao / Brownridge, Philip J / Simpson, Deborah M / Sun, Changye / Li, Yong / Bui, Thao P / Zhang, Xiaoying / Huang, Wei / Rigden, Daniel J / Beynon, Robert J / Sutton, Robert / Fernig, David G

    PloS one

    2019  Volume 14, Issue 6, Page(s) e0217633

    Abstract: Acute pancreatitis (AP) is acute inflammation of the pancreas, mainly caused by gallstones and alcohol, driven by changes in communication between cells. Heparin-binding proteins (HBPs) play a central role in health and diseases. Therefore, we used ... ...

    Abstract Acute pancreatitis (AP) is acute inflammation of the pancreas, mainly caused by gallstones and alcohol, driven by changes in communication between cells. Heparin-binding proteins (HBPs) play a central role in health and diseases. Therefore, we used heparin affinity proteomics to identify extracellular HBPs in pancreas and plasma of normal mice and in a caerulein mouse model of AP. Many new extracellular HBPs (360) were discovered in the pancreas, taking the total number of HBPs known to 786. Extracellular pancreas HBPs form highly interconnected protein-protein interaction networks in both normal pancreas (NP) and AP. Thus, HBPs represent an important set of extracellular proteins with significant regulatory potential in the pancreas. HBPs in NP are associated with biological functions such as molecular transport and cellular movement that underlie pancreatic homeostasis. However, in AP HBPs are associated with additional inflammatory processes such as acute phase response signalling, complement activation and mitochondrial dysfunction, which has a central role in the development of AP. Plasma HBPs in AP included known AP biomarkers such as serum amyloid A, as well as emerging targets such as histone H2A. Other HBPs such as alpha 2-HS glycoprotein (AHSG) and histidine-rich glycoprotein (HRG) need further investigation for potential applications in the management of AP. Pancreas HBPs are extracellular and so easily accessible and are potential drug targets in AP, whereas plasma HBPs represent potential biomarkers for AP. Thus, their identification paves the way to determine which HBPs may have potential applications in the management of AP.
    MeSH term(s) Animals ; Biomarkers/blood ; Disease Models, Animal ; Heparin/genetics ; Homeostasis ; Humans ; Mice ; Pancreas/metabolism ; Pancreas/pathology ; Pancreatitis/blood ; Pancreatitis/genetics ; Pancreatitis/pathology ; Protein Binding/genetics ; Proteins/genetics ; Proteome/genetics ; Proteomics/methods ; Serum Amyloid A Protein/metabolism ; alpha-2-HS-Glycoprotein/genetics
    Chemical Substances Ahsg protein, mouse ; Biomarkers ; Proteins ; Proteome ; Serum Amyloid A Protein ; alpha-2-HS-Glycoprotein ; histidine-rich proteins ; Heparin (9005-49-6)
    Language English
    Publishing date 2019-06-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0217633
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Author Correction: Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis.

    Xie, Si-Ming / Xiong, Jun-Jie / Liu, Xue-Ting / Chen, Hong-Yu / Iglesia-García, Daniel / Altaf, Kiran / Bharucha, Shameena / Huang, Wei / Nunes, Quentin M / Szatmary, Peter / Liu, Xu-Bao

    Scientific reports

    2018  Volume 8, Issue 1, Page(s) 6364

    Abstract: A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper. ...

    Abstract A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.
    Language English
    Publishing date 2018-04-18
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-018-24787-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Prognostic significance of pre-operative C-reactive protein and the neutrophil-lymphocyte ratio in resectable pancreatic cancer: a systematic review.

    Stevens, Lewis / Pathak, Samir / Nunes, Quentin M / Pandanaboyana, Sanjay / Macutkiewicz, Christian / Smart, Neil / Smith, Andrew M

    HPB : the official journal of the International Hepato Pancreato Biliary Association

    2015  Volume 17, Issue 4, Page(s) 285–291

    Abstract: Background: Better pre-operative risk stratification may improve patient selection for pancreatic resection in pancreatic cancer. C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) have demonstrated prognostic value in some cancers. The ... ...

