zot - 150824.bib

@article{balentine_obesity_2011,
	title = {Obesity does not increase complications following pancreatic surgery},
	volume = {170},
	issn = {1095-8673},
	doi = {10.1016/j.jss.2011.03.048},
	abstract = {{BACKGROUND}: Recent evidence suggests that the quantity of intra-abdominal fat may be a more important predictor of postoperative complications than body mass index ({BMI}). We hypothesized that increased intra-abdominal fat would be associated with longer operations, increased blood loss, more complications, and prolonged length of stay after pancreatic resection.
{METHODS}: Retrospective cohort study. Intra-abdominal fat was quantified using {CT} imaging, and patients were divided into three groups (low, moderate, high). Unconditional multiple logistic regression was used to evaluate the relationship between obesity measures and complications.
{RESULTS}: Between 2002 and 2010, 255 patients underwent pancreaticoduodenectomy or distal pancreatectomy, and 201 had preoperative {CT} imaging available for review. Operative time was significantly prolonged in patients with high quantities of intra-abdominal fat compared with those with low fat quantity (median 438 versus 354 min, P {\textless} 0.05), while {BMI} was not associated with changes in duration of surgery. Neither obesity defined by {BMI} ({OR} 0.90, 95\% {CI} 0.36-2.21) nor visceral fat ({OR} 1.20, 95\% {CI} 0.46-3.16) significantly predicted risk of complications. Median length of stay was similar in patients who were obese by {BMI} (7 versus 7.5 d) or amount of intra-abdominal fat (7 d).
{CONCLUSIONS}: Intra-abdominal fat was a better predictor than {BMI} for determining length of procedure. However, in contrast to previous studies evaluating abdominal surgery, neither {BMI} nor intra-abdominal fat significantly predicted risk of complication or length of hospital stay. Further research is needed to determine the best measure to assist in risk prediction of obese patients undergoing pancreatic surgery.},
	pages = {220--225},
	number = {2},
	journaltitle = {The Journal of Surgical Research},
	shortjournal = {J. Surg. Res.},
	author = {Balentine, Courtney J. and Enriquez, Jose and Cruz, Guillermina and Hodges, Sally and Bansal, Vivek and Jo, Eunji and Ahern, Charlotte and Sansgiry, Shubhada and Petersen, Nancy and Silberfein, Eric and Brunicardi, F. Charles and Berger, David H. and Fisher, William},
	date = {2011-10},
	pmid = {21514600},
	keywords = {Abdominal Fat, Adult, Aged, Body Mass Index, Cohort Studies, Comorbidity, Female, Humans, length of stay, Male, Middle Aged, Obesity, Abdominal, Pancreatic Diseases, Pancreaticoduodenectomy, postoperative complications, Predictive Value of Tests, Retrospective Studies, Risk Factors}
}

@article{richards_prognostic_2011,
	title = {The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review.},
	volume = {7},
	doi = {10.2217/fon.11.99},
	abstract = {{BACKGROUND}: Tumor necrosis has been proposed as a marker of poor prognosis in a variety of solid organ malignant tumor types. Despite this, its assessment has yet to be adopted into routine clinical practice and the mechanisms underpinning  the relationships with cancer outcome are undetermined. {AIMS}: To examine the prognostic value of tumor necrosis in solid organ malignant disease and to summarize the known clinical, pathological and inflammatory associations. {METHODS}: A systematic review of data published from 1966-2011 was undertaken by two reviewers according to a predefined protocol. A total of 57 independent studies relating to renal (n = 23), breast (n = 13), lung (n = 7), colorectal (n  = 5) and other solid tumors (n = 9) were included in the final review. {CONCLUSION}: There is now a substantial body of evidence confirming the prognostic value of tumor necrosis in solid organ malignant disease. There are consistent associations between necrosis and the presence of other high-risk tumor characteristics but the survival impact appears to be independent of pathological stage. We propose that relationships with the host inflammatory response, both local and systemic, may explain the influence of tumor necrosis on cancer outcome.},
	pages = {1223--1235},
	number = {10},
	journaltitle = {Future oncology (London, England)},
	shortjournal = {Future Oncol},
	author = {Richards, Colin H. and Mohammed, Zahra and Qayyum, Tahir and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-10},
	pmid = {21992733},
	keywords = {Humans, Necrosis, Neoplasms/mortality/*pathology, Prognosis}
}

@article{park_evaluation_2015,
	title = {Evaluation of a tumor microenvironment-based prognostic score in primary operable colorectal cancer.},
	volume = {21},
	rights = {(c)2014 American Association for Cancer Research.},
	doi = {10.1158/1078-0432.CCR-14-1686},
	abstract = {{PURPOSE}: The tumor microenvironment is recognized as an important determinant of  progression and outcome in colorectal cancer. The aim of the present study was to evaluate a novel tumor microenvironment-based prognostic score, based on histopathologic assessment of the tumor inflammatory cell infiltrate and tumor stroma, in patients with primary operable colorectal cancer. {EXPERIMENTAL} {DESIGN}: Using routine pathologic sections, the tumor inflammatory cell infiltrate and stroma were assessed using Klintrup-Makinen ({KM}) grade and tumor stroma percentage ({TSP}), respectively, in 307 patients who had undergone elective resection for stage I-{III} colorectal cancer. The clinical utility of a cumulative score based on these characteristics was examined. {RESULTS}: On univariate analysis, both weak {KM} grade and high {TSP} were associated with reduced survival ({HR}, 2.42; P = 0.001 and {HR}, 2.05; P = 0.001, respectively). A cumulative score based on these characteristics, the Glasgow Microenvironment Score ({GMS}), was associated with survival ({HR}, 1.93; 95\% confidence interval, 1.36-2.73; P {\textless} 0.001), independent of {TNM} stage and venous invasion (both P {\textless} 0.05). {GMS} stratified patients in to three prognostic groups: strong {KM} ({GMS} = 0), weak {KM}/low {TSP} ({GMS} = 1), and weak {KM}/high {TSP} ({GMS} = 2), with 5-year survival of 89\%, 75\%, and 51\%, respectively (P {\textless} 0.001). Furthermore, {GMS} in combination with node involvement, venous invasion, and mismatch repair status further stratified},
	pages = {882--888},
	number = {4},
	journaltitle = {Clinical cancer research : an official journal of the American Association for Cancer Research},
	shortjournal = {Clin Cancer Res},
	author = {Park, James H. and {McMillan}, Donald C. and Powell, Arfon G. and Richards, Colin H. and Horgan, Paul G. and Edwards, Joanne and Roxburgh, Campbell S. D.},
	date = {2015-02-15},
	pmid = {25473000}
}

@article{cirocchi_minimally_2013,
	title = {Minimally invasive necrosectomy versus conventional surgery in the treatment of infected pancreatic necrosis: a systematic review and a meta-analysis of comparative studies},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23386143},
	abstract = {Aim: The purpose of this meta-analysis and systematic review is to compare minimally invasive necrosectomy ({MIN}) versus open necrosectomy ({ON}) surgery for infected necrosis of acute pancreatitis. {METHODS}: One randomized controlled trial and 3 clinical controlled trials were selected, with a total of 336 patients (215 patients who underwent {MIN} and 121 patients underwent {ON}) included after searching in the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, {BioMed} Central, Science Citation Index (from inception to August 2011), Greynet, {SIGLE} (System for Information on Grey Literature in Europe), National Technological Information Service, British Library Integrated catalogue, and the Current Controlled Trials. Statistical analysis is performed using the odds ratio ({OR}) and weighted mean difference with 95\% confidence interval ({CI}). {RESULTS}: After the analysis of the data amenable to polling, significant advantages were found in favor of the {MIN} in terms of: incidence of multiple organ failure ({OR}, 0.16; 95\% {CI}, 0.06-0.39) (P {\textless} 0.0001), incisional hernias ({OR}, 0.23; 95\% {CI}, 0.06-0.90) (P = 0.03), new-onset diabetes ({OR}, 0.32; 95\% {CI}, 0.12-0.88) (P = 0.03), and for the use of pancreatic enzymes ({OR}, 0.005; 95\% {CI}, 0.04-0.57) (P = 0.005). No differences were found in terms of mortality rate ({OR}, 0.43; 95\% {CI}, 0.18-1.05) (P = 0.06), multiple systemic complications ({OR}, 0.34; 95\% {CI}, 0.01-8.60) (P = 0.51), surgical reintervention for further necrosectomy ({OR}, 0.16; 95\% {CI}, 0.00-3.07) (P = 0.19), intra-abdominal bleeding ({OR}, 0.79; 95\% {CI}, 0.41-1.50) (P = 0.46), enterocutaneous fistula or perforation of visceral organs ({OR}, 0.52; 95\% {CI}, 0.27-1.00) (P = 0.05), pancreatic fistula ({OR}, 0.66; 95\% {CI}, 0.30-1.46) (P = 0.30), and surgical reintervention for postoperative complications ({OR}, 0.50; 95\% {CI}, 0.23-1.08) (P = 0.08). {CONCLUSIONS}: The lack of comparative studies and high heterogeneity of the data present in the literature did not permit to draw a definitive conclusion on this topic. The results of the present meta-analysis might be helpful to design future high-powered randomized studies that compare {MIN} with {ON} for acute necrotizing pancreatitis.},
	pages = {8--20},
	number = {1},
	journaltitle = {Surg Laparosc Endosc Percutan Tech},
	author = {Cirocchi, Roberto and Trastulli, Stefano and Desiderio, Jacopo and Boselli, Carlo and Parisi, Amilcare and Noya, Giuseppe and Falconi, Massimo},
	date = {2013-02}
}

@article{wouters_systemic_2009,
	title = {Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease: Is There a Connection?},
	volume = {6},
	issn = {1546-3222},
	url = {http://pats.atsjournals.org/cgi/doi/10.1513/pats.200907-073DP},
	doi = {10.1513/pats.200907-073DP},
	shorttitle = {Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease},
	pages = {638--647},
	number = {8},
	journaltitle = {Proceedings of the American Thoracic Society},
	author = {Wouters, E. F. M. and Reynaert, N. L. and Dentener, M. A. and Vernooy, J. H. J.},
	urldate = {2015-04-28},
	date = {2009-12-15},
	langid = {english},
	file = {Wouters et al. - 2009 - Systemic and Local Inflammation in Asthma and Chro.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6UGRIMGT\\Wouters et al. - 2009 - Systemic and Local Inflammation in Asthma and Chro.pdf:application/pdf}
}

@article{kubota_prognostic_2014,
	title = {Prognostic significance of complications after curative surgery for gastric cancer},
	volume = {21},
	issn = {1534-4681},
	doi = {10.1245/s10434-013-3384-9},
	abstract = {{BACKGROUND}: Postoperative complications such as anastomotic leakage were reported to be a major independent prognostic factor for long-term survival in gastrointestinal malignancies. This study sought to clarify the prognostic significance of postoperative inflammatory complications specifically for patients with gastric cancer.
{METHODS}: This study included 1,395 patients who underwent curative resection for gastric cancer from 2005 to 2008. Complications were evaluated according to the Clavien-Dindo classification. Overall survival ({OS}) and disease-specific mortality ({DSM}) were compared between complication and no-complication groups. Presence of complications was modeled by the Cox proportional hazard model for {OS} and the Fine and Gray competing risk regression model for {DSM} to assess the correlation between complication and prognosis.
{RESULTS}: The median follow-up time was 3.1 years. Two hundred seven patients (14.8 \%) had complications of grade 2 or higher. Of 131 patients who died within this period, 87 died of gastric cancer. The 3-year {OS} in the complication group was 84.1 \% compared to 93.1 \% in the no-complication group (P {\textless} 0.0001). The cumulative incidence of {DSM} was also significantly worse in patients with complications (P {\textless} 0.0001). Multivariate analysis identified the same significant increasing risk of complication for both {OS} (hazard ratio 1.88; 95 \% confidence interval 1.26-2.80) and {DSM} (hazard ratio 1.90; 95 \% confidence interval 1.19-3.02).
{CONCLUSIONS}: Postoperative complications that can cause prolonged inflammation have an obvious impact not only on the {OS} but also on the {DSM} of patients with gastric cancer even if the tumor is resected curatively.},
	pages = {891--898},
	number = {3},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Kubota, Takeshi and Hiki, Naoki and Sano, Takeshi and Nomura, Shogo and Nunobe, Souya and Kumagai, Koshi and Aikou, Susumu and Watanabe, Ryohei and Kosuga, Toshiyuki and Yamaguchi, Toshiharu},
	date = {2014-03},
	pmid = {24254205},
	keywords = {Adenocarcinoma, Aged, Female, Follow-Up Studies, Gastrectomy, Humans, Lymph Node Excision, Male, Neoplasm Staging, Oncology, postoperative complications, prognosis, Stomach Neoplasms, surgery, Surgical Oncology, Survival Rate},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Q6UDCN43\\Kubota et al. - 2013 - Prognostic Significance of Complications after Cur.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NWI4S8GK\\10.html:text/html}
}

@article{wang_preoperative_2008,
	title = {Preoperative biliary drainage for obstructive jaundice},
	issn = {1469-493X},
	doi = {10.1002/14651858.CD005444.pub2},
	abstract = {{BACKGROUND}: Obstruction in the biliary drainage system causes a rise in serum bilirubin levels (obstructive jaundice). Studies have shown that surgery for severe obstructive jaundice is associated with high peri-operative mortality and morbidity. Jaundice has been considered as a potential risk factor for poor outcome, and pre-operative biliary drainage has been proposed as a method of reversing the pathophysiologic disturbance seen in patients with obstructive jaundice.
{OBJECTIVES}: To determine the benefits and harms of pre-operative biliary drainage (ie, endoscopic sphincterotomy with stent insertion or percutaneous transhepatic biliary drainage) in obstructive jaundice.
{SEARCH} {STRATEGY}: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register ({CHBG}), the Cochrane Central Register of Controlled Clinical Trials ({CENTRAL}) in The Cochrane Library, {MEDLINE}, {EMBASE}, the Chinese {BioMedical} Literature on disc ({CBM} disc), and the Chinese Medical Current Contents ({CMCC}). All databases were searched up to October 2006.
{SELECTION} {CRITERIA}: We considered for inclusion randomised clinical trials comparing biliary drainage followed by surgery and direct surgery performed for obstructive jaundice.
{DATA} {COLLECTION} {AND} {ANALYSIS}: We collected the available data on the characteristics of the trial, methodological quality of the trials, mortality, morbidity, and hospital stay as reported in each trial. We analysed the data with both the fixed-effect and the random-effects models, using {RevMan} Analysis. For each outcome, we calculated the odds ratio ({OR}) with 95\% confidence intervals ({CI}) based on intention-to-treat analysis.
{MAIN} {RESULTS}: Five trials with 320 patients (160 in each group) were included. Four trials (n = 235) compared percutaneous transhepatic biliary drainage with direct surgery, and one trial (n = 85) compared pre-operative endoscopic drainage with direct surgery. All trials were of low methodological quality. There was no significant difference in mortality ({OR} 1.14, 95\% {CI} 0.60 to 2.10) between the pre-operative biliary drainage group and the direct surgery group. No significant difference was found in mortality ({OR} 1.16, 95\% {CI} 0.56 to 2.41), overall morbidity ({OR} 1.35, 95\%{CI} 0.48 to 3.83), and in different complications between the percutaneous transhepatic biliary drainage group and the direct surgery group. The trial comparing pre-operative endoscopic drainage and direct surgery showed no significant difference in mortality ({OR} 1.09, 95\% {CI} 0.32 to 3.68), but found higher morbidity in the endoscopic drainage group. The overall hospital stay was 8 to 17 days shorter in the direct surgery group.
{AUTHORS}' {CONCLUSIONS}: Our analyses neither supports nor refutes pre-operative biliary drainage for patients with obstructive jaundice needing surgery. In some specific lesion site it may cause more complications. Pre-operative biliary drainage also prolonged hospital stay and increased cost. However, the strength of evidence is low because of the poor quality of the included trials. More rigorously designed randomised clinical trials with larger sample size and advanced techniques and drugs are needed.},
	pages = {CD005444},
	number = {3},
	journaltitle = {The Cochrane Database of Systematic Reviews},
	shortjournal = {Cochrane Database Syst Rev},
	author = {Wang, Qin and Gurusamy, Kurinchi Selvan and Lin, He and Xie, Xiaodong and Wang, Chaohua},
	date = {2008},
	pmid = {18677779},
	keywords = {Drainage, Humans, {JAUNDICE}, Obstructive, Randomized Controlled Trials as Topic},
	file = {Wang et al. - 2008 - Preoperative biliary drainage for obstructive jaun.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MTWS6KFS\\Wang et al. - 2008 - Preoperative biliary drainage for obstructive jaun.pdf:application/pdf}
}

@article{sitges-serra_body_1992,
	title = {Body water compartments in patients with obstructive jaundice},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1611451},
	abstract = {To elucidate the pathogenesis of renal dysfunction associated with obstructive jaundice, body water compartments were measured using a multi-isotope dilution technique in ten patients with biliary tract obstruction and in ten control subjects matched for age, sex, weight, height and body surface area. Expressed as a fraction of body-weight, total body water was reduced in jaundiced patients (41.8 versus 46.2 per cent, P less than 0.02). Extracellular water volume was also reduced in patients with jaundice (20.3 versus 24.3 per cent, P less than 0.003) owing to a reduction of the interstitial space (16.1 versus 19.5 per cent, P less than 0.004) and, to a lesser degree, of the plasma volume (4.2 versus 4.8 per cent, P = 0.1). There was a close correlation in jaundiced patients between plasma volume and the creatinine clearance rate (r2 = 0.56, P less than 0.02) and between plasma volume and extracellular volume (r2 = 0.77, P less than 0.0001). Extracellular volume in such patients also correlated with the percentage weight loss (r2 = 0.42, P = 0.04). Obstructive jaundice is associated with a contracted extracellular water compartment, although extracellular water, as a percentage of body-weight, increased in proportion to the body-weight lost. Reduction of the interstitial volume and a marginally reduced plasma volume may be determinant factors in the pathogenesis of the renal and haemodynamic disturbances observed in patients with biliary tract obstruction.},
	pages = {553--6},
	number = {6},
	journaltitle = {Br J Surg},
	author = {Sitges-Serra, A and Carulla, X and Piera, C and Martínez-Ródenas, F and Franch, G and Pereira, J and Gubern, J M},
	date = {1992-06}
}

@article{cunningham_complications_1998,
	title = {Complications requiring reoperation following pancreatectomy},
	volume = {24},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9746886},
	abstract = {In this series, the overall reoperative rate following pancreatic surgery is 9\%. Complications following pancreatectomy that require reoperation fall into four categories: hemorrhage, infectious, delayed gastric emptying, and anastomotic leak. A delay in the management of these types of complications can be fatal.},
	pages = {23--9},
	number = {1},
	journaltitle = {Int J Pancreatol},
	author = {Cunningham, J D and Weyant, M T and Levitt, M and Brower, S T and Aufses, A H Jr},
	date = {1998-08}
}

@article{isenmann_bacterial_1999,
	title = {Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis},
	volume = {86},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10460637},
	abstract = {The risk factors predisposing to organ failure in patients with necrotizing pancreatitis remain unclear. The relationship between the extent of pancreatic necrosis, the presence of infection and the incidence of organ failure was analysed.},
	pages = {1020--4},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Isenmann, R and Rau, B and Beger, H G},
	date = {1999-08}
}

@article{buttenschoen_effect_2010,
	title = {Effect of major abdominal surgery on the host immune response to infection},
	volume = {23},
	issn = {1473-6527},
	doi = {10.1097/QCO.0b013e32833939cb},
	abstract = {{PURPOSE} {OF} {REVIEW}: The present review summarizes key studies on the effects of major abdominal surgery on the host response to infection published during the last 18 months.
{RECENT} {FINDINGS}: Surgical trauma causes stereotyped systemic proinflammatory and compensatory anti-inflammatory reactions. It is leukocyte reprogramming rather than general immune suppression. The list of recent findings is long. Preoperative infectious challenge was found to increase survival. Obesity is associated with increased production of interleukin-17A in peritonitis. Abdominal surgery alters expression of toll-like receptors ({TLRs}). The acute phase reaction down-regulates the transcription factor carbohydrate response element binding protein. Myosin light chain kinase activation is a final pathway of acute tight junction regulation of gut barrier and zonula occludens 1 protein is an essential effector. The brain is involved in regulating the immune and gut system. Elimination of lipopolysaccharide is challenging. Th1/Th2 ratio is lowered in patients with postoperative complications. Cholinergic anti-inflammatory pathways can inhibit tissue damage. The new substance {PXL}01 prevents adhesions. Postoperative infection causes incisional hernias. Hypothermia reduced human leukocyte antigen {DR} surface expression and delayed tumor necrosis factor clearance. Systems biology identified interferon regulatory factor 3 as the negative regulator of {TLR} signaling. Protective immunity could contribute defeating surgical infections.
{SUMMARY}: Systemic inflammation is the usual response to trauma. All organs seem to be involved and linked up in cybernetic systems aiming at reconstitution of homeostasis. Although knowledge is still fragmentary, it is already difficult to integrate known facts and new technologies are required for information processing. Defining criteria to develop therapeutic strategies requires much more insight into molecular mechanisms and cybernetics of organ systems.},
	pages = {259--267},
	number = {3},
	journaltitle = {Current Opinion in Infectious Diseases},
	shortjournal = {Curr. Opin. Infect. Dis.},
	author = {Buttenschoen, Klaus and Fathimani, Kamran and Buttenschoen, Daniela Carli},
	date = {2010-06},
	pmid = {20375890},
	keywords = {Abdomen, Humans, Immune System, Infection},
	file = {Buttenschoen et al. - 2010 - Effect of major abdominal surgery on the host immu.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RIQBAVCK\\Buttenschoen et al. - 2010 - Effect of major abdominal surgery on the host immu.pdf:application/pdf}
}

@article{phypers_test-retest_2011,
	title = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients: Oxygen uptake efficiency slope},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2011.06714.x},
	doi = {10.1111/j.1365-2044.2011.06714.x},
	shorttitle = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients},
	pages = {659--666},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Phypers, B. J. and Robiony-Rogers, D. and Pickering, R. M. and Garden, A. L.},
	urldate = {2014-01-27},
	date = {2011-08},
	file = {Phypers et al. - 2011 - Test-retest reliability of the oxygen uptake effic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BW2FBN2Z\\Phypers et al. - 2011 - Test-retest reliability of the oxygen uptake effic.pdf:application/pdf}
}

@article{reisinger_sarcopenia_2015,
	title = {Sarcopenia is associated with an increased inflammatory response to surgery in colorectal cancer},
	issn = {1532-1983},
	doi = {10.1016/j.clnu.2015.07.005},
	abstract = {{BACKGROUND} \& {AIMS}: Sarcopenia in gastrointestinal cancer has been associated with poor clinical outcome after surgery. The effect of low muscle mass on the inflammatory response to surgery has not been investigated, however skeletal muscle wasting in the context of cachexia is associated with a hyperinflammatory state at baseline. Knowledge on this matter can provide new insight into the detrimental effects of sarcopenia on postoperative recovery, possibly leading to novel therapeutic strategies. The aim of this study was to evaluate whether low muscle mass is associated with increased inflammation after resection of colorectal malignancies.
{METHODS}: Eighty-seven consecutive patients undergoing elective resection of a primary colorectal tumor were enrolled. Muscle mass was assessed on routine preoperative computed tomography ({CT}) scans using image analysis by Osirix(®) by measuring skeletal muscle at the third lumbar vertebra (L3) level. The effect of muscle mass on pre- and postoperative plasma concentrations of C-reactive protein ({CRP}), calprotectin and interleukin-6 ({IL}-6) was analyzed. Clinical outcome was assessed by {HARM} ({HospitAl} stay, Readmission, and Mortality) scores.
{RESULTS}: Skeletal muscle mass was not predictive of plasma concentrations of {CRP} and {IL}-6. However, low skeletal muscle mass was significantly predictive of high plasma concentrations of calprotectin on postoperative days ({POD}) 2 through 5, reaching highest significance on {POD}4 (regression beta, -6.06; 95\% confidence interval, -10.45 to -1.68; p = 0.007).
{CONCLUSIONS}: Low muscle mass in patients undergoing surgery for colorectal cancer was associated with an increased postoperative inflammatory response. This may be at least part of the explanation for the high incidence of postoperative complications in sarcopenic patients.},
	journaltitle = {Clinical Nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {Reisinger, Kostan W. and Derikx, Joep P. M. and van Vugt, Jeroen L. A. and Von Meyenfeldt, Maarten F. and Hulsewé, Karel W. and Olde Damink, Steven W. M. and Stoot, Jan H. M. B. and Poeze, Martijn},
	date = {2015-07-16},
	pmid = {26205321},
	keywords = {colorectal surgery, Complications, Inflammation, Sarcopenia},
	file = {1-s2.0-S026156141500179X-main.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\I7CU9PV9\\1-s2.0-S026156141500179X-main.pdf:application/pdf;ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\USSAVD67\\Reisinger et al. - Sarcopenia is associated with an increased inflamm.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IFGPR7S7\\S026156141500179X.html:text/html}
}

@article{hashimoto_is_2010,
	title = {Is an estimation of physiologic ability and surgical stress able to predict operative morbidity after pancreaticoduodenectomy?},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19430714},
	abstract = {Mortality rates after pancreaticoduodenectomy ({PD}) are below 4\% in high volume centers, although morbidity rates still remain high. Therefore, it is important to clarify a predictor associated with operative morbidity after {PD}. The estimation of physiologic ability and surgical stress (E-{PASS}) score has been developed for comparative audit in general surgical patients.},
	pages = {132--8},
	number = {2},
	journaltitle = {J Hepatobiliary Pancreat Sci},
	author = {Hashimoto, Daisuke and Takamori, Hiroshi and Sakamoto, Yasuo and Ikuta, Yoshiaki and Nakahara, Osamu and Furuhashi, Satoshi and Tanaka, Hiroshi and Watanabe, Masayuki and Beppu, Toru and Hirota, Masahiko and Baba, Hideo},
	date = {2010-03}
}

@article{halloran_complications_2002,
	title = {Complications of pancreatic cancer resection},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11979003},
	abstract = {Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20\% but is around 6\% or less in specialist centres. The overall complication rate even in specialist centres is 18-54\%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4\% for fistula, 9.9\% for delayed gastric emptying, 4.8\% for bleeding, 4.8\% for wound infection and 3.8\% for intra-abdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9\% with a mortality rate of 23 to 67\%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.},
	pages = {138--46},
	number = {2},
	journaltitle = {Dig Surg},
	author = {Halloran, C M and Ghaneh, P and Bosonnet, L and Hartley, M N and Sutton, R and Neoptolemos, J P},
	date = {2002}
}

@article{bone_immunologic_1996,
	title = {Immunologic Dissonance: A Continuing Evolution in Our Understanding of the Systemic Inflammatory Response Syndrome ({SIRS}) and the Multiple Organ Dysfunction Syndrome ({MODS})},
	volume = {125},
	issn = {0003-4819},
	url = {http://dx.doi.org/10.7326/0003-4819-125-8-199610150-00009},
	doi = {10.7326/0003-4819-125-8-199610150-00009},
	shorttitle = {Immunologic Dissonance},
	abstract = {Our current understanding of sepsis and multiple organ dysfunction needs to be revised, as the uniformly negative results of new therapies for these disorders suggest.Previous theories for the pathogenesis of these conditions are incomplete; reasons for this include the following. First, the surrogate models that have been used to study these disorders are not analogous to the clinical situation. Second, patients who have less severe manifestations of these diseases are often overlooked. And third, patients' preexisting conditions have not been taken into account. Considerable new evidence indicates that, in addition to a massive proinflammatory reaction, a compensatory anti-inflammatory response contributes to the onset of these disorders. At a local site of injury or infection and during the initial appearance of pro- and anti-inflammatory mediators in the circulation, the beneficial effects of these mediators outweigh their harmful effects. Only when the balance between these two forces is lost do these mediators become harmful. Sequelae of an unbalanced systemic proinflammatory reaction include shock, transudation into organs, and defects in coagulation. An unbalanced systemic compensatory anti-inflammatory response can result in anergy and immunosuppression. The proinflammatory and anti-inflammatory forces may ultimately reinforce each other, creating a state of increasingly destructive immunologic dissonance.},
	pages = {680--687},
	number = {8},
	journaltitle = {Annals of Internal Medicine},
	shortjournal = {Ann Intern Med},
	author = {Bone, Roger C.},
	urldate = {2015-05-25},
	date = {1996-10-15}
}

@article{montagnana_postoperative_2009,
	title = {Postoperative variation of C-reactive protein and procalcitonin in patients with gastrointestinal cancer},
	volume = {55},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19728551},
	abstract = {Despite substantial advances in radiotherapy, chemotherapy and immunotherapy, surgical management remains the standard of care, especially in patients with no evidence of distant metastases and who are fit for surgery. It is traditionally known, however, that patients undergoing surgery for gastrointestinal malignancies suffer from a high rate of infective complications and there is little information on the behavior of C-Reactive Protein ({CRP}) and procalcitonin ({PCT}) in these patients.},
	pages = {187--92},
	number = {5},
	journaltitle = {Clin Lab},
	author = {Montagnana, Martina and Minicozzi, Anna Maria and Salvagno, Gian Luca and Danese, Elisa and Cordiano, Claudio and De Manzoni, Giovanni and Guidi, Gian Cesare and Lippi, Giuseppe},
	date = {2009}
}

@article{pisters_effect_2001,
	title = {Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients},
	volume = {234},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11420482},
	abstract = {{OBJECTIVE}: To examine the relationship between preoperative biliary drainage and the morbidity and mortality associated with pancreaticoduodenectomy. {SUMMARY} {BACKGROUND} {DATA}: Recent reports have suggested that preoperative biliary drainage increases the perioperative morbidity and mortality rates of pancreaticoduodenectomy. {METHODS}: Peri-operative morbidity and mortality were evaluated in 300 consecutive patients who underwent pancreaticoduodenectomy. Univariate and multivariate logistic regression analyses were done to evaluate the relationship between preoperative biliary decompression and the following end points: any complication, any major complication, infectious complications, intraabdominal abscess, pancreaticojejunal anastomotic leak, wound infection, and postoperative death. {RESULTS}: Preoperative prosthetic biliary drainage was performed in 172 patients (57\%) (stent group), 35 patients (12\%) underwent surgical biliary bypass performed during prereferral laparotomy, and the remaining 93 patients (31\%) (no-stent group) did not undergo any form of preoperative biliary decompression. The overall surgical death rate was 1\% (four patients); the number of deaths was too small for multivariate analysis. By multivariate logistic regression, no differences were found between the stent and no-stent groups in the incidence of all complications, major complications, infectious complications, intraabdominal abscess, or pancreaticojejunal anastomotic leak. Wound infections were more common in the stent group than the no-stent group. {CONCLUSIONS}: Preoperative biliary decompression increases the risk for postoperative wound infections after pancreaticoduodenectomy. However, there was no increase in the risk of major postoperative complications or death associated with preoperative stent placement. Patients with extrahepatic biliary obstruction do not necessarily require immediate laparotomy to undergo pancreaticoduodenectomy with acceptable morbidity and mortality rates; such patients can be treated by endoscopic biliary drainage without concern for increased major complications and death associated with subsequent pancreaticoduodenectomy.},
	pages = {47--55},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Pisters, P W and Hudec, W A and Hess, K R and Lee, J E and Vauthey, J N and Lahoti, S and Raijman, I and Evans, D B},
	date = {2001-07}
}

@article{vitek_bilirubin_2009,
	title = {Bilirubin chemistry and metabolism; harmful and protective aspects},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19754364},
	abstract = {Unconjugated bilirubin ({UCB}), the principal mammalian bile pigment, is the end product of heme catabolism. Both belong to the superfamily of tetrapyrrolic compounds that serve multiple biological functions in animals and plants. Its six internal hydrogen bonds give {UCB} a unique structure responsible for its physico-chemical properties and biological effects. Like many weakly-polar, poorly-soluble compounds, {UCB} is transported in blood tightly bound to albumin, with less than 0.01\% of total bilirubin circulating in an unbound form (free bilirubin, Bf). This fraction governs the diffusion of {UCB} into tissues, and therefore Bf is responsible for both its beneficial and toxic effects on cells. Although, {UCB} was long thought to be a non-functional waste product, recent studies have shown that the antioxidant effects of mildly elevated serum bilirubin levels, as well as activation of heme oxygenase, may protect against diseases associated with oxidative stress, such as atherosclerosis. By contrast, markedly elevated serum {UCB} levels may cause severe neurological damage, especially in neonates. The regulation of cellular {UCB} content, by its conjugation, oxidation, and export, are, therefore of paramount importance to cellular health.},
	pages = {2869--83},
	number = {25},
	journaltitle = {Curr Pharm Des},
	author = {Vítek, Libor and Ostrow, J Donald},
	date = {2009}
}

@article{levett_cardiopulmonary_2015,
	title = {Cardiopulmonary exercise testing, prehabilitation, and Enhanced Recovery After Surgery ({ERAS})},
	volume = {62},
	issn = {0832-610X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315486/},
	doi = {10.1007/s12630-014-0307-6},
	abstract = {Purpose
This review evaluates the current and future role of cardiopulmonary exercise testing ({CPET}) in the context of Enhanced Recovery After Surgery ({ERAS}) programs.

Principal findings
There is substantial literature confirming the relationship between physical fitness and perioperative outcome in general. The few small studies in patients undergoing surgery within an {ERAS} program describe less fit individuals having a greater incidence of morbidity and mortality. There is evidence of increasing adoption of perioperative {CPET}, particularly in the {UK}. Although {CPET}-derived variables have been used to guide clinical decisions about choice of surgical procedure and level of perioperative care as well as to screen for uncommon comorbidities, the ability of {CPET}-derived variables to guide therapy and thereby improve outcome remains uncertain. Recent studies have reported a reduction in {CPET}-defined physical fitness following neoadjuvant therapies (chemo- and radio-therapy) prior to surgery. Preliminary data suggest that this effect may be associated with an adverse effect on clinical outcomes in less fit patients. Early reports suggest that {CPET}-derived variables can be used to guide the prescription of exercise training interventions and thereby improve physical fitness in patients prior to surgery (i.e., prehabilitation). The impact of such interventions on clinical outcomes remains uncertain.

Conclusions
Perioperative {CPET} is finding an increasing spectrum of roles, including risk evaluation, collaborative decision-making, personalized care, monitoring interventions, and guiding prescription of prehabilitation. These indications are potentially of importance to patients having surgery within an {ERAS} program, but there are currently few publications specific to {CPET} in the context of {ERAS} programs.},
	pages = {131--142},
	journaltitle = {Canadian Journal of Anaesthesia},
	shortjournal = {Can J Anaesth},
	author = {Levett, Denny Z. H. and Grocott, Michael P. W.},
	urldate = {2015-05-05},
	date = {2015},
	pmid = {25608638},
	pmcid = {PMC4315486},
	file = {Levett and Grocott - 2015 - Cardiopulmonary exercise testing, prehabilitation,.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MMIFNH4H\\Levett and Grocott - 2015 - Cardiopulmonary exercise testing, prehabilitation,.pdf:application/pdf}
}

@article{myers_effects_2010,
	title = {Effects of exercise training in patients with abdominal aortic aneurysm: preliminary results from a randomized trial},
	volume = {30},
	issn = {1932-751X},
	doi = {10.1097/HCR.0b013e3181ebf2db},
	shorttitle = {Effects of exercise training in patients with abdominal aortic aneurysm},
	abstract = {{OBJECTIVE}: No effective medical therapy exists for early abdominal aortic aneurysm ({AAA}) disease. Lower extremity exercise improves aortic hemodynamics and reduces inflammation, but the safety and efficacy of exercise training in {AAA} disease is unknown. As an interim analysis of our prospective, randomized, longitudinal trial of exercise for {AAA} suppression, we investigated whether subjects with early disease could safely achieve target metabolic and hemodynamic goals.
{METHODS}: One hundred eight participants were randomized to exercise training ({EX}) or usual care ({UC}). {EX} subjects participated in a combination of in-house and home exercise training, with efforts directed toward moderate daily exercise participation. Comparisons were made between {EX} and {UC} subjects who completed 1 year of follow-up (n = 26 and 31, respectively, mean age 72 ± 8 years). {EX} and {UC} groups were compared for safety, cardiopulmonary exercise test responses, weekly energy expenditure, and biometric indices.
{RESULTS}: No paradoxical increase in {AAA} growth rate or adverse clinical events occurred as a consequence of exercise training. {EX} participants expended an average of 2269 ± 1207 kcal/wk and increased exercise capacity (42\% increase in treadmill time, 24\% increase in estimated metabolic equivalents, P = .01 and .08 between groups, respectively). {EX} participants demonstrated a significant reduction in C-reactive protein and tended to reduce waist circumference and waist-to-hip ratio (P = .06 and .07, respectively).
{CONCLUSIONS}: Preliminary analyses suggest that exercise training is well tolerated and sustainable in small {AAA} subjects over 1 year. Despite age and comorbidities, exercising {AAA} subjects achieve meaningful exercise targets and significantly modify activity-dependent variables.},
	pages = {374--383},
	number = {6},
	journaltitle = {Journal of Cardiopulmonary Rehabilitation and Prevention},
	shortjournal = {J Cardiopulm Rehabil Prev},
	author = {Myers, Jonathan N. and White, Julie J. and Narasimhan, Balasubramanian and Dalman, Ronald L.},
	date = {2010-12},
	pmid = {20724934},
	keywords = {Aged, Analysis of Variance, Aneurysm, Dissecting, Aortic Aneurysm, Abdominal, Biomechanical Phenomena, C-Reactive Protein, Disease Progression, Electrocardiography, Energy Metabolism, Exercise Test, Exercise Therapy, Exercise Tolerance, Female, Heart Rate, Hemodynamics, Humans, Male, Risk Factors, Time Factors, Waist-Hip Ratio},
	file = {Myers et al. - 2010 - Effects of Exercise Training in Patients With Abdo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UGNKTHG8\\Myers et al. - 2010 - Effects of Exercise Training in Patients With Abdo.pdf:application/pdf}
}

@article{murray_preoperative_2007,
	title = {Preoperative shuttle walking testing and outcome after oesophagogastrectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17959592},
	abstract = {{BACKGROUND}: Objective assessment of cardiorespiratory reserve has been recommended before major surgery to identify patients with impaired oxygen delivery who may be at increased operative risk. Access to formal cardiopulmonary exercise ({CPX}) testing is limited outside larger centres. Following a previous audit of morbidity and mortality after oesophagectomy, we decided to add a simpler form of exercise test to our preoperative screen and review the outcomes. {METHODS}: Fifty-one patients who had surgical resection of an oesophageal cancer in our unit between April 2002 and April 2005 carried out an incremental shuttle walk exercise test before operation. Thirty-day outcome data were collected for each patient. {RESULTS}: Overall mortality in the group was 10\%. No patient who walked 350 m or more died within 30 days. Five of the eight patients who could not achieve this distance died and two others remained in the critical care unit at 30 days. {CONCLUSION}: Preoperative shuttle walk testing using a standard protocol appears to be a sensitive indicator of operative risk in this group of patients. The apparent threshold value of 350 m is consistent with previously reported measures of functional capacity obtained using formal {CPX} testing.},
	pages = {809--11},
	number = {6},
	journaltitle = {Br J Anaesth},
	author = {Murray, P and Whiting, P and Hutchinson, S P and Ackroyd, R and Stoddard, C J and Billings, C},
	date = {2007-12}
}

@article{garcia-plata_[influence_2005,
	title = {[Influence of preoperative biliary drainage on postoperative morbidity and mortality after pancreatoduodenectomy]},
	volume = {77},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16420918},
	abstract = {Pancreatoduodenectomy is the only potentially curative treatment for peripapillary tumors. However, postoperative mortality remains as high as 5\% and as many as 50\% of patients have postoperative morbidity. Preoperative endoscopic retrograde cholangiopancreatography and placement of a biliary drainage stent aim to achieve a precise diagnosis, reduce jaundice and improve the results of surgery for biliary malignancies, but the effectiveness of preoperative biliary drainage in the prevention of postoperative infections is controversial. A retrospective analysis was performed in a series of 58 patients with periampullary tumors who underwent pancreatoduodenectomy and the relationship between preoperative biliary drainage and postoperative complications was examined. Biliary drainage (25.8\%) before pancreatoduodenectomy was significantly associated with more frequent biliary and pancreatic anastomotic leakage (60\% with drainage versus 20.9\% without drainage), higher postoperative morbidity, and greater mean postoperative length of hospital stay (33.3 days with drainage versus 21.6 without drainage). No significant difference was found between the two groups in postoperative mortality at 30 days (13.7\%). The effectiveness of biliary drainage before surgery in patients with pancreatic and peripancreatic lesions has not been well established, but we believe that this procedure should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Prospective randomized studies are required to clarify the indications for preoperative biliary drainage in these patients.},
	pages = {203--7},
	number = {4},
	journaltitle = {Cir Esp},
	author = {García-Plata, Esther and Seco, Juan L and de la Plaza, María and Vidal, Oscar and Alvarez, Miguel A and Botín, Ignacio L and Santamaría, José L},
	date = {2005-04}
}

@article{van_santvoort_step-up_2010,
	title = {A step-up approach or open necrosectomy for necrotizing pancreatitis},
	volume = {362},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20410514},
	abstract = {Necrotizing pancreatitis with infected necrotic tissue is associated with a high rate of complications and death. Standard treatment is open necrosectomy. The outcome may be improved by a minimally invasive step-up approach.},
	pages = {1491--502},
	number = {16},
	journaltitle = {N Engl J Med},
	author = {van Santvoort, Hjalmar C and Besselink, Marc G and Bakker, Olaf J and Hofker, H Sijbrand and Boermeester, Marja A and Dejong, Cornelis H and van Goor, Harry and Schaapherder, Alexander F and van Eijck, Casper H and Bollen, Thomas L and van Ramshorst, Bert and Nieuwenhuijs, Vincent B and Timmer, Robin and Laméris, Johan S and Kruyt, Philip M and Manusama, Eric R and van der Harst, Erwin and van der Schelling, George P and Karsten, Tom and Hesselink, Eric J and van Laarhoven, Cornelis J and Rosman, Camiel and Bosscha, Koop and de Wit, Ralph J and Houdijk, Alexander P and van Leeuwen, Maarten S and Buskens, Erik and Gooszen, Hein G},
	date = {2010-04},
	file = {van Santvoort et al. - 2010 - A step-up approach or open necrosectomy for necrot.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\S3UHZKNK\\van Santvoort et al. - 2010 - A step-up approach or open necrosectomy for necrot.pdf:application/pdf}
}

