Philip Keeling

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The relationship between cytomegalovirus (CMV) infection and cardiac allograft rejection is controversial, some authors reporting a significant association, others not, on the basis of the results of conventional virological diagnosis by culture or serology. This problem was reinvestigated in 88 patients using a semi-quantitative nest polymerase chain(More)
OBJECTIVES To explore paramedics' attitudes to administering prehospital thrombolysis (PHT). METHOD In-depth interviews with 20 paramedics were recorded and transcribed and analysed for emergent themes using the constant comparative method. RESULTS Although there was a will to provide PHT because of its benefits to patients, its associated risks,(More)
Thirty-seven patients have undergone transhiatal oesophagectomy for tumours in the upper (n = 3), middle (n = 12) and lower (n = 22) thirds of the oesophagus. Four tumours arose in association with Barrett's oesophagus. Dysphagia for solids was the presenting symptom in 95% of cases. Orringer's technique was used and all cervical anastomoses were hand-sewn.(More)
Enteroviruses cause significant illness in man but viral diagnosis is problematic. Enterovirus-specific IgM tests have been developed but due to the difficulties of obtaining reliable control sera the interpretation of assay data remains mainly arbitrary and empirical. The present study was undertaken to assess the reliability of such assays by comparing(More)
Advocates of transhiatal oesophagectomy warn of the danger of tracheal injury resulting from the blind dissection of tumours of the upper and middle thirds of the oesophagus when the tumour has invaded the membranous part of the trachea. We report an unusual cause of tracheal injury at transhiatal oesophagectomy due to dissection at the level of the(More)
All patients presenting to a regional unit with oesophageal carcinoma over a twelve month period are reviewed and the role of transhiatal oesophagectomy for tumours of the middle third of the intrathoracic oesophagus is evaluated. Of the 28 cases of oesophageal carcinoma, 22 (78%) were resected by blunt transhiatal oesophagectomy, the remaining six (22%)(More)
INTRODUCTION Patients with cardiovascular disease are living longer and are more frequently accessing healthcare resources. The Evaluation of the Methods and Management of Acute Coronary Events (EMMACE)-3 national study is designed to improve understanding of the effect of quality of care on health-related outcomes for patients hospitalised with acute(More)