    Abstract Background: Better pre-operative risk stratification may improve patient selection for pancreatic resection in pancreatic cancer. C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) have demonstrated prognostic value in some cancers. The role of CRP and NLR in predicting outcome in pancreatic cancer after curative resection is not well established.
    Methods: An electronic search of MEDLINE, EMBASE and CINAHL was performed to identify studies assessing survival in patients after pancreatic cancer resection with high or low pre-operative CRP or NLR. Systematic review was undertaken using the PRISMA protocol.
    Results: In total, 327 studies were identified with 10 reporting on survival outcomes after a pancreatic resection in patients with high or low CRP, NLR or both. All but one paper showed a trend of lower inflammatory markers in patients with longer survival. Three studies from six showed low CRP to be independently associated with increased survival and two studies of eight showed the same for NLR. All studies were retrospective cohort studies of low to moderate quality.
    Discussion: Inflammatory markers might prove useful guides to the management of resectable pancreatic cancer but, given the poor quality of evidence, further longitudinal studies are required before incorporating pre-operative inflammatory markers into clinical decision making.
    MeSH term(s) Biomarkers, Tumor/blood ; C-Reactive Protein/analysis ; Humans ; Inflammation Mediators/blood ; Lymphocyte Count ; Lymphocytes ; Neutrophils ; Pancreatic Neoplasms/blood ; Pancreatic Neoplasms/immunology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Patient Selection ; Predictive Value of Tests ; Prognosis ; Risk Factors
    Chemical Substances Biomarkers, Tumor ; Inflammation Mediators ; C-Reactive Protein (9007-41-4)
    Language English
    Publishing date 2015-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1111/hpb.12355
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Major hepatectomy in Bismuth types I and II hilar cholangiocarcinoma.

    Xiong, Junjie / Nunes, Quentin M / Huang, Wei / Wei, Ailin / Ke, Nengwen / Mai, Gang / Liu, Xubao / Hu, Weiming

    The Journal of surgical research

    2015  Volume 194, Issue 1, Page(s) 194–201

    Abstract: Background: Historically, hilar bile duct resection (HBDR) has been regarded as the choice of treatment for Bismuth types I and II hilar cholangiocarcinoma (HCCA). The present study aimed to evaluate the advantages of major liver resection (MLR) in the ... ...

    Abstract Background: Historically, hilar bile duct resection (HBDR) has been regarded as the choice of treatment for Bismuth types I and II hilar cholangiocarcinoma (HCCA). The present study aimed to evaluate the advantages of major liver resection (MLR) in the treatment of patients with Bismuth types I and II HCCA when compared with HBDR.
    Materials and methods: Between January 2005 and September 2012, in total, 52 patients with Bismuth types I and II HCCA who underwent HBDR alone or MLR were included for retrospective analysis. The intraoperative outcomes, postoperative complications, and oncological outcomes including recurrence and overall or disease-free survival rate were compared.
    Results: The MLR group had significantly higher curative resection rates compared with the HBDR group (95% versus 62.5%, P = 0.021) and lower tumor recurrence (28% versus 63%, P = 0.049), albeit with longer operating time (395.5 ± 112.7 versus 270.9 ± 98.8, P < 0.001), and higher blood transfusion requirements (70% versus 16%, P < 0.001). MLR resulted in significantly higher overall postoperative morbidity (70% versus 34.4%, P = 0.012), compared with HBDR alone. When restricted to R0 resections for all the procedures, MLR significantly increased the overall postoperative survival rate compared with the HBDR group (P = 0.016); the overall survival rate at 1, 3 y was 68.4% and 60.8% for MLR group and 59.6% and 21.9% for HBDR group, respectively. Also, the disease-free survival rate was significantly higher in patients who underwent MLR, as compared with those who underwent HBDR (53.2% versus 0% at 3 y, P = 0.005).
    Conclusions: Our study has shown that MLR results in higher curative resections, fewer recurrences, and increased postoperative survival rate for Bismuth types I and II HCCA as compared with HBDR alone. However, there is a need for well-designed, multicenter studies to be undertaken to better inform a decision on the standard treatment for Bismuth types I and II HCCA.
    MeSH term(s) Aged ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery ; Female ; Hepatectomy ; Humans ; Length of Stay ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2014.10.029
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Gangrene due to axial torsion of a Giant Meckel's Diverticulum containing multiple stones in the lumen: a case report.

    Nunes, Quentin M / Hotouras, Alex / Tiwari, Sandeep / Sheth, Anuradha

    Cases journal

    2009  Volume 2, Page(s) 7141

    Abstract: Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction and inflammation. Gangrene due to axial torsion and enteroliths of a ... ...

    Abstract Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction and inflammation. Gangrene due to axial torsion and enteroliths of a Meckel's diverticulum are the rarest complications that have been reported in the literature. We report a case of gangrene due to axial torsion of giant Meckel's diverticulum with multiple stones in its lumen.
    Language English
    Publishing date 2009-05-18
    Publishing country England
    Document type Case Reports
    ZDB-ID 2431132-7
    ISSN 1757-1626 ; 1757-1626
    ISSN (online) 1757-1626
    ISSN 1757-1626
    DOI 10.1186/1757-1626-2-7141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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