@article{gabay_acute-phase_1999,
	title = {Acute-Phase Proteins and Other Systemic Responses to Inflammation},
	volume = {340},
	issn = {0028-4793},
	url = {http://dx.doi.org/10.1056/NEJM199902113400607},
	doi = {10.1056/NEJM199902113400607},
	abstract = {A large number of changes, distant from the site or sites of inflammation and involving many organ systems, may accompany inflammation. In 1930 interest was focused on these changes by the discovery of C-reactive protein (so named because it reacted with the pneumococcal C-polysaccharide) in the plasma of patients during the acute phase of pneumococcal pneumonia.1 Accordingly, these systemic changes have since been referred to as the acute-phase response,2 even though they accompany both acute and chronic inflammatory disorders. New acute-phase phenomena continue to be recognized, and the mechanisms mediating them are becoming better understood. This review summarizes much of . . .},
	pages = {448--454},
	number = {6},
	journaltitle = {New England Journal of Medicine},
	author = {Gabay, Cem and Kushner, Irving},
	urldate = {2015-08-21},
	date = {1999-02-11},
	pmid = {9971870},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GA7UZHUI\\Gabay and Kushner - 1999 - Acute-Phase Proteins and Other Systemic Responses .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\E2K667C6\\NEJM199902113400607.html:text/html}
}

@article{snowden_submaximal_2010,
	title = {Submaximal Cardiopulmonary Exercise Testing Predicts Complications and Hospital Length of Stay in Patients Undergoing Major Elective Surgery:},
	volume = {251},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201003000-00024},
	doi = {10.1097/SLA.0b013e3181cf811d},
	shorttitle = {Submaximal Cardiopulmonary Exercise Testing Predicts Complications and Hospital Length of Stay in Patients Undergoing Major Elective Surgery},
	pages = {535--541},
	number = {3},
	journaltitle = {Annals of Surgery},
	author = {Snowden, Chris P. and Prentis, James M. and Anderson, Helen L. and Roberts, Digby R. and Randles, Derek and Renton, Morag and Manas, Derek M.},
	urldate = {2014-01-27},
	date = {2010-03},
	file = {Snowden et al. - 2010 - Submaximal Cardiopulmonary Exercise Testing Predic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\E73BW2BM\\Snowden et al. - 2010 - Submaximal Cardiopulmonary Exercise Testing Predic.pdf:application/pdf}
}

@article{ramsey_longitudinal_2008,
	title = {The longitudinal relationship between the systemic inflammatory response, circulating T-lymphocytes, interleukin-6 and -10 in patients undergoing immunotherapy for metastatic renal cancer.},
	volume = {102},
	doi = {10.1111/j.1464-410X.2008.07466.x},
	abstract = {{OBJECTIVE}: To examine the longitudinal relationship between the systemic inflammatory response, circulating T-lymphocyte subpopulations, interleukin-6 and -10 in patients undergoing immunotherapy for metastatic renal cancer, as the inflammation-based Glasgow Prognostic Score ({GPS}) provides additional prognostic  information in patients with advanced renal cancer, but the basis of the relationship between the systemic inflammatory response and poorer survival is not clear, and nor is the effect of immunotherapy on related variables. {PATIENTS}  {AND} {METHODS}: The study included 23 patients with metastatic renal cancer and starting immunotherapy. Samples of blood were drawn for routine laboratory analysis and to quantify cytokines using enzyme-linked immunosorbent assays before immunotherapy, and repeated after 2 weeks of treatment. {RESULTS}: Most patients had a good performance status, favourable or intermediate Memorial Sloane-Kettering Cancer Center ({MSKCC}) risk scores, and with elevated C-reactive  protein ({\textgreater}10 mg/L), {GPS} (1 or 2), interleukin-6 ({\textgreater}4 pg/{mL}) and interleukin-10 ({\textgreater}10 pg/{mL}). Patients who completed one cycle of immunotherapy were more likely to have a normal {MSKCC} (P {\textless} 0.05) or {GPS} (P {\textless} 0.05) scores, whilst the percentage of lymphocytes was lower (P {\textless} 0.05). The {MSKCC} and the {GPS} scores did not alter significantly during one cycle of immunotherapy. Similarly, leukocyte counts, {CD}4+ and {CD}8+ T-lymphocytes, interleukin-6 and -10 concentrations did not change  significantly. {CONCLUSIONS}: The pretreatment systemic inflammatory response and its related lymphopenia are important in determining the tolerance to immunotherapy in patients with metastatic renal cancer. Immunotherapy is not associated with changes in circulating T-lymphocytes, nor the systemic inflammatory response.},
	pages = {125--129},
	number = {1},
	journaltitle = {{BJU} international},
	shortjournal = {{BJU} Int},
	author = {Ramsey, Sara and Aitchison, Michael and Graham, John and {McMillan}, Donald C.},
	date = {2008-07},
	pmid = {18336617},
	keywords = {*Immunotherapy, Albumins/metabolism, Carcinoma, Renal Cell/*immunology/therapy, C-Reactive Protein/metabolism, Enzyme-Linked Immunosorbent Assay, Female, Humans, Interleukin-6/metabolism, Interleukin-10/metabolism, Kidney Neoplasms/*immunology/therapy, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Systemic Inflammatory Response Syndrome/*immunology, T-Lymphocytes/*metabolism}
}

@article{inoue_diagnosis_2001,
	title = {Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18493560},
	abstract = {The characteristics of sites of intramural cancer spread were examined by comparing the intraductal ultrasonography ({IDUS}) and wall thickening findings at sites of intramural cancer spread and non-spread, in patients with malignant bile duct stenosis who had undergone percutaneous transhepatic biliary drainage ({PTBD}).The subjects were ten patients with extrahepatic bile duct cancer, two with pancreatic cancer, one with cancer of the gallbladder, and one with cancer of the papilla of Vater who underwent preoperative {IDUS}. From these patients, 50 {IDUS} slices were examined with a congruent relationship with the histologic section of resected tissue. The maximum thickening, minimum thickening, maximum/minimum thickening ratio, and form factor of the medial and lateral margins of the medial hypoechoic layer were determined using diagnostic imaging, and the results were compared at sites of cancer spread and non-spread.Twelve slices were obtained from the site of stenosis, 14 from sites of cancer spread, and 24 from non-spread sites. The maximum thickening, minimum thickening, and maximum/minimum thickening ratio differed significantly between the sites of spread and the non-spread.The absolute values for wall thickening are useful for diagnosing the presence of intramural spread in patients with malignant biliary duct stenosis.},
	pages = {159--64},
	number = {3},
	journaltitle = {Diagn Ther Endosc},
	author = {Inoue, H},
	date = {2001}
}

@article{proctor_optimization_2013,
	title = {Optimization of the systemic inflammation-based Glasgow prognostic score: a Glasgow Inflammation Outcome Study.},
	volume = {119},
	rights = {Copyright (c) 2013 American Cancer Society.},
	doi = {10.1002/cncr.28018},
	abstract = {{BACKGROUND}: The modified Glasgow Prognostic Score ({mGPS}), an inflammation-based prognostic score that uses thresholds of C-reactive protein ({\textgreater} 10 mg/L) and albumin ({\textless} 35 g/L), has been found to be independently prognostic of survival in  patients with cancer. The objective of the current study was to establish whether the addition of a differential leukocyte count and a high-sensitivity C-reactive  protein measurement enhanced the prognostic value of the {mGPS}. {METHODS}: A total of 12,119 patients who had an incidental blood sample taken between 2000 and 2007 for C-reactive protein, albumin, and a differential leukocyte count as well as a  diagnosis of cancer made within 2 years were identified. This group was studied for the prognostic value of neutrophil, lymphocyte, and platelet counts. In addition 2742 patients whose blood was sampled after the introduction of high-sensitivity C-reactive protein measurements were studied for the prognostic  value of different thresholds. {RESULTS}: Using cancer-specific survival as an endpoint, the prognostic value of the {mGPS} (hazard ratio [{HR}], 2.61; P {\textless} .001 [area under the receiver operating characteristic curve ({AUC}), 0.695]) was found  to be improved by the addition of neutrophil and platelet counts ({HR}, 4.86; P {\textless} .001 [{AUC}, 0.734]) and a high-sensitivity C-reactive protein measurement ({\textgreater} 3 mg/L) ({HR}, 5.77; P {\textless} .001 [{AUC}, 0.734]). {CONCLUSIONS}: The results of the current  study demonstrate that the addition of neutrophil and platelet counts, as well as a high-sensitivity C-reactive protein measurement, enhanced the prognostic value  of the {mGPS}.},
	pages = {2325--2332},
	number = {12},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {Proctor, Michael J. and Horgan, Paul G. and Talwar, Dinesh and Fletcher, Colin D. and Morrison, David S. and {McMillan}, Donald C.},
	date = {2013-06-15},
	pmid = {23575969},
	keywords = {*Leukocyte Count, *Platelet Count, Aged, Area Under Curve, Cohort Studies, C-Reactive Protein/*analysis, Female, Humans, Inflammation/blood/*mortality/*physiopathology, Male, Middle Aged, Neoplasms/*diagnosis/mortality/physiopathology, Neutrophils, Predictive Value of Tests, Prognosis, Scotland, Serum Albumin/analysis}
}

@article{tew_high-intensity_2014,
	title = {High-intensity interval exercise training before abdominal aortic aneurysm repair ({HIT}-{AAA}): protocol for a randomised controlled feasibility trial},
	volume = {4},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2013-004094},
	shorttitle = {High-intensity interval exercise training before abdominal aortic aneurysm repair ({HIT}-{AAA})},
	abstract = {{INTRODUCTION}: In patients with large abdominal aortic aneurysm ({AAA}), open surgical or endovascular aneurysm repair procedures are often used to minimise the risk of aneurysm-related rupture and death; however, aneurysm repair itself carries a high risk. Low cardiopulmonary fitness is associated with an increased risk of early post-operative complications and death following elective {AAA} repair. Therefore, fitness should be enhanced before aneurysm repair. High-intensity interval exercise training ({HIT}) is a potent, time-efficient strategy for enhancing cardiopulmonary fitness. Here, we describe a feasibility study for a definitive trial of a pre-operative {HIT} intervention to improve post-operative outcomes in patients undergoing elective {AAA} repair.
{METHODS} {AND} {ANALYSIS}: A minimum of 50 patients awaiting elective repair of a 5.5-7.0 cm infrarenal {AAA} will be allocated by minimisation to {HIT} or usual care control in a 1:1 ratio. The patients allocated to {HIT} will complete three hospital-based exercise sessions per week, for 4 weeks. Each session will include 2 or 4 min of high-intensity stationary cycling followed by the same duration of easy cycling or passive recovery, repeated until a total of 16 min of high-intensity exercise is accumulated. Outcomes to be assessed before randomisation and 24-48 h before aneurysm repair include cardiopulmonary fitness, maximum {AAA} diameter and health-related quality of life. In the post-operative period, we will record destination (ward or critical care unit), organ-specific morbidity, mortality and the durations of critical care and hospital stay. Twelve weeks after the discharge, participants will be interviewed to reassess quality of life and determine post-discharge healthcare utilisation. The costs associated with the exercise intervention and healthcare utilisation will be calculated.
{ETHICS} {AND} {DISSEMINATION}: Ethics approval was secured through Sunderland Research Ethics Committee. The findings of the trial will be disseminated through peer-reviewed journals, and national and international presentations.
{TRIAL} {REGISTRATION}: Current Controlled Trials {ISRCTN}09433624.},
	pages = {e004094},
	number = {1},
	journaltitle = {{BMJ} open},
	shortjournal = {{BMJ} Open},
	author = {Tew, Garry A. and Weston, Matthew and Kothmann, Elke and Batterham, Alan M. and Gray, Joanne and Kerr, Karen and Martin, Denis and Nawaz, Shah and Yates, David and Danjoux, Gerard},
	date = {2014},
	pmid = {24413350},
	pmcid = {PMC3902383}
}

@article{harten_effect_2005,
	title = {The effect of gender on postoperative mortality after emergency abdominal surgery.},
	volume = {2},
	abstract = {{BACKGROUND}: The factors contributing to the high mortality after emergency abdominal surgery are unclear. Recent studies have revealed gender differences in immune function after trauma and in the presence of sepsis. {OBJECTIVE}: This study tested the hypothesis that factors determining survival after emergency abdominal surgery differ in males and females. {METHODS}: Consecutive patients, aged {\textgreater} or =50 years, who underwent emergency abdominal surgery between July 1998 and June 2000  at the Royal and Western Infirmaries in Glasgow, Scotland, were identified for study. Data collected retrospectively included sex, age, severity of surgery, seniority of surgeon and anesthetist, extent of deprivation, and 30-day postoperative mortality. {RESULTS}: A total of 633 patients were identified for study; 49 (8\%) were excluded from analysis because 30-day mortality or surgery details were unavailable. Of the remaining 584 patients, 256 were male and 328 were female. The overall 30-day mortality was 26\%, with 74 (29\%) males and 79 (24\%) females dying within this period. The mortality rates were 25\% in males and 10\% in females (P = 0.043) after minor surgery, 26\% in males and 23\% in females (P = {NS}) after intermediate surgery, and 44\% in males and 39\% in females (P = {NS}) after major surgery. On univariate logistic regression analysis in males, increasing age (P {\textless} 0.001), severity of surgery (P = 0.04), and seniority of anesthetist (P {\textless} 0.001) were associated with mortality. In females, severity of surgery (P {\textless} 0.001) was associated with mortality. {CONCLUSIONS}: These results show that in females, 30-day mortality was determined by severity of surgery, whereas in males increasing age and seniority of anesthetist also influenced},
	number = {1},
	journaltitle = {Gender medicine},
	shortjournal = {Gend Med},
	author = {Harten, Johann and {McCreath}, Brian J. and {McMillan}, Donald C. and {McArdle}, Colin S. and Kinsella, John},
	date = {2005-03},
	pmid = {16115596},
	keywords = {*Emergencies, Abdomen/*surgery, Aged, Aged, 80 and over, Age Factors, Anesthesiology, Clinical Competence, Female, Great Britain/epidemiology, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Physicians, Postoperative Complications/*mortality, Retrospective Studies, Severity of Illness Index}
}

@article{crumley_comparison_2008,
	title = {Comparison of an inflammation-based prognostic score ({GPS}) with performance status ({ECOG}-ps) in patients receiving palliative chemotherapy for gastroesophageal cancer.},
	volume = {23},
	doi = {10.1111/j.1440-1746.2007.05105.x},
	abstract = {{AIM}: The aim of the present study was to compare an inflammation-based prognostic score (Glasgow Prognostic Score, {GPS}) with performance status ({ECOG}-ps) in patients receiving platinum-based chemotherapy for palliation of gastroesophageal cancer. {METHODS}: Sixty-five patients presenting with gastroesophageal carcinoma to the Royal Infirmary, Glasgow between January 1999 and December 2005 and who received palliative chemotherapy or chemo-radiotherapy were studied. {ECOG}-ps,},
	pages = {e325--329},
	number = {8},
	journaltitle = {Journal of gastroenterology and hepatology},
	shortjournal = {J Gastroenterol Hepatol},
	author = {Crumley, Andrew B. C. and Stuart, Robert C. and {McKernan}, Margaret and {McDonald}, Alexander C. and {McMillan}, Donald C.},
	date = {2008-08},
	pmid = {17645468},
	keywords = {*Health Status Indicators, *Palliative Care, Adenocarcinoma/drug therapy/mortality, Aged, Antineoplastic Agents/*therapeutic use, Carcinoma, Squamous Cell/drug therapy/mortality, Esophageal Neoplasms/*drug therapy/mortality, Female, Humans, Male, Middle Aged, Platinum Compounds/*therapeutic use, Prognosis, Stomach Neoplasms/*drug therapy/mortality, Survival Analysis}
}

@article{forrest_evaluation_2005,
	title = {An evaluation of the impact of a multidisciplinary team, in a single centre, on treatment and survival in patients with inoperable non-small-cell lung cancer.},
	volume = {93},
	doi = {10.1038/sj.bjc.6602825},
	abstract = {Treatment and survival of patients with inoperable Non-small-cell lung cancer in  1997 (n=117) and 2001 (n=126), before and after the introduction of a multidisciplinary team, was examined in a single centre. There were no differences in age, sex and extent of deprivation between the two years. However, in 2001, 23\% of patients received chemotherapy treatment compared with 7\% in 1997 (P{\textless}0.001). Median survival in 2001 was 6.6 months compared with 3.2 months in 1997 (P{\textless}0.001).},
	pages = {977--978},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Forrest, L. M. and {McMillan}, D. C. and {McArdle}, C. S. and Dunlop, D. J.},
	date = {2005-10-31},
	pmid = {16234818},
	pmcid = {PMC2361678},
	keywords = {Age Distribution, Antineoplastic Agents/therapeutic use, Carcinoma, Non-Small-Cell Lung/*drug therapy/*mortality, Combined Modality Therapy, Female, Humans, Lung Neoplasms/*drug therapy/*mortality, Male, Middle Aged, Neoplasm Staging, Patient Care Team/*organization \& administration, Prospective Studies, Retrospective Studies, Sex Distribution, Survival Rate}
}

@article{older_clinical_2004,
	title = {Clinical review: how to identify high-risk surgical patients},
	volume = {8},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15469600},
	abstract = {Postoperative outcome is mainly influenced by ventricular function. Tests designed to identify myocardial ischemia alone will fail to detect cardiac failure and are thus inadequate as a screening test for identification of cardiac risk in noncardiac surgical patients. We find that the degree of cardiac failure is the most important predictor of morbidity and mortality. We use cardiopulmonary exercise testing to establish the anaerobic threshold as the sole measure of cardiopulmonary function as well as to detect myocardial ischemia. Patients with an anaerobic threshold {\textless} 11 ml/min/kg are at risk for major surgery, and perioperative management must be planned accordingly. Myocardial ischemia combined with moderate to severe cardiac failure (anaerobic threshold {\textless} 11 ml/min/kg) is predictive of the highest morbidity and mortality.},
	pages = {369--72},
	number = {5},
	journaltitle = {Crit Care},
	author = {Older, Paul and Hall, Adrian},
	date = {2004-10},
	file = {Older and Hall - 2004 - Clinical review how to identify high-risk surgica.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2C8QCSKQ\\Older and Hall - 2004 - Clinical review how to identify high-risk surgica.pdf:application/pdf}
}

@article{ollinger_bilirubin_2007,
	title = {Bilirubin inhibits tumor cell growth via activation of {ERK}},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18073533},
	abstract = {Bilirubin for decades was considered a potentially toxic waste product of heme degradation until the discovery that it is a potent antioxidant. Accumulating data from observations in humans and experimental studies indicate that the bile pigment may be protective against certain diseases. Based on our own observations that bilirubin induces cell cycle arrest in abnormally proliferating vascular smooth muscle cells and clinical observations describing a lesser incidence of cancer in healthy individuals with high normal or slightly elevated serum bilirubin levels, we hypothesized that bilirubin might suppress tumor cell proliferation in vitro and in vivo. As possible effectors we analyzed key proteins that are involved in cell cycle progression and apoptosis. In vivo, tumor growth was assessed in {BALB}/c nude mice bearing {HRT}-18 colon cancer xenografts that were treated with bilirubin. In vitro, we investigated the effect of bilirubin on various cell lines and the signaling pathways involved in bilirubin action on tumor cell proliferation in {HRT}-18 cells using western blots. Bilirubin potently inhibited tumor cell proliferation in vivo and acted cytostatic and pro-apoptotic in vitro. The signaling cascades responsible for this action involved induction of p53, p27, hypophosphorylation of the retinoblastoma tumor suppressor protein as well as caspase activation. These effects were dependent on {ERK} 1/2. Our study demonstrates that bilirubin may play a role in the defense against cancer by interfering with pro-cancerogenic signaling pathways.},
	pages = {3078--85},
	number = {24},
	journaltitle = {Cell Cycle},
	author = {Ollinger, Robert and Kogler, Pamela and Troppmair, Jakob and Hermann, Martin and Wurm, Martin and Drasche, Astrid and Königsrainer, Ingmar and Amberger, Albert and Weiss, Helmut and Ofner, Dietmar and Bach, Fritz H and Margreiter, Raimund},
	date = {2007-12},
	file = {Ollinger et al. - 2007 - Bilirubin inhibits tumor cell growth via activatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WV4IF83H\\Ollinger et al. - 2007 - Bilirubin inhibits tumor cell growth via activatio.pdf:application/pdf}
}

@article{bassi_postoperative_2005,
	title = {Postoperative pancreatic fistula: an international study group ({ISGPF}) definition},
	volume = {138},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16003309},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({POPF}) is still regarded as a major complication. The incidence of {POPF} varies greatly in different reports, depending on the definition applied at each surgical center. Our aim was to agree upon an objective and internationally accepted definition to allow comparison of different surgical experiences. {METHODS}: An international panel of pancreatic surgeons, working in well-known, high-volume centers, reviewed the literature on the topic and worked together to develop a simple, objective, reliable, and easy-to-apply definition of {POPF}, graded primarily on clinical impact. {RESULTS}: A {POPF} represents a failure of healing/sealing of a pancreatic-enteric anastomosis or a parenchymal leak not directly related to an anastomosis. An all-inclusive definition is a drain output of any measurable volume of fluid on or after postoperative day 3 with an amylase content greater than 3 times the serum amylase activity. Three different grades of {POPF} (grades A, B, C) are defined according to the clinical impact on the patient's hospital course. {CONCLUSIONS}: The present definition and clinical grading of {POPF} should allow realistic comparisons of surgical experiences in the future when new techniques, new operations, or new pharmacologic agents that may impact surgical treatment of pancreatic disorders are addressed.},
	author = {Bassi, Claudio and Dervenis, Christos and Butturini, Giovanni and Fingerhut, Abe and Yeo, Charles and Izbicki, Jakob and Neoptolemos, John and Sarr, Michael and Traverso, William and Buchler, Marcus},
	date = {2005-07},
	file = {Bassi et al. - 2005 - Postoperative pancreatic fistula an international.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PI3ZJNRV\\Bassi et al. - 2005 - Postoperative pancreatic fistula an international.pdf:application/pdf}
}

@article{hill_muscular_1924,
	title = {Muscular Exercise, Lactic Acid, and the Supply and Utilisation of Oxygen},
	volume = {97},
	issn = {0962-8452, 1471-2954},
	url = {http://rspb.royalsocietypublishing.org/content/97/681/84},
	doi = {10.1098/rspb.1924.0045},
	pages = {84--138},
	number = {681},
	journaltitle = {Proceedings of the Royal Society of London B: Biological Sciences},
	author = {Hill, A. V. and Long, C. N. H. and Lupton, H.},
	urldate = {2015-08-22},
	date = {1924-11-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VSC83UUZ\\Hill et al. - 1924 - Muscular Exercise, Lactic Acid, and the Supply and.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M4XRN3Z6\\84.html:text/html}
}

@article{guthrie_circulating_2013,
	title = {Circulating {IL}-6 concentrations link tumour necrosis and systemic and local inflammatory responses in patients undergoing resection for colorectal cancer.},
	volume = {109},
	doi = {10.1038/bjc.2013.291},
	abstract = {{BACKGROUND}: Cancer-associated inflammation, in the form of local and systemic inflammatory responses, appear to be linked to tumour necrosis and have prognostic value in patients with colorectal cancer. However, their relationship  with circulating biochemical mediators is unclear. The aim of the present study was to examine the interrelationships between circulating mediators, in particular interleukin-6 ({IL}-6) and tumour necrosis, and local and systemic inflammatory responses in patients undergoing resection for colorectal cancer. {METHODS}: Data were collected from preoperative blood tests for 118 patients who underwent resection for colorectal cancer. Analysis of circulating {IL}-6, {IL}-10, vascular endothelial growth factor ({VEGF}), differential white cell count,},
	pages = {131--137},
	number = {1},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Guthrie, G. J. K. and Roxburgh, C. S. D. and Richards, C. H. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2013-07-09},
	pmid = {23756867},
	pmcid = {PMC3708575},
	keywords = {Aged, Body Composition, Colorectal Neoplasms/*blood/surgery, C-Reactive Protein/analysis, Female, Humans, Inflammation/*blood, Interleukin-6/*blood, Interleukin-10/blood, Leukocyte Count, Lymphocyte Count, Lymphocytes, Male, Necrosis, Neutrophils, Platelet Count, Serum Albumin/analysis, Vascular Endothelial Growth Factor A/blood}
}

@article{marla_factors_2013,
	title = {Factors influencing postoperative length of hospital stay after breast cancer surgery.},
	volume = {22},
	rights = {Copyright (c) 2012 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.breast.2012.07.009},
	abstract = {As part of a feasibility study to restructure the breast cancer services in Glasgow, factors influencing 'postoperative length of stay' ({LOS}) and bed utilisation in patients undergoing surgery for breast cancer were examined. Data  for patients admitted at five hospitals between March 2007 and February 2008 was  collected prospectively. Age, socio-demographic and clinico-pathologic factors were recorded. Independent affects of variables predicting prolonged {LOS} were assessed using binary logistic regression analysis. Of the 519 women, 252(49\%) had screen-detected cancers with a median {LOS} of 1 day while 267(51\%) had symptomatic cancers with a median {LOS} of 4 days (p {\textless} 0.001). On multivariate analysis, axillary procedure performed independently influenced prolonged {LOS} in  both screen-detected and symptomatic cancers. In symptomatic cancers, comorbidities and deprivation also had some influence. While mastectomy with or without axillary surgery utilised 51\% of the bed days, a further 20\% were utilised by patients having re-operations. This study has helped in the planning  of ambulatory surgery services and inpatient bed requirements for patients undergoing breast cancer surgery in Glasgow.},
	pages = {289--294},
	number = {3},
	journaltitle = {Breast (Edinburgh, Scotland)},
	shortjournal = {Breast},
	author = {Marla, Sekhar and {McMillan}, D. C. and Stallard, Sheila},
	date = {2013-06},
	pmid = {22841480},
	keywords = {*Lymph Node Excision, Aged, Axilla, Bed Occupancy/*utilization, Breast Neoplasms/*diagnosis/pathology/*surgery, Early Detection of Cancer, Female, Health Services Needs and Demand, Humans, Length of Stay/*statistics \& numerical data, Middle Aged, Postoperative Period, Reoperation, Scotland, Socioeconomic Factors, Tumor Burden}
}

@article{kang_detrimental_2009,
	title = {Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas},
	volume = {13},
	issn = {1873-4626},
	doi = {10.1007/s11605-009-0823-9},
	abstract = {{BACKGROUND}: Margin-negative resection of pancreatic cancers has proven to be the most effective treatment to date. Although there are frequent surgery-related complications following pancreatectomy, the oncologic effect of these complications following pancreatectomy for pancreatic cancer has not been studied.
{MATERIALS} {AND} {METHODS}: Retrospective observation of medical records of resected pancreatic ductal adenocarcinoma performed from January 1990 to June 2006 was used in this study. Potentially curative surgical resections of pancreatic ductal adenocarcinoma were performed on 103 patients. Survival was analyzed according to various clinicopathologic variables.
{RESULTS}: Negative surgical margins (p = 0.0075) and absence of postoperative major complications related to surgery (p = 0.0116) were all significantly favorable prognostic factors in both univariate and multivariate analysis. Margin-negative pancreatectomy without major complications showed the most favorable oncologic outcomes in resected pancreatic cancer (median survival, 35.6 months; 95\% confidential interval, 25.8-45.4 months), while major morbidities diminished survival benefit of R0 resection [R0-Cx(+), Exp(beta) = 1.925, p = 0.034, and R1, Exp(beta) = 3.129, p = 0.001].
{CONCLUSION}: Surgery-related major complication diminished the oncologic efficacy of R0 pancreatectomy. Margin-negative resection without major complication can enhance postoperative oncologic outcomes in ductal adenocarcinoma of the pancreas.},
	pages = {907--914},
	number = {5},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Kang, Chang Moo and Kim, Dong Hyun and Choi, Gi Hong and Kim, Kyung Sik and Choi, Jin Sub and Lee, Woo Jung},
	date = {2009-05},
	pmid = {19224295},
	keywords = {Adult, Aged, Carcinoma, Pancreatic Ductal, Cohort Studies, Female, Humans, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm, Residual, Pancreatectomy, Pancreatic Neoplasms, Pancreaticoduodenectomy, Retrospective Studies, Risk Factors, Survival Rate, Treatment Outcome}
}

@article{cohen_effect_2010,
	title = {The effect of erythropoietin on exercise capacity, left ventricular remodeling, pressure-volume relationships, and quality of life in older patients with anemia and heart failure with preserved ejection fraction},
	volume = {16},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20557328},
	abstract = {A prospective, open-label, 3-month study was conducted to evaluate the feasibility and short-term clinical effect of subcutaneous erythropoietin injections in patients with anemia and heart failure with preserved ejection fraction (ejection fraction, 55\%+/-2\%). Using a dose-adjusted algorithm to effect a rate of rise in hemoglobin not to exceed 0.4 g/{dL} /wk, hemoglobin (10.8+/-0.3 to 12.2+/-0.3 g/{dL}) and red blood cell volume (1187+/-55 to 1333+/-38 {mL}) increased with an average weekly dose of 3926 units. Functional measures increased from baseline (6-minute walk test [289+/-24 to 331+/-22 m], exercise time [432+/-62 to 571+/-51 s], and peak oxygen consumption [8.2+/-0.7 to 9.4+/-0.9 {mL}/kg/min], all P{\textless}.05). End-diastolic volume declined significantly (8\% volumetric decrease, 108+/-3 to 100+/-3 {mL}, P =.03), but there were no significant changes in left ventricular mass or estimated left ventricular end-diastolic pressure. Pressure-volume analysis demonstrated a reduction in ventricular capacitance at an end-diastolic pressure of 30 mm Hg without significant changes in contractile state.},
	pages = {96--103},
	number = {3},
	journaltitle = {Congest Heart Fail},
	author = {Cohen, Rose S and Karlin, Paula and Yushak, Madeline and Mancini, Donna and Maurer, Mathew S},
	date = {2010-05}
}

@article{almushatat_vitamin_2006,
	title = {Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer.},
	volume = {118},
	doi = {10.1002/ijc.21451},
	abstract = {The relationship between lipid soluble antioxidant vitamins, lipid peroxidation,  disease stage and the systemic inflammatory response were examined in healthy subjects (n = 14), patients with benign prostate hyperplasia {BPH} (n = 20), localized (n = 40) and metastatic (n = 38) prostate cancer. Prostate cancer patients had higher concentrations of malondialdehyde (p {\textless} 0.05) and lower circulating concentrations of lutein (p {\textless} 0.05), lycopene (p {\textless} 0.001) and beta-carotene (p {\textless} 0.05). Patients with metastatic prostate cancer, when compared with patients having localized disease, had a higher Gleason score (p {\textless} 0.01) and had more hormonal treatment, but lower concentrations of {PSA} (p {\textless} 0.05), alpha-tocopherol (p {\textless} or = 0.05), retinol (p {\textless} 0.01), lutein (p {\textless} 0.05) and lycopene (p {\textless} 0.01). In the prostate cancer patients, {PSA} was correlated with the concentrations of the lipid peroxidation product, malondialdehyde (rs= 0.353, p = 0.002). C-reactive protein was not correlated with the vitamin antioxidants nor malondialdehyde. In contrast, there was a negative correlation between malondialdehyde concentrations and both lutein (rs= -0.263, p = 0.020) and lycopene (rs= -0.269, p = 0.017). These results indicate that lower concentrations of carotenoids, in particular, lycopene reflect disease progression rather than the systemic inflammatory response in patients with prostate cancer.},
	pages = {1051--1053},
	number = {4},
	journaltitle = {International journal of cancer. Journal international du cancer},
	shortjournal = {Int J Cancer},
	author = {Almushatat, Ahmed S. K. and Talwar, Dinesh and {McArdle}, Peter A. and Williamson, Cathy and Sattar, Naveed and O'Reilly, Denis St J. and Underwood, Mark A. and {McMillan}, Donald C.},
	date = {2006-02-15},
	pmid = {16106418},
	keywords = {*Inflammation, *Lipid Peroxidation, Aged, Aged, 80 and over, Antineoplastic Agents, Hormonal/therapeutic use, Antioxidants/*analysis, Carotenoids/*blood, Case-Control Studies, Disease Progression, Humans, Male, Malondialdehyde/blood, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Oxidative Stress, Prostatic Hyperplasia/immunology/physiopathology, Prostatic Neoplasms/*immunology/*physiopathology}
}

@article{bevier_relationship_1989,
	title = {Relationship of body composition, muscle strength, and aerobic capacity to bone mineral density in older men and women},
	volume = {4},
	rights = {Copyright © 1989 {ASBMR}},
	issn = {1523-4681},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/jbmr.5650040318/abstract},
	doi = {10.1002/jbmr.5650040318},
	abstract = {We evaluated the relationship of body composition, maximal aerobic capacity ({VO}2max), and muscle strength to bone mineral density in 91 healthy men and women, age 61–84 years. Lean body mass was estimated from two independent measures of fat mass, bioelectrical impedance and skinfold thickness. {VO}2max was determined by treadmill ergometry with direct measurement of oxygen consumption. Grip and back strength were measured by isometric dynamometry. Mineral density of lumbar spine and midradius were measured by dual- and single-photon absorptiometry. Men had significantly greater lean mass, muscle strength, aerobic capacity, and bone density than women. In women, grip strength correlated with forearm and spine density (r = 0.37, r = 0.28, p {\textless} 0.05). In men, grip strength correlated with forearm density (r = 0.47, p {\textless} 0.05), and back strength was significantly correlated with both spine (r = 0.46, p {\textless} 0.01) and forearm density (r = 0.46, p {\textless} 0.01). In women, neither forearm nor spine density correlated significantly with aerobic capacity. In men, midradius density did not correlate significantly with oxygen consumption, but the simple correlation between spine density and {VO}2max was significant (r = 0.41, p {\textless} 0.05). Back strength and {VO}2max were significantly related in men (r = 0.47, p {\textless} 0.01). By stepwise multiple regression, back strength emerged as the most robust predictor of spine mineral, accounting for 19\% of the variation in bone density. Addition of {VO}2max to the regression did not add significant predictive value. However, when {VO}2max was expressed per kilogram lean body mass, both back strength and {VO}2max contributed significantly to the prediction of spine density in men, and the coefficient of determination R2 increased to 0.30. We conclude that body mass and grip strength, but not aerobic capacity, significantly predict bone density in elderly women. In elderly men, back strength is a more robust predictor of axial bone density than traditional expressions of aerobic capacity, but {VO}2max per kilogram lean mass and back strength both make significant contributions to the prediction of spine mineral density. The applicability of these results to younger men and women is uncertain.},
	pages = {421--432},
	number = {3},
	journaltitle = {Journal of Bone and Mineral Research},
	shortjournal = {J Bone Miner Res},
	author = {Bevier, Wendy C. and Wiswell, Robert A. and Pyka, Gisela and Kozak, Kathryn C. and Newhall, Katherine M. and Marcus, Robert},
	urldate = {2015-04-30},
	date = {1989-06-01},
	langid = {english},
	file = {Bevier et al. - 1989 - Relationship of body composition, muscle strength,.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GA978ZJR\\Bevier et al. - 1989 - Relationship of body composition, muscle strength,.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\49W5HWB6\\abstract.html:text/html}
}

@article{burcharth_[pancreaticoduodenectomy_1995,
	title = {[Pancreaticoduodenectomy (Whipple's operation) for periampullary cancer]},
	volume = {157},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7571098},
	abstract = {This study evaluated the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients with periampullary adenocarcinoma. Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumour. The postoperative mortality rate after Whipple's operation was 8\% (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15\% (confidence limits, 5 to 25\%). The five year survival rate for patients without tumour extension beyond the pancreas was 25\% (confidence limits, 5 to 50\%), and in patients with adenocarcinoma of the ampulla af Vater, 34\% (confidence limits, 3 to 65\%). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25\% and a postoperative mortality rate of less than 5\%.},
	pages = {5544--8},
	number = {40},
	journaltitle = {Ugeskr Laeger},
	author = {Burcharth, F and Andersen, H B and Brahe, N E and Baden, H},
	date = {1995-10}
}

@article{kim_quality_2008,
	title = {Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus non-surgical palliation},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19073412},
	abstract = {{BACKGROUND}: Appropriate palliation for unresectable pancreatic head cancer is most important. This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. {METHODS}: We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer. Fifty-two patients with locally advanced disease (local vascular invasion) and 17 with distant metastatic disease were included. The patients were divided into two groups, surgical and non-surgical palliation. {RESULTS}: Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage ({PTBD}). There was no significant difference in the early complications, successful biliary drainage, recurrent jaundice, and 30-day mortality between surgical palliation and {PTBD}. However, in 52 patients whose tumor was unresectable secondary to local vascular invasion, the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non-surgical palliation (P{\textless}0.05). The patients who underwent surgical palliation had a longer hospital-free survival rate (P{\textless}0.001), although they had a longer postoperative hospital stay (P=0.004) during the first admission period. {CONCLUSIONS}: In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions, surgical exploration should be performed. Thus, in patients who have unresectable cancer or limited metastatic disease on exploration, surgical palliation should be performed for longer survival and better quality of survival.},
	pages = {643--8},
	number = {6},
	journaltitle = {Hepatobiliary Pancreat Dis Int},
	author = {Kim, Hyung Ook and Hwang, Sang Il and Kim, Hungdai and Shin, Jun Ho},
	date = {2008-12}
}

@article{padillo_cytokines_2001,
	title = {Cytokines and acute-phase response markers derangements in patients with obstructive jaundice},
	volume = {48},
	issn = {0172-6390},
	abstract = {Background/Aims: Prolonged acute-phase response and increase of cytokines have been associated with higher mortality and surgical complications. This study investigated the status of cytokines and acute-phase response markers in patients with Obstructive jaundice. Methodology: Forty-one patients were investigated Endotoxin, tumor necrosis factor-g interleukin-6, nitric oxide, C-reactive protein, liver enzymes, albumin and percentage of weight loss were determined at admission. Results: Endotoxin, interleukin-6 and C-reactive protein were significantly elevated in both benign and malignant obstructive jaundice. Increased plasma levels of tumor necrosis factor-a were only detected in malignant tumors (68 us. 24pg/{mL}; P {\textless} 0.001). Patients with positive acute-phase response (C-reactive protein {\textgreater} mean + 2 {SD} of controls) had greater weight loss (P = 0.02), endotoxin (P = 0.03) and interleukin-6 plasma levels (P = 0.05) than those with no inflammatory response. Prolonged biliary obstruction ({\textgreater} 10 days) was associated with higher weight loss (P = 0.04), tumor necrosis factor-alpha (P = 0.003) and interleukin-6 (P = 0.05) plasma levels. Conclusions: A prolonged high-grade biliary tract obstruction prompted an increase in endotoxin levels, associated with a positive acute-phase response and cytokine elevation.},
	pages = {378--381},
	number = {38},
	journaltitle = {Hepato-Gastroenterology},
	shortjournal = {Hepato-Gastroenterol.},
	author = {Padillo, F. J. and Andicoberry, B. and Muntane, J. and Lozano, J. M. and Mino, G. and Sitges-Serra, A. and Solorzano, G. and Pera-Madrazo, C.},
	date = {2001-04},
	note = {{WOS}:000168303500019},
	keywords = {biliary obstruction, cachexia, C-Reactive Protein, endotoxin, expression, factor-alpha, hepatocytes, il-6, Interleukin-6, mortality, nitric oxide, {OBSTRUCTIVE} {JAUNDICE}, pancreatic-cancer, protein response, {TNF}-alpha, tumor-necrosis-factor}
}

@article{cicoira_skeletal_2001,
	title = {Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure},
	volume = {37},
	url = {http://content.onlinejacc.org/article.aspx?articleid=1127276},
	pages = {2080--2085},
	number = {8},
	journaltitle = {Journal of the American College of Cardiology},
	author = {Cicoira, Mariantonietta and Zanolla, Luisa and Franceschini, Lorenzo and Rossi, Andrea and Golia, Giorgio and Zamboni, Mauro and Tosoni, Paolo and Zardini, Piero},
	urldate = {2014-01-27},
	date = {2001},
	file = {Cicoira et al. - 2001 - Skeletal muscle mass independently predicts peak o.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UFTBJ6EQ\\Cicoira et al. - 2001 - Skeletal muscle mass independently predicts peak o.pdf:application/pdf}
}

@article{hopker_controversies_2011,
	title = {Controversies in the physiological basis of the ‘anaerobic threshold’ and their implications for clinical cardiopulmonary exercise testing: Controversies in the ‘anaerobic threshold’},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2010.06604.x},
	doi = {10.1111/j.1365-2044.2010.06604.x},
	shorttitle = {Controversies in the physiological basis of the ‘anaerobic threshold’ and their implications for clinical cardiopulmonary exercise testing},
	pages = {111--123},
	number = {2},
	journaltitle = {Anaesthesia},
	author = {Hopker, J. G. and Jobson, S. A. and Pandit, J. J.},
	urldate = {2015-04-28},
	date = {2011-02},
	langid = {english},
	file = {Hopker et al. - 2011 - Controversies in the physiological basis of the ‘a.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3BCJ4TI9\\Hopker et al. - 2011 - Controversies in the physiological basis of the ‘a.pdf:application/pdf}
}

@article{ramanathan_impact_2013,
	title = {Impact of day 2 C-reactive protein on day 3 and 4 thresholds associated with infective complications following curative surgery for colorectal cancer.},
	volume = {37},
	doi = {10.1007/s00268-013-2177-4},
	abstract = {{BACKGROUND}: The postoperative systemic inflammatory response, as evidenced by},
	pages = {2705--2710},
	number = {11},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Ramanathan, Michelle L. and Mackay, Graham and Platt, Jonathan and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2013-11},
	pmid = {23942534},
	keywords = {Aged, Colectomy/methods, Colorectal Neoplasms/*metabolism/pathology/*surgery, C-Reactive Protein/*metabolism, Female, Humans, Male, Middle Aged, Neoplasm Staging, Postoperative Complications/*metabolism, Prospective Studies, Surgical Wound Infection/*metabolism}
}

@article{raraty_minimal_2010,
	title = {Minimal Access Retroperitoneal Pancreatic Necrosectomy: Improvement in Morbidity and Mortality With a Less Invasive Approach},
	volume = {251},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201005000-00002},
	doi = {10.1097/SLA.0b013e3181d96c53},
	shorttitle = {Minimal Access Retroperitoneal Pancreatic Necrosectomy},
	pages = {787--793},
	number = {5},
	journaltitle = {Annals of Surgery},
	author = {Raraty, Michael G. T. and Halloran, Christopher M. and Dodd, Susanna and Ghaneh, Paula and Connor, Saxon and Evans, Jonathan and Sutton, Robert and Neoptolemos, John P.},
	urldate = {2014-01-27},
	date = {2010-05},
	file = {Raraty et al. - 2010 - Minimal Access Retroperitoneal Pancreatic Necrosec.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4W64PV2D\\Raraty et al. - 2010 - Minimal Access Retroperitoneal Pancreatic Necrosec.pdf:application/pdf}
}

@article{dutta_comparison_2011,
	title = {Comparison of the prognostic value of tumour- and patient-related factors in patients undergoing potentially curative resection of oesophageal cancer.},
	volume = {35},
	doi = {10.1007/s00268-011-1130-7},
	abstract = {{BACKGROUND}: Evidence is increasing that elevated systemic inflammation is associated with poor survival in patients with oesophageal carcinoma. However, it is not yet established if any specific component of systemic inflammatory response is a better predictor of cancer survival. The aim of the present study was to compare the predictive value of selected markers of systemic inflammation  in patients who undergo surgical resection of oesophageal cancer. {METHODS}: One hundred twelve patients who underwent potentially curative resection for oesophageal carcinoma, including type I and type {II} tumours of the gastro-oesophageal junction (Siewert and Stein in Dis Esophagus 9:173-182, 1996), between 1996 and 2008 were included in the study. Patients had laboratory measurement of white cells, neutrophils, lymphocytes, platelet counts, albumin, and C-reactive protein. Glasgow Prognostic Score ({mGPS}), neutrophil lymphocyte ratio ({NLR}), platelet lymphocyte ratio ({PLR}), and metastatic lymph node ratio ({LNR}) were calculated. {RESULTS}: On multivariate analysis, only the {LNR} ({HR} 2.87,  95\% {CI} 1.99-4.15, p {\textless} 0.001) and the {mGPS} ({HR} 4.31, 95\% {CI} 2.20-8.45, p {\textless} 0.001)  were independently associated with cancer-specific survival in oesophageal cancer. An elevated {mGPS} was associated with high white cell count (p {\textless} 0.05) and poorer survival (p = 0.001). {CONCLUSION}: The present study indicates that the {mGPS}, an acute-phase protein-based prognostic score, better predicts cancer survival compared with the cellular components of systemic inflammation in patients with oesophageal carcinoma.},
	pages = {1861--1866},
	number = {8},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Dutta, Sumanta and Crumley, Andrew B. C. and Fullarton, Grant M. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-08},
	pmid = {21538187},
	keywords = {*Esophagectomy, Adenocarcinoma/*immunology/mortality/pathology/*surgery, Aged, C-Reactive Protein/analysis, Esophageal Neoplasms/*immunology/mortality/pathology/*surgery, Esophagogastric Junction/immunology/pathology/surgery, Humans, Inflammation Mediators/*blood, Leukocyte Count, Lymphatic Metastasis/pathology, Lymphocyte Count, Lymphocytes/*immunology, Male, Middle Aged, Neoplasm Staging, Neutrophils/*immunology, Platelet Count, Predictive Value of Tests, Prognosis, Serum Albumin/analysis, Survival Rate}
}

@article{guthrie_does_2013,
	title = {Does interleukin-6 link explain the link between tumour necrosis, local and systemic inflammatory responses and outcome in patients with colorectal cancer?},
	volume = {39},
	rights = {Copyright (c) 2012 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2012.07.003},
	abstract = {Cancer-associated inflammation has been identified as a key determinant of disease progression and survival in colorectal cancer. In particular, it has been consistently reported that both the local and systemic inflammatory responses play an important role in determining outcome in colorectal cancer. Given the importance of cancer-associated inflammation, up-regulation or attenuation of these respective inflammatory responses may be important for progression and survival in colorectal cancer. Recent work has focused on the inter-relationships between the tumour and these key inflammatory processes. In particular, tumour necrosis has been reported to be associated with decreased local inflammatory infiltrate and with elevated markers of systemic inflammation in colorectal cancer and has been proposed as a potential link between the systemic and local inflammatory responses. Thus there is increasing interest in the potential biochemical mediators of this link. In this review we examine the evidence for},
	number = {1},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {Guthrie, Graeme J. K. and Roxburgh, Campbell S. D. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2013-02},
	pmid = {22858249},
	keywords = {Colorectal Neoplasms/*immunology/*pathology, Humans, Inflammation/*immunology/*pathology, Interleukin-6/*immunology}
}

@article{knaus_apache_1985,
	title = {{APACHE} {II}: a severity of disease classification system},
	volume = {13},
	issn = {0090-3493},
	shorttitle = {{APACHE} {II}},
	abstract = {This paper presents the form and validation results of {APACHE} {II}, a severity of disease classification system. {APACHE} {II} uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status to provide a general measure of severity of disease. An increasing score (range 0 to 71) was closely correlated with the subsequent risk of hospital death for 5815 intensive care admissions from 13 hospitals. This relationship was also found for many common diseases. When {APACHE} {II} scores are combined with an accurate description of disease, they can prognostically stratify acutely ill patients and assist investigators comparing the success of new or differing forms of therapy. This scoring index can be used to evaluate the use of hospital resources and compare the efficacy of intensive care in different hospitals or over time.},
	pages = {818--829},
	number = {10},
	journaltitle = {Critical Care Medicine},
	shortjournal = {Crit. Care Med.},
	author = {Knaus, W. A. and Draper, E. A. and Wagner, D. P. and Zimmerman, J. E.},
	date = {1985-10},
	pmid = {3928249},
	keywords = {Acute Disease, Adult, Aged, Age Factors, Chronic Disease, Coronary Artery Bypass, Costs and Cost Analysis, Critical Care, Diagnosis-Related Groups, disease, Humans, Middle Aged, Patient Admission, prognosis, Risk, Surgical Procedures, Operative}
}

@article{mcmillan_relationship_2002,
	title = {The relationship between reduced vitamin antioxidant concentrations and the systemic inflammatory response in patients with common solid tumours.},
	volume = {21},
	rights = {Copyright 2002 Elsevier Science Ltd.},
	doi = {10.1054/clnu.2001.0527},
	abstract = {{BACKGROUND} {AND} {AIMS}: The majority of patients with advanced cancer have reduced circulating concentrations of the vitamin antioxidants including retinol, alpha-tocopherol and carotenoids. However, the basis of this reduction is not known. Vitamin antioxidant concentrations have been reported to be correlated with a systemic inflammatory response (as evidenced by C-reactive protein) in normal subjects and in patients with lung cancer. In order to determine whether this relationship was independent of tumour type patients other common solid tumours were studied. {METHODS}: Fasting circulating concentrations of vitamin antioxidants and C-reactive protein were measured in normal subjects (n=30) and patients with breast (n=15), prostate (n=15) and colorectal cancer (n=11). {RESULTS}: Concentrations of C-reactive protein were higher (P{\textless}0.0001) and vitamin  antioxidants lower (P{\textless}0.0001) in the cancer patients. In normal subjects and cancer patients, C-reactive protein concentrations were inversely correlated with circulating concentrations of retinol (r(2)=0.162), alpha-tocopherol (r(2)=0.297), lutein (r(2)=0.256), lycopene (r(2)=-0.171), alpha-(r(2)=0.140) and beta-carotene (r(2)=0.254): (all P{\textless}0.001). {CONCLUSIONS}: Concentrations of retinol, alpha -tocopherol and carotenoids are inversely associated with the magnitude of the systemic inflammatory response. These relationships appear to be independent of the presence and type of cancer.},
	pages = {161--164},
	number = {2},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {{McMillan}, Donald C. and Talwar, Dinesh and Sattar, Naveed and Underwood, Mark and O'Reilly, Denis St J. and {McArdle}, Colin},
	date = {2002-04},
	pmid = {12056790},
	keywords = {Adult, Aged, Aged, 80 and over, alpha-Tocopherol/blood, Antioxidants/*analysis, Body Mass Index, Breast Neoplasms/blood, Carotenoids/blood, Colorectal Neoplasms/blood, C-Reactive Protein/*analysis, Female, Humans, Inflammation/*blood/etiology, Male, Middle Aged, Neoplasms/*blood/complications, Prostatic Neoplasms/blood, Vitamin A/blood, Vitamins/*blood}
}

@article{hartley_preoperative_2012,
	title = {Preoperative cardiopulmonary exercise testing and risk of early mortality following abdominal aortic aneurysm repair},
	volume = {99},
	issn = {1365-2168},
	doi = {10.1002/bjs.8896},
	abstract = {{BACKGROUND}: Cardiopulmonary exercise testing ({CPET}) provides an objective assessment of functional capacity. The aim of this study was to assess whether preoperative {CPET} identifies patients at risk of early death following elective open and endovascular abdominal aortic aneurysm ({AAA}) repair.
{METHODS}: Prospective data were collected from a pilot study between September 2005 and February 2007, and from all patients who underwent {CPET} before elective {AAA} repair at two vascular centres between February 2007 and November 2011. Symptom-limited, maximal {CPET} was performed on each patient. Univariable and multivariable analyses were used to identify risk factors for 30- and 90-day mortality.
{RESULTS}: Some 415 patients underwent {CPET} before elective {AAA} repair. Anaerobic threshold ({AT}), peak oxygen consumption (peak V.O(2) ) and ventilatory equivalents for carbon dioxide were associated with 30- and 90-day mortality on univariable analysis. On multivariable analysis, open repair (odds ratio ({OR}) 4·92, 95 per cent confidence interval 1·55 to 17·00; P = 0·008), {AT} below 10·2 ml per kg per min ({OR} 6·35, 1·84 to 29·80; P = 0·007), anaemia ({OR} 3·27, 1·04 to 10·50; P = 0·041) and inducible cardiac ischaemia ({OR} 6·16, 1·48 to 23·07; P = 0·008) were associated with 30-day mortality. Anaemia, inducible cardiac ischaemia and peak V.O(2) less than 15 ml per kg per min ({OR} 8·59, 2·33 to 55·75; P = 0·005) were associated with 90-day mortality on multivariable analysis. Patients with two or more subthreshold {CPET} values were at increased risk of both 30- and 90-day mortality.
{CONCLUSION}: An {AT} below 10·2 ml per kg per min, peak V.O(2) less than 15 ml per kg per min and at least two subthreshold {CPET} values identify patients at increased risk of early death following {AAA} repair.},
	pages = {1539--1546},
	number = {11},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Hartley, R. A. and Pichel, A. C. and Grant, S. W. and Hickey, G. L. and Lancaster, P. S. and Wisely, N. A. and {McCollum}, C. N. and Atkinson, D.},
	date = {2012-11},
	pmid = {23001820},
	keywords = {Adult, Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, Exercise Test, Female, Humans, Male, Middle Aged, Oxygen Consumption, Pilot Projects, postoperative complications, preoperative care, Prospective Studies, Risk assessment, Risk Factors, Young Adult}
}

@article{agostoni_relationship_2010,
	title = {Relationship of resting hemoglobin concentration to peak oxygen uptake in heart failure patients},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20513118},
	abstract = {Anemia is frequent in chronic heart failure ({HF}). To calculate what change in peak oxygen uptake ( {VO}(2)) should be expected in the event of changes in hemoglobin concentration, we studied the correlation between peak {VO}(2) and hemoglobin concentration in a large {HF} population. We carried out retrospective analysis of all cardiopulmonary exercise tests ({CPET}) performed in our {HF} Clinic between June 2001 and March 2009 in {HF} patients who had a resting hemoglobin concentration measurement taken within 7 days of the {CPET}. We collected 967 {CPETs}, 704 tests were considered maximal and analyzed. We identified 181 patients (26\%) as anemic. Peak {VO}(2) was lower (P {\textless} 0.001) in anemic patients (971 +/- 23 ml/min) compared with nonanemic (1243 +/- 18 ml/min). The slope of the {VO}(2) vs. hemoglobin ratio was 109 ml/min/g/dl at peak exercise. This correlation remained significant also when several confounding variables were analyzed by multivariate analysis. As an average, each gram of hemoglobin accounts, at peak exercise, for 109 ml/min change in {VO}(2) which is equivalent to 0.97 ml/min/kg. Therefore, in {HF} patients anemia treatment should increase {VO}(2) by 109 ml/min for each g/dl of hemoglobin increase.},
	pages = {414--7},
	number = {6},
	journaltitle = {Am J Hematol},
	author = {Agostoni, Piergiuseppe and Salvioni, Elisabetta and Debenedetti, Chiara and Vignati, Carlo and Cattadori, Gaia and Contini, Mauro and Magrì, Damiano and Palermo, Pietro and Gondoni, Erica and Brusoni, Denise and Fiorentini, Cesare and Apostolo, Anna},
	date = {2010-06},
	file = {Agostoni et al. - 2010 - Relationship of resting hemoglobin concentration t.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N27JGTB6\\Agostoni et al. - 2010 - Relationship of resting hemoglobin concentration t.pdf:application/pdf}
}

@article{haupt_association_1999,
	title = {Association of low preoperative serum albumin concentrations and the acute phase response},
	volume = {165},
	rights = {Copyright © 1999 Taylor and Francis Ltd},
	issn = {1741-9271},
	url = {http://onlinelibrary.wiley.com.ezproxy.lib.gla.ac.uk/doi/10.1080/110241599750006820/abstract},
	doi = {10.1080/110241599750006820},
	abstract = {Objective:
To investigate the incidence of a preoperative acute phase response and its association with low albumin concentrations.
Design:
Prospective open study.
Setting:
Teaching hospital, Germany.
Subjects:
225 patients who were to undergo major abdominal operations, and who had no acute infections.
Interventions:
Measurements of serum concentrations of albumin, C-reactive protein ({CRP}), α-1 antitrypsin, and interleukin-6 ({IL}-6).
Results:
Abnormal concentrations of acute phase proteins (indicating an acute phase response) were detected in 43 of 225 patients (19\%). The mean ({SD}) albumin concentration in these patients (35[5]g/L) was lower than that of patients who did not mount an acute phase response preoperatively (40[5]g/L). High concentrations of {CRP} (≥60mg/L) were associated with low albumin concentrations (33[5]g/L); high α-1 antitrypsin concentrations (≥4.0g/L) were associated with low albumin concentrations (34[6]g/L); and high {IL}-6 concentrations (≥4pg/ml) were associated with low albumin concentrations (37[6]g/L) compared with a mean({SD}) albumin concentration of 40(5)g/L in patients who had no evidence of an acute phase response.
Conclusion:
A metabolic response to disease referred to as an acute phase response may explain low preoperative albumin concentrations. This association interferes with the association of low preoperative albumin concentrations and malnutrition. It is a new aspect of preoperative risk evaluation and may indicate a potential for prevention. Copyright © 1999 Taylor and Francis Ltd.},
	pages = {307--313},
	number = {4},
	journaltitle = {European Journal of Surgery},
	shortjournal = {Eur J Surg},
	author = {Haupt, W. and Holzheimer, R. G. and Riese, J. and Klein, P. and Hohenberger, W.},
	urldate = {2015-08-20},
	date = {1999-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BP6FQHDV\\Haupt et al. - 1999 - Association of low preoperative serum albumin conc.pdf:application/pdf;Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\989VR32K\\Haupt et al. - 1999 - Association of low preoperative serum albumin conc.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\67QBRSF2\\abstract.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DCPNWS7D\\abstract.html:text/html}
}

@article{nagamatsu_preoperative_2001,
	title = {Preoperative evaluation of cardiopulmonary reserve with the use of expired gas analysis during exercise testing in patients with squamous cell carcinoma of the thoracic esophagus},
	volume = {121},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11385372},
	abstract = {{OBJECTIVE}: We evaluated the usefulness of analyzing expired gas during exercise testing for the prediction of postoperative cardiopulmonary complications in patients with esophageal carcinoma. {BACKGROUND} {DATA}: Radical esophagectomy with 3-field lymphadenectomy is performed in patients with thoracic esophageal carcinoma but has a high risk of postoperative complications. To reduce the surgical risk, we performed preoperative risk analysis using 8 factors. Although hospital mortality was decreased when this risk analysis was used, severe cardiopulmonary complications still occurred. {METHODS}: The study group consisted of 91 patients who had undergone curative esophagectomy with 3-field lymphadenectomy. The maximum oxygen uptake, anaerobic threshold, vital capacity, percent vital capacity, forced expiratory volume in 1 second, percent forced expiratory volume, V.(25)/{HT}, forced expired flow at 75\% of forced vital capacity to height ratio ({FEF}(75\%)/{HT}), forced expired flow at 50\% to 75\% of forced vital capacity ratio ({FEF}(50\%)/{FEF}(75\%)), percent diffusion capacity for carbon monoxide, and arterial oxygen tension were measured. Patients were divided into 2 groups on the basis of the presence or absence of postoperative cardiopulmonary complications. {RESULTS}: Only the maximum oxygen uptake was significantly different between the 2 groups. All patients were grouped according to the value of the maximum oxygen uptake, and the occurrence of postoperative cardiopulmonary complications was calculated for each group. A cardiopulmonary complication rate of 86\% was found for patients with a maximum oxygen uptake of less than 699 {mL}. min(-1). m(-2); for those with a value of 700 to 799 {mL}. min(-1). m(-2), the complication rate was 44\%. {CONCLUSIONS}: The maximum oxygen uptake obtained by expired gas analysis during exercise testing correlates with the postoperative cardiopulmonary complication rate. On the basis of these results, esophagectomy with 3-field lymphadenectomy can be safely performed in patients with a maximum oxygen uptake of at least 800 {mL}. min(-1). m(-2).},
	pages = {1064--8},
	number = {6},
	journaltitle = {J Thorac Cardiovasc Surg},
	author = {Nagamatsu, Y and Shima, I and Yamana, H and Fujita, H and Shirouzu, K and Ishitake, T},
	date = {2001-06},
	file = {Nagamatsu et al. - 2001 - Preoperative evaluation of cardiopulmonary reserve.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J8JTIU3A\\Nagamatsu et al. - 2001 - Preoperative evaluation of cardiopulmonary reserve.pdf:application/pdf}
}

@article{mcmillan_pilot_1997,
	title = {A pilot study of megestrol acetate and ibuprofen in the treatment of cachexia in  gastrointestinal cancer patients.},
	volume = {76},
	abstract = {Advanced gastrointestinal cancer patients with weight loss and an acute-phase response (n = 15) were given megestrol acetate (480 mg day(-1)) and ibuprofen (1200 mg day(-1)) for 6 weeks. Overall, there was an increase in body weight (P = 0.01) and a reduction in C-reactive protein concentrations (P = 0.02), with no change in total body water (P = 0.24) over this period. This regimen may be an effective non-toxic treatment for cancer cachexia and is worthy of further study.},
	pages = {788--790},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and O'Gorman, P. and Fearon, K. C. and {McArdle}, C. S.},
	date = {1997},
	pmid = {9310247},
	pmcid = {PMC2228041},
	keywords = {Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use, Appetite Stimulants/*therapeutic use, Body Water/drug effects, Body Weight/drug effects, Cachexia/*drug therapy, C-Reactive Protein/metabolism, Female, Gastrointestinal Neoplasms/*drug therapy, Humans, Ibuprofen/*therapeutic use, Male, Megestrol Acetate/*therapeutic use, Middle Aged, Pilot Projects}
}

@article{lemyze_cardiopulmonary_2011,
	title = {Cardiopulmonary response to exercise in patients with liver cirrhosis and impaired pulmonary gas exchange},
	volume = {105},
	issn = {09546111},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0954611111002113},
	doi = {10.1016/j.rmed.2011.06.011},
	pages = {1550--1556},
	number = {10},
	journaltitle = {Respiratory Medicine},
	author = {Lemyze, Malcolm and Dharancy, Sébastien and Nevière, Remy and Wallaert, Benoît},
	urldate = {2014-01-27},
	date = {2011-10},
	file = {Lemyze et al. - 2011 - Cardiopulmonary response to exercise in patients w.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AR72426V\\Lemyze et al. - 2011 - Cardiopulmonary response to exercise in patients w.pdf:application/pdf}
}

@article{sewnath_effect_2001,
	title = {The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy},
	volume = {192},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11400966},
	abstract = {{BACKGROUND}: The benefit of preoperative biliary drainage in jaundiced patients undergoing pancreaticoduodenectomy for a suspected malignancy of the periampullary region is still under debate. This study evaluated preoperative biliary drainage in relation to postoperative outcomes. {STUDY} {DESIGN}: At the Academic Medical Center, Amsterdam, the Netherlands, a cohort of 311 patients undergoing pancreaticoduodenectomy from June 1992 up to and including December 1999 was studied. Of this cohort 21 patients with external or surgical biliary drainage were excluded and 232 patients who had received preoperative internal biliary drainage were divided into three groups corresponding with severity of jaundice according to preoperative plasma bilirubin levels: {\textless} 40 {microM} (n = 177), 40 to 100 {microM} (n = 32), and {\textgreater} 100 {microM} (n = 23) were designated as groups 1, 2, and 3, respectively. These groups were compared with patients who underwent immediate surgery (n = 58) without preoperative drainage. {RESULTS}: The median number of stent (re)placements was 2 (range 1 to 6) with a median drainage duration of 41 days (range 2 to 182 days) and a stent dysfunction rate of 33\%. Although patients in group 1 were better drained than patients in groups 2 and 3 (median reduction of bilirubin levels 82\%, 57\%, and 37\%, respectively, p {\textless} 0.01), there was no difference in overall morbidity among the drained groups (50\%, 50\%, and 52\%, respectively). There was no significant difference in overall morbidity between patients with and without preoperative biliary drainage (50\% and 55\%, respectively). {CONCLUSIONS}: Preoperative biliary drainage did not influence the incidence of postoperative complications, and although it can be performed safely in jaundiced patients it should not be used routinely.},
	pages = {726--34},
	number = {6},
	journaltitle = {J Am Coll Surg},
	author = {Sewnath, M E and Birjmohun, R S and Rauws, E A and Huibregtse, K and Obertop, H and Gouma, D J},
	date = {2001-06}
}

@article{murri_relationship_2008,
	title = {The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer.},
	volume = {99},
	doi = {10.1038/sj.bjc.6604667},
	abstract = {The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic ({CD}4+ and {CD}8+) and macrophage  ({CD}68+) infiltration, proliferative (Ki-67) index and microvessel density ({CD}34+) was examined using immunohistochemistry and slide-counting techniques, and their  prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P{\textless}0.05)  and macrophage (P{\textless}0.05) infiltration and microvessel density (P{\textless}0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P{\textless}0.01), negative hormonal receptor (P{\textless}0.10), lower albumin concentrations (P{\textless}0.01), increased tumour proliferation (P{\textless}0.05), increased tumour microvessel density (P{\textless}0.05), the extent of locoregional control (P{\textless}0.0001) and limited systemic treatment (P{\textless}or=0.01) were associated with cancer-specific survival. On  multivariate analysis of these significant covariates, albumin ({HR} 4.77, 95\% {CI} 1.35-16.85, P=0.015), locoregional treatment ({HR} 3.64, 95\% {CI} 1.04-12.72, P=0.043) and systemic treatment ({HR} 2.29, 95\% {CI} 1.23-4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P{\textless}0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer.},
	pages = {1013--1019},
	number = {7},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Murri, A. M. Al and Hilmy, M. and Bell, J. and Wilson, C. and {McNicol}, A.-M. and Lannigan, A. and Doughty, J. C. and {McMillan}, D. C.},
	date = {2008-10-07},
	pmid = {18797461},
	pmcid = {PMC2567062},
	keywords = {*Cell Proliferation, *Survival Rate, Blood Vessels/*growth \& development, Breast Neoplasms/blood supply/immunology/*pathology/surgery, Female, Humans, Immunohistochemistry, Macrophages/*immunology, Neoplasm Invasiveness, T-Lymphocytes/*immunology}
}

@article{adib-conquy_compensatory_2008,
	title = {Compensatory anti-inflammatory response syndrome},
	issn = {0340-6245},
	url = {http://www.schattauer.de/index.php?id=1214&doi=10.1160/TH08-07-0421},
	doi = {10.1160/TH08-07-0421},
	journaltitle = {Thrombosis and Haemostasis},
	author = {Adib-Conquy, Minou and Cavaillon, Jean-Marc},
	urldate = {2015-08-21},
	date = {2008-12-06},
	langid = {english},
	file = {th_2009-101-1_10625.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M9GUH2SE\\th_2009-101-1_10625.pdf:application/pdf;th_2009-101-1_10625.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WHV5PDSQ\\th_2009-101-1_10625.pdf:application/pdf}
}

@article{soreide_preoperative_1990,
	title = {Preoperative biliary drainage},
	volume = {156},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2336919},
	pages = {251--2},
	number = {3},
	journaltitle = {Acta Chir Scand},
	author = {Søreide, O and Eide, G E},
	date = {1990-03}
}

@article{sue_metabolic_1988,
	title = {Metabolic acidosis during exercise in patients with chronic obstructive pulmonary disease. Use of the V-slope method for anaerobic threshold determination},
	volume = {94},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3180897},
	abstract = {Patients with chronic obstructive pulmonary disease ({COPD}) usually have limited exercise tolerance owing to low ventilatory capacity. Because metabolic acidosis induced by exercise increases ventilatory drive, decreasing the hydrogen ion stimulus may improve exercise capacity. However, in those with mechanical limitation to ventilation or chemoreceptor insensitivity, identifying metabolic acidosis may be difficult using gas exchange methods that depend on the ventilatory response to the acidosis. We compared a modification of a gas exchange method (V-slope) for determining the lactate (anaerobic) threshold ({AT}), which is independent of ventilatory response with a method using the change in blood standard bicarbonate ({HCO}3-) level in {COPD} and normal subjects during cycle incremental exercise. In 43 normal subjects, the {VO}2 at which metabolic acidosis was identified using the two method correlated (r = 0.75), although mean values differed. In 22 patients with moderately severe to severe {COPD}, eight who had a change in standard {HCO}3- less than 2.0 {mEq}/L between rest and 2 min of recovery from exercise (group 1) were contrasted with 14 whose blood standard {HCO}3- fell by greater than 2.5 {mEq}/L (group 2). Mean {VC} was higher and {FEV}1/{VC} was lower in group 2, but mean {FEV}1, maximal voluntary ventilation, and diffusing capacity for carbon monoxide were not different. The degree of obstruction did not correlate strongly with the degree of exercise metabolic acidosis. The {AT} determined by the V-slope method was compared with that from standard {HCO}3-; good correlation between these methods was found (r = 0.98), although mean values were different. The V-slope method predicted metabolic acidosis in 10/14 who had a fall in {HCO}3- more than 2.5 {mEq}/L. A significant proportion of patients with {COPD} seem to develop metabolic acidosis during exercise. The V-slope gas exchange method may be useful in selecting those patients with {COPD} who develop exercise metabolic acidosis and might therefore benefit from exercise training.},
	pages = {931--8},
	number = {5},
	journaltitle = {Chest},
	author = {Sue, D Y and Wasserman, K and Moricca, R B and Casaburi, R},
	date = {1988-11}
}

@article{torre_glasgow_2012,
	title = {The Glasgow Prognostic Score as a Predictor of Survival in Patients with Potentially Resectable Pancreatic Adenocarcinoma},
	volume = {19},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-012-2348-9},
	doi = {10.1245/s10434-012-2348-9},
	abstract = {Background Survival rates after resection of pancreatic adenocarcinoma are poor; however, several tumor-related prognostic factors have been identified. There is increasing evidence that additional patient-related prognostic factors, such as ongoing systemic inflammatory response, are associated with poor outcomes in patients with common solid tumors. The purpose of this study was to evaluate the prognostic significance of the modified glasgow prognostic score ({mGPS}) in resected pancreatic ductal adenocarcinoma. Methods Data were collected from 101 patients who had undergone pancreatic resection for ductal adenocarcinoma. Tumor and host factors were analyzed by Kaplan–Meier and Cox proportional hazard models to evaluate their potential prognostic effects. Results An elevated {mGPS} was associated with lower overall survival rate after pancreatic resection. The median actuarial survival rate for patients with an {mGPS} of 0, 1, or 2 was 37.2, 11.5, and 7.3, respectively (p = 0.0001). The Cox proportional hazards model, including all the parameters statistically significant at univariate analysis, demonstrated that {mGPS}, lymph node ratio ({LNR}), and positive resection margins were independent negative prognostic factors Conclusions Margin involvement, {LNR}, and the preoperative {mGPS} were identified as independent predictors of survival in patients undergoing potentially curative pancreatic resection. Based on the present results and existing validation literature, the {mGPS} should be included in the routine assessment of patients with pancreatic cancer to better stratify patients for entry into therapeutic trials.},
	pages = {2917--2923},
	number = {9},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Torre, Marco La and Nigri, Giuseppe and Cavallini, Marco and Mercantini, Paolo and Ziparo, Vincenzo and Ramacciato, Giovanni},
	urldate = {2015-05-18},
	date = {2012-04-10},
	langid = {english},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X4ZN49DC\\Torre et al. - 2012 - The Glasgow Prognostic Score as a Predictor of Sur.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2UVA8DXI\\10.html:text/html}
}

@article{marcus_endoscopic_1998,
	title = {Endoscopic biliary drainage before pancreaticoduodenectomy for periampullary malignancies},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9563924},
	abstract = {Despite decreased operative mortality, pancreaticoduodenectomy ({PD}) remains a formidable operation with substantial morbidity. We have evaluated the influence of preoperative endoscopic biliary drainage ({EBD}) on morbidity after {PD} for malignant biliary obstruction by retrospectively reviewing the medical records of 182 patients undergoing {PD} between April 1985 and August 1996. Of 52 study patients with malignant obstructive jaundice, 22 underwent preoperative {EBD}, and 30 were not drained. Eighty-three patients were excluded for bilirubin levels less than 5 mg/dl, 43 had other biliary drainage, and 4 had jaundice with benign pathology. Preoperative, intraoperative, and postoperative factors were compared. The two groups were well matched for clinical presentation and operative characteristics except for lower preoperative values of liver chemistries in patients undergoing {EBD}. Length of postoperative hospitalization for patients undergoing {EBD} was 13.5 days, compared with 19 days for patients who were not drained (p = 0.02). Patients who were not drained tended to have more overall complications (p = 0.054). Multivariate analysis revealed time to regular diet (p {\textless} 0.0001) and no preoperative drainage (p = 0.04) to be independent factors significantly increasing the length of hospitalization. Endoscopic biliary drainage before {PD} significantly reduced the length of postoperative hospitalization and was associated with less postoperative morbidity. Further studies, including cost analysis, are warranted.},
	pages = {125--9},
	number = {2},
	journaltitle = {J Clin Gastroenterol},
	author = {Marcus, S G and Dobryansky, M and Shamamian, P and Cohen, H and Gouge, T H and Pachter, H L and Eng, K},
	date = {1998-03}
}

@article{grewal_left_2009,
	title = {Left ventricular function and exercise capacity},
	volume = {301},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19155455},
	abstract = {Limited information exists regarding the role of left ventricular function in predicting exercise capacity and impact on age- and sex-related differences.},
	pages = {286--94},
	number = {3},
	journaltitle = {{JAMA}},
	author = {Grewal, Jasmine and {McCully}, Robert B and Kane, Garvan C and Lam, Carolyn and Pellikka, Patricia A},
	date = {2009-01}
}

@article{gruberg_impact_2002,
	title = {The impact of obesity on the short-term andlong-term outcomes after percutaneous coronary intervention: the obesity paradox?},
	volume = {39},
	issn = {0735-1097},
	url = {http://www.sciencedirect.com/science/article/pii/S0735109701018022},
	doi = {10.1016/S0735-1097(01)01802-2},
	shorttitle = {The impact of obesity on the short-term andlong-term outcomes after percutaneous coronary intervention},
	abstract = {{AbstractObjectives}
The purpose of this study was to assess the impact of body mass index ({BMI}) on the short- and long-term outcomes after percutaneous coronary intervention ({PCI}).
Background
Obesity is associated with advanced coronary artery disease ({CAD}). However, the relation between {BMI} and outcome after {PCI} remains controversial.
Methods
We studied 9,633 consecutive patients who underwent {PCI} between January 1994 and December 1999. Patients were divided into three groups according to {BMI}: normal, {BMI} between 18.5 and 24.9 (n = 1,923); overweight, {BMI} between 25 and 30 (n = 4,813); and obese, {BMI} \>30 (n = 2,897).
Results
Obese patients were significantly younger and had consistently worse baseline clinical characteristics than normal or overweight patients, with a higher incidence of hypertension, diabetes, hypercholesterolemia and smoking history (p \< 0.0001). Despite similar angiographic success rates among the three groups, normal {BMI} patients had a higher incidence of major in-hospital complications, including cardiac death (p = 0.001). At one-year follow-up, overall mortality rates were significantly higher for normal {BMI} patients compared with overweight or obese patients (p \< 0.0001). Myocardial infarction and revascularization rates did not differ among the three groups. By multivariate Cox regression analysis, diabetes, hypertension, age, {BMI} and left ventricular function were independent predictors of long-term mortality.
Conclusions
In patients with known {CAD} who undergo {PCI}, very lean patients ({BMI} \<18.5) and those with {BMI} within the normal range are at the highest risk for in-hospital complications and cardiac death and for increased one-year mortality.},
	pages = {578--584},
	number = {4},
	journaltitle = {Journal of the American College of Cardiology},
	shortjournal = {Journal of the American College of Cardiology},
	author = {Gruberg, Luis and Weissman, Neil J and Waksman, Ron and Fuchs, Shmuel and Deible, Regina and Pinnow, Ellen E and Ahmed, Lanja M and Kent, Kenneth M and Pichard, Augusto D and Suddath, William O and Satler, Lowell F and Lindsay Jr, Joseph},
	urldate = {2015-08-04},
	date = {2002-02-20},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZQ33A8SX\\Gruberg et al. - 2002 - The impact of obesity on the short-term andlong-te.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N5EM4BQN\\S0735109701018022.html:text/html}
}

@article{mansouri_flexible_2013,
	title = {Flexible sigmoidoscopy following a positive faecal occult blood test within a bowel screening programme may reduce the detection of neoplasia.},
	volume = {15},
	rights = {Colorectal Disease (c) 2013 The Association of Coloproctology of Great Britain and Ireland.},
	doi = {10.1111/codi.12377},
	abstract = {{AIM}: Colorectal cancer screening using the faecal occult blood test ({FOBt}) detects a disproportionate number of left-sided tumours. This study aims to examine the theoretical impact on neoplasia detection rates of a sigmoidoscopy-first protocol in {FOBt}-positive patients undergoing colonoscopy. {METHOD}: From retrieved endoscopy/pathology reports, pathology up to and including the splenic flexure was assumed detectable by sigmoidoscopy. High-risk polyps prompting subsequent colonoscopy were classed as three or more polyps, one polyp  of {\textgreater}/= 1 cm, villous or tubulovillous components or the presence of high-grade dysplasia. {RESULTS}: Between April 2009 and April 2011, 4631 patients underwent colonoscopy as a result of a positive {FOBt} in Greater Glasgow and Clyde. Cancer was detected in 398 (9\%) and adenomas were detected in 1985 (47\%) of which 1323 (67\%) were deemed significant according to British Society of Gastroenterology guidelines. Applying the flexible sigmoidoscopy-first model, cancer would have been detected in 329 (8\%) patients and adenomas in 1640 (39\%), of which 1140 (70\%) would have been significant. In total, 1546 (37\%) patients would have required subsequent colonoscopy, following which 21 patients would have a new diagnosis of cancer. The positive predictive values ({PPVs}) for neoplasia (47 vs 57\%, P {\textless} 0.001), significant neoplasia (35 vs 41\%, P {\textless} 0.001) and cancer (8 vs 9\%, P = 0.007) were all lower in the sigmoidoscopy-first model. {CONCLUSION}: A significant reduction in the detection of both adenomas and cancers would be seen if the sigmoidoscopy-first protocol were to be used following a positive {FOBt}. Furthermore, a significant proportion of patients would be subjected to two procedures, with considerable implications for both the patient and cost.},
	pages = {1375--1381},
	number = {11},
	journaltitle = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
	shortjournal = {Colorectal Dis},
	author = {Mansouri, D. and {McMillan}, D. C. and Roxburgh, C. S. D. and Moug, S. J. and Crighton, E. M. and Horgan, P. G.},
	date = {2013-11},
	pmid = {23927751},
	keywords = {*Occult Blood, Adenocarcinoma/*diagnosis, Adenoma/*diagnosis, Aged, Colonoscopy/*statistics \& numerical data, Colorectal Neoplasms/*diagnosis, Early Detection of Cancer/methods/*statistics \& numerical data, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Sigmoidoscopy/*statistics \& numerical data}
}

@article{kothmann_reliability_2009,
	title = {Reliability of the anaerobic threshold in cardiopulmonary exercise testing of patients with abdominal aortic aneurysms*},
	volume = {64},
	rights = {© 2008 The Authors. Journal compilation © 2008 The Association of Anaesthetists of Great Britain and Ireland},
	issn = {1365-2044},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.2008.05690.x/abstract},
	doi = {10.1111/j.1365-2044.2008.05690.x},
	abstract = {Anaerobic threshold ({AT}), determined by cardiopulmonary exercise testing ({CPET}), is a well-documented measure of pre-operative fitness, although its reliability in patient populations is uncertain. Our aim was to assess the reliability of {AT} measurement in patients with abdominal aortic aneurysms. Eighteen patients were recruited. {CPET} was performed four times over a 6-week period. We examined shifts in the mean {AT} to evaluate systematic bias with random measurement error assessed using typical within-patient error and intraclass correlation coefficient ({ICC}, 3,1) statistics. There was no significant or clinically substantial change in mean {AT} across the tests (p = 0.68). The typical within-patient error expressed as a percentage coefficient of variation was 10\% (95\% {CI}, 8–13\%), with an {ICC} of 0.74 (95\% {CI}, 0.55–0.89). We consider the reliability of the {AT} to be acceptable, supporting its clinical validity and utility as an objective marker of pre-operative fitness in this population.},
	pages = {9--13},
	number = {1},
	journaltitle = {Anaesthesia},
	author = {Kothmann, E. and Danjoux, G. and Owen, S. J. and Parry, A. and Turley, A. J. and Batterham, A. M.},
	urldate = {2015-06-05},
	date = {2009-01-01},
	langid = {english},
	keywords = {Aged, anaerobic threshold, Aortic Aneurysm, Abdominal, Electrocardiography, Ambulatory, Exercise Test, Female, Humans, Male, Middle Aged, Physical fitness, Pilot Projects, Reproducibility of Results},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M69AICK5\\Kothmann et al. - 2009 - Reliability of the anaerobic threshold in cardiopu.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AI4BT2WT\\abstract.html:text/html}
}

@article{robertson_use_1981,
	title = {Use of receiver operating characteristic curves to evaluate the clinical performance of analytical systems.},
	volume = {27},
	issn = {0009-9147, 1530-8561},
	url = {http://www.clinchem.org/content/27/9/1569},
	pages = {1569--1574},
	number = {9},
	journaltitle = {Clinical Chemistry},
	shortjournal = {Clinical Chemistry},
	author = {Robertson, E. A. and Zweig, M. H.},
	urldate = {2015-07-15},
	date = {1981-09-01},
	langid = {english},
	pmid = {7261334},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WJI8SUQH\\Robertson and Zweig - 1981 - Use of receiver operating characteristic curves to.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\553NNZ7J\\1569.html:text/html}
}

@article{toouli_guidelines_2002,
	title = {Guidelines for the management of acute pancreatitis},
	volume = {17 Suppl},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12000591},
	pages = {S15--39},
	journaltitle = {J Gastroenterol Hepatol},
	author = {Toouli, J and Brooke-Smith, M and Bassi, C and Carr-Locke, D and Telford, J and Freeny, P and Imrie, C and Tandon, R},
	date = {2002-02}
}

@article{brown_correlation_2005,
	title = {The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer.},
	volume = {103},
	rights = {(c) 2004 American Cancer Society.},
	doi = {10.1002/cncr.20777},
	abstract = {{BACKGROUND}: Functional disability is reported frequently in fatigued cancer patients, but little is known about the correlation between fatigue and objective physical function. In addition, from previous work, the systemic inflammatory response and psychological distress appear to be related to fatigue. {METHODS}: Thirty-eight patients with metastatic or locally advanced lung carcinoma and 15 age-matched and gender-matched, healthy controls completed the Functional Assessment of Chronic Illness Therapy-Fatigue scale, a visual analogue weakness score, and the Hospital Anxiety and Depression ({HAD}) scale. Hemoglobin concentrations, C-reactive protein ({CRP}) concentrations, creatine kinase concentrations, white blood cell count, body composition, Karnofsky performance status ({KPS}), grip strength, and chair-rise time also were measured in both groups. The cancer patients were then grouped into tertiles on the basis of fatigue scores. {RESULTS}: The cancer patients had greater fatigue compared with the control group (P {\textless} 0.001). They also weighed less, had lower hemoglobin and creatine kinase levels and higher {CRP} levels, and had lower {KPS}, poorer grip strength, longer chair-rise times, and increased {HAD} scale scores (all P {\textless} 0.01). {KPS} and chair-rise time were correlated strongly (r(2) = 0.565; P {\textless} 0.001). With  increasing fatigue, {KPS} was lower, and chair-rise time and {HAD} scale scores were  greater (P {\textless} 0.01). On multiple regression analysis, only {KPS}, weakness, and {HAD}  scale scores were correlated independently with fatigue (r(2) = 0.570; P {\textless} 0.001). {CONCLUSIONS}: Objective physical function (as measured by chair-rise time) in patients with advanced lung cancer was poorer with increasing fatigue. Results of the current study suggest that fatigue is not a result primarily of weight loss or anemia but is related to {KPS} and psychological distress.},
	pages = {377--382},
	number = {2},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {Brown, Duncan J. F. and {McMillan}, Donald C. and Milroy, Robert},
	date = {2005-01-15},
	pmid = {15558809},
	keywords = {*Quality of Life, Adult, Aged, Aged, 80 and over, Age Distribution, Analysis of Variance, Anxiety/diagnosis/epidemiology, Case-Control Studies, Cohort Studies, Comorbidity, Depressive Disorder/diagnosis/*epidemiology, Exercise Tolerance/physiology, Fatigue/diagnosis/*epidemiology, Female, Humans, Incidence, Inflammation/diagnosis/epidemiology, Karnofsky Performance Status, Lung Neoplasms/*epidemiology/*pathology/therapy, Male, Middle Aged, Muscle Weakness, Neoplasm Invasiveness/*pathology, Neoplasm Staging, Pain Measurement, Probability, Reference Values, Risk Assessment, Severity of Illness Index, Sex Distribution, Statistics, Nonparametric, Survival Analysis}
}

@article{nagino_preoperative_2008,
	title = {Preoperative biliary drainage for biliary tract and ampullary carcinomas},
	volume = {15},
	issn = {0944-1166, 1436-0691},
	url = {http://link.springer.com/10.1007/s00534-007-1277-7},
	doi = {10.1007/s00534-007-1277-7},
	pages = {25--30},
	number = {1},
	journaltitle = {Journal of Hepato-Biliary-Pancreatic Surgery},
	author = {Nagino, Masato and Takada, Tadahiro and Miyazaki, Masaru and Miyakawa, Shuichi and Tsukada, Kazuhiro and Kondo, Satoshi and Furuse, Junji and Saito, Hiroya and Tsuyuguchi, Toshio and Yoshikawa, Tatsuya and Ohta, Tetsuo and Kimura, Fumio and Ohta, Takehiro and Yoshitomi, Hideyuki and Nozawa, Satoshi and Yoshida, Masahiro and Wada, Keita and Amano, Hodaka and Miura, Fumihiko},
	urldate = {2014-01-27},
	date = {2008-02-16},
	file = {Nagino et al. - 2008 - Preoperative biliary drainage for biliary tract an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PDED5EHI\\Nagino et al. - 2008 - Preoperative biliary drainage for biliary tract an.pdf:application/pdf}
}

@article{mcardle_systemic_2010,
	title = {Systemic inflammatory response and survival in patients with localised prostate cancer: 10-year follow-up.},
	volume = {84},
	rights = {Copyright (c) 2010 S. Karger {AG}, Basel.},
	doi = {10.1159/000313364},
	abstract = {{AIM}: To examine the prognostic value of circulating C-reactive protein concentrations at diagnosis in patients with organ-confined prostate cancer. {PATIENTS} {AND} {METHODS}: Ninety-eight patients with histologically proven clinically localised prostate cancer were studied. Clinical stage, tumour grade, circulating {PSA} and C-reactive protein concentrations at diagnosis were recorded. {RESULTS}: The majority of patients was under the age of 70 years and had low-grade tumours. Approximately half the patients received radical local treatment. During the follow-up period (median 10 years) 38 patients died, of whom 18 died of prostate  cancer, 6 of other cancers and 14 of non-cancer causes. On univariate survival analysis, age (p {\textless} 0.001), Gleason score (p {\textless} 0.05), C-reactive protein (p {\textless} 0.05) and treatment (p {\textless} 0.05) were significant predictors of overall survival. On univariate survival analysis, age (p {\textless} 0.001), Gleason score (p {\textless} 0.05) and},
	pages = {430--435},
	number = {4},
	journaltitle = {Urologia internationalis},
	shortjournal = {Urol Int},
	author = {{McArdle}, Peter A. and Qayyum, Tahir and {McMillan}, Donald C.},
	date = {2010},
	pmid = {20395655},
	keywords = {Aged, Age Factors, C-Reactive Protein/*analysis, Cross-Sectional Studies, Humans, Inflammation Mediators/*blood, Male, Neoplasm Invasiveness, Neoplasm Staging, Predictive Value of Tests, Proportional Hazards Models, Prostate-Specific Antigen/blood, Prostatic Neoplasms/immunology/*mortality/pathology/*therapy, Risk Assessment, Risk Factors, Scotland/epidemiology, Survival Analysis, Survivors/*statistics \& numerical data, Systemic Inflammatory Response Syndrome/immunology/*mortality, Time Factors, Treatment Outcome}
}

@article{yeo_six_1997,
	title = {Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes},
	volume = {226},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9339931},
	abstract = {{OBJECTIVE}: The authors reviewed the pathology, complications, and outcomes in a consecutive group of 650 patients undergoing pancreaticoduodenectomy in the 1990s. {SUMMARY} {BACKGROUND} {DATA}: Pancreaticoduodenectomy has been used increasingly in recent years to resect a variety of malignant and benign diseases of the pancreas and periampullary region. {METHODS}: Between January 1990 and July 1996, inclusive, 650 patients underwent pancreaticoduodenal resection at The Johns Hopkins Hospital. Data were recorded prospectively on all patients. All pathology specimens were reviewed and categorized. Statistical analyses were performed using both univariate and multivariate models. {RESULTS}: The patients had a mean age of 63 +/- 12.8 years, with 54\% male and 91\% white. The number of resections per year rose from 60 in 1990 to 161 in 1995. Pathologic examination results showed pancreatic cancer (n = 282; 43\%), ampullary cancer (n = 70; 11\%), distal common bile duct cancer (n = 65; 10\%), duodenal cancer (n = 26; 4\%), chronic pancreatitis (n = 71; 11\%), neuroendocrine tumor (n = 31; 5\%), periampullary adenoma (n = 21; 3\%), cystadenocarcinoma (n = 14; 2\%), cystadenoma (n = 25; 4\%), and other (n = 45; 7\%). The surgical procedure involved pylorus preservation in 82\%, partial pancreatectomy in 95\%, and portal or superior mesenteric venous resection in 4\%. Pancreatic-enteric reconstruction, when appropriate, was via pancreaticojejunostomy in 71\% and pancreaticogastrostomy in 29\%. The median intraoperative blood loss was 625 {mL}, median units of red cells transfused was zero, and the median operative time was 7 hours. During this period, 190 consecutive pancreaticoduodenectomies were performed without a mortality. Nine deaths occurred in-hospital or within 30 days of operation (1.4\% operative mortality). The postoperative complication rate was 41\%, with the most common complications being early delayed gastric emptying (19\%), pancreatic fistula (14\%), and wound infection (10\%). Twenty-three patients required reoperation in the immediate postoperative period (3.5\%), most commonly for bleeding, abscess, or dehiscence. The median postoperative length of stay was 13 days. A multivariate analysis of the 443 patients with periampullary adenocarcinoma indicated that the most powerful independent predictors favoring long-term survival included a pathologic diagnosis of duodenal adenocarcinoma, tumor diameter {\textless}3 cm, negative resection margins, absence of lymph node metastases, well-differentiated histology, and no reoperation. {CONCLUSIONS}: This single institution, high-volume experience indicates that pancreaticoduodenectomy can be performed safely for a variety of malignant and benign disorders of the pancreas and periampullary region. Overall survival is determined largely by the pathology within the resection specimen.},
	pages = {248--57; discussion 257--60},
	number = {3},
	journaltitle = {Ann Surg},
	author = {Yeo, C J and Cameron, J L and Sohn, T A and Lillemoe, K D and Pitt, H A and Talamini, M A and Hruban, R H and Ord, S E and Sauter, P K and Coleman, J and Zahurak, M L and Grochow, L B and Abrams, R A},
	date = {1997-09},
	file = {Yeo et al. - 1997 - Six hundred fifty consecutive pancreaticoduodenect.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KVSDTNSQ\\Yeo et al. - 1997 - Six hundred fifty consecutive pancreaticoduodenect.pdf:application/pdf}
}

@article{martin_irreversible_2012,
	title = {Irreversible electroporation therapy in the management of locally advanced pancreatic adenocarcinoma},
	volume = {215},
	issn = {1879-1190},
	doi = {10.1016/j.jamcollsurg.2012.05.021},
	abstract = {{BACKGROUND}: Locally advanced pancreatic cancer patients have limited options for disease control. Local ablation technologies based on thermal damage have been used but are associated with major complications in this region of the pancreas. Irreversible electroporation ({IRE}) is a nonthermal ablation technology that we have shown is safe near vital vascular and ductal structures. The aim of this study was to evaluate the safety and efficacy of {IRE} as a therapy in the treatment of locally advanced pancreatic cancer.
{STUDY} {DESIGN}: We performed a prospective multi-institutional pilot evaluation of patients undergoing {IRE} for locally advanced pancreatic cancer from December 2009 to March 2011. These patients were evaluated for 90-day morbidity, mortality, and local disease control.
{RESULTS}: Twenty-seven patients (13 women and 14 men) underwent {IRE}, with median age of 61 years (range 45 to 80 years). Eight patients underwent margin accentuation with {IRE} in combination with left-sided resection (n = 4) or pancreatic head resection (n = 4). Nineteen patients had in situ {IRE}. All patients underwent successful {IRE}, with intraoperative imaging confirming effective delivery of therapy. All 27 patients demonstrated nonclinically relevant elevation of their amylase and lipase, which peaked at 48 hours and returned to normal at 72 hour postprocedure. There has been one 90-day mortality. No patient has shown evidence of clinical pancreatitis or fistula formation. After all patients have completed 90-day follow-up, there has been 100\% ablation success.
{CONCLUSIONS}: {IRE} ablation of locally advanced pancreatic cancer tumors is a safe and feasible primary local treatment in unresectable, locally advanced disease. Confirming these early results must occur in a planned phase {II} investigational device exemption ({IDE}) study to be initiated in 2012.},
	pages = {361--369},
	number = {3},
	journaltitle = {Journal of the American College of Surgeons},
	shortjournal = {J. Am. Coll. Surg.},
	author = {Martin, Robert C. G. and {McFarland}, Kelli and Ellis, Susan and Velanovich, Vic},
	date = {2012-09},
	pmid = {22726894},
	keywords = {Ablation Techniques, Adenocarcinoma, Aged, Aged, 80 and over, Combined Modality Therapy, Electroporation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Pancreatectomy, Pancreatic Neoplasms, Pilot Projects, Prospective Studies, Treatment Outcome}
}

@article{tarrant_models_2004,
	title = {Models of the medical consultation: opportunities and limitations of a game theory perspective},
	volume = {13},
	issn = {1475-3898, 1475-3901},
	url = {http://qualitysafety.bmj.com/lookup/doi/10.1136/qshc.2003.008417},
	doi = {10.1136/qshc.2003.008417},
	shorttitle = {Models of the medical consultation},
	pages = {461--466},
	number = {6},
	journaltitle = {Quality and Safety in Health Care},
	author = {Tarrant, C},
	urldate = {2015-06-06},
	date = {2004-12-01},
	langid = {english},
	file = {GT2.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WWCVRB8J\\GT2.pdf:application/pdf}
}

@article{tsai_effect_2006,
	title = {Effect of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17153432},
	abstract = {{BACKGROUND}/{AIMS}: Preoperative biliary drainage ({PBD}) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial. {METHODOLOGY}: Retrospective analysis of 313 patients undergoing pancreaticoduodenectomy between 1991 and 2004 was performed. Patients were stratified into {PBD} and no preoperative biliary drainage ({NPBD}) groups. Perioperative morbidity and mortality were evaluated and surgical risks compared. Nine retrospective studies were also evaluated. {RESULTS}: {PBD} was performed in 210; 103 had {NPBD}. Common indications for {PBD} were jaundice and cholangitis. Postoperative complications occurred in 153; 20 died postoperatively. {PBD} patients were older and predominantly male. Cholangitis, low albumin, and higher preoperative bilirubin were increased in {PBD}. Pancreatic leakage and postoperative hospital days were increased in {NPBD}. Wound infection occurred more frequently in {PBD}, but this was not significant. Perioperative mortality rate was 6.7\% in {PBD} compared to 5.8\% in {NPBD}. Postoperative complication rate was 45.7\% for {PBD} and 55.3\% for {NPBD}. Twelve {PBD} patients had procedure-related complications. Of 2391 patients pooled from the nine reviews and our study (1516 {PBD} and 875 {NPBD}), no significant difference was observed in postoperative mortality and overall complications. Wound infection was significantly increased in {PBD} (p{\textless}0.001). {CONCLUSIONS}: Preoperative biliary drainage did not increase postoperative morbidity and mortality rate in pancreaticoduodenectomy patients, but should be used judiciously.},
	pages = {823--7},
	number = {72},
	journaltitle = {Hepatogastroenterology},
	author = {Tsai, Yi-Fang and Shyu, Jia-Fwu and Chen, Tien-Hua and Shyr, Yi-Ming and Su, Cheng-Hsi},
	date = {2006-12}
}

@article{mcpherson_improving_1984,
	title = {Improving renal function in obstructive jaundice without preoperative drainage},
	volume = {1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6142234},
	pages = {511--2},
	number = {8375},
	journaltitle = {Lancet},
	author = {{McPherson}, G A and Benjamin, I S and Blumgart, L H},
	date = {1984-03},
	note = {Cochrane review paper}
}

@article{deitch_obstructive_1990,
	title = {Obstructive jaundice promotes bacterial translocation from the gut},
	volume = {159},
	issn = {0002-9610},
	abstract = {Experiments were performed to determine if obstructive jaundice promotes the translocation of bacteria from the gastrointestinal tract to visceral organs. Three groups of mice were studied: control (n = 20), sham ligated (n = 28), and bile duct ligated (n = 33). The sham-ligated group underwent laparotomy and manipulation of the portal region, whereas the ligated group had their common bile ducts ligated. Seven days later, the mice were killed, their organs cultured, and the gastrointestinal tract examined histologically. The bilirubin levels of the ligated group (18.7 mg/{dL}) were elevated compared with the other groups (0.5 mg/{dL}) (p less than 0.05). The incidence of bacterial translocation was higher in the ligated (33\%) than in the control (5\%) or sham-ligated (7\%) groups (p less than 0.05). Since bile is important in binding endotoxin and maintaining a normal intestinal microflora, cecal bacterial populations were quantitated. The cecal levels of gram-negative, enteric bacilli were 100-fold higher in the bile duct-ligated mice in which bacterial translocation occurred (p less than 0.05), indicating that intestinal bacterial overgrowth was a major factor responsible for bacterial translocation. The mucosal appearance of the intestines from the control and sham-ligated groups was normal. In contrast, subepithelial edema involving the ileal villi was present in the ligated group. In conclusion, the absence of bile within the gastrointestinal tract allows intestinal overgrowth with enteric bacilli and the combination of bacterial overgrowth and mucosal injury appears to promote bacterial translocation.},
	pages = {79--84},
	number = {1},
	journaltitle = {American Journal of Surgery},
	shortjournal = {Am. J. Surg.},
	author = {Deitch, E. A. and Sittig, K. and Li, M. and Berg, R. and Specian, R. D.},
	date = {1990-01},
	pmid = {2136788},
	keywords = {Animals, cholestasis, Common Bile Duct, Female, Ileum, Intestines, ligation, Liver, Lymph Nodes, Male, Mesentery, Mice, Specific Pathogen-Free Organisms, Spleen}
}

@article{sinclair_cardiopulmonary_2009,
	title = {Cardiopulmonary exercise testing diagnosis of myocardial suppression},
	volume = {64},
	rights = {© 2009 The Association of Anaesthetists of Great Britain and Ireland},
	issn = {1365-2044},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.2009.05979.x/abstract},
	doi = {10.1111/j.1365-2044.2009.05979.x},
	pages = {788--789},
	number = {7},
	journaltitle = {Anaesthesia},
	author = {Sinclair, R. C. F. and Danjoux, G. R.},
	urldate = {2015-06-04},
	date = {2009-07-01},
	langid = {english},
	keywords = {Aged, Aneurysm, Anti-Arrhythmia Agents, Disopyramide, Exercise Test, Humans, Male, preoperative care, Ventricular Dysfunction, Left},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UXSBCR5J\\Sinclair and Danjoux - 2009 - Cardiopulmonary exercise testing diagnosis of myoc.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4JZCZXHS\\abstract.html:text/html}
}

@article{klempa_[palliative_1994,
	title = {[Palliative surgical and endoscopic therapy of malignant bile duct occlusion]},
	volume = {65},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7529670},
	abstract = {Cholestatic jaundice is the result of a malignancy of the bile duct itself, of the gallbladder, of the ampulla or (as in most cases) of the pancreas. Patients without evidence of metastases or other signs of advanced cancer (e.g. ascites) are candidates for explorative laparotomy. In the vast majority of cases resection of a tumor is not feasible and the surgeon is faced with the objective of providing palliation. To date there exists not only one palliative procedure, and the surgeon has to take into account the following: In patients with pancreatic cancer palliation can be given with biliary bypass with or without gastroenterostomy. This carries an operative mortality of almost 20\% and means a survival of only 5-6 months. Nonsurgical procedures as transpapillary stenting play an increasing role in the management of patients with obstructive jaundice due to pancreatic cancer. In some cases however resectable tumors perhaps will be overlooked. The results of controlled studies comparing endoscopic stenting and surgical bypass are encouraging for stenting techniques (lower morbidity and mortality ({\textless} 10\%), technical success rates exceeding 90\%). The availability of different palliative treatment modalities for carcinoma of the bile ducts suggests that no approach is definitely superior. Operative biliary-enteric anastomosis gives a tolerable operative mortality rate in younger patients, less morbidity, than external biliary drainage by better quality of life of the patients. In retrograde placement of prosthetic stents, in patients with high bile duct obstruction difficulties are frequently. In such cases the percutaneous drainage should be reserved for endoscopic failures, in cases the endoscopic and percutaneous approaches can be combined in the 'rendezvous' procedure. In recent years several reports have advocated extensive surgery for biliary neoplasms. Preoperative staging of these patients remains an issue as none of the commonly modalities are accurate in predicting resectability.},
	pages = {836--48},
	number = {10},
	journaltitle = {Chirurg},
	author = {Klempa, I and Arnold, W},
	date = {1994-10}
}

@article{dolfing_different_2005,
	title = {Different cycle ergometer outcomes in severely obese men and women without documented cardiopulmonary morbidities before bariatric surgery},
	volume = {128},
	issn = {0012-3692},
	doi = {10.1378/chest.128.1.256},
	abstract = {{STUDY} {OBJECTIVES}: The number of severely obese patients undergoing bariatric surgery is increasing. No incremental cycle ergometer data are available in this category of patients. The current study was undertaken to provide information and to compare outcomes between severely obese men and women during physical exercise.
{DESIGN}: Cross-sectional study.
{PARTICIPANTS}: Twenty-two men and 34 women, all with a body mass index ({BMI}) of at least 40 kg/m(2), were selected from among persons participating in a dedicated weight management program that was carried out in the outpatient clinic of a large teaching hospital.
{MEASUREMENTS} {AND} {RESULTS}: Body composition was estimated with bioelectrical impedance. Oxygen uptake (Vo(2)) was obtained by breath-by-breath minute ventilation (ventilated hood) and was measured under resting energy expenditure ({REE}) conditions. Endurance was measured with an incremental cycle ergometer test. Male and female groups were balanced for mean (+/- {SD}) age (42.7 +/- 7.6 vs 41.8 +/- 8.9 years, respectively), {BMI} (43.0 +/- 4.9 vs 41.3 +/- 5.2 kg/m(2), respectively), and fat weight (55.5 +/- 14.0 vs 56.8 +/- 2.2 kg, respectively). Fat-free mass ({FFM}), {FFM} index, fasting blood glucose level, insulin level, {REE}, and Vo(2) at rest and during subjective maximal endurance were higher in the male group. However, maximal Vo(2) (women, 119 +/- 19\% predicted; men, 92 +/- 16\% predicted) and anaerobic threshold were higher in the female group (women, 64 +/- 12\% predicted; men, 48 +/- 76\% predicted, respectively; p {\textless} 0.0001).
{CONCLUSIONS}: Severely obese men were more carbohydrate-intolerant and sustained less physical endurance than was predicted according to standards in comparison with obese women. The cycle ergometer data indicated that male gender was associated with less physical fitness.},
	pages = {256--262},
	number = {1},
	journaltitle = {Chest},
	shortjournal = {Chest},
	author = {Dolfing, Jacqueline G. and Dubois, Emile F. and Wolffenbuttel, Bruce H. R. and ten Hoor-Aukema, Nienke M. and Schweitzer, Dave H.},
	date = {2005-07},
	pmid = {16002944},
	keywords = {Adult, Bariatrics, Cross-Sectional Studies, Ergometry, Female, Heart Rate, Humans, Male, Obesity, Morbid, Oxygen Consumption, Physical Endurance, Physical fitness}
}

@article{moyes_preoperative_2009,
	title = {Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer},
	volume = {100},
	rights = {© 2009 Nature Publishing Group},
	issn = {0007-0920},
	url = {http://www.nature.com/bjc/journal/v100/n8/full/6604997a.html},
	doi = {10.1038/sj.bjc.6604997},
	abstract = {The presence of systemic inflammation before surgery, as evidenced by the glasgow prognostic score ({mGPS}), predicts poor long-term survival in colorectal cancer. The aim was to examine the relationship between the preoperative {mGPS} and the development of postoperative complications in patients undergoing potentially curative resection for colorectal cancer. Patients (n=455) who underwent potentially curative resections between 2003 and 2007 were assessed consecutively, and details were recorded in a database. The majority of patients presented for elective surgery (85\%) were over the age of 65 years (70\%), were male (58\%), were deprived (53\%), and had {TNM} stage I/{II} disease (61\%), had preoperative haemoglobin (56\%), white cell count (87\%) and {mGPS} 0 (58\%) in the normal range. After surgery, 86 (19\%) patients developed a postoperative complication; 70 (81\%) of which were infectious complications. On multivariate analysis, peritoneal soiling (P{\textless}0.01), elevated preoperative white cell count (P{\textless}0.05) and {mGPS} (P{\textless}0.01) were independently associated with increased risk of developing a postoperative infection. In elective patients, only the {mGPS} ({OR}=1.75, 95\% {CI}=1.17–2.63, P=0.007) was significantly associated with increased risk of developing a postoperative infection. Preoperative elevated {mGPS} predicts increased postoperative infectious complications in patients undergoing potentially curative resection for colorectal cancer.},
	pages = {1236--1239},
	number = {8},
	journaltitle = {British Journal of Cancer},
	shortjournal = {Br J Cancer},
	author = {Moyes, L. H. and Leitch, E. F. and {McKee}, R. F. and Anderson, J. H. and Horgan, P. G. and {McMillan}, D. C.},
	urldate = {2015-05-18},
	date = {2009-03-24},
	langid = {english},
	keywords = {Aged, Colonic Neoplasms/surgery, Colorectal cancer, Colorectal Neoplasms/blood/mortality/*physiopathology/*surgery, C-Reactive Protein/analysis, Female, Glasgow Prognostic Score, Humans, Infection/*epidemiology, infectious complications, Inflammation/*pathology, Male, Middle Aged, Neoplasm Staging, Postoperative Complications/*epidemiology, Predictive Value of Tests, Preoperative Care, Prognosis, Rectal Neoplasms/surgery, Serum Albumin/analysis, Socioeconomic Factors, surgery, Survival Rate},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WG8SXMTH\\Moyes et al. - 2009 - Preoperative systemic inflammation predicts postop.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XXQFVZXV\\6604997a.html:text/html}
}

@article{werner_management_2005,
	title = {Management of acute pancreatitis: from surgery to interventional intensive care},
	volume = {54},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15710995},
	pages = {426--36},
	number = {3},
	journaltitle = {Gut},
	author = {Werner, J and Feuerbach, S and Uhl, W and Büchler, M W},
	date = {2005-03}
}

@article{hietbrink_trauma:_2006,
	title = {Trauma: the role of the innate immune system},
	volume = {1},
	rights = {2006 Hietbrink et al; licensee {BioMed} Central Ltd.},
	issn = {1749-7922},
	url = {http://www.wjes.org/content/1/1/15/abstract},
	doi = {10.1186/1749-7922-1-15},
	shorttitle = {Trauma},
	abstract = {{PMID}: 16759367},
	pages = {15},
	number = {1},
	journaltitle = {World Journal of Emergency Surgery},
	author = {Hietbrink, F. and Koenderman, L. and Rijkers, G. T. and Leenen, L. P. H.},
	urldate = {2015-07-15},
	date = {2006-05-20},
	langid = {english},
	pmid = {16759367},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IPEKRHMZ\\Hietbrink et al. - 2006 - Trauma the role of the innate immune system.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MDEJIX7C\\15.html:text/html}
}

@article{padillo_multivariate_2005,
	title = {Multivariate analysis of factors associated with renal dysfunction in patients with obstructive jaundice},
	volume = {92},
	issn = {0007-1323, 1365-2168},
	url = {http://doi.wiley.com/10.1002/bjs.5091},
	doi = {10.1002/bjs.5091},
	pages = {1388--1392},
	number = {11},
	journaltitle = {British Journal of Surgery},
	author = {Padillo, F. J. and Cruz, A. and Briceño, J. and Martin-Malo, A. and Pera-Madrazo, C. and Sitges-Serra, A.},
	urldate = {2014-01-27},
	date = {2005-11},
	file = {Padillo et al. - 2005 - Multivariate analysis of factors associated with r.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KDECJBAH\\Padillo et al. - 2005 - Multivariate analysis of factors associated with r.pdf:application/pdf}
}

@article{mcmillan_relationship_1994,
	title = {Relationship between weight loss, reduction of body cell mass and inflammatory response in patients with cancer.},
	volume = {81},
	abstract = {Reduced food intake is a major cause of continuing weight loss in patients with cancer. Previous work has suggested that an ongoing inflammatory response may also contribute to weight loss and alter the nature of body tissue loss. To examine this, body cell mass was estimated using measurements of total body potassium ({TBK}) in 31 patients with gastrointestinal cancer and weight loss with  or without an inflammatory response (C-reactive protein level above 5 mg/l). Albumin levels, total body water and 24-h urinary creatinine clearance were also  measured. When measured {TBK} was expressed as a percentage of predicted normal values there was a significant reduction in {TBK} for patients with an inflammatory response compared with that of those without (P = 0.04). However, when a different prediction equation for {TBK} was used this difference was not significant (P = 0.29). Therefore, it remains uncertain whether an ongoing inflammatory response in patients with cancer and weight loss contributes to loss of body cell mass.},
	pages = {1011--1014},
	number = {7},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {{McMillan}, D. C. and Preston, T. and Watson, W. S. and Simpson, J. M. and Fearon, K. C. and Shenkin, A. and Burns, H. J. and {McArdle}, C. S.},
	date = {1994-07},
	pmid = {7922049},
	keywords = {*Body Composition, *Weight Loss, Aged, C-Reactive Protein/analysis, Female, Gastrointestinal Neoplasms/*pathology, Humans, Inflammation, Male, Middle Aged, Potassium/analysis, Sex Distribution}
}

@article{balladur_bleeding_1996,
	title = {Bleeding of the pancreatic stump following pancreatoduodenectomy for cancer},
	volume = {43},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8682476},
	abstract = {The purpose of this study was to determine the characteristics of bleeding of the pancreatic stump after pancreatoduodenal resection with pancreatojejunal anastomosis.},
	pages = {268--70},
	number = {7},
	journaltitle = {Hepatogastroenterology},
	author = {Balladur, P and Christophe, M and Tiret, E and Parc, R},
	date = {1996-02}
}

@article{mcdonagh_ready_1972,
	title = {The ready isomerization of bilirubin {IX}- in aqueous solution},
	volume = {129},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4659001},
	pages = {797--800},
	number = {3},
	journaltitle = {Biochem J},
	author = {{McDonagh}, A F and Assisi, F},
	date = {1972-09},
	file = {McDonagh and Assisi - 1972 - The ready isomerization of bilirubin IX- in aqueou.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HNEK5MHZ\\McDonagh and Assisi - 1972 - The ready isomerization of bilirubin IX- in aqueou.pdf:application/pdf}
}

@article{mofidi_association_2006,
	title = {Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis},
	volume = {93},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16671062},
	abstract = {Mortality in patients with acute pancreatitis is associated with the number of failing organs and the severity and reversibility of organ dysfunction. The aim of this study was to assess the significance of early systemic inflammatory response syndrome ({SIRS}) in the development of multiorgan dysfunction syndrome ({MODS}) and death from acute pancreatitis.},
	pages = {738--44},
	number = {6},
	journaltitle = {Br J Surg},
	author = {Mofidi, R and Duff, M D and Wigmore, S J and Madhavan, K K and Garden, O J and Parks, R W},
	date = {2006-06}
}

@article{pearson_mathematical_1896,
	title = {Mathematical Contributions to the Theory of Evolution.--On a Form of Spurious Correlation Which May Arise When Indices Are Used in the Measurement of Organs},
	volume = {60},
	issn = {0370-1662,},
	url = {http://rspl.royalsocietypublishing.org/content/60/359-367/489},
	doi = {10.1098/rspl.1896.0076},
	pages = {489--498},
	number = {359},
	journaltitle = {Proceedings of the Royal Society of London},
	shortjournal = {Proc. R. Soc. Lond.},
	author = {Pearson, Karl},
	urldate = {2015-08-18},
	date = {1896-01-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Z42GRNR5\\Pearson - 1896 - Mathematical Contributions to the Theory of Evolut.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6ZA6BCC7\\489.html:text/html}
}

@article{woo_influence_2006,
	title = {The influence of age, gender, and training on exercise efficiency},
	volume = {47},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16516092},
	abstract = {The aim of this study was to determine whether changes in oxygen efficiency occur with aging or exercise training in healthy young and older subjects.},
	pages = {1049--57},
	number = {5},
	journaltitle = {J Am Coll Cardiol},
	author = {Woo, J Susie and Derleth, Christina and Stratton, John R and Levy, Wayne C},
	date = {2006-03}
}

@article{gomez_reconstruction_2014,
	title = {Reconstruction after pancreatoduodenectomy: Pancreatojejunostomy vs pancreatogastrostomy},
	volume = {6},
	issn = {1948-5204},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163735/},
	doi = {10.4251/wjgo.v6.i9.369},
	shorttitle = {Reconstruction after pancreatoduodenectomy},
	abstract = {Pancreatic surgeons try to find the best technique for reconstruction after pancreatoduodenectomy ({PD}) in order to decrease postoperative complications, mainly pancreatic fistulas ({PF}). In this work, we compare the two most frequent techniques of reconstruction after {PD}, pancreatojejunostomy ({PJ}) and pancreatogastrostomy ({PG}), in order to determine which of the two is better. A systematic review of the literature was performed, including major meta-analysis articles, clinical randomized trials, systematic reviews, and retrospective studies. A total of 64 articles were finally included. {PJ} and {PG} are usually responsible for most of the postoperative morbidity, mainly due to the onset of {PF}, being considered a major trigger of life-threatening complications such as intra-abdominal abscess and hemorrhagia. The included systematic reviews reported a significant difference only in the incidence of intraabdominal collections favouring {PG}. {PF}, delayed gastric emptying and mortality were not different. Although there was heterogeneity between these studies, all were conducted in specialized centers by highly experienced surgeons, and the surgical care was likely to be similar for all the studies. The disadvantages of {PG} include an increased incidence of delayed gastric emptying and of main pancreatic duct obstruction due to overgrowth by the gastric mucosa. Exocrine function appears to be worse after {PG} than after {PJ}, resulting in severe atrophic changes in the remnant pancreas. Depending on the type of {PJ} or {PG} used, the {PF} rate and other complications can also be different. The best method to deal with the pancreatic stump after {PD} remains questionable. The choice of method of pancreatic anastomosis could be based on individual experience and on the surgeon’s preference and adherence to basic principles such as good exposure and visualization. In conclusion, up to now none of the techniques can be considered superior or be recommended as standard for reconstruction after {PD}.},
	pages = {369--376},
	number = {9},
	journaltitle = {World Journal of Gastrointestinal Oncology},
	shortjournal = {World J Gastrointest Oncol},
	author = {Gómez, Tatiana and Palomares, Ana and Serradilla, Mario and Tejedor, Luis},
	urldate = {2015-05-17},
	date = {2014-09-15},
	pmid = {25232462},
	pmcid = {PMC4163735},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GMFUBTG8\\Gómez et al. - 2014 - Reconstruction after pancreatoduodenectomy Pancre.pdf:application/pdf}
}

@article{maxwell_telomere_2011,
	title = {Telomere attrition and decreased fetuin-A levels indicate accelerated biological  aging and are implicated in the pathogenesis of colorectal cancer.},
	volume = {17},
	rights = {(c)2011 {AACR}.},
	doi = {10.1158/1078-0432.CCR-10-3271},
	abstract = {{PURPOSE}: Increasing chronological age is a risk factor for many types of cancer including colorectal. An understanding of the biology of aging and factors which  regulate it may provide insight into cancer pathogenesis. The role of telomere biology in both the cancer and aging process could prove useful in this regard. {EXPERIMENTAL} {DESIGN}: Using quantitative {PCR}, we determined telomere length in the peripheral blood leukocytes of 64 colorectal cancer ({CRC}) patients and 1,348 controls. We also measured telomere length in 32 colorectal tumor samples and matched normal tissue. We aimed to assess whether telomere lengths were reflected in circulating mediators of inflammation and redox control factors, including fetuin-A, a circulating modulator of calcium homeostasis. {RESULTS}: {CRC} patients had shorter telomeres [adjusted mean ratio of relative telomere repeat copy number to single-copy gene number ({RelT}/S) = 0.61] compared with chronologically  older controls (mean age = 75, adjusted mean {RelT}/S = 0.70; {ANCOVA}, P = 0.004). Telomere length in tumor tissue [median = 0.43, interquartile range ({IQR}) = 0.40] was significantly shorter than adjacent normal tissue (median = 0.65, {IQR} = 0.28; P = 0.004). Patients with low fetuin-A levels were shown to have significantly shorter telomeres (P = 0.041). Patients with rectal tumors had significantly higher levels of fetuin-A than those with colonic tumors (P = 0.045). {CONCLUSIONS}: We have observed that patients with {CRC} display clear evidence of telomere attrition compared with controls. This is congruent with accelerated biological aging in the pathogenesis of {CRC}. An imbalance in redox control mechanisms and calcium homeostasis may be a contributing factor to telomere dynamics in our patients. Furthermore, fetuin-A levels can be used to distinguish between colon and rectal cancers.},
	pages = {5573--5581},
	number = {17},
	journaltitle = {Clinical cancer research : an official journal of the American Association for Cancer Research},
	shortjournal = {Clin Cancer Res},
	author = {Maxwell, Fraser and {McGlynn}, Liane M. and Muir, Hannah C. and Talwar, Dinesh and Benzeval, Michaela and Robertson, Tony and Roxburgh, Campbell S. and {McMillan}, Donald C. and Horgan, Paul G. and Shiels, Paul G.},
	date = {2011-09-01},
	pmid = {21753158},
	keywords = {*Aging/genetics, *Telomere Shortening, Aged, Aged, 80 and over, alpha-2-{HS}-Glycoprotein/*analysis, Calcium/metabolism, Colorectal Neoplasms/*blood/genetics/*pathology, {DNA}/blood, Female, Humans, Leukocytes/pathology, Male, Middle Aged, Oxidation-Reduction, Rectal Neoplasms/blood/genetics/pathology, Risk Factors, Telomere/*ultrastructure, Tumor Markers, Biological/analysis}
}

@article{grizas_etiology_2005,
	title = {Etiology of bile infection and its association with postoperative complications following pancreatoduodenectomy},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15947522},
	abstract = {Currently controversy exists whether bile infection following preoperative biliary drainage has an impact on postoperative complications and mortality rate. The objective of the study was to determine etiology of preoperative bile infection and to evaluate its influence on postoperative complications and mortality after pancreatoduodenectomy. {METHODS}: Data on 64 patients, undergoing pancreatoduodenectomy at Kaunas University of Medicine Hospital between 2002 and 2004 were collected prospectively. We evaluated etiology and the impact of bile infection on development of post-operative complications. Patients were divided into groups according to results of intraoperative bile culture. {RESULTS}: In 31 patients (48.4\%) intraoperative bile cultures were negative, while in remaining 33 patients (51.6\%) infected bile was documented. Both patient groups were homogenous according to demographic data, preoperative and intraoperative variables. Pancreaticoduodenectomy was performed in 21 patients after preoperative biliary drainage (endoscopic stenting, bilidigestive anastomosis or percutaneous bile drainage), others (n=43) had primary operation. Infected bile was found more often in patients who underwent biliary drainage (p{\textless}0.0001). Among 43 patients with primary pancreaticoduodenectomy 22 patients underwent endoscopic retrograde cholangiopancreatography without stenting, while remaining 21 had no preoperative endoscopic manipulation. Infected bile was present in 9 patients after endoscopic retrograde cholangiopancreatography (40.9\%) and in 4 without preoperative endoscopy (19\%). Enterococcus and Escherichia coli dominated in bile cultures of patients with primary pancreaticoduodenectomy, while multiple species (3 and more microorganisms) dominated following drainage procedures. Septic postoperative complications were identified in 26.6\% of cases. Infected bile did not influence both overall and septic postoperative complications. Bacteria causing abdominal cavity and wound infections matched bile cultures in 7.7\% of cases only. {CONCLUSIONS}: Our data show that infected bile is found more often after preoperative biliary drainage procedures. However, bile infection did not increase statistically significantly the number of postoperative septic complication.},
	pages = {386--91},
	number = {5},
	journaltitle = {Medicina (Kaunas)},
	author = {Grizas, Saulius and Stakyte, Migle and Kincius, Marius and Barauskas, Giedrius and Pundzius, Juozas},
	date = {2005}
}

@article{davidson_marsupialization_1981,
	title = {"Marsupialization" in the treatment of pancreatic abscess},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7455911},
	abstract = {Seventeen patients who underwent operations for pancreatic abscess are the subject of this article. In a nonselective manner, 11 patients were treated by debridement and sump drainage, whereas six patients were treated with similar debridement with open packing (marsupialization) of the abscess. There was a 55\% mortality rate in those patients who underwent sump drainage and 0\% mortality rate in those who underwent marsupialization. No differences could be found between the groups to account for this variation in survival, except the method of treatment. We suggest that marsupialization to considered for patients with pancreatic abscess, particularly when they have extensive necrosis.},
	pages = {252--6},
	number = {2},
	journaltitle = {Surgery},
	author = {Davidson, E D and Bradley, E L 3rd},
	date = {1981-02}
}

@article{kaibori_assessment_2013,
	title = {Assessment of preoperative exercise capacity in hepatocellular carcinoma patients with chronic liver injury undergoing hepatectomy},
	volume = {13},
	issn = {1471-230X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725155/},
	doi = {10.1186/1471-230X-13-119},
	abstract = {Background
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma ({HCC}) patients with chronic liver injury who underwent hepatectomy.

Methods
Sixty-one {HCC} patients underwent preoperative cardiopulmonary exercise testing to determine their anaerobic threshold ({AT}). The {AT} was defined as the break point between carbon dioxide production and oxygen consumption per unit of time ({VO}2). Postoperative events including recurrence of {HCC}, death, liver failure, and complications of cirrhosis were recorded. Univariate and multivariate analyses were performed to evaluate associations between 35 clinical factors and outcomes, and identify independent prognostic indicators of event-free survival and maintenance of Child-Pugh class.

Results
Multivariate analyses identified preoperative branched-chain amino acid/tyrosine ratio ({BTR}) {\textless}5, alanine aminotransferase level ≥42 {IU}/l, and {AT} {VO}2 {\textless}11.5 ml/min/kg as independent prognostic indicators of event-free survival. {AT} {VO}2 {\textless}11.5 ml/min/kg and {BTR} {\textless}5 were identified as independent prognostic indicators of maintenance of Child-Pugh class.

Conclusions
This study identified preoperative exercise capacity as an independent prognostic indicator of event-free survival and maintenance of Child-Pugh class in {HCC} patients with chronic liver injury undergoing hepatectomy.},
	pages = {119},
	journaltitle = {{BMC} Gastroenterology},
	shortjournal = {{BMC} Gastroenterol},
	author = {Kaibori, Masaki and Ishizaki, Morihiko and Matsui, Kosuke and Nakatake, Richi and Sakaguchi, Tatsuma and Habu, Daiki and Yoshiuchi, Sawako and Kimura, Yutaka and Kon, A Hon},
	urldate = {2015-05-05},
	date = {2013-07-22},
	pmid = {23875788},
	pmcid = {PMC3725155},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZG6DQXHS\\Kaibori et al. - 2013 - Assessment of preoperative exercise capacity in he.pdf:application/pdf}
}

@article{zelenka_highly_2008,
	title = {Highly sensitive method for quantitative determination of bilirubin in biological fluids and tissues},
	volume = {867},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18373963},
	abstract = {Unconjugated bilirubin ({UCB}) exhibits potent antioxidant and cytoprotective properties, but causes apoptosis and cytotoxicity at pathologically elevated concentrations. Accurate measurement of {UCB} concentrations in cells, fluids and tissues is needed to evaluate its role in redox regulation, prevention of atherosclerotic and malignant diseases, and bilirubin encephalopathy. In the present study, we developed and validated a highly sensitive method for tissue {UCB} determinations. {UCB} was extracted from rat organs with chloroform/methanol/hexane at {pH} 6.2 and then partitioned into a minute volume of alkaline buffer that was subjected to {HPLC} using an octyl reverse phase ({RP}) column. Addition of mesobilirubin as an internal standard corrected for losses of {UCB} during extraction. Recoveries averaged 75+/-5\%. The detection limit was 10pmol {UCB}/g wet tissue. Variance was +/-2.5\%. When used to measure {UCB} concentrations in tissues of jaundiced Gunn rats, this procedure yielded {UCB} levels directly comparable to published methods, and accurately determined very low tissue bilirubin concentrations ({\textless}/=40pmol {UCB}/g tissue) in non-jaundiced rats.},
	pages = {37--42},
	number = {1},
	journaltitle = {J Chromatogr B Analyt Technol Biomed Life Sci},
	author = {Zelenka, Jaroslav and Lenícek, Martin and Muchová, Lucie and Jirsa, Milan and Kudla, Michal and Balaz, Peter and Zadinová, Marie and Ostrow, J Donald and Wong, Ronald J and Vítek, Libor},
	date = {2008-05}
}

@article{radtke_self-renewal_2005,
	title = {Self-Renewal and Cancer of the Gut: Two Sides of a Coin},
	volume = {307},
	issn = {0036-8075, 1095-9203},
	url = {http://www.sciencemag.org/cgi/doi/10.1126/science.1104815},
	doi = {10.1126/science.1104815},
	shorttitle = {Self-Renewal and Cancer of the Gut},
	pages = {1904--1909},
	number = {5717},
	journaltitle = {Science},
	author = {Radtke, F.},
	urldate = {2015-04-28},
	date = {2005-03-25},
	langid = {english},
	file = {Radtke - 2005 - Self-Renewal and Cancer of the Gut Two Sides of a.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\49U7II3F\\Radtke - 2005 - Self-Renewal and Cancer of the Gut Two Sides of a.pdf:application/pdf}
}

@article{swart_case-controlled_2012,
	title = {Case-controlled study of critical care or surgical ward care after elective open colorectal surgery},
	volume = {99},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.7789},
	doi = {10.1002/bjs.7789},
	pages = {295--299},
	number = {2},
	journaltitle = {British Journal of Surgery},
	author = {Swart, M. and Carlisle, J. B.},
	urldate = {2014-01-27},
	date = {2012-02},
	file = {Swart and Carlisle - 2012 - Case-controlled study of critical care or surgical.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5A9GE3HV\\Swart and Carlisle - 2012 - Case-controlled study of critical care or surgical.pdf:application/pdf}
}

@article{greig_surgical_1988,
	title = {Surgical morbidity and mortality in one hundred and twenty-nine patients with obstructive jaundice},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3349328},
	abstract = {One hundred and twenty-nine jaundiced patients were operated upon for the relief of benign and malignant bile duct obstruction during a 10-year period, 1977-86. The overall mortality was 4.7 per cent but increased to 9.1 per cent in patients with a serum bilirubin greater than 300 mumol/l. In all, 46.5 per cent of patients had a rise in postoperative creatinine but renal dysfunction occurred in only 4.7 per cent. Wound infection developed in 3.1 per cent of patients and appeared unrelated to infected bile; 3.9 per cent of patients were treated for postoperative septicaemic episodes. The low morbidity and mortality observed suggests that preoperative biliary drainage need not be considered in routine surgical practice if simple measures to maintain urine flow and prevent postoperative sepsis are used.},
	pages = {216--9},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Greig, J D and Krukowski, Z H and Matheson, N A},
	date = {1988-03}
}

@article{berger_neoadjuvant_2004,
	title = {Neoadjuvant therapy and biliary decompression lower biliary and pancreatic juice vascular endothelial growth factor levels in patients with periampullary adenocarcinoma},
	volume = {70},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15011922},
	abstract = {Increased expression of vascular endothelial growth factor ({VEGF}) by pancreatic cancer correlates with poor survival. The significance of {VEGF} in biliary and pancreatic secretions in periampullary cancers is unknown. Bile and pancreatic juice samples were collected from patients undergoing pancreaticoduodenectomy ({PD}). All samples were frozen at -70 degrees C until subsequent analysis for {VEGF} concentration using enzyme-linked immunoabsorbent assay ({ELISA}). Plasma {VEGF} levels in pancreatic cancer patients were {\textless}10 pg/{mL}. The biliary {VEGF} concentration for patients with malignancy was significantly elevated compared to benign disease (P = 0.05). There was no difference in pancreatic {VEGF} concentrations between benign and malignant disease. Cancer patients undergoing preoperative chemoradiation ({CRT}) had lower biliary and pancreatic {VEGF} concentrations than those who did not. Preoperative biliary drainage ({BD}) was associated with decreased {VEGF} concentrations in bile (3500 pg/{mL} vs 7740 pg/{mL}, P = 0.027). Patients undergoing both {CRT} and {BD} had diminished biliary and pancreatic {VEGF} concentrations compared to those who had neither. This was statistically significant for pancreatic {VEGF} concentrations (917 pg/{mL} vs 4723 pg/{mL}, P = 0.044). {VEGF} is highly concentrated in bile and pancreatic juice compared to plasma. Preoperative {CRT} and {BD} significantly reduce these levels in patients with periampullary cancers. Antiangiogenic therapy aimed at interrupting the {VEGF} pathway appears to be a logical target in periampullary cancer.},
	pages = {169--73; discussion 173--4},
	number = {2},
	journaltitle = {Am Surg},
	author = {Berger, Adam C and Watson, James C and Ross, Eric A and Zalatoris, Alice and Hoffman, John P},
	date = {2004-02}
}

@article{sjostrom_determination_1986,
	title = {Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium},
	volume = {250},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3717334},
	abstract = {The adipose tissue volumes of 12 women were determined by computed tomography ({CT}). Body weight ranged from 46 to 129 kg. Nine or twenty-two transsectional scans were examined with respect to the adipose tissue area. The total adipose tissue volume ({ATCT}22 or {ATCT}9) was calculated by assuming linear changes in the adipose tissue area between adjacent scans. Body fat ({BF}) was also calculated from total body potassium ({BF}40K), from total body water ({BFTHO}), and from both these determinations ({BF}40K + {THO}). Body mass index ({BMI}) was calculated by dividing body weight ({BW}) by height2 (H2). {ATCT}22, {ATCT}9, and {BFK} were more closely related to {BW} and {BMI} than were {BFTHO} and {BF}40K + {THO}. When {ATCT} was used as a standard, the optimal index of adiposity based on {BW} and H was in the range {BW}/H0.8 to {BW}/H1.2. From the {CT} and 40K measurements it was possible to deduce that the potassium content is 62 mmol/kg fat free mass and 73-75 mmol/kg lean body mass. The error of {ATCT}9 was 0.6\%, while that of {BF}40K was at least three to four times larger. It is concluded that the {CT}-based {AT} determination is the most reproducible method so far available. The technique might turn out to be of great value in human energy balance experiments.},
	pages = {E736--45},
	number = {6},
	journaltitle = {Am J Physiol},
	author = {Sjöström, L and Kvist, H and Cederblad, A and Tylén, U},
	date = {1986-06}
}

@article{wallace_effect_1998,
	title = {Effect of weight loss and the inflammatory response on leptin concentrations in gastrointestinal cancer patients.},
	volume = {4},
	abstract = {Animal research suggests that leptin may have an important role in the regulation of energy balance. The role of leptin in the progressive involuntary weight loss  associated with cancer in humans is of considerable interest. However, such studies are limited. In this study, we compared circulating leptin concentrations in gastrointestinal cancer patients and weight loss (n = 27) with those of healthy subjects (n = 27). The effect of the presence of an inflammatory response on leptin concentrations was also examined. There were significantly lower leptin concentrations in male (median, 2.4 microg/liter; range, {\textless}0.5-6.0 microg/liter) and female (median, 3.4 microg/liter; range, {\textless}0.5-9.8 microg/liter) cancer patients than there were in male (median, 6.5 microg/liter; range, 3.1-10.9 microg/liter) and female (median, 18.7 microg/liter; range, 8.0-31.5 mcirog/liter) healthy subjects (P {\textless} 0.001). However, the leptin concentrations in both patients and normal subjects were related to the predicted percentage of body fat (r = 0.731; P {\textless} 0.001). Circulating leptin concentrations in the cancer  patients were not altered by the presence of an inflammatory response. These results suggest that cancer anorexia/cachexia is not due to a simple dysregulation of leptin production.},
	pages = {2977--2979},
	number = {12},
	journaltitle = {Clinical cancer research : an official journal of the American Association for Cancer Research},
	shortjournal = {Clin Cancer Res},
	author = {Wallace, A. M. and Sattar, N. and {McMillan}, D. C.},
	date = {1998-12},
	pmid = {9865908},
	keywords = {*Weight Loss, Adult, Aged, Case-Control Studies, Energy Metabolism, Female, Gastrointestinal Neoplasms/*metabolism/pathology/physiopathology, Humans, Inflammation/metabolism/physiopathology, Leptin, Male, Middle Aged, Proteins/*metabolism}
}

@article{bernardi_reduced_1991,
	title = {Reduced cardiovascular responsiveness to exercise-induced sympathoadrenergic stimulation in patients with cirrhosis},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2050999},
	abstract = {Cardiovascular responsiveness to sympathoadrenergic activation obtained by muscle exercise in the supine position was evaluated in 22 patients with cirrhosis (11 alcoholic, 11 postnecrotic/cryptogenic; 14 with ascites) and 10 controls of comparable age. Plasma norepinephrine, heart rate, diastolic arterial pressure and cardiac function, as evaluated by systolic time intervals, were monitored. At rest, cirrhotics had higher norepinephrine (154 +/- 19 S.E.M. ng/l) and heart rate (79 +/- 2 beats per min) than controls (71 +/- 3 ng/l, p less than 0.01; 67 +/- 2 beats per min, p less than 0.001), whereas diastolic arterial pressure was similar. Among systolic time intervals, electromechanical systole, pre-ejection period, electromechanical delay and pre-ejection period to left ventricular ejection time ratios were prolonged (p less than 0.05 or less). Exercise led to significant increases in plasma norepinephrine, heart rate and diastolic arterial pressure in both controls and patients. In the latter, however, whereas the increase in norepinephrine was greater (p less than 0.001), those in heart rate and diastolic arterial pressure were less (p less than 0.005). As expected, most systolic time intervals shortened, but the decrease in pre-ejection period (p less than 0.05), isometric contraction time (p less than 0.02) and pre-ejection period to left ventricular ejection time ratio (p = 0.06) was less in patients than in controls. Direct correlations between exercise-induced changes in norepinephrine and both diastolic arterial pressure (r = 0.81; p less than 0.005) and heart rate (r = 0.85; p less than 0.002) were observed in controls, while inverse correlations (r = -0.67, p less than 0.001 and r = -0.44; p less than 0.05) were found in cirrhotics. These results suggest that cardiovascular reactivity to the sympathetic drive is impaired in cirrhotics. The impairment of cardiac contractility may be due to altered electromechanical coupling.},
	pages = {207--16},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Bernardi, M and Rubboli, A and Trevisani, F and Cancellieri, C and Ligabue, A and Baraldini, M and Gasbarrini, G},
	date = {1991-03},
	note = {cited 75}
}

@article{mullen_obesity_2009,
	title = {The obesity paradox: body mass index and outcomes in patients undergoing nonbariatric general surgery},
	volume = {250},
	issn = {1528-1140},
	doi = {10.1097/SLA.0b013e3181ad8935},
	shorttitle = {The obesity paradox},
	abstract = {{OBJECTIVE}: We sought to examine the effect of body mass index ({BMI}) on 30-day morbidity and mortality in a large cohort of patients undergoing nonbariatric general surgery.
{SUMMARY} {BACKGROUND} {DATA}: Obesity has long been considered a risk factor for poor outcomes from a variety of surgical procedures, yet recent studies of critically and chronically ill patients suggest that overweight and obese patients may paradoxically have better outcomes than "normal" weight patients.
{METHODS}: A prospective, multi-institutional, risk-adjusted cohort study of 118,707 patients undergoing nonbariatric general surgery who were included in the National Surgical Quality Improvement Program Participant Use database in 2005 and 2006 was performed. Outcomes and risk variables were compared across {NIH}-defined {BMI} class using analysis of variance, Bonferroni multiple comparisons of means tests, and multivariable logistic regression.
{RESULTS}: After adjusting for all significant perioperative risk factors, the risk of death according to {BMI} exhibited a reverse J-shaped relationship, with the highest rates in the underweight and morbidly obese extremes and the lowest rates in the overweight and moderately obese. Overweight (odds ratio, 0.85; 95\% {CI}, 0.75-0.99) and moderately obese (odds ratio, 0.73; 95\% {CI}, 0.57-0.94) patients had a significantly lower risk of death than normal weight patients. There was a progressive increase in the likelihood of a complication with increasing {BMI} class, almost entirely due to increasing rates of wound infection.
{CONCLUSIONS}: Overweight and moderately obese patients undergoing nonbariatric general surgery have paradoxically "lower" crude and adjusted risks of mortality compared with patients at a "normal" weight. This finding is in contrast to observations from the general population, confirming the existence of an "obesity paradox" in this patient population.},
	pages = {166--172},
	number = {1},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {Mullen, John T. and Moorman, Donald W. and Davenport, Daniel L.},
	date = {2009-07},
	pmid = {19561456},
	keywords = {Body Mass Index, Chronic Disease, Cohort Studies, Critical Illness, Female, Humans, Male, Middle Aged, Obesity, Obesity, Morbid, Overweight, Prospective Studies, Risk Factors, Surgical Procedures, Operative, Thinness, Treatment Outcome, United States}
}

@article{sohn_resected_2000,
	title = {Resected adenocarcinoma of the pancreas—616 patients: results, outcomes, and prognostic indicators},
	volume = {4},
	url = {http://link.springer.com/article/10.1016/S1091-255X(00)80105-5},
	shorttitle = {Resected adenocarcinoma of the pancreas—616 patients},
	pages = {567--579},
	number = {6},
	journaltitle = {Journal of Gastrointestinal Surgery},
	author = {Sohn, Taylor A. and Yeo, Charles J. and Cameron, Jokn L. and Koniaris, Leonidas and Kaushal, Sunjay and Abrams, Ross A. and Hruban, Ralph H. and Lillemoe, Keith D.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Sohn et al. - 2000 - Resected adenocarcinoma of the pancreas—616 patien.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QWJ2X7S2\\Sohn et al. - 2000 - Resected adenocarcinoma of the pancreas—616 patien.pdf:application/pdf}
}

@article{mann_review_2010,
	title = {A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20662788},
	abstract = {Objectives: In the context of comparisons of surgical outcomes, risk adjustment is the retrospective adjustment of a provider's or a surgeon's results for case mix and/or hospital volume. It allows accurate, meaningful inter-provider comparison. It is therefore an essential component of any audit and quality improvement process. The aim of this study was to review the literature to identify those factors known to affect prognosis in hepatobiliary and pancreatic cancer surgery. Methods: {PubMed} was used to identify studies assessing risk in patients undergoing resection surgery, rather than bypass surgery, for hepatobiliary and pancreatic cancer. Results: In total, 63 and 68 papers, pertaining to 24 609 and 63 654 patients who underwent hepatic or pancreatic resection for malignancy, respectively, were identified. Overall, 22 generic preoperative factors predicting outcome on multivariate analysis, including demographics, blood results, preoperative biliary drainage and co-morbidities, were identified, with tumour characteristics proving disease-specific factors. Operative duration, transfusion, operative extent, vascular resection and additional intra-abdominal procedures were also found to be predictive of early outcome. Conclusions: The development of a risk adjustment model will allow for the identification of those factors with most influence on early outcome and will thus identify potential targets for preoperative optimization and allow for the development of a multicentre risk prediction model.},
	pages = {380--8},
	number = {6},
	journaltitle = {{HPB} (Oxford)},
	author = {Mann, Chris D and Palser, Tom and Briggs, Chris D and Cameron, Iain and Rees, Myrrdin and Buckles, John and Berry, David P},
	date = {2010-08}
}

@article{suzuki_[respiratory_1988,
	title = {[Respiratory function of mitochondria fractionated from isolated hepatocytes of rats with obstructive jaundice]},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3412302},
	abstract = {Obstructive jaundice model was created using rats by the ligation of bile duct. One, 2, 3 weeks later, the respiratory function and morphology of the hepatic mitochondria were comparatively evaluated between mitochondria directly fractionated from liver tissue and mitochondria from isolated hepatocytes. Respiratory function of the former deteriorated with the duration of jaundice. {ATP} synthesis decreased to 75\% of the control at 1 and 2 weeks, and 58\% at 3 weeks after ligation. On the contrary, it was 97\%, 88\% and 87\% of the control. On the contrary, it was 97\%, 88\% and 87\% of the control at 1, 2 and 3 weeks in the latter. By electron microscopic examination, the size of mitochondria of the jaundiced liver is inconsistent and smaller in general than the control. These data suggest that the deterioration of mitochondrial function in the jaundiced liver is not caused mainly by the disturbance of mitochondria themselves, but caused by the respiratory inhibitory factors which exist around the mitochondria.},
	pages = {703--8},
	number = {5},
	journaltitle = {Nippon Geka Gakkai Zasshi},
	author = {Suzuki, K and Koyama, K and Asanuma, Y and Ouchi, S and Tanaka, J and Shirayama, K and Yoshida, S},
	date = {1988-05}
}

@article{moon_visceral_2008,
	title = {Visceral Obesity May Affect Oncologic Outcome in Patients with Colorectal Cancer},
	volume = {15},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-008-9891-4},
	doi = {10.1245/s10434-008-9891-4},
	pages = {1918--1922},
	number = {7},
	journaltitle = {Annals of Surgical Oncology},
	author = {Moon, Hyeong-Gon and Ju, Young-Tae and Jeong, Chi-Young and Jung, Eun-Jung and Lee, Young-Joon and Hong, Soon-Chan and Ha, Woo-Song and Park, Soon-Tae and Choi, Sang-Kyung},
	urldate = {2015-04-28},
	date = {2008-07},
	langid = {english},
	file = {Moon et al. - 2008 - Visceral Obesity May Affect Oncologic Outcome in P.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IGK57XZT\\Moon et al. - 2008 - Visceral Obesity May Affect Oncologic Outcome in P.pdf:application/pdf}
}

@article{terziyski_exercise_2008,
	title = {Exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis},
	volume = {35},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18197891},
	abstract = {1. The impact of ventilatory efficiency on reduced exercise capacity and recovery oxygen kinetics has not been addressed in cirrhotic patients. The aim of the present study was to investigate exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis ({LC}). 2. Nineteen male non-hypoxic patients with {LC} (age 51.3 +/- 9.1 years; body mass index ({BMI}) 25.6 +/- 3.6 kg/m(2)) classified by the Child-Pugh score as class A (n = 7) and class B (n = 12) and 19 age- and {BMI}-matched controls participated in the study. Subjects undertook maximal incremental exercise testing on a treadmill using the Bruce protocol. 3. Patients with {LC} showed a reduced diffusion capacity (D(L,{CO})\%) compared with controls (74.6 +/- 15.2 vs 95.6 +/- 12.9\%, respectively; P {\textless} 0.001), but a comparable volume standardized diffusion coefficient (1.33 +/- 0.22 vs 1.45 +/- 0.18 mmol/min per {kPa} per L, respectively; P = 0.74). Patients with {LC} had a significantly lower exercise capacity compared with controls ({VO}(2 max) 23.8 +/- 3.8 vs 30.6 +/- 4.4 {mL}/min per kg, respectively; P {\textless} 0.001). Recovery oxygen kinetics were also impaired in {LC} patients compared with controls (104.6 +/- 19.3 vs 84.4 +/- 22.7 s, respectively; P = 0.012). The chronotropic index was significantly lower in the {LC} group compared with controls (0.67 +/- 0.19 vs 0.82 +/- 0.17, respectively; P = 0.030) and {LC} patients showed higher ventilatory equivalents (30.4 +/- 3.8 vs 26.3 +/- 2.3, respectively; P {\textless} 0.001) and lower oxygen uptake efficiency slope values (2187 +/- 445 vs 2745 +/- 473 {mL}/min per log(10)L, respectively; P {\textless} 0.001) compared with controls, which is indicative of decreased ventilatory efficiency. Patients with {LC} also had a higher standardized maximal exercise perception score ({SMEPS}) compared with controls (0.62 +/- 0.18 vs 0.46 +/- 0.15, respectively; P = 0.011). Moderate negative correlations were found between Child-Pugh score and {VO}(2 max)\% (r = -0.496; P = 0.031). 4. In conclusion, patients with mild and moderate {LC} have reduced exercise capacity, which correlates with Child-Pugh score, as well as reduced chronotropic index and prolonged recovery oxygen uptake kinetics. The results suggest worsened ventilatory efficiency during exercise and cardiopulmonary reasons for the higher {SMEPS} in these patients.},
	pages = {135--40},
	number = {2},
	journaltitle = {Clin Exp Pharmacol Physiol},
	author = {Terziyski, K and Andonov, V and Marinov, B and Kostianev, S},
	date = {2008-02}
}

@article{vashist_glasgow_2010,
	title = {Glasgow Prognostic Score is a Predictor of Perioperative and Long-term Outcome in Patients with only Surgically Treated Esophageal Cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20981494},
	abstract = {{BACKGROUND}: Systemic inflammation ({SI}) plays a pivotal role in cancer. C-reactive protein ({CRP}) and albumin as parameters of {SI} form the Glasgow Prognostic Score ({GPS}). The purpose of the study was to evaluate the potential prognostic role of {GPS} in a homogeneous population of esophageal cancer ({EC}) patients undergoing only resection. {METHODS}: {GPS} was evaluated on the basis of admission blood sample taken before surgery. Patients with a {CRP} {\textless} 10 mg/L and albumin {\textgreater} 35 g/L were allocated to {GPS}0 group. If only {CRP} was increased or albumin decreased patients were allocated to the {GPS}1 and patients in whom {CRP} was ≥10 mg/L and albumin level ≤35 g/L were classified as {GPS}2. {GPS} was correlated to clinicopathological parameters and clinical outcome. {RESULTS}: Increasing {GPS} significantly correlated with more aggressive tumor biology in terms of tumor size (P {\textless} 0.001), presence of regional (P = 0.01) and nonregional lymph node metastasis (P = 0.02), and higher tumor recurrence rate (P {\textless} 0.001). Furthermore, {GPS} was identified as an independent prognosticator of perioperative morbidity (odds ratio 1.9; P = 0.03). In addition, a gradual decrease in disease-free and overall survival was evident between the three {GPS} subgroups. Survival differences between the {GPS} groups remained apparent even after stratification of the study population to underlying tumor type and nodal status. {GPS} was identified as a strong prognosticator of tumor recurrence (hazard ratio 2.5; P {\textless} 0.001) and survival (hazard ratio 3.0; P {\textless} 0.001) in {EC}. {CONCLUSIONS}: {GPS} represents a strong prognosticator of perioperative morbidity and long-term outcome in resected {EC} patients without neoadjuvant or adjuvant treatment.},
	journaltitle = {Ann Surg Oncol},
	author = {Vashist, Yogesh K and Loos, Julian and Dedow, Josephine and Tachezy, Michael and Uzunoglu, Guentac and Kutup, Asad and Yekebas, Emre F and Izbicki, Jakob R},
	date = {2010-10},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DDBVIWD6\\Vashist et al. - 2010 - Glasgow Prognostic Score is a Predictor of Periope.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J3U48B32\\s10434-010-1383-7.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C5JUDPI8\\s10434-010-1383-7.html:text/html}
}

@article{birkmeyer_surgeon_2003,
	title = {Surgeon Volume and Operative Mortality in the United States},
	volume = {349},
	issn = {0028-4793},
	url = {http://dx.doi.org/10.1056/NEJMsa035205},
	doi = {10.1056/NEJMsa035205},
	abstract = {For many surgical procedures, patients at hospitals where a high number of such procedures are performed (high-volume hospitals) have lower mortality rates than those at hospitals that are less experienced with the procedures.1–4 In one recent study of the national population of Medicare recipients, we found strong relations between hospital volume and operative mortality associated with 14 high-risk cancer resections and cardiovascular procedures.5 Despite the considerable body of research in this area, little is known about the mechanisms underlying the observed associations between volume and outcome. Because they tend to be much larger facilities, high-volume hospitals have a broader . . .},
	pages = {2117--2127},
	number = {22},
	journaltitle = {New England Journal of Medicine},
	author = {Birkmeyer, John D. and Stukel, Therese A. and Siewers, Andrea E. and Goodney, Philip P. and Wennberg, David E. and Lucas, F. Lee},
	urldate = {2015-08-23},
	date = {2003-11-27},
	pmid = {14645640},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SCW49DPR\\Birkmeyer et al. - 2003 - Surgeon Volume and Operative Mortality in the Unit.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CVJ3M6GH\\NEJMsa035205.html:text/html}
}

@article{sudo_specific_2007,
	title = {Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage},
	volume = {31},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17726628},
	abstract = {{BACKGROUND}: Preoperative biliary drainage ({PBD}) is associated with bacterial contamination of bile, but the effects of {PBD} on morbidity after pancreatoduodenectomy remain controversial. The aim of this study was to characterize bile contamination to develop successful specific antibiotic prophylactic strategies for pancreatoduodenectomy. {METHODS}: Ninety-one consecutive patients who underwent pancreatoduodenectomy for periampullary tumor were prospectively evaluated. Prophylactic antibiotics were selected based on preoperative bile cultures. Bile cultures and postoperative complications were compared in 46 patients who underwent {PBD} (drainage group) versus 45 patients who did not (nondrainage group). {RESULTS}: The incidence of positive bile cultures was higher in the drainage group (78\%) than in the nondrainage group (36\%) (P {\textless} 0.001). In the drainage group, positive bile cultures were frequently polymicrobial (61\%) and demonstrated resistance to several antibiotics, including cefazolin (83\%), cefmetazole (72\%), and cefpirome (64\%). Overall morbidity (30\% and 22\%) and infectious morbidity (13\% and 11\%) did not differ significantly between the drainage and nondrainage groups, respectively. {CONCLUSIONS}: {PBD} had a notable influence on bile microbial contamination, including a higher rate of antibiotic resistance. Therefore, specific antibiotic prophylaxis based on bile culture is required for preventing infectious complications in pancreatoduodenectomy patients who undergo {PBD}.},
	pages = {2230--5},
	number = {11},
	journaltitle = {World J Surg},
	author = {Sudo, Takeshi and Murakami, Yoshiaki and Uemura, Kenichiro and Hayashidani, Yasuo and Hashimoto, Yasushi and Ohge, Hiroki and Sueda, Taijiro},
	date = {2007-11}
}

@article{tschaikowsky_coincidence_2002,
	title = {Coincidence of pro-and anti-inflammatory responses in the early phase of severe sepsis: longitudinal study of mononuclear histocompatibility leukocyte antigen-{DR} expression, procalcitonin, C-reactive protein, and changes in T-cell subsets in septic and postoperative patients},
	volume = {30},
	url = {http://journals.lww.com/ccmjournal/Abstract/2002/05000/Coincidence_of_pro__and_anti_inflammatory.10.aspx},
	shorttitle = {Coincidence of pro-and anti-inflammatory responses in the early phase of severe sepsis},
	pages = {1015--1023},
	number = {5},
	journaltitle = {Critical care medicine},
	author = {Tschaikowsky, Klaus and Hedwig-Geissing, Monika and Schiele, Albert and Bremer, Frank and Schywalsky, Michael and Schüttler, Jürgen},
	urldate = {2015-08-21},
	date = {2002},
	file = {00003246-200205000-00010.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UUCF784S\\00003246-200205000-00010.pdf:application/pdf}
}

@article{ferrari_expression_2014,
	title = {Expression of {RUNX}1 correlates with poor patient prognosis in triple negative breast cancer.},
	volume = {9},
	doi = {10.1371/journal.pone.0100759},
	abstract = {The {RUNX}1 transcription factor is widely recognised for its tumour suppressor effects in leukaemia. Recently a putative link to breast cancer has started to emerge, however the function of {RUNX}1 in breast cancer is still unknown. To investigate if {RUNX}1 expression was important to clinical outcome in primary breast tumours a tissue microarray ({TMA}) containing biopsies from 483 patients with primary operable invasive ductal breast cancer was stained by immunohistochemistry. {RUNX}1 was associated with progesterone receptor ({PR})-positive tumours (P{\textless}0.05), more tumour {CD}4+(P{\textless}0.05) and {CD}8+(P{\textless}0.01)},
	number = {6},
	journaltitle = {{PloS} one},
	shortjournal = {{PLoS} One},
	author = {Ferrari, Nicola and Mohammed, Zahra M. A. and Nixon, Colin and Mason, Susan M. and Mallon, Elizabeth and {McMillan}, Donald C. and Morris, Joanna S. and Cameron, Ewan R. and Edwards, Joanne and Blyth, Karen},
	date = {2014},
	pmid = {24967588},
	pmcid = {PMC4072705},
	keywords = {*Gene Expression Regulation, Neoplastic, Cell Line, Tumor, Core Binding Factor Alpha 2 Subunit/*metabolism, Female, Humans, Middle Aged, Prognosis, Receptors, Estrogen/metabolism, Triple Negative Breast Neoplasms/*diagnosis/*metabolism/pathology}
}

@article{jiao_body_2010,
	title = {Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts},
	volume = {21},
	issn = {0957-5243},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904431/},
	doi = {10.1007/s10552-010-9558-x},
	shorttitle = {Body mass index, effect modifiers, and risk of pancreatic cancer},
	abstract = {Objective
To investigate whether the positive association of body mass index ({BMI}, kg/m2) with risk of pancreatic cancer is modified by age, sex, smoking status, physical activity, and history of diabetes.

Methods
In a pooled analysis of primary data of seven prospective cohorts including 458,070 men and 485,689 women, we identified 2,454 patients with incident pancreatic cancer during an average 6.9 years of follow-up. Cox proportional hazard regression models were used in data analysis.

Results
In a random-effects meta-analysis, for every 5 kg/m2 increment in {BMI}, the summary relative risk ({RR}) was 1.06 (95\% confidence interval ({CI}) 0.99–1.13) for men and 1.12 (95\% {CI} 1.05–1.19) for women. The aggregate analysis showed that compared with normal weight ({BMI}: 18.5 to {\textless}25), the adjusted {RR} was 1.13 (95\% {CI} 1.03–1.23) for overweight ({BMI}: 25 to {\textless}30) and 1.19 (95\% {CI} 1.05–1.35) for obesity class I ({BMI}: 30 to {\textless}35). Tests of interactions of {BMI} effects by other risk factors were not statistically significant. Every 5 kg/m2 increment in {BMI} was associated with an increased risk of pancreatic cancer among never and former smokers, but not among current smokers (P-interaction = 0.08).

Conclusion
The present evidence suggests that a high {BMI} is an independent risk factor of pancreatic cancer.},
	pages = {1305--1314},
	number = {8},
	journaltitle = {Cancer causes \& control : {CCC}},
	shortjournal = {Cancer Causes Control},
	author = {Jiao, Li and de Gonzalez, Amy Berrington and Hartge, Patricia and Pfeiffer, Ruth M. and Park, Yikyung and Freedman, D. Michal and Gail, Mitchell H. and Alavanja, Michael C. R. and Albanes, Demetrius and Beane Freeman, Laura E. and Chow, Wong-Ho and Huang, Wen-Yi and Hayes, Richard B. and Hoppin, Jane A. and Ji, Bu-tian and Leitzmann, Michael F. and Linet, Martha S. and Meinhold, Cari L. and Schairer, Catherine and Schatzkin, Arthur and Virtamo, Jarmo and Weinstein, Stephanie J. and Zheng, Wei and Stolzenberg-Solomon, Rachael Z.},
	urldate = {2015-08-08},
	date = {2010-08},
	pmid = {20383573},
	pmcid = {PMC2904431},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XJHJ2WV4\\Jiao et al. - 2010 - Body mass index, effect modifiers, and risk of pan.pdf:application/pdf}
}

@article{mustafa_effects_1969,
	title = {Effects of bilirubin on mitochondrial reactions},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4982202},
	pages = {6403--14},
	number = {23},
	journaltitle = {J Biol Chem},
	author = {Mustafa, M G and Cowger, M L and King, T E},
	date = {1969-12}
}

@article{korner_diagnostic_2009,
	title = {Diagnostic accuracy of C-reactive protein for intraabdominal infections after colorectal resections},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19479312},
	abstract = {Intraabdominal infections are caused mainly by anastomotic leaks and represent a serious complication. Diagnosis is usually made when patients become critically ill. Though inflammatory markers, including C-reactive protein ({CRP}) and white blood count ({WBC}), may contribute to an early diagnosis, their clinical roles remain unclear. The diagnostic accuracy of continuous tests depends on the choice of cut-off values. We analyzed the diagnostic accuracy of serial {CRP} and {WBC} measurements to detect infectious complications after colorectal resections.},
	pages = {1599--606},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Kørner, Hartwig and Nielsen, Hans Jørgen and Søreide, Jon Arne and Nedrebø, Bjørn S and Søreide, Kjetil and Knapp, Jens C},
	date = {2009-09}
}

@article{green_systemic_1995,
	title = {Systemic hypotension and renal failure in obstructive jaundice-mechanistic and therapeutic aspects},
	volume = {5},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7620083},
	abstract = {The association between obstructive jaundice and postoperative acute renal failure has been originally described more than eight decades ago and is now a well-established clinical phenomenon. Acute renal failure occurs in 8 to 10\% of patients requiring surgery for relief of obstructive jaundice and contributes to eventual mortality in 70 to 80\% of those who develop it. A major factor that may underlie the susceptibility to renal failure in patients with obstructive jaundice is cardiovascular instability manifested as systemic hypotension and defective vascular reactivity. This article outlines the scope of the clinical association between jaundice and renal failure and reviews the clinical and experimental studies that have contributed to our understanding of the underlying pathophysiologic mechanisms for this phenomenon. A growing body of evidence emanating from these studies indicates that bile constituents (e.g., bile acids, bilirubin, cholesterol) do not exert a direct nephrotoxic effect. Rather, the retention of bile during cholestatic jaundice has deleterious effects on cardiovascular function and on blood volume. This, in turn, sensitizes the kidney to prerenal failure and acute tubular necrosis in postsurgical patients with obstructive jaundice. The institution of prophylactic measures based on the appreciation of these underlying pathogenic mechanisms may result in an improvement in the overall prognosis of jaundiced patients undergoing surgery.},
	pages = {1853--71},
	number = {11},
	journaltitle = {J Am Soc Nephrol},
	author = {Green, J and Better, O S},
	date = {1995-05},
	file = {Green and Better - 1995 - Systemic hypotension and renal failure in obstruct.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3ZZKZTSA\\Green and Better - 1995 - Systemic hypotension and renal failure in obstruct.pdf:application/pdf}
}

@article{mohammed_role_2012,
	title = {The role of the tumour inflammatory cell infiltrate in predicting recurrence and  survival in patients with primary operable breast cancer.},
	volume = {38},
	rights = {Copyright (c) 2012 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2012.04.011},
	abstract = {Although the first studies highlighting the importance of the tumour inflammatory cell infiltrate were reported more than 80 years ago, the prognostic value of this response in breast cancer is still controversial. With the realisation of the importance of the inflammatory response in determining tumour progression there has been renewed interest in establishing the relationship between the type, density and location of inflammatory cell infiltrate and survival in patients with primary operable breast cancer. The aim was to undertake a systematic review of the literature examining the evidence for the role of the tumour inflammatory cell infiltrate in predicting recurrence and survival in patients with primary operable breast cancer. A systematic review of published papers up to September 2011 was undertaken according to a pre-defined protocol (Fig. 1). A total of 66 independent studies (34,086 patients) were identified. It can be concluded from the review that despite the large number of studies and considerable effort over an extended period, the relationship between different aspects of tumour inflammatory cell infiltrate and outcome in primary operable breast cancer remains unclear. This is in large part due to the absence of methodological validation, underpowered studies (small sample size and sample subtype heterogeneity, insufficient follow-up) and the absence of validation datasets. Therefore, although there are tantalising examples of the potential of  the tumour inflammatory cell infiltrate to improve risk stratification patients with operable breast cancer (personalised care), this has not yet been realised.  Future studies with standardised methodology, large and homogenous groups, sufficient follow-up and validation datasets should be undertaken to unlock the potential of the tumour inflammatory infiltrate to predict outcome in patients with primary operable breast cancer.},
	pages = {943--955},
	number = {8},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {Mohammed, Zahra M. A. and Going, James J. and Edwards, Joanne and {McMillan}, Donald C.},
	date = {2012-12},
	pmid = {22651904},
	keywords = {Breast Neoplasms/*pathology/surgery, Female, Humans, Inflammation/*pathology, Neoplasm Recurrence, Local/*pathology, Survival Rate}
}

@book{vincent_sofa_1996,
	location = {Erasme University Hospital, Brussels, Belgium.},
	title = {The {SOFA} (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine},
	volume = {22},
	isbn = {0342-4642},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8844239},
	pagetotal = {707-10},
	number = {7},
	author = {Vincent, J L and Moreno, R and Takala, J and Willatts, S and De Mendonça, A and Bruining, H and Reinhart, C K and Suter, P M and Thijs, L G},
	date = {1996-07}
}

@article{taggart_effects_1991,
	title = {Effects of cardiac surgery and intraoperative hypothermia on energy expenditure as measured by doubly labelled water.},
	volume = {78},
	abstract = {Total energy expenditure ({TEE}) was measured over two 10-day periods, before and after operation in 16 patients undergoing coronary artery surgery and randomized  to have cardiopulmonary bypass with an intraoperative blood temperature of either 28 or 20 degrees C. {TEE} was measured with doubly labelled water containing stable isotopes of hydrogen and oxygen to allow calculation of {TEE} over fixed periods from the differential rate of excretion of the two isotopes. Results were available for eight patients in the 28 degrees C group but for only seven in the  20 degrees C group (one patient in this group was excluded as the temperature allocated was not achieved). The groups were similar with respect to body-weight  and lean body mass. The 20 degrees C group received more grafts than the 28 degrees C group, resulting in an increase in cross-clamp and bypass times. Mean preoperative {TEE} was similar in both groups. The mean difference in fractional turnover rates of hydrogen and oxygen was not significantly different in the postoperative period. There was a non-significant increase in the mean 10-day postoperative {TEE}, calculated in total calories, of 4.7 per cent in the 28 degrees C and 5.1 per cent in the 20 degrees C group. When changes in postoperative {TEE} were calculated according to lean body mass, the mean increases were respectively 3.7 and 3.2 per cent. Cardiac surgery utilizing cardiopulmonary bypass and intraoperative hypothermia results in only a modest increase in postoperative {TEE}. In this study a more profound level of intraoperative hypothermia did not influence the change in postoperative {TEE}.},
	pages = {237--241},
	number = {2},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Taggart, D. P. and {McMillan}, D. C. and Preston, T. and Richardson, R. and Burns, H. J. and Wheatley, D. J.},
	date = {1991-02},
	pmid = {2015484},
	keywords = {*Coronary Artery Bypass, *Hypothermia, Induced, Adult, Body Mass Index, Body Water, Cardiopulmonary Bypass, Deuterium, Energy Metabolism/*physiology, Humans, Male, Methods, Middle Aged, Oxygen Isotopes, Prospective Studies, Random Allocation}
}

@article{johnson_multidetector-row_2003,
	title = {Multidetector-row computed tomography with three-dimensional volume rendering of pancreatic cancer: a complete preoperative staging tool using computed tomography angiography and volume-rendered cholangiopancreatography},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12794597},
	abstract = {Volume rendering, a postprocessing computer algorithm that creates three-dimensional (3D) displays from computed tomography ({CT}) datasets, can create 3D cholangiographic images (volume-rendered cholangiopancreatography, or {VRCP}) from intravenous contrast-enhanced abdominal {CT} datasets without the use of a biliary contrast agent. This article illustrates the utility of {VRCP} in the setting of biliary obstruction due to pancreatic cancer. The 3D renderings of the intra- and extrahepatic biliary tree provide valuable information for planning biliary drainage, including the location and length of the obstruction as well as the relationship of intrahepatic ducts to liver metastases.},
	pages = {347--53},
	number = {3},
	journaltitle = {J Comput Assist Tomogr},
	author = {Johnson, Pamela T and Heath, David G and Hofmann, Lawrence V and Horton, Karen M and Fishman, Elliot K},
	date = {2003-06}
}

@article{mcmillan_stereoselective_1987,
	title = {Stereoselective fungal metabolism of 7,12-dimethylbenz[a]anthracene: identification and enantiomeric resolution of a K-region dihydrodiol.},
	volume = {53},
	abstract = {Syncephalastrum racemosum {UT}-70 and Cunninghamella elegans {ATCC} 36112 metabolized 7,12-dimethylbenz[a]anthracene (7,12-{DMBA}) to hydroxymethyl metabolites as well as 7-hydroxymethyl-12-methylbenz[a]anthracene trans-3,4-, -5,6-, -8,9-, and -10,11-dihydrodiols. The 7,12-{DMBA} metabolites were isolated by reversed-phase high-performance liquid chromatography and identified by their {UV}-visible absorption, mass, and nuclear magnetic resonance spectral characteristics. A comparison of the circular dichroism spectra of the K-region (5,6-position) dihydrodiol of both fungal strains with those of the 7,12-{DMBA} 5S,6S-dihydrodiol  formed from 7,12-{DMBA} by rat liver microsomes indicated that the major enantiomer of the 7-hydroxymethyl-12-methylbenz[a]anthracene trans-5,6-dihydrodiol formed by both fungal strains had a 5R,6R absolute stereochemistry. Direct resolution of the fungal trans-5,6-dihydrodiols by chiral stationary-phase high-performance liquid chromatography indicated that the ratios of the R,R and S,S enantiomers were 88:12 and 77:23 for S. racemosum and C. elegans, respectively. These results indicate that the fungal metabolism of 7,12-{DMBA} at the K region (5,6-position) is highly stereoselective and different from that reported for mammalian enzyme systems.},
	pages = {2560--2566},
	number = {10},
	journaltitle = {Applied and environmental microbiology},
	shortjournal = {Appl Environ Microbiol},
	author = {{McMillan}, D. C. and Fu, P. P. and Cerniglia, C. E.},
	date = {1987-10},
	pmid = {3122656},
	pmcid = {PMC204146},
	keywords = {9,10-Dimethyl-1,2-benzanthracene/*metabolism, Animals, Chemical Phenomena, Chemistry, Chromatography, High Pressure Liquid, Magnetic Resonance Spectroscopy, Microsomes, Liver/enzymology, Mucorales/*metabolism, Rats, Stereoisomerism}
}

@article{dindo_obesity_2003,
	title = {Obesity in general elective surgery},
	volume = {361},
	url = {http://www.sciencedirect.com/science/article/pii/S0140673603136409},
	pages = {2032--2035},
	number = {9374},
	journaltitle = {The Lancet},
	author = {Dindo, Daniel and Muller, Markus K. and Weber, Markus and Clavien, Pierre-Alain},
	urldate = {2015-05-18},
	date = {2003},
	file = {Obesity in general elective surgery.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\V4NMSS4R\\Obesity in general elective surgery.pdf:application/pdf}
}

@article{smith_preoperative_2008,
	title = {Preoperative resolution of jaundice following biliary stenting predicts more favourable early survival in resected pancreatic ductal adenocarcinoma},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18787902},
	abstract = {{INTRODUCTION}: Despite the widespread use of endoscopic biliary stenting in patients presenting with potentially resectable pancreatic cancer, there is no general consensus regarding whether this represents a superior management approach over expeditious surgical intervention. The objective of this study was to investigate the influence of preoperative biliary stenting and resolution of jaundice on subsequent postoperative survival following resection for pancreatic cancer. {METHODS}: 155 patients undergoing partial pancreatoduodenectomy for pancreatic ductal adenocarcinoma between January 1997 and August 2007 were identified from a prospectively maintained database. {RESULTS}: There was no survival difference when comparing patients undergoing preoperative biliary drainage (n = 130) with those who did not (n = 25) (log rank, P = 0.981). When analysing individual prognostic factors as continuous variables in univariate Cox analysis, lower albumin levels (P = 0.016), elevated alkaline phosphatase levels (P = 0.011) and elevated {CRP} levels (P = 0.021) were associated with poorer overall survival. Multivariable Cox regression demonstrated that both albumin (P = 0.008) and {CRP} (P = 0.038) remained significant independent predictors of overall survival alongside lymph node ratio (P = 0.018). Although preoperative bilirubin levels were not associated with overall survival when analysed as a continuous variable (Cox, P = 0.786), the presence of jaundice (i.e., bilirubin {\textgreater}35 micromol/l) at the time of surgery was a significant adverse predictor of early survival in patients undergoing preoperative biliary drainage (Breslow-Gehan-Wilcoxon, P = 0.013) and remained a significant predictor of early survival when included in a further Cox analysis with censoring of cases who survived beyond 6 months (Cox, P = 0.017). {CONCLUSION}: These results suggest that the presence of jaundice at the time of resection has an adverse impact on early, but not overall, postoperative survival in pancreatic cancer patients undergoing preoperative biliary drainage.},
	pages = {3138--46},
	number = {11},
	journaltitle = {Ann Surg Oncol},
	author = {Smith, Richard A and Dajani, K and Dodd, S and Whelan, P and Raraty, M and Sutton, R and Campbell, F and Neoptolemos, J P and Ghaneh, P},
	date = {2008-11}
}

@article{gujam_relationship_2014,
	title = {The relationship between the tumour stroma percentage, clinicopathological characteristics and outcome in patients with operable ductal breast cancer.},
	volume = {111},
	doi = {10.1038/bjc.2014.279},
	abstract = {{BACKGROUND}: The percentage of tumour stroma ({TSP}) has recently been reported to be a novel independent predictor of outcome in patients with a variety of common  solid organ tumours. The aim of this study was to examine the relationship between {TSP}, clinicopathological characteristics and outcome in patients with invasive ductal breast cancer, in particular node negative and triple negative disease. {METHODS}: A total of 361 patients with primary operable invasive ductal breast cancer were included in this study. The {TSP} was assessed visually on the haematoxylin and eosin-stained tissue sections. With a cutoff value of 50\% {TSP}, patients with {\textless}/= 50\% stroma were classified as the low-{TSP} group and those with  {\textgreater}50\% stroma were classified as the high-{TSP} group. {RESULTS}: A total of 109 (30\%)  patients had high {TSP}. Patients with high {TSP} were old age (P=0.035), had more Her-2-positive tumours (P=0.029), low-grade tumour inflammatory infiltrate (P=0.034), low {CD}68+macrophage infiltrate (P{\textless}0.001), low {CD}4+ (P=0.023) and low {CD}8+ T-lymphocytes infiltrate (P=0.017), tumour recurrence (P=0.015) and shorter  cancer-specific survival (P{\textless}0.001). In node-negative patients (n=207), high {TSP} was associated with low {CD}68+macrophage infiltrate (P=0.001), low {CD}4+ (P=0.040)  and low {CD}8+ T-lymphocytes infiltrate (P=0.016) and shorter cancer-specific survival (P=0.005). In triple negative patients (n=151), high {TSP} was associated  with high tumour grade (P={\textless}0.001), lymph node positivity (P=0.027), low {CD}68+macrophage infiltrate (P=0.011) and shorter cancer-specific survival (P=0.035). The 15-year cancer-specific survival rate was 79\% vs 21\% in the low-{TSP} group vs high-{TSP} group. In multivariate survival analysis, a high {TSP} was associated with reduced cancer-specific survival in the whole cohort (P=0.001), node-negative patients (P=0.007) and those who received systemic adjuvant therapy (P=0.021), independent of other pathological characteristics including host inflammatory response. However, {TSP} was not an independent prognostic factor for triple negative patients (P=0.151). {CONCLUSIONS}: A high {TSP} in primary operable invasive ductal breast cancer was associated with recurrence  and poorer long-term survival. The inverse relation with the tumour inflammatory  infiltrate highlights the importance of the amount of tumour stroma on immunological response in patients with primary operable ductal breast cancer. Implementing this simple and reproducible parameter in routine pathological examination may help optimise risk stratification in patients with invasive ductal breast cancer.},
	pages = {157--165},
	number = {1},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Gujam, F. J. A. and Edwards, J. and Mohammed, Z. M. A. and Going, J. J. and {McMillan}, D. C.},
	date = {2014-07-08},
	pmid = {24874480},
	pmcid = {PMC4090742},
	keywords = {Aged, Breast Neoplasms/*pathology/surgery/*therapy, Carcinoma, Ductal, Breast/*pathology/surgery/*therapy, Combined Modality Therapy, Female, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Recurrence, Local/pathology, Stromal Cells/pathology, Survival Analysis, Triple Negative Breast Neoplasms/pathology/surgery/therapy, Tumor Microenvironment}
}

@article{martin_prognostic_2012,
	title = {The prognostic value of cardiopulmonary exercise testing in vascular surgery patients},
	volume = {44},
	issn = {1532-2165},
	doi = {10.1016/j.ejvs.2012.06.029},
	pages = {457},
	number = {4},
	journaltitle = {European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery},
	shortjournal = {Eur J Vasc Endovasc Surg},
	author = {Martin, D. and O'Doherty, A. and Imray, C.},
	date = {2012-10},
	pmid = {22871944},
	keywords = {Aortic Aneurysm, Abdominal, Exercise Test, Exercise Tolerance, Humans, preoperative care, Vascular Surgical Procedures}
}

@article{zweig_receiver-operating_1993,
	title = {Receiver-operating characteristic ({ROC}) plots: a fundamental evaluation tool in clinical medicine.},
	volume = {39},
	issn = {0009-9147, 1530-8561},
	url = {http://www.clinchem.org/content/39/4/561},
	shorttitle = {Receiver-operating characteristic ({ROC}) plots},
	pages = {561--577},
	number = {4},
	journaltitle = {Clinical Chemistry},
	shortjournal = {Clinical Chemistry},
	author = {Zweig, M. H. and Campbell, G.},
	urldate = {2015-07-15},
	date = {1993-04-01},
	langid = {english},
	pmid = {8472349},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EKUHRHU6\\Zweig and Campbell - 1993 - Receiver-operating characteristic (ROC) plots a f.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RBPC9738\\561.html:text/html}
}

@article{mansouri_impact_2013,
	title = {The impact of age, sex and socioeconomic deprivation on outcomes in a colorectal  cancer screening programme.},
	volume = {8},
	doi = {10.1371/journal.pone.0066063},
	abstract = {{BACKGROUND}: Population-based colorectal cancer screening has been shown to reduce cancer specific mortality and is used across the {UK}. Despite evidence that older  age, male sex and deprivation are associated with an increased incidence of colorectal cancer, uptake of bowel cancer screening varies across demographic groups. The aim of this study was to assess the impact of age, sex and deprivation on outcomes throughout the screening process. {METHODS}: A prospectively maintained database, encompassing the first screening round of a faecal occult blood test screening programme in a single geographical area, was analysed. {RESULTS}: Overall, 395,096 individuals were invited to screening, 204,139 (52\%) participated and 6079 (3\%) tested positive. Of the positive tests,  4625 (76\%) attended for colonoscopy and cancer was detected in 396 individuals (9\%). Lower uptake of screening was associated with younger age, male sex and deprivation (all p{\textless}0.001). Only deprivation was associated with failure to proceed to colonoscopy following a positive test (p{\textless}0.001). Despite higher positivity rates in those that were more deprived (p{\textless}0.001), the likelihood of detecting cancer in those attending for colonoscopy was lower (8\% most deprived vs 10\% least deprived, p = 0.003). {CONCLUSION}: Individuals who are deprived are less likely to participate in screening, less likely to undergo colonoscopy and less likely to have cancer identified as a result of a positive test. Therefore,  this study suggests that strategies aimed at improving participation of deprived  individuals in colorectal cancer screening should be directed at all stages of the screening process and not just uptake of the test.},
	number = {6},
	journaltitle = {{PloS} one},
	shortjournal = {{PLoS} One},
	author = {Mansouri, David and {McMillan}, Donald C. and Grant, Yasmin and Crighton, Emilia M. and Horgan, Paul G.},
	date = {2013},
	pmid = {23776606},
	pmcid = {PMC3680425},
	keywords = {Age Factors, Colonoscopy/*utilization, Colorectal Neoplasms/*diagnosis/*epidemiology, Female, Great Britain/epidemiology, Humans, Logistic Models, Male, Mass Screening, Occult Blood, Prospective Studies, Sex Factors, Socioeconomic Factors}
}

@article{whipple_history_1918,
	title = {History analysis applied to surgical diseases of the biliary tract and pancreas},
	volume = {68},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1427080/},
	pages = {471--484},
	number = {5},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1918-11},
	pmid = {17864013},
	pmcid = {PMC1427080},
	file = {Whipple - 1918 - HISTORY ANALYSIS APPLIED TO SURGICAL DISEASES OF T.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6GTTVGAV\\Whipple - 1918 - HISTORY ANALYSIS APPLIED TO SURGICAL DISEASES OF T.pdf:application/pdf}
}

@article{deoliveira_assessment_2006,
	title = {Assessment of complications after pancreatic surgery: A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17122618},
	abstract = {{OBJECTIVE}: To define a simple and reproducible classification of complications following pancreaticoduodenectomy ({PD}) based on a therapy-oriented severity grading system. {BACKGROUND}: While mortality is rare after {PD}, morbidity rates remain high. The lack of standardization in evaluating morbidity after {PD} has severely hampered meaningful comparisons over time and among centers. We adapted a novel classification of complication to stratify morbidity by severity after {PD}, to test whether the incidence of pancreatic fistula has changed over time, and to identify risk factors in a single North American center. {METHODS}: The classification was applied to a consecutive series of 633 patients undergoing {PD} between February 2003 and August 2005. Another series of 141 patients treated between 1987 and 1990 was also analyzed to identify changes in the incidence and severity of fistula. Univariate and multivariate analyses were performed to link respective complications with preoperative and intraoperative parameters, length of hospital stay, and long-term survival. {RESULTS}: A total of 263 (41.5\%) patients did not develop any complication, while 370 (58.5\%) had at least one complication; 62 (10.0\%) patients had only grade I complications (no need for specific intervention), 192 patients (30.0\%) had grade {II} (need for drug therapy such as antibiotics), 85 patients (13.5\%) had grade {III} (need for invasive therapy), and 19 patients (3.0\%) had grade {IV} complications (organ dysfunction with {ICU} stay). Grade V (death) occurred in 12 patients (2.0\%). A total of 57 patients (9.0\%) developed pancreatic fistula, of which 33 (58.0\%) were classified as grade {II}, 17 (30.0\%) as grade {III}, 5 (9.0\%) as grade {IV}, and 2 (3.5\%) as grade V. Delayed gastric emptying was documented in 80 patients (12.7\%); half of them were scored as grade {II} and the other half as grade {III}. A significant decrease in the incidence of fistula was observed between the 2 periods analyzed (14.0\% vs. 9.0\%, P {\textless} 0.001), mostly due to a decrease in grade {II} fistula. Cardiovascular disease was a risk factor for overall morbidity and complication severity, while texture of the gland and cardiovascular disease were risk factors for pancreatic fistula. {CONCLUSION}: This study demonstrates the applicability and utility of a new classification in grading complications following pancreatic surgery. This novel approach may provide a standardized, objective, and reproducible assessment of pancreas surgery enabling meaningful comparison among centers and over time.},
	pages = {931--7; discussion 937--9},
	number = {6},
	journaltitle = {Ann Surg},
	author = {{DeOliveira}, Michelle L and Winter, Jordan M and Schafer, Markus and Cunningham, Steven C and Cameron, John L and Yeo, Charles J and Clavien, Pierre-Alain},
	date = {2006-12}
}

@article{dutta_comparison_2011-1,
	title = {A comparison of {POSSUM} and {GPS} models in the prediction of post-operative outcome in patients undergoing oesophago-gastric cancer resection.},
	volume = {18},
	doi = {10.1245/s10434-011-1676-5},
	abstract = {{BACKGROUND}: There is some evidence that a patient's pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}) and modified Glasgow prognostic score ({mGPS}) models in the prediction of post-operative outcome, both  short term and long term, in patients undergoing resection of oesophago-gastric cancer. {PATIENTS} {AND} {METHODS}: Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score  the {POSSUM}, P-{POSSUM}, O-{POSSUM} and {mGPS} models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Both short-term outcome and long-term survival were recorded. {RESULTS}: Observed morbidity was 49\%, whereas {POSSUM} predicted post-operative morbidity in 60\%, giving an overall standardised morbidity ratio of 0.82. Only male sex [hazard ratio ({HR}) 3.61, 95\% confidence interval ({CI}) 1.38-9.46, P = 0.009] and {POSSUM} physiology score ({HR} 2.13, 95\% {CI} 1.11-4.08, P = 0.023) were independently associated with post-operative morbidity. The post-operative mortality rates predicted by {POSSUM}, P-{POSSUM} and O-{POSSUM} were 16.5, 5.8 and 9.9\%, respectively, giving a standardised mortality ratio of 0.25,  0.71 and 0.42. Only {mGPS} ({HR} 1.96, 95\% {CI} 1.09-3.54, P = 0.025) and tumour-node-metastasis ({TNM}) stage ({HR} 2.21, 95\% {CI} 1.44-3.38, P {\textless} 0.001) were independently associated with cancer-specific survival. {CONCLUSIONS}: The {POSSUM} physiology score was useful in predicting post-operative morbidity, and the {mGPS}  was useful in predicting cancer-specific survival, in patients undergoing surgery for oesophago-gastric cancer.},
	pages = {2808--2817},
	number = {10},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Dutta, Sumanta and Al-Mrabt, Nesrin M. and Fullarton, Grant M. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-10},
	pmid = {21431986},
	keywords = {*Models, Statistical, *Morbidity, *Postoperative Complications, *Severity of Illness Index, Aged, Esophageal Neoplasms/*surgery, Esophagectomy, Female, Follow-Up Studies, Gastrectomy, Humans, Male, Middle Aged, Stomach Neoplasms/*surgery, Survival Rate, Treatment Outcome}
}

@article{older_preoperative_2005,
	title = {Preoperative evaluation of cardiac risk},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16097517},
	pages = {452--7},
	number = {8},
	journaltitle = {Br J Hosp Med (Lond)},
	author = {Older, Paul and Hall, Adrian},
	date = {2005-08}
}

@article{mirnezami_increased_2011,
	title = {Increased Local Recurrence and Reduced Survival From Colorectal Cancer Following Anastomotic Leak: Systematic Review and Meta-Analysis},
	volume = {253},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201105000-00009},
	doi = {10.1097/SLA.0b013e3182128929},
	shorttitle = {Increased Local Recurrence and Reduced Survival From Colorectal Cancer Following Anastomotic Leak},
	pages = {890--899},
	number = {5},
	journaltitle = {Annals of Surgery},
	author = {Mirnezami, Alexander and Mirnezami, Reza and Chandrakumaran, Kandiah and Sasapu, Kishore and Sagar, Peter and Finan, Paul},
	urldate = {2015-05-25},
	date = {2011-05},
	langid = {english},
	file = {Mirnezami et al. - 2011 - Increased Local Recurrence and Reduced Survival Fr.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7PE245KP\\Mirnezami et al. - 2011 - Increased Local Recurrence and Reduced Survival Fr.pdf:application/pdf}
}

@article{kamphues_postoperative_2012,
	title = {Postoperative complications deteriorate long-term outcome in pancreatic cancer patients},
	volume = {19},
	issn = {1534-4681},
	doi = {10.1245/s10434-011-2041-4},
	abstract = {{BACKGROUND}: Different tumor-specific prognostic factors have been identified in recent years for patients who undergo surgery due to pancreatic head cancer, but the results often were inconsistent. Furthermore, the impact of postoperative complications on patient long-term survival has not been described.
{METHODS}: The long-term outcome of 428 patients who underwent resection of pancreatic head cancer at our center during a 17-year period was evaluated. Perioperative details, including postoperative complications, as well as the follow-up of all patients who left the hospital postoperatively were collected in a prospective database. Univariate and multivariate models were used to identify potential prognostic factors and to evaluate the impact of postoperative complications on long-term survival.
{RESULTS}: The median survival was 15.5 months with a postoperative complication rate (grade I-{IV}) of 32.7\%. Independent prognostic significance was detected for grading (P {\textless} 0.001), R status (P = 0.001), and lymph node status (P = 0.003). The occurrence of severe postoperative complications (grade {III}-{IV}) was associated with a significantly shortened survival (16.5 vs. 12.4 months; P = 0.002) and was identified as an independent prognostic factor (P = 0.002).
{CONCLUSIONS}: This large study demonstrates that severe postoperative complications have a strong impact on the long-term survival of patients with pancreatic head cancer comparable to tumor characteristics, such as lymph node status, grading, or R status. As a result, the improvement of surgical procedures in specialized centers might lead to a survival benefit in these patients.},
	pages = {856--863},
	number = {3},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Kamphues, Carsten and Bova, Roberta and Schricke, Dorothee and Hippler-Benscheidt, Michael and Klauschen, Frederick and Stenzinger, Albrecht and Seehofer, Daniel and Glanemann, Matthias and Neuhaus, Peter and Bahra, Marcus},
	date = {2012-03},
	pmid = {21879265},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Carcinoma, Pancreatic Ductal, Female, Humans, Male, Middle Aged, Oncology, Pancreatectomy, Pancreatic Neoplasms, postoperative complications, prognosis, surgery, Surgical Oncology, Survival Rate, Young Adult},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X8T4CKJH\\Kamphues et al. - 2011 - Postoperative Complications Deteriorate Long-Term .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4DWAIDGQ\\10.html:text/html}
}

@article{valkenet_effects_2010,
	title = {The effects of preoperative exercise therapy on postoperative outcome: a systematic review},
	volume = {25},
	issn = {0269-2155, 1477-0873},
	url = {http://cre.sagepub.com/cgi/doi/10.1177/0269215510380830},
	doi = {10.1177/0269215510380830},
	shorttitle = {The effects of preoperative exercise therapy on postoperative outcome},
	pages = {99--111},
	number = {2},
	journaltitle = {Clinical Rehabilitation},
	author = {Valkenet, K. and van de Port, I. G. and Dronkers, J. J. and de Vries, W. R. and Lindeman, E. and Backx, F. J.},
	urldate = {2014-01-27},
	date = {2010-11-08},
	file = {Valkenet et al. - 2010 - The effects of preoperative exercise therapy on po.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H4HDKDET\\Valkenet et al. - 2010 - The effects of preoperative exercise therapy on po.pdf:application/pdf}
}

@article{boeken_increased_1998,
	title = {Increased preoperative C-reactive protein ({CRP})-values without signs of an infection and complicated course after cardiopulmonary bypass ({CPB})-operations},
	volume = {13},
	issn = {1010-7940},
	abstract = {{OBJECTIVE}: C-Reactive protein ({CRP}) is known to be a sensitive indicator of infection. Since it is also involved in the acute phase reaction, it is of great interest, whether an isolated preoperative increase of {CRP} without further signs of infection is of any prognostic value for postoperative outcome after cardiac surgery with cardiopulmonary bypass ({CPB}), which itself is possibly causing a systemic inflammatory response syndrome ({SIRS}).
{METHODS}: Fifty patients with an isolated {CRP}-elevation ({\textgreater}5 mg/l) (from 6.2 to 93.3 mg/l) were operated using {CPB} (group A). A control group (group B) consisted of 50 cardiac surgery patients, matched in the patterns of age, gender and kind of disease. No preoperative {CRP}-elevation (from 0 to 4.8 mg/l) occurred in this group.
{RESULTS}: The postoperative course of both groups showed significant differences. Septic complications were seen more often in group A (20\%) than in the controls (2\%) (P {\textless} 0.01). Microbiology (blood culture, cultures from nose, tracheal aspirate and urine) was positive only in 10\% of these patients. Catecholamine support (epinephrine, norepinephrine and/or doses of dopamine or dobutamine of more than 3 microg/kg per min) was needed in 26\% of group A cases, whereas it was only needed in 10\% of group B (P {\textless} 0.05). A significantly longer respiratory support was also necessary in patients with elevated {CRP} (25.2 +/- 6.4 h vs. 6.6 +/- 0.8 h) (P {\textless} 0.01). Furthermore there was a significant difference in the duration of intensive care (4.6 +/- 0.8 days vs. 2.6 +/- 0.3 days) (P {\textless} 0.05).
{CONCLUSIONS}: These data show that patients without apparent infection or inflammation, who had elevated {CRP}-values preoperatively, face an increased risk of septic complications after extracorporeal circulation. As microbiology tests are negative in most cases, it may be speculated that the majority of septic complications are due to a {SIRS}.},
	pages = {541--545},
	number = {5},
	journaltitle = {European Journal of Cardio-Thoracic Surgery: Official Journal of the European Association for Cardio-Thoracic Surgery},
	shortjournal = {Eur J Cardiothorac Surg},
	author = {Boeken, U. and Feindt, P. and Zimmermann, N. and Kalweit, G. and Petzold, T. and Gams, E.},
	date = {1998-05},
	pmid = {9663535},
	keywords = {Cardiac Surgical Procedures, Cardiopulmonary Bypass, C-Reactive Protein, Female, Humans, Male, Postoperative Care, postoperative complications, prognosis, Retrospective Studies, Sepsis}
}

@article{dandurand_mitochondrial_1995,
	title = {Mitochondrial Disease: Pulmonary Function, Exercise Performance, and Blood Lactate Levels},
	volume = {108},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.108.1.182},
	doi = {10.1378/chest.108.1.182},
	shorttitle = {Mitochondrial Disease},
	pages = {182},
	number = {1},
	journaltitle = {{CHEST} Journal},
	author = {Dandurand, Ronald J.},
	urldate = {2015-04-28},
	date = {1995-07-01},
	langid = {english},
	file = {Dandurand - 1995 - Mitochondrial Disease Pulmonary Function, Exercis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HU7HNGCD\\Dandurand - 1995 - Mitochondrial Disease Pulmonary Function, Exercis.pdf:application/pdf}
}

@article{yamamoto_association_2013,
	title = {Association between Reduction of Plasma Adiponectin Levels and Risk of Bacterial Infection after Gastric Cancer Surgery},
	volume = {8},
	issn = {1932-6203},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592855/},
	doi = {10.1371/journal.pone.0056129},
	abstract = {Background and Purpose
Infections are important causes of postoperative morbidity after gastric surgery; currently, no factors have been identified that can predict postoperative infection. Adiponectin ({ADN}) mediates energy metabolism and functions as an immunomodulator. Perioperative {ADN} levels and perioperative immune functioning could be mutually related. Here we evaluated a potential biological marker to reliably predict the incidence of postoperative infections to prevent such comorbidities.

Methods
We analyzed 150 consecutive patients who underwent elective gastric cancer surgery at the Shiga University of Medical Science Hospital (Shiga, Japan) from 1997 to 2009; of these, most surgeries (n = 100) were performed 2008 onwards. The patient characteristics and surgery-related factors between two groups (with and without infection) were compared by the paired t-test and χ2 test, including preoperative {ADN} levels, postoperative day 1 {ADN} levels, and {ADN} ratio (postoperative {ADN} levels/preoperative {ADN} levels) as baseline factors. Logistic regression analysis was performed to access the independent association between {ADN} ratio and postoperative infection. Finally, receiver operating curves ({ROCs}) were constructed to examine its clinical utility.

Results
Sixty patients (40\%) experienced postoperative infections. The baseline values of age, American Society of Anesthesiologists physical status, total operating time, blood loss, surgical procedure, C-reactive protein ({CRP}) levels, preoperative {ADN} levels, and {ADN} ratio were significantly different between groups. Logistic regression analysis using these factors indicated that type 2 diabetes mellitus (T2DM) and {ADN} ratio were significantly independent variables (*p{\textless}0.05, ** p{\textless}0.01, respectively). {ROC} analysis revealed that the useful cutoff values (sensitivity/specificity) for preoperative {ADN} levels, {ADN} ratio, blood loss, operating time, and {CRP} levels were 8.81(0.567/0.568), 0.76 (0.767/0.761), 405 g (0.717/0.693), 342 min (0.617/0.614), and 8.94 mg/dl (0.583/0.591), respectively.

Conclusion
T2DM and {ADN} ratio were independent predictors of postoperative infection and {ADN} ratio was the most useful predictor for postoperative infection.},
	number = {3},
	journaltitle = {{PLoS} {ONE}},
	shortjournal = {{PLoS} One},
	author = {Yamamoto, Hiroshi and Maeda, Kazuhisa and Uji, Yoshitaka and Tsuchihashi, Hiroshi and Mori, Tsuyoshi and Shimizu, Tomoharu and Endo, Yoshihiro and Kadota, Aya and Miura, Katsuyuki and Koga, Yusuke and Ito, Toshinori and Tani, Tohru},
	urldate = {2015-08-20},
	date = {2013-03-08},
	pmid = {23520452},
	pmcid = {PMC3592855},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8GIXVF85\\Yamamoto et al. - 2013 - Association between Reduction of Plasma Adiponecti.pdf:application/pdf}
}

@article{shafique_systemic_2012,
	title = {Systemic inflammation and survival of patients with prostate cancer: evidence from the Glasgow Inflammation Outcome Study.},
	volume = {15},
	doi = {10.1038/pcan.2011.60},
	abstract = {{BACKGROUND}: There is some evidence that systemic inflammation may be associated with survival in patients with prostate cancer; however, it is unclear whether this is independent of grade. We therefore investigated the role of inflammation-based prognostic scores, the modified Glasgow Prognostic Score ({mGPS}) and neutrophil lymphocyte ratio ({NLR}), and their associations with Gleason grade in patients with prostate cancer. {METHODS}: Patients from a cohort, the Glasgow Inflammation Outcome Study, who had diagnosis of prostate cancer, were included in this study. The {mGPS} was constructed by combining C-reactive protein  and albumin whereas {NLR} by calculating the ratio of neutrophils to lymphocytes. We estimated 5-year relative survival and relative excess risk ({RER}) of death by  {mGPS} and {NLR} categories after adjusting for age, socioeconomic circumstances and  Gleason grade. {RESULTS}: In all, 897 prostate cancer patients were identified; of  those 422 (47\%) died during a maximum follow-up of 6.2 years. Systemic inflammation appeared to have significant prognostic value. The {mGPS} predicted poorer 5-year overall and relative survival independent of age, socioeconomic circumstances, disease grade and {NLR}. Raised {mGPS} also had a significant association with excess risk of death ({mGPS} 2: {RER} =2.41, 95\% confidence interval 1.37-4.23) among aggressive, clinically significant prostate cancer (Gleason grades 8-10). {CONCLUSIONS}: The {mGPS} is a strong measure of systemic inflammation, when compared with {NLR}. Prostate cancer patients with a raised {mGPS} had significantly higher risk of death for overall as well high-grade disease. Inflammation-based prognostic scores predict outcome in patients with prostate cancer and should be added to their routine clinical assessment.},
	number = {2},
	journaltitle = {Prostate cancer and prostatic diseases},
	shortjournal = {Prostate Cancer Prostatic Dis},
	author = {Shafique, K. and Proctor, M. J. and {McMillan}, D. C. and Qureshi, K. and Leung, H. and Morrison, D. S.},
	date = {2012-06},
	pmid = {22343838},
	keywords = {Aged, Cohort Studies, C-Reactive Protein/analysis, Humans, Inflammation/*immunology, Lymphocyte Count, Male, Middle Aged, Neutrophils/cytology, Prognosis, Prostatic Neoplasms/*mortality/*pathology, Risk, Serum Albumin/analysis, Socioeconomic Factors, Survival Analysis}
}

@article{guthrie_comparison_2013,
	title = {Comparison of the prognostic value of longitudinal measurements of systemic inflammation in patients undergoing curative resection of colorectal cancer.},
	volume = {109},
	doi = {10.1038/bjc.2013.330},
	abstract = {{BACKGROUND}: The systemic inflammation-based prognostic scores, modified Glasgow Prognostic Score ({mGPS}) and the neutrophil-lymphocyte ratio ({NLR}) are now recognised to be useful in predicting survival in a variety of solid organ malignancies, including colorectal cancer ({CRC}) before treatment. However, there  would appear to have been no direct comparison of these longitudinal measurements of systemic inflammation. Therefore, the aim of the present study was to compare  the prognostic value of longitudinal measures of systemic inflammation, the {mGPS}  and {NLR} in patients undergoing potentially curative resection for {CRC}. {METHODS}: Three hundred and twenty-six patients underwent potentially curative resection for {CRC} between 2006 and 2010. Full biochemical and haematological data both pre- and post-operatively (3-6 months) were available for 206 patients. {RESULTS}: In 206 patients, there was no significant overall change in either the {mGPS} or the {NLR}, from pre- to post-operatively. On univariate survival analysis, T-stage (P{\textless}0.001), tumour, node, metastasis stage (P{\textless}0.005), pre-operative {mGPS} (P{\textless}0.05), pre-operative {NLR} ({\textless}0.05), post-operative {mGPS} (P{\textless}0.001) and post-operative {NLR} (P{\textless}0.005) were associated with cancer-specific survival. On multivariate survival analysis, comparing pre-operative {mGPS} and {NLR}, both pre-operative {mGPS} and {NLR} were independently associated with reduced cancer-specific survival ({mGPS} hazard  ratio ({HR}) 1.97, {CI} 1.16-3.34, P{\textless}0.05, and {NLR} {HR} 3.07, {CI} 1.23-7.63, P{\textless}0.05). When the same multivariate comparison was carried out on post-operative data, only the post-operative {mGPS} was independently associated with cancer-specific survival ({HR} 4.81, {CI} 2.13-10.83, P{\textless}0.001). {CONCLUSION}: The results of the present study support the longitudinal assessment of the systemic inflammatory response, in particular the {mGPS}, in patients undergoing potentially curative resection for {CRC}.},
	pages = {24--28},
	number = {1},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Guthrie, G. J. K. and Roxburgh, C. S. D. and Farhan-Alanie, O. M. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2013-07-09},
	pmid = {23799846},
	pmcid = {PMC3708558},
	keywords = {*Lymphocyte Count, Aged, Colorectal Neoplasms/*mortality/*surgery, Female, Humans, Inflammation/*immunology, Longitudinal Studies, Lymphocytes, Male, Multivariate Analysis, Neutrophils, Outcome Assessment (Health Care), Prognosis, Survival Analysis}
}

@article{mantovani_cancer-related_2008,
	title = {Cancer-related inflammation},
	volume = {454},
	issn = {0028-0836, 1476-4687},
	url = {http://www.nature.com/doifinder/10.1038/nature07205},
	doi = {10.1038/nature07205},
	pages = {436--444},
	number = {7203},
	journaltitle = {Nature},
	author = {Mantovani, Alberto and Allavena, Paola and Sica, Antonio and Balkwill, Frances},
	urldate = {2015-04-28},
	date = {2008-07-24},
	file = {Mantovani et al. - 2008 - Cancer-related inflammation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N6TAE86F\\Mantovani et al. - 2008 - Cancer-related inflammation.pdf:application/pdf}
}

@article{tokunaga_poor_2013,
	title = {Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer},
	volume = {20},
	issn = {1534-4681},
	doi = {10.1245/s10434-012-2720-9},
	abstract = {{BACKGROUND}: The impact of postoperative complications on recurrence rate and long-term outcome has been reported in patients with colorectal and esophageal cancer, but not in patients with gastric cancer. This study evaluated the impact of postoperative intra-abdominal infectious complications on long-term survival following curative gastrectomy.
{METHODS}: This study included 765 patients who underwent curative gastrectomy for gastric cancer between 2002 and 2006. Patients were divided into 2 groups: with (C-group, n = 81) or without ({NC}-group, n = 684) intra-abdominal infectious complications. Survival curves were compared between the groups, and multivariate analysis was conducted to identify independent prognostic factors.
{RESULTS}: Male patients were dominant, and total gastrectomy was frequently performed in the C-group. The pathological stage was more advanced and D2 lymph node dissection and splenectomy were preferred in the C-group. The 5-year overall survival ({OS}) rate was better in the {NC}-group (86.8 \%) than in the C-group (66.4 \%; P {\textless} .001). The 5-year relapse-free survival ({RFS}) rate was also better in the {NC}-group (84.5 \%) than in the C-group (64.9 \%; P {\textless} .001). This trend was still observed in stage {II} and {III} patients after stratification by pathological stage. Multivariate analysis identified intra-abdominal infectious complication as an independent prognostic factor for {OS} (hazard ratio, 2.448; 95 \% confidence interval [95 \% {CI}], 1.475-4.060) and {RFS} (hazard ratio, 2.219; 95 \% {CI}, 1.330-3.409) in patients with advanced disease.
{CONCLUSIONS}: Postoperative intra-abdominal infectious complications adversely affect {OS} and {RFS}. Meticulous surgery is needed to decrease the complication rate and improve the long-term outcome of patients following curative gastrectomy.},
	pages = {1575--1583},
	number = {5},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Tokunaga, Masanori and Tanizawa, Yutaka and Bando, Etsuro and Kawamura, Taiichi and Terashima, Masanori},
	date = {2013-05},
	pmid = {23076557},
	keywords = {Abdominal Abscess, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Anastomotic leak, Blood Loss, Surgical, Cholecystitis, Disease-Free Survival, Female, Gastrectomy, Humans, Intestinal Obstruction, Kaplan-Meier Estimate, Male, Malnutrition, Middle Aged, Operative Time, Pancreatic Diseases, Patient Readmission, postoperative complications, Proportional Hazards Models, Retrospective Studies, Stomach Neoplasms, Survival Rate, Young Adult}
}

@article{yoo_negative_2011,
	title = {Negative impact of leakage on survival of patients undergoing curative resection for advanced gastric cancer},
	volume = {104},
	issn = {1096-9098},
	doi = {10.1002/jso.22045},
	abstract = {{BACKGROUND} {AND} {OBJECTIVES}: Leakage has been shown to adversely affect survival in patients undergoing surgery for gastrointestinal malignancies. However, the effect of leakage following radical gastrectomy in patients with gastric cancer remains unclear.
{METHODS}: In total, 478 patients with advanced gastric cancer who underwent surgery with curative intent were reviewed. Anastomosis or duodenal stump leakage was diagnosed clinically or radiologically. Risk factors for leakage were evaluated by univariate and multivariate analyses. The impact of leakage on patient survival was analyzed using the Kaplan-Meier method.
{RESULTS}: Leakage was diagnosed in 32 of 478 patients (6.7\%); 14 patients (2.9\%) exhibited esophagojejunal anastomotic leakage, 14 (2.9\%) showed duodenal stump leakage, and four (0.8\%) showed gastroduodenal anastomotic leakage. Poor performance status [odds ratio ({OR}): 4.01, 95\% confidence interval ({CI}): 1.80-8.93] and tumor location ({OR}: 3.74, 95\% {CI}: 1.56-8.89) were risk factors for postoperative leakage. Overall mean survival of patients with leakage was significantly lower than that of patients without leakage (30.5 vs. 96.2 months; P {\textless} 0.001). Leakage was one of the independent predictive factor for overall survival [hazard ratio ({HR}): 3.58, 95\% {CI}: 2.29-5.59].
{CONCLUSIONS}: Postoperative inflammation due to leakage is a negative prognostic factor for patients with advanced gastric cancer.},
	pages = {734--740},
	number = {7},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J Surg Oncol},
	author = {Yoo, Han Mo and Lee, Han Hong and Shim, Jung Ho and Jeon, Hae Myung and Park, Cho Hyun and Song, Kyo Young},
	date = {2011-12},
	pmid = {21792945},
	keywords = {Anastomosis, Surgical, Anastomotic leak, Female, Gastrectomy, Humans, Korea, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, Proportional Hazards Models, Prospective Studies, Risk Factors, Stomach Neoplasms, Survival Rate}
}

@article{rodriguez-roisin_hepatopulmonary_2008,
	title = {Hepatopulmonary syndrome—a liver-induced lung vascular disorder},
	volume = {358},
	url = {http://www.nejm.org/doi/full/10.1056/nejmra0707185},
	pages = {2378--2387},
	number = {22},
	journaltitle = {New England Journal of Medicine},
	author = {Rodríguez-Roisin, Roberto and Krowka, Michael J.},
	urldate = {2014-01-27},
	date = {2008},
	file = {Rodríguez-Roisin and Krowka - 2008 - Hepatopulmonary syndrome—a liver-induced lung vasc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GDSZCVUZ\\Rodríguez-Roisin and Krowka - 2008 - Hepatopulmonary syndrome—a liver-induced lung vasc.pdf:application/pdf}
}

@article{kosaka_multivariate_2014,
	title = {Multivariate logistic regression analysis for prediction of clinically relevant pancreatic fistula in the early phase after pancreaticoduodenectomy},
	volume = {21},
	issn = {1868-6982},
	doi = {10.1002/jhbp.11},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({PF}) remains a major complication after pancreaticoduodenectomy ({PD}). We aimed to investigate the predictors of clinically relevant {PF} after {PD}.
{METHODS}: We retrospectively analyzed the predictive factors of relevant grade B/C {PF} using logistic regression analysis of 100 consecutive patients who underwent {PD}. {PF} was defined in accordance with the International Study Group on {PF} ({ISGPF}).
{RESULTS}: White blood cell count ({WBC}) of 73.6 × 10(2) /μl, C-reactive protein ({CRP}) of 9.3 mg/dl and amylase value in drains (d-amylase) of 647 U/I on postoperative day ({POD}) 4 were proposed as the cut-off values for predicting grade B/C {PF} with high accuracy by the receiver operating characteristic ({ROC}) curve. Multivariate logistic regression analysis revealed that the three factors as significant predictive factors and the predicted probability of detecting grade B/C {PF} was calculated by the following formula; P = 1/[1 + exp\{-(2.033 × {WBC}+3.269 × {CRP}+2.698 × d-amylase-4.122)\}]. P {\textgreater} 0.5 indicates the prospective incidence of the {PF}. When the cut-off values of the three significant predictors were substituted into the formula, P always showed above 0.5 if more than two predictors were above their cut-off values, indicating a high probability of grade B/C {PF}.
{CONCLUSIONS}: White blood cell count, {CRP} and d-amylase on {POD}4 were predictive factors for clinically relevant {PF} after {PD}. These findings indicate that our formula is useful for management of drain after {PD}.},
	pages = {128--133},
	number = {2},
	journaltitle = {Journal of Hepato-Biliary-Pancreatic Sciences},
	shortjournal = {J Hepatobiliary Pancreat Sci},
	author = {Kosaka, Hisashi and Kuroda, Nobukazu and Suzumura, Kazuhiro and Asano, Yasukane and Okada, Toshihiro and Fujimoto, Jiro},
	date = {2014-02},
	pmid = {23804410},
	keywords = {Aged, Amylases, C-Reactive Protein, Female, Forecasting, Humans, Leukocyte Count, Logistic Models, Male, Multivariate Analysis, Pancreatic Fistula, Pancreaticoduodenectomy, postoperative complications, {ROC} Curve}
}

@article{mcmillan_lean_2000,
	title = {Lean body mass changes in cancer patients with weight loss.},
	volume = {19},
	rights = {Copyright 2000 Harcourt Publishers Ltd.},
	doi = {10.1054/clnu.2000.0136},
	abstract = {{BACKGROUND} {AND} {AIMS}: Metabolic measurements (e.g. resting energy expenditure) are adjusted to lean body mass to account for body composition differences. Usually lean body mass is estimated from total body water. However, this may be compromised in weight-losing cancer patients owing to alterations in the degree of hydration of the lean body mass. This study examined the relationship between  two independent estimates of lean body mass in healthy subjects and cancer patients with weight loss. {METHODS} {AND} {RESULTS}: Height, weight, total body water  and total body potassium were measured in healthy subjects (n=9) and weight losing cancer patients (n=13). They were similar in terms of age and gender. However, the cancer group had a significantly lower percentage ideal body weight  (P{\textless}0.001). The measured total body water values in both groups were similar to those predicted. In contrast, measured total body potassium values in the cancer  group were significantly lower than predicted (P{\textless}0.001). There was a correlation  between the ratio of measured lean body mass (water/lean bodymass (potassium) and the percentage weight loss (r=0.698, P{\textless}0.001). {CONCLUSIONS}: These results suggest that total body water significantly overestimates metabolically active tissue in  weight-losing cancer patients and therefore its use as the basis for metabolic requirements in this group of patients is questionable.},
	pages = {403--406},
	number = {6},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {Mcmillan, D. C. and Watson, W. S. and Preston, T. and Mcardle, C. S.},
	date = {2000-12},
	pmid = {11104590},
	keywords = {*Body Composition, *Body Water, Aged, Anthropometry, Female, Gastrointestinal Neoplasms/*complications/metabolism, Humans, Male, Middle Aged, Potassium/*analysis, Weight Loss/*physiology}
}

@article{barakat_prediction_2015,
	title = {Prediction of organ-specific complications following abdominal aortic aneurysm repair using cardiopulmonary exercise testing},
	volume = {70},
	issn = {1365-2044},
	doi = {10.1111/anae.12986},
	abstract = {This study aimed at assessing whether measures of aerobic fitness can predict postoperative cardiac and pulmonary complications, 30-day mortality and length of hospital stay following elective abdominal aortic aneurysm repair. We prospectively collected cardiopulmonary exercise testing data over two years for 130 patients. Upon multivariate analysis, a decreased anaerobic threshold ({OR} (95\% {CI}) 0.55 (0.37-0.84); p = 0.005) and open repair ({OR} (95\% {CI}) 6.99 (1.56-31.48); p = 0.011) were associated with cardiac complications. Similarly, an increased ventilatory equivalent for carbon dioxide ({OR} (95\% {CI}) 1.18 (1.05-1.33); p = 0.005) and open repair ({OR} (95\% {CI}) 14.29 (3.24-62.90); p {\textless} 0.001) were associated with pulmonary complications. Patients who had an endovascular repair had shorter hospital and critical care lengths of stay (p {\textless} 0.001). Measures of fitness were not associated with 30-day mortality or length of hospital stay. Cardiopulmonary exercise testing variables, therefore, seem to predict different postoperative complications following abdominal aortic aneurysm repair, which adds value to their routine use in risk stratification and optimisation of peri-operative care.},
	pages = {679--685},
	number = {6},
	journaltitle = {Anaesthesia},
	shortjournal = {Anaesthesia},
	author = {Barakat, H. M. and Shahin, Y. and {McCollum}, P. T. and Chetter, I. C.},
	date = {2015-06},
	pmid = {25656939}
}

@article{jamieson_systemic_2005,
	title = {Systemic inflammatory response predicts outcome in patients undergoing resection  for ductal adenocarcinoma head of pancreas.},
	volume = {92},
	doi = {10.1038/sj.bjc.6602305},
	abstract = {The aim of the present study was to examine the relationship between the clinicopathological status, the pre- and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients (n = 65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre- and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage {III} disease (International Union Against Cancer Criteria, {IUCC}), positive circumferential margin involvement (R1), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size (hazard ratio ({HR}) 2.10, 95\% confidence interval ({CI}) 1.20-3.68, P =  0.009), vascular invasion ({HR} 2.58, 95\% {CI} 1.48-4.50, P {\textless} 0.001) and postoperative C-reactive protein ({HR} 2.00, 95\% {CI} 1.14-3.52, P = 0.015) retained  independent significance. Those patients with a postoperative C-reactive protein  {\textless} or = 10 mg l(-1) had a median survival of 21.5 months compared with 8.4 months  in those patients with a C-reactive protein {\textgreater}10 mg l(-1) (P {\textless} 0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.},
	pages = {21--23},
	number = {1},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Jamieson, N. B. and Glen, P. and {McMillan}, D. C. and {McKay}, C. J. and Foulis, A. K. and Carter, R. and Imrie, C. W.},
	date = {2005-01-17},
	pmid = {15597096},
	pmcid = {PMC2361749},
	keywords = {Aged, Carcinoma, Pancreatic Ductal/blood/*immunology/surgery, C-Reactive Protein/analysis, Female, Humans, Inflammation/*complications, Male, Middle Aged, Multivariate Analysis, Pancreatectomy, Pancreatic Neoplasms/blood/*immunology/surgery, Prognosis, Retrospective Studies, Survival Analysis, Treatment Outcome},
	file = {92-6602305a.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2H4EBE3J\\92-6602305a.pdf:application/pdf;N B Jamieson - 2005 - Systemic inflammatory response predicts outcome in.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J5XHG9CC\\N B Jamieson - 2005 - Systemic inflammatory response predicts outcome in.pdf:application/pdf;Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas - ResearchGate:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UBFP7PXX\\8132988_Systemic_inflammatory_response_predicts_outcome_in_patients_undergoing_resection_for_du.html:text/html}
}

@article{bromwich_relationship_2003,
	title = {The relationship between T-lymphocyte infiltration, stage, tumour grade and survival in patients undergoing curative surgery for renal cell cancer.},
	volume = {89},
	doi = {10.1038/sj.bjc.6601400},
	abstract = {The present study examined the relationship between tumour stage, grade,},
	pages = {1906--1908},
	number = {10},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Bromwich, E. J. and {McArdle}, P. A. and Canna, K. and {McMillan}, D. C. and {McNicol}, A.-M. and Brown, M. and Aitchison, M.},
	date = {2003-11-17},
	pmid = {14612901},
	pmcid = {PMC2394435},
	keywords = {*Neoplasm Staging, Aged, Carcinoma, Renal Cell/*immunology/*pathology/surgery, Cohort Studies, Female, Humans, Immunohistochemistry, Kidney Neoplasms/*immunology/*pathology/surgery, Male, Middle Aged, Survival Analysis, T-Lymphocytes/*immunology, Treatment Outcome}
}

@article{aoyama_impact_2015,
	title = {Impact of Postoperative Complications on Survival and Recurrence in Pancreatic Cancer},
	volume = {35},
	issn = {0250-7005, 1791-7530},
	url = {http://ar.iiarjournals.org/content/35/4/2401},
	abstract = {Background: We investigated the impact of postoperative complications on survival and recurrence after curative surgery for pancreatic cancer. Patients and Methods: This study included 164 patients who underwent curative surgery for pancreatic cancer between 2005 and 2014. The patients were classified into those with postoperative complications (C group) and those without postoperative complications ({NC} group). The risk factors for overall survival ({OS}) and recurrence-free survival ({RFS}) were identified. Results: Postoperative complications were found in 61 out of the 164 patients (37.2\%). The {RFS} rate at five years after surgery was 10.6\% in the C group and 21.0\% in the {NC} group. The {RFS} tended to be worse in the C group than in the {NC} group (p=0.1756). The {OS} rate at five years after surgery was 7.4\% in the C group and 22.8\% in the {NC} group, which was significantly different (p=0.0189). The multivariate analysis demonstrated that the occurrence of postoperative complications was a significant independent risk factor for {OS} and a marginally significant risk factor for {RFS}. Conclusion: The development of postoperative complications was a risk factor for a decreased overall survival in the patients who underwent curative surgery for pancreatic cancer. The surgical procedure, perioperative care and the surgical strategy should be carefully planned to avoid complications.},
	pages = {2401--2409},
	number = {4},
	journaltitle = {Anticancer Research},
	shortjournal = {Anticancer Res},
	author = {Aoyama, Toru and Murakawa, Masaaki and Katayama, Yusuke and Yamaoku, Koichiro and Kanazawa, Amane and Higuchi, Akio and Shiozawa, Manabu and Morimoto, Manabu and Yoshikawa, Takaki and Yamamoto, Naoto and Rino, Yasushi and Masuda, Munetaka and Morinaga, Soichiro},
	urldate = {2015-05-25},
	date = {2015-04-01},
	langid = {english},
	pmid = {25862906},
	keywords = {pancreatic cancer, recurrence, surgical complication, Survival},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VJ9XZP38\\2401.html:text/html}
}

@article{whipple_rationale_1941,
	title = {The rationale of radical surgery for cancer of the pancreas and ampullary region},
	volume = {114},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1385814/},
	pages = {612--615},
	number = {4},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1941-10},
	pmid = {17857897},
	pmcid = {PMC1385814},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7RQKTESR\\Whipple - 1941 - THE RATIONALE OF RADICAL SURGERY FOR CANCER OF THE.pdf:application/pdf}
}

@article{eknoyan_adolphe_2008,
	title = {Adolphe Quetelet (1796–1874)—the average man and indices of obesity},
	volume = {23},
	issn = {0931-0509, 1460-2385},
	url = {http://ndt.oxfordjournals.org/content/23/1/47},
	doi = {10.1093/ndt/gfm517},
	abstract = {The quest for a practical index of relative body weight that began shortly after actuaries reported the increased mortality of their overweight policyholders culminated after World War {II}, when the relationship between weight and cardiovascular disease became the subject of epidemiological studies. It became evident then that the best index was the ratio of the weight in kilograms divided by the square of the height in meters, or the Quetelet Index described in 1832. Adolphe Quetelet (1796–1874) was a Belgian mathematician, astronomer and statistician, who developed a passionate interest in probability calculus that he applied to study human physical characteristics and social aptitudes. His pioneering cross-sectional studies of human growth led him to conclude that other than the spurts of growth after birth and during puberty, ‘the weight increases as the square of the height’, known as the Quetelet Index until it was termed the Body Mass Index in 1972 by Ancel Keys (1904–2004).
For his application of comparative statistics to social conditions and moral issues, Quetelet is considered a founder of the social sciences. His principal work, ‘A Treatise of Man and the development of his faculties’ published in 1835 is considered ‘one of the greatest books of the 19th century’. A tireless promoter of statistical data collection based on standard methods and definitions, Quetelet organized in 1853 the first International Statistical Congress, which launched the development of ‘a uniform nomenclature of the causes of death applicable to all countries’, progenitor of the current International Classification of Diseases.},
	pages = {47--51},
	number = {1},
	journaltitle = {Nephrology Dialysis Transplantation},
	shortjournal = {Nephrol. Dial. Transplant.},
	author = {Eknoyan, Garabed},
	urldate = {2015-08-08},
	date = {2008-01-01},
	langid = {english},
	pmid = {17890752},
	keywords = {Adolphe Quetelet, Body Mass Index, International Classification of Diseases, Obesity, probability calculus, Quetelet Index, statistics},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EHEZD4HQ\\Eknoyan - 2008 - Adolphe Quetelet (1796–1874)—the average man and i.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\56ASBAGE\\47.html:text/html}
}

@article{mohammed_comparison_2012,
	title = {Comparison of visual and automated assessment of Ki-67 proliferative activity and their impact on outcome in primary operable invasive ductal breast cancer.},
	volume = {106},
	doi = {10.1038/bjc.2011.569},
	abstract = {{BACKGROUND}: Immunohistochemistry of Ki-67 protein is widely used to assess tumour proliferation, and is an established prognostic factor in breast cancer. There is interest in automating the assessment of Ki-67 labelling index ({LI}) with possible benefits in handling increased workload, with improved accuracy and precision. {PATIENTS} {AND} {METHODS}: Visual and automated assessment of Ki-67 {LI} and survival were examined in patients with primary operable invasive ductal breast cancer. Tissue microarrays (n=379 patients) immunostained for Ki-67 were scored visually  and automatically with the Slidepath Tissue {IA} system. {RESULTS}: Visual and automated Ki-67 {LI} were in excellent agreement ({ICCC}=0.96, P{\textless}0.001). On univariate analysis, visual (P{\textless}0.001) and automated Ki67 {LI} (P{\textless}0.05) were associated with cancer-specific survival in patients with invasive ductal breast  cancer overall and in patients who received endocrine therapy (Tamoxifen) (P{\textless}0.01 for visual and P{\textless}0.05 for automated scoring). {CONCLUSION}: Automated assessment of Ki-67 {LI} would appear to be comparable to visual Ki-67 {LI}. However, automated Ki-67 {LI} assessment was inferior in predicting cancer survival in patients with breast cancer, including patients who received Tamoxifen.},
	pages = {383--388},
	number = {2},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Mohammed, Z. M. A. and {McMillan}, D. C. and Elsberger, B. and Going, J. J. and Orange, C. and Mallon, E. and Doughty, J. C. and Edwards, J.},
	date = {2012-01-17},
	pmid = {22251968},
	pmcid = {PMC3261670},
	keywords = {*Automation, *Cell Proliferation, *Vision, Ocular, Breast Neoplasms/*pathology/surgery, Carcinoma, Ductal, Breast/*pathology/surgery, Female, Humans, Immunohistochemistry, Ki-67 Antigen/*metabolism, Middle Aged, Neoplasm Invasiveness, Treatment Outcome}
}

@article{prem_operative_1965,
	title = {{OPERATIVE} {TREATMENT} {OF} {ADENOCARCINOMA} {OF} {THE} {ENDOMETRIUM} {IN} {OBESE} {WOMEN}},
	volume = {92},
	issn = {0002-9378},
	pages = {16--22},
	journaltitle = {American Journal of Obstetrics and Gynecology},
	shortjournal = {Am. J. Obstet. Gynecol.},
	author = {Prem, K. A. and Mensheha, N. and Mckelvey, J. L.},
	date = {1965-05-01},
	pmid = {14288909},
	keywords = {Adenocarcinoma, Geriatrics, Hysterectomy, mortality, Obesity, postoperative complications, prognosis, Uterine Neoplasms}
}

@article{gallagher_comparative_2005,
	title = {Comparative impact of morbid obesity vs heart failure on cardiorespiratory fitness},
	volume = {127},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15947337},
	abstract = {We are in the midst of an obesity pandemic. Morbid obesity is associated with dyspnea on exertion and higher overall mortality rates. The relations between measures of cardiorespiratory fitness in morbidly obese persons compared to those with heart failure are unknown.},
	pages = {2197--203},
	number = {6},
	journaltitle = {Chest},
	author = {Gallagher, Michael J and Franklin, Barry A and Ehrman, Jonathan K and Keteyian, Steven J and Brawner, Clinton A and {deJong}, Adam T and {McCullough}, Peter A},
	date = {2005-06},
	file = {Gallagher et al. - 2005 - Comparative impact of morbid obesity vs heart fail.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TAF4WCRQ\\Gallagher et al. - 2005 - Comparative impact of morbid obesity vs heart fail.pdf:application/pdf}
}

@article{ho_effect_2003,
	title = {Effect of hospital volume and experience on in-hospital mortality for pancreaticoduodenectomy},
	volume = {237},
	issn = {0003-4932},
	doi = {10.1097/00000658-200304000-00012},
	abstract = {Objective To examine the relative impact of procedure volume versus years of hospital experience on inpatient death rates after pancreaticoduodenectomy. Summary Background Data Past studies have identified a significant volume-outcome relation for hospitals performing pancreaticoduodenectomy (the Whipple procedure). Methods Administrative discharge data were examined for 6,652 patients who underwent the procedure between 1988 and 1998 in California and Florida. Patients were divided into approximate quartiles according to each hospital's annual procedure volume: very low (1), low (2 or 3), medium (4-9), and high (10+). Logistic regression analysis was used to examine differences in inpatient mortality among hospitals with different procedure volume and years of experience, while adjusting for patient characteristics. Results Medium- and high-volume hospitals had lower rates of inpatient mortality after pancreaticoduodenectomy relative to very-low-volume facilities. Greater years of hospital experience also reduced the odds of inpatient death, Predictions based on the regression estimates indicate that within volume categories, increased hospital experience did not lead to significant reductions in inpatient mortality. However, high-volume hospitals had significantly lower inpatient mortality rates than very-low-volume facilities with the same amount of experience. Conclusions Hospitals with more years of experience with pancreaticoduodenectomy had lower rates of inpatient mortality. However, higher procedure volume has played a larger role than increased experience in reducing inpatient death rates.},
	pages = {509--514},
	number = {4},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {Ho, V. and Heslin, M. J.},
	date = {2003-04},
	note = {{WOS}:000185834400012},
	keywords = {comorbidities, Complications, coronary angioplasty, outcomes, pancreatic-cancer, quality, resection, risk-factors, surgery, surgical volume},
	file = {00000658-200304000-00012.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5HDJJIND\\00000658-200304000-00012.pdf:application/pdf}
}

@article{brunelli_risk_2010,
	title = {Risk assessment for pulmonary resection},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20813311},
	abstract = {Risk assessment for pulmonary resection must include a preliminary cardiac evaluation. Patients deemed at prohibitive cardiac risk should be evaluated and treated as per American Heart Association/American Society of Cardiology guidelines. Those with low cardiac risk or with optimized treatment can proceed with pulmonary assessment. A systematic measurement of lung carbon monoxide diffusing capacity is recommended. In addition, predicted postoperative forced expiratory volume in 1 second should not be used alone for patient selection because it is not an accurate predictor of complications, particularly in patients with chronic obstructive pulmonary disease. The use of exercise testing should be emphasized. Low-technology tests, such as stair climbing, can be used whenever a formal cardiopulmonary exercise test is not readily available. However, in case of suboptimal performance (ie, {\textless}22 m in the stair-climbing test) patients should be referred to cardiopulmonary exercise testing with measurement of Vo(2max) for a better definition of their aerobic reserve. A Vo(2max) less than 10 {mL}/kg/min (or {\textless}35\% of predicted) indicates a high risk for major lung resection.},
	pages = {2--13},
	number = {1},
	journaltitle = {Semin Thorac Cardiovasc Surg},
	author = {Brunelli, Alessandro},
	date = {2010}
}

@article{mcardle_adjuvant_2010,
	title = {Adjuvant radiotherapy and chemotherapy in breast cancer: 30 year follow-up of survival.},
	volume = {10},
	doi = {10.1186/1471-2407-10-398},
	abstract = {{BACKGROUND}: The long term outcome (more than 15 years) of adjuvant treatment in patients with primary operable breast cancer has rarely been examined. {METHODS}: A randomised clinical trial of radiotherapy, chemotherapy (28 day cycles of cyclophosphamide, methotrexate and 5-fluorouracil) or both on women with primary  operable breast cancer (n = 322) was followed-up for a median of 27 years. {RESULTS}: 260 (81\%) patients died, 204 (78\%) from breast cancer. Cancer specific survival ({SE}) at 10 years, 20 years and 30 years was 41 (3)\%, 34 (3)\% and 33 (3)\% respectively. Presence of more than 3 involved lymph nodes increased cancer-specific mortality ({HR} 1.88, 95\% {CI} 1.34-2.63) after adjustment for age, socio-economic deprivation and adjuvant treatment. Both age ({HR} 1.63, 95\% {CI} 1.19-2.22) and involved lymph nodes ({HR} 1.59, 95\% {CI} 1.17-2.14) were significant  predictors of all-cause mortality after adjustment for other factors. There was no significant difference in all-cause or cancer-specific survival between patients in each of the 3 treatment arms. {CONCLUSIONS}: The present study highlights the long term impact of node positive disease but does not indicate that any regimen was associated with significantly better long-term survival.},
	journaltitle = {{BMC} cancer},
	shortjournal = {{BMC} Cancer},
	author = {{McArdle}, Colin S. and {McMillan}, Donald C. and Greenlaw, Nicola and Morrison, David S.},
	date = {2010},
	pmid = {20673353},
	pmcid = {PMC2918580},
	keywords = {Adult, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Breast Neoplasms/*drug therapy/pathology/*radiotherapy, Chemotherapy, Adjuvant, Cyclophosphamide/administration \& dosage, Female, Fluorouracil/administration \& dosage, Follow-Up Studies, Humans, Methotrexate/administration \& dosage, Middle Aged, Radiotherapy, Adjuvant, Survival Rate, Treatment Outcome}
}

@article{glen_evaluation_2006,
	title = {Evaluation of an inflammation-based prognostic score in patients with inoperable  pancreatic cancer.},
	volume = {6},
	rights = {Copyright (c) 2006 S. Karger {AG}, Basel and {IAP}.},
	doi = {10.1159/000094562},
	abstract = {{BACKGROUND}/{AIMS}: Patients with pancreatic cancer have one of the poorest survival rates and selection of patients for active treatment remains problematical. The present study assesses the value of an inflammation-based score (Glasgow Prognostic Score, {GPS}) in patients with inoperable pancreatic cancer. {METHODS}: The {GPS} was constructed as follows: patients with both an elevated C-reactive protein ({\textgreater}10 mg/l) and hypoalbuminaemia ({\textless}35 g/l) were allocated a score of 2. Patients in whom only 1 or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. {RESULTS}: One hundred and eighty-seven patients were studied and 49 (26\%) underwent an operative palliative bypass procedure. At the end of follow-up, 181 (97\%) patients died, 17\% of patients were alive at 12 months. On univariate analysis, age (p {\textless} 0.01), {TNM} stage (p {\textless} 0.001) and the {GPS} (p {\textless} 0.001) were significant predictors of survival. On multivariate survival analysis, stratified for bypass procedure, age (hazard ratio 1.53, 95\%{CI} 1.12-2.10, p = 0.008), {TNM} stage (hazard ratio 1.70, 95\%{CI} 1.33-2.18, p {\textless} 0.001) and the {GPS} (hazard ratio 1.72, 95\%{CI} 1.40-2.11, p {\textless}  0.001) remained independent significant predictors of survival. {CONCLUSION}: At diagnosis, the presence of a systemic inflammatory response (as measured by the {GPS}) appears to be a useful indicator of poor outcome, independent of {TNM} stage,  in patients with inoperable pancreatic cancer.},
	pages = {450--453},
	number = {5},
	journaltitle = {Pancreatology : official journal of the International Association of Pancreatology ({IAP}) ... [et al.]},
	shortjournal = {Pancreatology},
	author = {Glen, Paul and Jamieson, Nigel B. and {McMillan}, Donald C. and Carter, Ross and Imrie, Clem W. and {McKay}, Colin J.},
	date = {2006},
	pmid = {16847382},
	keywords = {Aged, Albumin, Female, Glasgow Prognostic Score, Humans, Inflammation/diagnosis, Male, Middle Aged, Neoplasm Staging, pancreatic cancer, Pancreatic Neoplasms/*diagnosis/*pathology/surgery, Predictive Value of Tests, Prognosis, Severity of Illness Index, Survival Analysis, survival rates, {TNM} stage C-reactive protein},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GRT2D3JT\\abstract.html:text/html}
}

@article{shen_total_2004,
	title = {Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image},
	volume = {97},
	issn = {8750-7587},
	doi = {10.1152/japplphysiol.00744.2004},
	shorttitle = {Total body skeletal muscle and adipose tissue volumes},
	abstract = {A single abdominal cross-sectional computerized axial tomography and magnetic resonance image is often obtained in studies examining adipose tissue ({AT}) distribution. An abdominal image might also provide additional useful information on total body skeletal muscle ({SM}) and {AT} volumes with related physiological insights. We therefore investigated the relationships between abdominal {SM} and {AT} areas from single images and total body component volumes in a large and diverse sample of healthy adult subjects. Total body {SM} and {AT} volumes were derived by whole body multislice magnetic resonance imaging in 123 men [age (mean +/- {SD}) of 41.6 +/- 15.8 yr; body mass index of 25.9 +/- 3.4 kg/m(2)] and 205 women (age of 47.8 +/- 18.7 yr; body mass index of 26.7 +/- 5.6 kg/m(2)). Single abdominal {SM} and {AT} slice areas were highly correlated with total body {SM} (r = 0.71-0.92; r = 0.90 at L(4)-L(5) intervertebral space) and {AT} (r = 0.84-0.96; r = 0.94 at L(4)-L(5) intervertebral space) volumes, respectively. R(2) increased by only 5.7-6.1\% for {SM} and 2.7-4.4\% for {AT} with the inclusion of subject sex, age, ethnicity, scanning position, body mass index, and waist circumference in the model. The developed {SM} and {AT} models were validated in an additional 49 subjects. To achieve equivalent power to a study measuring total body {SM} or {AT} volumes, a study using a single abdominal image would require 17-24\% more subjects for {SM} and 6-12\% more subjects for {AT}. Measurement of a single abdominal image can thus provide estimates of total body {SM} and {AT} for group studies of healthy adults.},
	pages = {2333--2338},
	number = {6},
	journaltitle = {Journal of Applied Physiology (Bethesda, Md.: 1985)},
	shortjournal = {J. Appl. Physiol.},
	author = {Shen, Wei and Punyanitya, Mark and Wang, {ZiMian} and Gallagher, Dympna and St-Onge, Marie-Pierre and Albu, Jeanine and Heymsfield, Steven B. and Heshka, Stanley},
	date = {2004-12},
	pmid = {15310748},
	keywords = {Abdomen, Adipose Tissue, Adult, Aged, Body Composition, Female, Humans, magnetic resonance imaging, Male, Middle Aged, Muscle, Skeletal, Predictive Value of Tests, Reproducibility of Results},
	file = {Shen et al. - 2004 - Total body skeletal muscle and adipose tissue volu.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\93PMV5IK\\Shen et al. - 2004 - Total body skeletal muscle and adipose tissue volu.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XJ9PB3SR\\2333.full.html:text/html}
}

@article{mustard_c-reactive_1987,
	title = {C-reactive protein levels predict postoperative septic complications},
	volume = {122},
	issn = {0004-0010},
	abstract = {We studied 108 patients undergoing clean-contaminated and dirty surgical procedures to determine whether daily C-reactive protein ({CRP}) measurements for 14 days postoperatively could predict the occurrence of septic complications prior to clinical diagnosis. Diagnostic criteria for septic complications and positive {CRP} response were defined in advance of the study. The {CRP} assays were carried out using an automated laser nephelometer system after the patient's discharge from the hospital. Forty-six septic complications were diagnosed in 40 patients. These complications consisted of wound infection (23), urinary tract infection (11), pneumonia (six), upper respiratory tract infection (three), intra-abdominal abscess (one), and other (two). The {CRP} testing was found to have a positive predictive value of 69\% and a negative predictive value of 78\%. We conclude that serial {CRP} measurements may be a valuable adjunct to surgical care in patients at high risk of postoperative septic complications.},
	pages = {69--73},
	number = {1},
	journaltitle = {Archives of Surgery (Chicago, Ill.: 1960)},
	shortjournal = {Arch Surg},
	author = {Mustard, R. A. and Bohnen, J. M. and Haseeb, S. and Kasina, R.},
	date = {1987-01},
	pmid = {3800652},
	keywords = {Adult, Aged, Aged, 80 and over, Bacterial Infections, C-Reactive Protein, Female, Humans, Laparotomy, Male, Middle Aged, postoperative complications, Probability, Prospective Studies},
	file = {archsurg_122_1_011.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\R7NS5GHV\\archsurg_122_1_011.pdf:application/pdf}
}

@article{mcdermott_systematic_2015,
	title = {Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks},
	volume = {102},
	rights = {© 2015 {BJS} Society Ltd Published by John Wiley \& Sons Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.9697/abstract},
	doi = {10.1002/bjs.9697},
	abstract = {Background

Anastomotic leak ({AL}) represents a dreaded complication following colorectal surgery, with a prevalence of 1–19 per cent. There remains a lack of consensus regarding factors that may predispose to {AL} and the relative risks associated with them. The objective was to perform a systematic review of the literature, focusing on the role of preoperative, intraoperative and postoperative factors in the development of colorectal {ALs}.


Methods

A systematic review was performed to identify adjustable and non-adjustable preoperative, intraoperative and postoperative factors in the pathogenesis of {AL}. Additionally, a severity grading system was proposed to guide treatment.


Results

Of 1707 papers screened, 451 fulfilled the criteria for inclusion in the review. Significant preoperative risk factors were: male sex, American Society of Anesthesiologists fitness grade above {II}, renal disease, co-morbidity and history of radiotherapy. Tumour-related factors were: distal site, size larger than 3 cm, advanced stage, emergency surgery and metastatic disease. Adjustable risk factors were: smoking, obesity, poor nutrition, alcohol excess, immunosuppressants and bevacizumab. Intraoperative risk factors were: blood loss/transfusion and duration of surgery more than 4 h. Stomas lessen the consequences but not the prevalence of {AL}. In the postoperative period, {CT} is the most commonly used imaging tool, with or without rectal contrast, and a C-reactive protein level exceeding 150 mg/l on day 3–5 is the most sensitive biochemical marker. A five-level classification system for {AL} severity and appropriate management is presented.


Conclusion

Specific risk factors and their potential correction or indications for stoma were identified. An {AL} severity score is proposed to aid clinical decision-making.},
	pages = {462--479},
	number = {5},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {{McDermott}, F. D. and Heeney, A. and Kelly, M. E. and Steele, R. J. and Carlson, G. L. and Winter, D. C.},
	urldate = {2015-08-21},
	date = {2015-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7HJ482UI\\McDermott et al. - 2015 - Systematic review of preoperative, intraoperative .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M6WVJJE8\\abstract.html:text/html}
}

@article{mcmillan_impact_2008,
	title = {The impact of old age on cancer-specific and non-cancer-related survival following elective potentially curative surgery for Dukes A/B colorectal cancer.},
	volume = {99},
	doi = {10.1038/sj.bjc.6604669},
	abstract = {Previous studies have suggested that survival following surgery for colorectal cancer is poorer in the elderly. However, the findings were inconsistent and none of the studies adjusted for case mix. The aim of this study was to establish whether there were age-related differences in cancer (colorectal)-specific and non-cancer (colorectal)-related survival in patients undergoing elective potentially curative resection for Dukes stage A/B colorectal cancer. One thousand and forty three patients who underwent elective potentially curative resection for Dukes' A/B colorectal cancer between 1991 and 1994 in 11 hospitals  in Scotland were included in the study. Ten year cancer-specific and non-cancer-related survival and the hazard ratios were calculated according to age groups ({\textless}64; 65-74/{\textgreater}74 years). On follow-up 273 patients died of their cancer and 328 died of non-cancer-related causes. At 10 years, overall survival was 45\%, cancer specific was 70\% and non-cancer-related survival was 64\%. On multivariate  analysis of all factors, age ({HR} 1.38, 95\% {CI} 1.18-1.62, P{\textless}0.001), sex ({HR} 1.74,  95\% {CI} 1.36-2.23, P{\textless}0.001), site ({HR} 1.42, 95\% {CI} 1.11-1.81, P{\textless}0.01) and Dukes' stage ({HR} 1.71, 1.19-2.47, P{\textless}0.01) were independently associated with cancer-specific survival. On multivariate analysis of all factors, age ({HR} 2.14,  1.84-2.49, P{\textless}0.001), sex ({HR} 1.43, 1.15-1.79, P{\textless}0.01) and deprivation ({HR} 1.30, 1.09-1.55, P{\textless}0.01) were independently associated with non-cancer-related survival. The results of this study show that increasing age impacts negatively both on cancer-specific and non-cancer-related survival following elective potentially curative resection for node-negative colorectal cancer. However, the  effect of increasing age is greater on the non-cancer-related survival. These results suggest that cancer-specific and non-cancer-related mortality should be considered separately in survival analysis of these cancer patients.},
	pages = {1046--1049},
	number = {7},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and Hole, D. J. and {McArdle}, C. S.},
	date = {2008-10-07},
	pmid = {18797465},
	pmcid = {PMC2567073},
	keywords = {*Age Factors, *Survival Rate, Aged, Colorectal Neoplasms/physiopathology/*surgery, Female, Humans, Male, Middle Aged}
}

@article{rodriguez-roisin_hepatopulmonary_2008-1,
	title = {Hepatopulmonary syndrome–a liver-induced lung vascular disorder},
	volume = {358},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18509123},
	pages = {2378--87},
	number = {22},
	journaltitle = {N Engl J Med},
	author = {Rodríguez-Roisin, Roberto and Krowka, Michael J},
	date = {2008-05}
}

@article{hiyoshi_usefulness_2013,
	title = {Usefulness of drain amylase, serum C-reactive protein levels and body temperature to predict postoperative pancreatic fistula after pancreaticoduodenectomy},
	volume = {37},
	issn = {1432-2323},
	doi = {10.1007/s00268-013-2149-8},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({POPF}) after pancreaticoduodenectomy ({PD}) is a worrisome and life-threatening complication. Recently, early drain removal has been recommended as a means of preventing {POPF}. The present study sought to determine how to distinguish clinical {POPF} from non-clinical {POPF} in the early postoperative period after {PD} to aid in early drain removal.
{METHODS}: From March 2002 through December 2010, 176 patients underwent {PD} and were enrolled in this study to examine factors predictive of clinical {POPF} after {PD}. {POPF} was defined and classified according to the International Study Group of Pancreatic Surgery guideline, and grade B/C {POPF} was defined as clinical {POPF}.
{RESULTS}: Grade A {POPF} occurred in 39 (22.2 \%) patients, grade B in 19 (10.8 \%) patients, and grade C in 11 (6.3 \%) patients. Clinical {POPF} (grade B/C) occurred in 17.1 \% of patients. Multivariate analysis revealed male gender and body mass index ({BMI}) ≥22.5 kg/m(2) to be the independent preoperative risk factors predictive of {POPF}. Receiver operating characteristic curves showed that the combination of drain amylase ≥750 {IU}/L, C-reactive protein ({CRP}) ≥20 mg/{dL}, and body temperature ≥37.5 °C on postoperative day 3 could effectively distinguish clinical {POPF} from non-clinical {POPF}. Sensitivity, specificity, and accuracy were 84.6, 98.2, and 95.7 \%, respectively.
{CONCLUSIONS}: Male gender and {BMI} ≥22.5 were the independent preoperative predictive risk factors for {POPF}. We assume that when amylase is {\textless}750 {IU}/L, serum {CRP} is {\textless}20 mg/{dL}, and body temperature is {\textless}37.5 °C the drain can safely be removed, even if {POPF} is indicated.},
	pages = {2436--2442},
	number = {10},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J Surg},
	author = {Hiyoshi, Masahide and Chijiiwa, Kazuo and Fujii, Yoshiro and Imamura, Naoya and Nagano, Motoaki and Ohuchida, Jiro},
	date = {2013-10},
	pmid = {23838932},
	keywords = {Adult, Aged, Aged, 80 and over, Amylases, Biological Markers, Body Temperature, C-Reactive Protein, Decision Support Techniques, Drainage, Female, Humans, Male, Middle Aged, Pancreatic Fistula, Pancreaticoduodenectomy, Postoperative Care, postoperative complications, Risk Factors, Sensitivity and Specificity}
}

@article{lermite_risk_2007,
	title = {Risk Factors of Pancreatic Fistula and Delayed Gastric Emptying after Pancreaticoduodenectomy with Pancreaticogastrostomy},
	volume = {204},
	issn = {1072-7515},
	url = {http://www.journalacs.org/article/S1072751507000701/abstract},
	doi = {10.1016/j.jamcollsurg.2007.01.018},
	abstract = {Background
Pancreatic fistula ({PF}) and delayed gastric emptying ({DGE}) are, respectively, the most frightening and most frequent complications after pancreaticoduodenectomy ({PD}). This study was undertaken to determine which independent factors influence the development of {PF} and {DGE} after {PD}.
Study Design
Between January 1996 and December 2005, 131 consecutive patients underwent a {PD} with pancreaticogastrostomy. A total of 22 items, entered prospectively, were examined with univariate and multivariate analysis. {PF} was defined as amylase-rich fluid collected by needle aspiration from an intraabdominal collection or from the drainage placed intraoperatively from day 3. {DGE} was defined as the need for nasogastric decompression beyond the 10th postoperative day.
Results
{PF} occurred in 14 patients (10.7\%), with a mean length of hospital stay of 40.1 ± 16.6 days. {DGE} occurred in 41 patients (31.3\%), with a mean length of hospital stay of 35.5 ± 13.6 days. {PF} and {DGE} increased postoperative length of stay. Multivariate analysis identified two independent factors for {PF}: heart disease as a risk factor and arterial hypertension as a protective factor. According to these two predictive factors, the observed rates of {PF} ranged from 4.1\% to 66.6\%. Age and early enteral feeding with nasojejunal tube were independent risk factors for {DGE}. {DGE} was statistically more frequent when surgical complications occurred or when an intraabdominal collection was present.
Conclusions
Heart disease was a risk factor and arterial hypertension was a protective factor of {PF}. Age and early enteral feeding were independent risk factors for {DGE}. {DGE} is linked to the occurrence of other postoperative intraabdominal complications.},
	pages = {588--596},
	number = {4},
	journaltitle = {Journal of the American College of Surgeons},
	author = {Lermite, Emilie and Pessaux, Patrick and Brehant, Olivier and Teyssedou, Carlos and Pelletier, Isabelle and Etienne, Sandrine and Arnaud, Jean-Pierre},
	urldate = {2015-08-08},
	date = {2007-04-01},
	keywords = {delayed gastric emptying, {DGE}, odds ratio, {OR}, Pancreatic Fistula, Pancreaticoduodenectomy, {PD}, {PF}},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4SIA2BAV\\abstract.html:text/html}
}

@article{hassen_preoperative_2007,
	title = {Preoperative Nutritional Status Predicts the Severity of the Systemic Inflammatory Response Syndrome ({SIRS}) Following Major Vascular Surgery},
	volume = {33},
	issn = {1078-5884},
	url = {http://www.ejves.com/article/S1078588406007404/abstract},
	doi = {10.1016/j.ejvs.2006.12.006},
	abstract = {Objectives
This study examined the relationship between pre-operative nutritional status and systemic inflammatory response syndrome ({SIRS}) or sepsis following major vascular surgery.
Design and methods
Subjects undergoing open {AAA} repair, {EVAR} or lower limb revascularisation were studied prospectively. Pre-operative nutrition was assessed clinically using Mini-Nutritional Assessment ({MNA}) and body composition was measured by dual energy X-ray absorptiometry ({DEXA}) scanning. {SIRS} severity was assessed for 5 post-operative days and sepsis noted within 30 days of surgery.
Results
Using {MNA}, neither {SIRS} severity nor sepsis occurrence differed significantly between ‘well-nourished’ subjects and those ‘at risk of malnutrition’. Using {DEXA}, negative associations existed between body mass index and both {SIRS} score and {SIRS} duration. Fat free mass ({FFM}) was negatively associated with {SIRS} score and duration. Negative associations also existed between skeletal muscle mass ({SMM}) and {SIRS} score and duration. {SMM} was also negatively correlated with post-operative length of stay in hospital. There were no significant correlations between sepsis and any nutritional indices.
Conclusions
Lower pre-operative nutritional indices, indicating protein energy malnutrition, were associated with more severe systemic inflammatory responses following major vascular surgery.},
	pages = {696--702},
	number = {6},
	journaltitle = {European Journal of Vascular and Endovascular Surgery},
	author = {Hassen, T. A. and Pearson, S. and Cowled, P. A. and Fitridge, R. A.},
	urldate = {2015-08-21},
	date = {2007-06-01},
	keywords = {abdominal aortic aneurysm, Nutritional status, postoperative complications, Sepsis, Vascular Surgical Procedures},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8IKMPNKQ\\Hassen et al. - 2007 - Preoperative Nutritional Status Predicts the Sever.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\39GCMZ3T\\abstract.html:text/html}
}

@article{russ_impact_2009,
	title = {Impact of Selection Bias on the Utilization of Adjuvant Therapy for Pancreas Adenocarcinoma},
	volume = {17},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-009-0759-z},
	doi = {10.1245/s10434-009-0759-z},
	pages = {371--376},
	number = {2},
	journaltitle = {Annals of Surgical Oncology},
	author = {Russ, Andrew J. and Weber, Sharon M. and Rettammel, Robert J. and Mahvi, David M. and Rikkers, Layton F. and Cho, Clifford S.},
	urldate = {2014-01-27},
	date = {2009-10-23},
	file = {Russ et al. - 2009 - Impact of Selection Bias on the Utilization of Adj.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\36V6D52K\\Russ et al. - 2009 - Impact of Selection Bias on the Utilization of Adj.pdf:application/pdf}
}

@article{al_murri_evaluation_2006,
	title = {Evaluation of an inflammation-based prognostic score ({GPS}) in patients with metastatic breast cancer.},
	volume = {94},
	doi = {10.1038/sj.bjc.6602922},
	abstract = {Prediction of outcome in patients with metastatic breast cancer remains problematical. The present study evaluated the value of an inflammation-based score (Glasgow Prognostic Score, {GPS}) in patients with metastatic breast cancer.  The {GPS} was constructed as follows: patients with both an elevated C-reactive protein ({\textgreater}10 mg l(-1)) and hypoalbuminaemia ({\textless}35 g l(-1)) were allocated a score  of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. In total, 96 patients were studied. During follow-up 51 patients died of their cancer. On multivariate  analysis of the {GPS} and treatment received, only the {GPS} ({HR} 2.26, 95\% {CI} 1.45-3.52, P{\textless}0.001) remained significantly associated with cancer-specific survival. The presence of a systemic inflammatory response (the {GPS}) appears to be a useful indicator of poor outcome independent of treatment in patients with metastatic breast cancer.},
	pages = {227--230},
	number = {2},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Al Murri, A. M. and Bartlett, J. M. S. and Canney, P. A. and Doughty, J. C. and Wilson, C. and {McMillan}, D. C.},
	date = {2006-01-30},
	pmid = {16404432},
	pmcid = {PMC2361117},
	keywords = {*Glasgow Outcome Scale, Breast Neoplasms/mortality/*pathology, C-Reactive Protein/analysis, Disease-Free Survival, Female, Humans, Inflammation/*pathology, Middle Aged, Neoplasm Metastasis/*pathology, Prognosis, Serum Albumin, Survival Analysis, Survival Rate}
}

@article{oms_reduced_1990,
	title = {Reduced water and sodium intakes associated with high levels of natriuretic factor following common bile duct ligation in the rabbit},
	volume = {77},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2143428},
	abstract = {Renal failure complicating obstructive jaundice ({OJ}) is probably linked to reduction of the extracellular water compartment. To elucidate the mechanism by which {OJ} leads to isotonic water depletion we studied a group of rabbits with {OJ} after common bile duct ligation (n = 17) and another group of sham operated rabbits (n = 14) for 10 days. Water intake and balance for two study periods (1-4 and 7-10 days after operation) were calculated. Renal function, sodium balance and plasma atrial natriuretic factor were determined on the fourth and tenth days after operation. Water intake and balance were lower in the {OJ} group both in the first study period (230 versus 519 ml/days 1-4, P less than 0.001; and -2.4 versus 219 ml/days 1-4, P less than 0.0001 respectively) and in the second study period (260 versus 865 ml/days 7-10, P less than 0.0001; and 11 versus 379 ml/days 7-10, P less than 0.0001 respectively). Sodium intake was negligible in the {OJ} group both on day four (0.73 versus 7.15 {mM}/24 h, P less than 0.0001) and on day 10 (0.78 versus 15.78 {mM}/24 h, P less than 0.0001). As a result plasma osmolality did not change. Day 10 urine osmolality and osmolar clearance were reduced in the {OJ} group (653 versus 1103 {mOsm}/kg, P less than 0.0001 and 0.09 versus 0.25 ml/min, P less than 0.0001 respectively) together with a decreased creatinine clearance (3 versus 11 ml/min, P less than 0.0001). Atrial natriuretic factor was increased in jaundiced rabbits (day 4, 22.7 versus 7.5 fmol/ml, P less than 0.0001; and day 10, 26.5 versus 11.2 fmol/ml, P less than 0.02). These findings suggest that {OJ} leads to an isotonic volume depletion resulting from abnormalities of the extracellular volume regulating mechanisms. These appear to be secondary to an inappropriate elevation of the atrial natriuretic factor plasma concentration.},
	pages = {752--5},
	number = {7},
	journaltitle = {Br J Surg},
	author = {Oms, L and Martínez-Ródenas, F and Valverde, J and Jiménez, W and Sitges-Serra, A},
	date = {1990-07}
}

@article{padillo_anti-tnf-alpha_2007,
	title = {Anti-{TNF}-alpha treatment and bile duct drainage restore cellular immunity and prevent tissue injury in experimental obstructive jaundice},
	volume = {20},
	issn = {0394-6320},
	abstract = {Several experimental studies of obstructive jaundice ({OJ}) have shown the presence of immunosuppressive state associated with the rise of tumor necrosis factor-a ({TNF}-alpha) concentration in plasma. The present study evaluates the impact of anti-{TNF}-alpha administration or bile duct drainage on the inflammatory response, liver injury and renal insufficiency in obstructed rats. {OJ} was induced by the ligation of bile duct in Wistar rats. The parameters were determined at 14 and 21 days after {OJ}. Two additional groups of animals were treated with anti-{TNF}-alpha antibodies or submitted to bile duct drainage at 14 days, and sacrificed 21 days after {OJ}. Cholestasis decreased glucose, and enhanced urea, creatinin, bilirubin and transaminases. Cholestasis increased the number of different inflammatory cells (T and B lymphocytes, and monocytes-macrophages) but reduced the expression of the corresponding cellular activation markers. This low responsiveness of the inflammatory cells was related to a decreased free radical production and phagocytic activity of cells. Anti-{TNF}-alpha and bile duct drainage reduced tissue injury, and prevented the reduction of the number and activity of T lymphocytes and phagocytic cells observed at the advanced stages of cholestasis. In conclusion, anti-{TNF}-alpha and bile duct drainage improved cell immunodeficiency, and reduced liver injury, cholestasis and renal insufficiency in experimental {OJ}.},
	pages = {855--860},
	number = {4},
	journaltitle = {International Journal of Immunopathology and Pharmacology},
	shortjournal = {Int. J. Immunopathol. Pharmacol.},
	author = {Padillo, F. J. and Cruz, A. and Segura-Jimenez, I. and Ruiz-Rabelo, J. and Vazquez-Ezquerra, M. R. and Perea-Alvarez, M. D. and Pena, J. and Briceno, J. and Muntane, J.},
	date = {2007-12},
	note = {{WOS}:000251949700025},
	keywords = {bile duct, cholestasis, cytokines, Drainage, endotoxin, inflammatory   response, internal biliary drainage, ligation, liver injury, {OBSTRUCTIVE} {JAUNDICE}, {TNF}-alpha}
}

@article{collis_relations_2001,
	title = {Relations of Stroke Volume and Cardiac Output to Body Composition The Strong Heart Study},
	volume = {103},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/content/103/6/820},
	doi = {10.1161/01.CIR.103.6.820},
	abstract = {Background—Although cardiac output ({CO}) plays the vital role of delivering nutrients to body tissues, few data are available concerning the relations of stroke volume ({SV}) and {CO} to body composition in large population samples.
Methods and Results—Doppler and 2D echocardiography and bioelectric impedance in 2744 Strong Heart Study participants were used to calculate {SV} and {CO} and to relate them to fat-free body mass ({FFM}), adipose mass, and demographic variables. Both {SV} and {CO} were higher in men than women and in overweight than normal-weight individuals, but these differences were diminished or even reversed by normalization for {FFM} or body surface area. In both sexes, {SV} and {CO} were more strongly related to {FFM} than adipose mass, other body habitus measures, arterial pressure, diabetes, or age. In multivariate analyses using the average of Doppler and left ventricular {SV} to minimize measurement variability, {FFM} was the strongest correlate of {SV} and {CO}; other independent correlates were adipose mass, systolic pressure, diabetes, age, and use of digoxin and calcium channel and β-blockers.
Conclusions—In a population-based sample, {SV} and {CO} are more strongly related to {FFM} than other variables; increased {FFM} may be the primary determinant of increased {SV} and {CO} in obesity.},
	pages = {820--825},
	number = {6},
	journaltitle = {Circulation},
	shortjournal = {Circulation},
	author = {Collis, Tarquin and Devereux, Richard B. and Roman, Mary J. and Simone, Giovanii de and Yeh, Jeun-Liang and Howard, Barbara V. and Fabsitz, Richard R. and Welty, Thomas K.},
	urldate = {2015-04-30},
	date = {2001-02-13},
	langid = {english},
	pmid = {11171789},
	keywords = {American Indians, diabetes mellitus, echocardiography, ventricles},
	file = {Collis et al. - 2001 - Relations of Stroke Volume and Cardiac Output to B.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8I4RPESU\\Collis et al. - 2001 - Relations of Stroke Volume and Cardiac Output to B.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8A6B2WGR\\820.html:text/html}
}

@article{nitecki_long-term_1995,
	title = {Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?},
	volume = {221},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7826162},
	abstract = {The authors review their recent experience with resected pancreatic ductal adenocarcinoma.},
	pages = {59--66},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Nitecki, S S and Sarr, M G and Colby, T V and van Heerden, J A},
	date = {1995-01},
	note = {Cited 408},
	file = {Nitecki et al. - 1995 - Long-term survival after resection for ductal aden.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZD4SANKF\\Nitecki et al. - 1995 - Long-term survival after resection for ductal aden.pdf:application/pdf}
}

@article{coates_negligible_2009,
	title = {Negligible effect of selective preoperative biliary drainage on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy},
	volume = {144},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19797109},
	abstract = {{OBJECTIVE}: To examine the effect of selective preoperative biliary drainage ({BD}) on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy. Biliary drainage prior to pancreaticoduodenectomy remains controversial. Proponents argue that it facilitates referral to high-volume tertiary centers, while detractors maintain that it increases surgical morbidity and mortality. {DESIGN}: Retrospective analysis of single-institution tumor registry database. {SETTING}: University medical center. {PATIENTS}: From October 1, 2003, to May 31, 2008, 90 patients underwent pancreaticoduodenectomy for periampullary mass lesions. {MAIN} {OUTCOME} {MEASURES}: Clinicopathologic data were reviewed and analyzed among patients who did and did not receive {BD} for their association with perioperative outcomes. chi(2) Analysis, independent-samples t tests, and Mann-Whitney U tests were used as appropriate. {RESULTS}: Fifty-six patients (62\%) underwent {BD}, and 34 (38\%) did not. Intraoperative bile cultures were positive for 1 or more species of microorganisms in 88\% of stented patients (35 of 40). There were no significant differences in fluid requirements, transfusion requirements, or surgery duration between patients who did and did not undergo {BD}. Estimated blood loss was increased in patients who received {BD} (625 {mL} vs 525 {mL} in patients who did not undergo {BD}; P = .03), while reoperation was significantly more common in nonstented patients (4\% vs 15\% in patients who did not undergo {BD}; P = .02). Intensive care unit stay, overall length of stay, pancreatic leak/abscess/fistula, infectious complications, postoperative percutaneous drainage, hospital readmission, and 30- and 90-day mortality were not significantly different between the 2 groups. {CONCLUSIONS}: Although preoperative biliary stents may complicate the intraoperative management and lessen the postoperative complications of patients undergoing pancreaticoduodenectomy, only estimated blood loss and reoperation were significantly different in this cohort. Further study may reveal patient subgroups who may specifically benefit or suffer from preoperative biliary stenting. Currently, selective preoperative {BD} appears appropriate in the multidisciplinary management of patients with periampullary lesions.},
	pages = {841--7},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Coates, Jodi M and Beal, Shannon H and Russo, Jack E and Vanderveen, Kimberly A and Chen, Steven L and Bold, Richard J and Canter, Robert J},
	date = {2009-09},
	file = {Coates et al. - 2009 - Negligible effect of selective preoperative biliar.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2AR2T7VS\\Coates et al. - 2009 - Negligible effect of selective preoperative biliar.pdf:application/pdf}
}

@article{latif_relationship_2002,
	title = {The relationship of circulating insulin-like growth factor 1, its binding protein-3, prostate-specific antigen and C-reactive protein with disease stage in prostate cancer.},
	volume = {89},
	abstract = {{OBJECTIVE}: To assess the relationships among circulating insulin-like growth factor-1 ({IGF}-1), {IGF} binding protein-3 ({IGFBP}-3), prostate-specific antigen ({PSA}) and C-reactive protein (an indicator of inflammatory systemic response) in  patients with prostate disease and cancer of different stages. {PATIENTS} {AND} {METHODS}: Circulating {IGF}-1, {IGFBP}-3, {PSA} and C-reactive protein concentrations were measured in patients with {BPH} (17) or stages T1/T2 (15), T3/T4 (16) and metastatic prostate cancer (12 patients). {RESULTS}: {IGF}-1 and {IGFBP}-3 concentrations were similar between patients with {BPH} and those with cancer, and  there was no difference between the groups with cancer. In the latter patients there was a significant correlation between age and {IGFBP}-3 concentrations (r = -0.400, P = 0.008) but not with {IGF}-1 concentrations. Controlling for age, there  were significant partial correlations between C-reactive protein and {IGF}-1 (r = -0.412, P = 0.008) and {IGFBP}-3 (r = -0.277, P = 0.05). {CONCLUSIONS}: These results indicate that circulating {IGF}-1 and {IGFBP}-3 concentrations do not change with disease stage in prostate cancer, but that they decrease with an increase in the  systemic inflammatory response.},
	pages = {396--399},
	number = {4},
	journaltitle = {{BJU} international},
	shortjournal = {{BJU} Int},
	author = {Latif, Z. and {McMillan}, D. C. and Wallace, A. M. and Sattar, N. and Mir, K. and Jones, G. and Underwood, M. A.},
	date = {2002-03},
	pmid = {11872031},
	keywords = {Aged, Aged, 80 and over, C-Reactive Protein/*analysis, Humans, Insulin-Like Growth Factor Binding Protein 3/*blood, Insulin-Like Growth Factor I/*analysis, Male, Middle Aged, Prostatic Neoplasms/*blood}
}

@article{fiori_hepatocyte_2003,
	title = {Hepatocyte ultrastructural aspects after preoperative biliary drainage in pancreatic cancer patients with cholestatic jaundice},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14981936},
	abstract = {{BACKGROUND}: The usefulness of preoperative biliary drainage in long-standing obstructive jaundice remains controversial. This study was designed to assess microscopic and ultrastructural changes in the morphology of hepatocytes from patients with obstructive jaundice treated with biliary drainage for 14 days. {PATIENTS} {AND} {METHODS}: In 8 patients with jaundice due to pancreatic neoplasms we obtained two fine-needle liver biopsies: the first during a transhepatic cholangiographic examination before placing preoperative drainage and the second at surgery, on day 14 of drainage. Biopsy samples were examined by light and electron microscopy and correlated to serum liver functional tests recorded before and after biliary drainage. {RESULTS}: Pre-drainage biopsy presented diffuse morphological signs of congestion and cholestasis, lipid and bilirubin cytoplasm inclusions, loss of bile canaliculi microvilli and diffuse bile canaliculi dilatation. After-drainage biopsies presented reduction of bile canaliculi dilatation, partial restoring of bile canaliculi microvilli and persistence of diffuse hepatocyte structural and ultrastructural changes. Patients' laboratory values (bilirubin, alkaline phosphatase, {SGGT}, {SGOT} and {SGPT}), that were significantly impaired before drainage, returned almost to normal within two weeks after drainage. {CONCLUSION}: Preoperative biliary drainage in patients with long-standing obstructive jaundice has received wide yet controversial support due to a well established pathophysiological background. The present findings of scarce recovery of hepatocyte changes after 14 days' drainage seemingly question its appropriateness.},
	pages = {4859--63},
	number = {6},
	journaltitle = {Anticancer Res},
	author = {Fiori, Enrico and Macchiarelli, Guido and Schillaci, Alberto and Lamazza, Antonietta and Burza, Antonio and Paparelli, Claudia and Cavallaro, Antonino and Cangemi, Vincenzo},
	date = {2003-12}
}

@article{aslani_preoperative_2010,
	title = {Preoperative body composition is influenced by the stage of operable pancreatic adenocarcinoma but does not predict survival after Whipple's procedure},
	volume = {12},
	issn = {1365-182X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951821/},
	doi = {10.1111/j.1477-2574.2010.00171.x},
	abstract = {Objectives:
Cachexia is common in pancreatic cancer and may have an influence on longterm survival but few studies have investigated this in patients with operable tumours. Therefore, this study was carried out to document body composition status in patients with pancreatic adenocarcinoma ({PCa}) presenting for a Whipple's procedure ({WP}) and to relate the findings to histopathology and longterm survival.

Methods:
Body composition was measured 1 day before a {WP} for ductal {PCa} in 36 patients (15 men, 21 women) aged 41–81 years. Results for total body nitrogen ({TBN}), nitrogen index ({NI}), total body water ({TBW}), fat mass ({FM}) and total body potassium ({TBK}) were compared with results in 73 age- and sex-matched controls. Patients' survival and details from histopathology synoptic reports were documented.

Results:
Patients undergoing {WPs} had low {TBK} values (P {\textless} 0.001) and females had lower body fat (P= 0.007) compared with controls. Five of 36 presented with significant protein deficiency, but this was not associated with a prolonged length of stay or reduced survival. The 12 patients who had involved surgical margins had larger tumours and reduced weight (P= 0.015), {FM} (P= 0.001), {TBN} (P= 0.045), {TBK} (P= 0.014) and survival (P= 0.036). However, multivariate Cox's regression analysis only included {FM} along with vascular invasion and margin status as independent predictors of survival.

Conclusions:
{PCa} patients undergoing a {WP} have reduced body fat and {TBK} compared with community controls while those with stage {III} tumours had greater deficits of fat, {TBK} and protein stores. However, preoperative body composition was a poor predictor of postoperative survival after pathological data were considered.},
	pages = {325--333},
	number = {5},
	journaltitle = {{HPB} : The Official Journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Aslani, Alireza and Gill, Anthony J and Roach, Paul J and Allen, Barry J and Smith, Ross C},
	urldate = {2015-08-08},
	date = {2010-06},
	pmid = {20590908},
	pmcid = {PMC2951821},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\T9IP6RZT\\Aslani et al. - 2010 - Preoperative body composition is influenced by the.pdf:application/pdf}
}

@article{bhatti_preoperative_2010,
	title = {Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio},
	volume = {200},
	issn = {0002-9610},
	url = {http://www.americanjournalofsurgery.com/article/S0002961009007910/abstract},
	doi = {10.1016/j.amjsurg.2009.08.041},
	shorttitle = {Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma},
	abstract = {Background
The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio ({PLR}), or the neutrophil-lymphocyte ratio ({NLR}) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma.
Methods
A total of 84 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a retrospectively maintained database.
Results
The preoperative {NLR} was found to be a significant prognostic marker (P = .023), whereas {PLR} had no significant relationship with survival (P = .642) using univariate Cox survival analysis. The median overall survival in patients with an {NLR} of ≤3.0 (n = 55) was 13.7, 17.0 months in those with an {NLR} of 3.0 to 4.0 (n = 17) and 5.9 months in patients with a value of {\textgreater}4.0 (n = 12) (log rank, P = .016). The {NLR} retained its significance on multivariate analysis (P = .039) along with resection margin status (P = .001).
Conclusion
The preoperative {NLR} represents a significant independent prognostic indicator in patients with resected pancreatic ductal adenocarcinoma, whereas {PLR} does not.},
	pages = {197--203},
	number = {2},
	journaltitle = {The American Journal of Surgery},
	author = {Bhatti, Imran and Peacock, Oliver and Lloyd, Gareth and Larvin, Michael and Hall, Richard I.},
	urldate = {2015-05-18},
	date = {2010-08-01},
	pmid = {20122680},
	keywords = {Neutrophil-lymphocyte ratio, pancreatic cancer, Preoperative markers, prognosis},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XUJ2WKZN\\abstract.html:text/html}
}

@article{gooszen_[carcinoma_2010,
	title = {[Carcinoma of the head of the pancreas: indication for emergency surgery]},
	volume = {154},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20699039},
	abstract = {In a recent multicentre randomized clinical trial, Van der Gaag et al. randomly assigned 220 patients to early surgery or preoperative biliary drainage ('Preoperative drainage for cancer of the head of the pancreas'). The rate of serious complications was significantly higher in the preoperative drainage group (p {\textless} 0.001), mainly because of drainage-related complications. There was no difference in surgical complications or mortality. Data on costs and impact on quality of life were not presented, but it can be predicted that the preoperative drainage strategy would be more expensive and would have greater negative impact on quality of life. If forthcoming publications by this research group confirm this suggestion, the current paradigm - obstructive jaundice, endoscopic retrograde cholangiopancreatography with stenting, delayed surgery for carcinoma of the head of the pancreas - should be changed to: obstructive jaundice due to peri-ampullary carcinoma should be considered an indication for emergency surgery.},
	pages = {A2148},
	journaltitle = {Ned Tijdschr Geneeskd},
	author = {Gooszen, Hein},
	date = {2010}
}

@article{richards_clinical_2014,
	title = {The clinical utility of the local inflammatory response in colorectal cancer.},
	volume = {50},
	rights = {Copyright (c) 2013 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ejca.2013.09.008},
	abstract = {{BACKGROUND}: The host immune response is important in the prevention of tumour progression in solid organ cancers. The aim was to evaluate the clinical utility  of the local inflammatory response in patients with colorectal cancer. {METHODS}: Three hundred and sixty-five patients with primary operable colorectal cancer were included. The local inflammatory response was assessed using three different methods; (1) individual T-cell subtypes ({CD}3, {CD}8, {CD}45R0, {FOXP}3), (2) an immunohistochemistry-based immune score (Galon Immune Score) and (3) a histopathological assessment (Klintrup-Makinen grade). Relationships with tumour  and host characteristics were established and the prognostic value of each method compared. {RESULTS}: A strong infiltration of tumour infiltrating lymphoctyes ({TIL}'s) was associated with improved cancer-specific survival. When individual},
	pages = {309--319},
	number = {2},
	journaltitle = {European journal of cancer (Oxford, England : 1990)},
	shortjournal = {Eur J Cancer},
	author = {Richards, Colin H. and Roxburgh, Campbell S. D. and Powell, Arfon G. and Foulis, Alan K. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2014-01},
	pmid = {24103145},
	keywords = {Aged, Antigens, {CD}3/immunology/metabolism, Antigens, {CD}45/immunology/metabolism, {CD}8-Positive T-Lymphocytes/*immunology/metabolism, Colorectal Neoplasms/*immunology/pathology, Female, Forkhead Transcription Factors/immunology/metabolism, Humans, Immunohistochemistry, Inflammation/*immunology/pathology, Kaplan-Meier Estimate, Lymphocytes, Tumor-Infiltrating/*immunology/metabolism, Male, Middle Aged, Neoplasm Staging, Prognosis, T-Lymphocyte Subsets/*immunology/metabolism}
}

@article{roxburgh_relationship_2009,
	title = {The relationship between the local and systemic inflammatory responses and survival in patients undergoing curative surgery for colon and rectal cancers.},
	volume = {13},
	doi = {10.1007/s11605-009-1034-0},
	abstract = {{INTRODUCTION}: Both local (Klintrup criteria) and systemic (Glasgow Prognostic Score, {mGPS}) inflammatory responses have been reported to be independent predictors of cancer-specific survival in colorectal cancer. However, high-grade  local inflammatory response appears more common in rectal and high {mGPS} more common in colonic tumors. Whether relationships with survival are similar in colon and rectal tumors is unclear. The present study assesses the prognostic value of local and systemic inflammation in colon and rectal cancers and defines},
	pages = {2011--8; discussion 2018--2019},
	number = {11},
	journaltitle = {Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J Gastrointest Surg},
	author = {Roxburgh, Campbell S. D. and Salmond, Jonathan M. and Horgan, Paul G. and Oien, Karin A. and {McMillan}, Donald C.},
	date = {2009-11},
	pmid = {19768511},
	keywords = {Aged, Colonic Neoplasms/*mortality/*pathology, Colon/pathology, C-Reactive Protein/analysis, Female, Humans, Inflammation/pathology, Male, Neoplasm Invasiveness, Prognosis, Rectal Neoplasms/*mortality/*pathology, Rectum/pathology, Serum Albumin/analysis, Survival Analysis}
}

@article{mcmillan_protein_1994,
	title = {Protein synthesis in cancer patients with inflammatory response: investigations with [15N]glycine.},
	volume = {10},
	abstract = {It has been proposed that the increase in amino acid flux and derived protein synthesis rates observed in weight-losing cancer patients may contribute to an ongoing negative energy balance. The mediators and tissues responsible for such apparent increased protein synthesis have not been clearly identified. The aim of this study was to examine the relationship between protein synthetic rates in whole-body, skeletal muscle, and circulating cortisol concentrations in healthy subjects (n = 6) and cancer patients with evidence of an inflammatory response (n = 6). Protein synthetic rates were measured with a primed continuous 20-h infusion of [15N]glycine. Skeletal muscle was biopsied at laparotomy. Serum cortisol, resting energy expenditure, plasma proteins, nitrogen metabolites in urine, and skeletal muscle free amino acids were also measured. Derived whole-body and skeletal muscle protein synthetic rates in the cancer group were increased significantly (by 70 and 93\%, respectively, p {\textless} 0.05). Circulating concentrations of cortisol, fibrinogen, and C-reactive protein were also significantly increased in the cancer group and indicated the presence of an inflammatory response. However, there was no significant increase in resting energy expenditure. Mechanisms by which apparent increases in whole-body and skeletal protein synthesis do not result in an increase in resting energy expenditure are discussed. We conclude that glycine utilization is increased in cancer patients but that rates of protein synthesis derived from [15N]glycine kinetics may not be valid in such patients.},
	pages = {232--240},
	number = {3},
	journaltitle = {Nutrition (Burbank, Los Angeles County, Calif.)},
	shortjournal = {Nutrition},
	author = {{McMillan}, D. C. and Preston, T. and Fearon, K. C. and Burns, H. J. and Slater, C. and Shenkin, A.},
	date = {1994-06},
	pmid = {7919675},
	keywords = {*Protein Biosynthesis, Adenocarcinoma/*metabolism, Adult, Aged, Basal Metabolism, Colonic Neoplasms/*metabolism, Energy Metabolism, Female, Glycine/*metabolism, Humans, Inflammation/*metabolism, Kinetics, Male, Middle Aged, Muscle Proteins/biosynthesis, Muscle, Skeletal/metabolism, Nitrogen Isotopes, Nitrogen/urine}
}

@article{benzo_complications_2007,
	title = {Complications of lung resection and exercise capacity: A meta-analysis},
	volume = {101},
	issn = {09546111},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0954611107000868},
	doi = {10.1016/j.rmed.2007.02.012},
	shorttitle = {Complications of lung resection and exercise capacity},
	pages = {1790--1797},
	number = {8},
	journaltitle = {Respiratory Medicine},
	author = {Benzo, Roberto and Kelley, George A. and Recchi, Laura and Hofman, Albert and Sciurba, Frank},
	urldate = {2015-06-05},
	date = {2007-08},
	langid = {english},
	file = {PIIS0954611107000868.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5XA89BVV\\PIIS0954611107000868.pdf:application/pdf}
}

@article{west_effect_2015,
	title = {Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study},
	volume = {114},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/114/2/244},
	doi = {10.1093/bja/aeu318},
	shorttitle = {Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients},
	abstract = {Background Patients requiring surgery for locally advanced rectal cancer often additionally undergo neoadjuvant chemoradiotherapy ({NACRT}), of which the effects on physical fitness are unknown. The aim of this feasibility and pilot study was to investigate the effects of {NACRT} and a 6 week structured responsive exercise training programme ({SRETP}) on oxygen uptake (V˙O2){\textless}mml:math{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}({\textless}/mml:mo{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}){\textless}/mml:mo{\textgreater}{\textless}/mml:math{\textgreater} at lactate threshold (θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}) in such patients.
Methods We prospectively studied 39 consecutive subjects (27 males) with T3–4/N+ resection margin threatened rectal cancer who completed standardized {NACRT}. Subjects underwent cardiopulmonary exercise testing at baseline (pre-{NACRT}), at week 0 (post-{NACRT}), and week 6 (post-{SRETP}). Twenty-two subjects undertook a 6 week {SRETP} on a training bike (three sessions per week) between week 0 and week 6 (exercise group). These were compared with 17 contemporaneous non-randomized subjects (control group). Changes in V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} over time and between the groups were compared using a compound symmetry covariance linear mixed model.
Results Of 39 recruited subjects, 22 out of 22 (exercise) and 13 out of 17 (control) completed the study. There were differences between the exercise and control groups at baseline [age, {ASA} score physical status, World Health Organisation performance status, and Colorectal Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity ({CR}-{POSSUM}) predicted mortality]. In all subjects, V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} significantly reduced between baseline and week 0 [−1.9 ml kg−1 min−1; 95\% confidence interval ({CI}) −1.3, −2.6; P{\textless}0.0001]. In the exercise group, V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at θˆL{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}θ{\textless}/mml:mi{\textgreater}{\textless}mml:mo stretchy="false"{\textgreater}ˆ{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}L{\textless}/mml:mi{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} significantly improved between week 0 and week 6 (+2.1 ml kg−1 min−1; 95\% {CI} +1.3, +2.9; P{\textless}0.0001), whereas the control group values were unchanged (−0.7 ml kg−1 min−1; 95\% {CI} −1.66, +0.37; P=0.204).
Conclusions {NACRT} before rectal cancer surgery reduces physical fitness. A structured exercise intervention is feasible post-{NACRT} and returns fitness to baseline levels within 6 weeks.
Clinical trial registration {NCT}: 01325909.},
	pages = {244--251},
	number = {2},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {West, M. A. and Loughney, L. and Lythgoe, D. and Barben, C. P. and Sripadam, R. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2015-02-01},
	langid = {english},
	pmid = {25274049},
	keywords = {anaerobic threshold, cardiopulmonary exercise test, Exercise, prehabilitation, rectal cancer, surgery},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QV64JF8C\\244.html:text/html;West et al. - 2015 - Effect of prehabilitation on objectively measured .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JH4H5A29\\West et al. - 2015 - Effect of prehabilitation on objectively measured .pdf:application/pdf}
}

@article{al-jabi_value_2010,
	title = {Value of C-reactive protein after neurosurgery: a prospective study},
	volume = {24},
	issn = {1360-046X},
	doi = {10.3109/02688697.2010.500408},
	shorttitle = {Value of C-reactive protein after neurosurgery},
	abstract = {{AIM}: The aim of this manuscript is to review the current state of knowledge regarding C-reactive protein ({CRP}) kinetics after standard neurosurgical procedures, and to determine the value of {CRP} as a screening test for early post-operative infectious complications as opposed to other more commonly used tests, and as a marker of peri-operative surgical insult.
{METHODS}: Over 18 months period, {CRP} levels, alongside with {ESR} and {WCC} were assessed pre-operatively (at day 0) and post-operatively (at days 1,2,3,4 and 5) in 50 consecutive female patients and 50 consecutive male patients undergoing seven neurosurgical procedures. Each of the seven procedures involved a different level of intra-operative trauma. Factors of possible influences on {CRP}, including volume of blood transfused intra-operatively, type of anaesthetic administered, use of anti-inflammatory drugs and antibiotics levels were recorded.
{RESULTS}: The median age of our study population was 29.1 (mean ± {SD}: 28.4 ± 10.2; range: 20.4-53.8). Of the 100 patients recruited for our study, 13 developed post-operative infectious complications. In these patients, a secondary {CRP} rise or failure to decrease as expected had sensitivity, specificity, negative and positive predictive value of 100\%, 93.1\%, 100\% and 68.4\%, respectively, for detecting infectious complications. The mean post-operative {CRP} levels were highest in the most surgically traumatic procedure--lobotomy for epilepsy intervention, and lowest in the least surgically traumatic procedure--stereotactic brain biopsy (p {\textless} 0.001). Volume of blood transfused intra-operatively, type of anaesthetic administered, use of anti-inflammatory drugs and antibiotics levels did not affect {CRP} kinetics.
{CONCLUSION}: The results of this study suggest that {CRP} is a more reliable screening test for post-operative infectious complications in the practice of neurosurgery than other more commonly used tests ({WCC} and {ESR}). Furthermore, the results suggest that peak post-operative {CRP} levels mirrors the level of incurred intra-operative surgical insult.},
	pages = {653--659},
	number = {6},
	journaltitle = {British Journal of Neurosurgery},
	shortjournal = {Br J Neurosurg},
	author = {Al-Jabi, Yasser and El-Shawarby, Amr},
	date = {2010-12},
	pmid = {21070150},
	keywords = {Adult, Biological Markers, Blood Sedimentation, C-Reactive Protein, Female, Humans, Male, Middle Aged, Neurosurgery, Neurosurgical Procedures, postoperative complications, Predictive Value of Tests, Prospective Studies, Surgical Wound Infection, Young Adult}
}

@article{rumstadt_hemorrhage_1998,
	title = {Hemorrhage after pancreatoduodenectomy},
	volume = {227},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9488522},
	abstract = {{OBJECTIVE}: The authors reviewed the hemorrhagic complications of patients who underwent pancreatoduodenectomies between 1972 and 1996. {SUMMARY} {BACKGROUND} {DATA}: Although recent studies have demonstrated a reduction in the mortality of pancreatic resection, morbidity is still high. Bleeding is a close second to anastomotic dehiscence in the list of dangerous postoperative complications. {METHODS}: The medical records from a prospective data bank of 559 patients who underwent pancreatic resection at the Surgical Clinic of Mannheim (Heidelberg University) were analyzed in regard to postoperative hemorrhagic complications. Differences were evaluated with the Fisher exact test. {RESULTS}: The overall mortality rate was 2.7\%. Postoperative bleeding occurred in 42 patients (7.5\%), with 6 episodes ending fatally (14.3\%). Erosive bleeding after pancreatic leak was noted in 11 patients (26.2\%), 4 of whom died. Gastrointestinal hemorrhage occurred in 22 patients, and operative field hemorrhage was present in 20 cases. Relaparotomy was necessary in 29 patients. An angiography with interventional embolization for recurrent bleeding was performed in three patients. Seven hemorrhages (4.6\%) occurred after pancreatectomy for chronic pancreatitis and 35 episodes of bleeding (8.6\%) were encountered after pancreatectomy for malignant disease. Obstructive jaundice was present in 359 patients (63.9\%). In this group of patients, 32 (8.9\%) postoperative hemorrhages occurred. Preoperative biliary drainage did not influence the type and mortality rate of postoperative hemorrhage in jaundiced patients. {CONCLUSION}: The prevention of these bleeding complications depends in the first place on meticulous hemostatic technique. Preoperative biliary drainage does not lower postoperative bleeding complications in jaundiced patients. Continuous, close observation of the patient in the postoperative period, so as to detect complications in time, and expeditious hemostasis are paramount.},
	pages = {236--41},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Rumstadt, B and Schwab, M and Korth, P and Samman, M and Trede, M},
	date = {1998-02}
}

@article{pascual_surgical_2013,
	title = {Surgical versus nonsurgical treatment of infected pancreatic necrosis: more arguments to change the paradigm},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23820801},
	abstract = {This study aimed to compare primary surgical versus nonsurgical treatment in a series of patients with infected pancreatic necrosis ({IPN}) and to investigate whether the success of nonsurgical approach is related to a less severe disease.},
	pages = {1627--33},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Pascual, Isabel and Sabater, Luis and Añón, Ramón and Calvete, Julio and Pacheco, Gema and Muñoz, Elena and Lizarraga, Javier and Sastre, Juan and Peña, Andrés and Mora, Francisco and Pérez-Griera, Jaime and Ortega, Joaquin and Benages, Adolfo},
	date = {2013-09}
}

@article{yeh_pancreaticojejunal_1997,
	title = {Pancreaticojejunal anastomotic leak after pancreaticoduodenectomy–multivariate analysis of perioperative risk factors},
	volume = {67},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9073557},
	abstract = {The records of 131 consecutive patients with periampullary carcinoma who underwent pancreaticoduodenectomy within a 12-year period were reviewed to determine the perioperative risk factors of pancreaticojejunal ({PJ}) anastomotic leak. Twenty-one {PJ} leaks were identified, for a frequency of 16\% (21 of 131); 19\% (4 of 21) of these patients eventually died of {PJ} leak-related complications. A total of 23 items of perioperative data, presumed as risk factors predisposing to {PJ} leak, were examined. By univariate analysis, advanced age, prolonged duration of untreated jaundice, deep jaundice, decreased creatinine clearance, increased intraoperative blood loss, and shock during operation were statistically significant. However, by multivariate analysis, only duration of jaundice, creatinine clearance, and intraoperative blood loss turned out to be independent risk factors. Noteworthily, jaundiced patients with impaired creatinine clearance not only had a higher incidence of {PJ} leak, but were also more liable to experience sepsis and intraabdominal bleeding, which uniformly elicited a grave clinical course. Routine preoperative biliary drainage failed to enhance the security of {PJ}. Completion pancreatectomy continued to carry a poor prognosis, and should be avoided when possible and replaced by early, aggressive radiologic intervention.},
	pages = {119--25},
	number = {2},
	journaltitle = {J Surg Res},
	author = {Yeh, T S and Jan, Y Y and Jeng, L B and Hwang, T L and Wang, C S and Chen, S C and Chao, T C and Chen, M F},
	date = {1997-02}
}

@article{klava_interleukin-10._1997,
	title = {Interleukin-10. A role in the development of postoperative immunosuppression},
	volume = {132},
	issn = {0004-0010},
	abstract = {{BACKGROUND}: The cause of diminished monocyte major histocompatibility complex class {II} antigen expression after surgery or trauma is unclear. Interleukin-10 ({IL}-10) regulates inflammatory cytokine production and major histocompatibility complex class {II} ({HLA}-{DR}) expression in vitro.
{OBJECTIVES}: To quantify in vivo {IL}-10 messenger {RNA} ({mRNA}) and protein and monocyte {HLA}-{DR} expression after major surgery and to investigate the effects of {IL}-10 neutralizing blockade on monocyte {HLA}-{DR} expression in vitro.
{DESIGN}: Inception cohort study of 48 surgical patients from preoperative status to postoperative day 7 and 9 healthy volunteers (controls).
{SETTING}: Large teaching hospital, Northern England.
{PATIENTS}: Monocyte {HLA}-{DR} and cytokine {mRNA} expression was determined in 32 of 48 consecutive patients undergoing elective major resectional surgery. Mononuclear cells for in vitro studies and serum samples for {IL}-10 measurement were obtained from the remaining 16 patients.
{MAIN} {OUTCOME} {MEASURES}: Monocyte {HLA}-{DR} expression determined by flow cytometry, {IL}-10, and tumor necrosis factor {mRNA} in peripheral blood mononuclear cells assayed by multiplex reverse transcriptase polymerase chain reaction, and serum {IL}-10 determined by enzyme-linked immunosorbent assay.
{RESULTS}: Monocyte {HLA}-{DR} expression (in mean channel fluorescence units [{MCF}]) was significantly reduced 24 hours after surgery ({MCF} [+/- {SEM}], 32.6 +/- 2.3 vs 16.3 +/- 1.2; P {\textless} .001) and remained low during the first postoperative week. A relative increase in {IL}-10 to G3PDH {mRNA} ratio (mean [+/- {SEM}], 0.95 +/- 0.08 vs 0.59 +/- 0.06; P {\textless} .01) and serum {IL}-10 (mean [+/- {SEM}], 18.1 +/- 4.1 vs 5.4 +/- 0.8 pg/{mL}; P {\textless} .01) was noted on the first postoperative day. A significant correlation existed between {HLA}-{DR} antigen expression and the presence of {IL}-10 {mRNA} transcript on the first postoperative day (P {\textless} .01). Lipopolysaccharide-induced up-regulation of monocyte {HLA}-{DR} expression was significantly impaired on the first postoperative day (mean [+/- {SEM}], 151\% +/- 24.4\% vs 60\% +/- 10.1\%; P {\textless} .01), but this was partially reversed by {IL}-10 neutralizing antibody (mean [+/- {SEM}], 60\% +/- 10.1\% vs 115\% +/- 11.6\%; P {\textless} .01).
{CONCLUSIONS}: Interleukin-10 gene expression correlates with the fall in monocyte {HLA}-{DR} antigen expression in patients undergoing major abdominal surgery and may account for the immunosuppression associated with surgical injury.},
	pages = {425--429},
	number = {4},
	journaltitle = {Archives of Surgery (Chicago, Ill.: 1960)},
	shortjournal = {Arch Surg},
	author = {Klava, A. and Windsor, A. C. and Farmery, S. M. and Woodhouse, L. F. and Reynolds, J. V. and Ramsden, C. W. and Boylston, A. W. and Guillou, P. J.},
	date = {1997-04},
	pmid = {9108765},
	keywords = {Gene Expression, {HLA}-{DR} Antigens, Humans, Immune Tolerance, Interleukin-10, Monocytes, postoperative complications, {RNA}, Messenger}
}

@article{moyes_cardiopulmonary_2013,
	title = {Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery},
	volume = {95},
	issn = {0035-8843},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098578/},
	doi = {10.1308/003588413X13511609954897},
	abstract = {Introduction
An anaerobic threshold ({AT}) of {\textless}11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing ({CPET}) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection.

Methods
Between March 2008 and October 2010, 108 patients (83 men, 25 women) with a median age of 66 years (range: 38–84 years) underwent {CPET} before potentially curative resections for oesophagogastric cancers. Measured {CPET} variables included {AT} and maximum oxygen uptake at peak exercise ({VO}2 peak). Outcome measures were length of high dependency unit stay, length of hospital stay, unplanned intensive care unit ({ICU}) admission, and postoperative morbidity and mortality.

Results
The mean {AT} and {VO}2 peak were 10.8ml/min/kg (standard deviation [{SD}]: 2.8ml/min/kg, range: 4.6–19.3ml/min/kg) and 15.2ml/min/kg ({SD}: 5.3ml/min/kg, range: 5.4–33.3ml/min/kg) respectively; 57 patients (55\%) had an {AT} of {\textless}11ml/min/ kg and 26 (12\%) had an {AT} of {\textless}9ml/min/kg. Postoperative complications occurred in 57 patients (29 cardiopulmonary [28\%] and 28 non-cardiopulmonary [27\%]). Four patients (4\%) died in hospital and 21 (20\%) required an unplanned {ICU} admission. Cardiopulmonary complications occurred in 42\% of patients with an {AT} of {\textless}9ml/min/kg compared with 29\% of patients with an {AT} of ≥9ml/min/kg but {\textless}11ml/min/kg and 20\% of patients with an {AT} of ≥11ml/min/kg (p=0.04). There was a trend that those with an {AT} of {\textless}11ml/min/kg and a low {VO}2 peak had a higher rate of unplanned {ICU} admission.

Conclusions
This study has shown a correlation between {AT} and the development of cardiopulmonary complications although the discriminatory ability was low.},
	pages = {125--130},
	number = {2},
	journaltitle = {Annals of The Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Moyes, {LH} and {McCaffer}, {CJ} and Carter, {RC} and Fullarton, {GM} and Mackay, {CK} and Forshaw, {MJ}},
	urldate = {2015-05-05},
	date = {2013-03},
	pmid = {23484995},
	pmcid = {PMC4098578},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\I8VFTJQ7\\Moyes et al. - 2013 - Cardiopulmonary exercise testing as a predictor of.pdf:application/pdf}
}

@article{nehez_compromise_2002,
	title = {Compromise of Immune Function in Obstructive Jaundice},
	volume = {168},
	issn = {11024151},
	url = {http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=7437326&site=ehost-live},
	doi = {10.1080/11024150260284815},
	abstract = {Summarizes the current knowledge on immune function in obstructive jaundice and  potentials for future therapeutic interventions.  Important roles of bacterial translocation, failure of the gut barrier and endotoxin in the immunological changes and septic complications that follow biliary obstruction; Factors contributing to endotoxaemia in jaundice and summarizable as disturbances in homeostasis of the gut-liver axis.},
	pages = {315--328},
	number = {6},
	journaltitle = {European Journal of Surgery},
	shortjournal = {European Journal of Surgery},
	author = {Nehéz, László and Andersson, Roland},
	urldate = {2015-06-02},
	date = {2002-06},
	keywords = {{IMMUNE} {FUNCTION}, {IMMUNE} response, Intervention, {JAUNDICE}, Obstructive, {OBSTRUCTIONS} of the bile ducts, {OBSTRUCTIVE} {JAUNDICE}},
	file = {Nehéz and Andersson - 2002 - Compromise of Immune Function in Obstructive Jaund.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MXC2VD63\\Nehéz and Andersson - 2002 - Compromise of Immune Function in Obstructive Jaund.pdf:application/pdf}
}

@article{ramsey_prospective_2008,
	title = {Prospective study of the relationship between the systemic inflammatory response, prognostic scoring systems and relapse-free and cancer-specific survival in patients undergoing potentially curative resection for renal cancer.},
	volume = {101},
	doi = {10.1111/j.1464-410X.2007.07363.x},
	abstract = {{OBJECTIVE}: To examine the prognostic value of markers of systemic inflammatory response, together with established scoring systems, in predicting relapse-free and cancer-specific survival in patients with primary operable renal cancer, as there is increasing evidence that such markers provide prognostic information, in addition to scoring systems, in patients with metastatic renal cancer. {PATIENTS} {AND} {METHODS}: In all, 83 patients undergoing potentially curative nephrectomy for  localized renal cancer were recruited. The University of California Los Angeles Integrated Staging System ({UISS}), 'Stage Size Grade Necrosis' ({SSIGN}) and Kattan  scores were constructed. The systemic inflammatory response was assessed by counting white cells, neutrophils, lymphocytes and platelets, and measuring albumin and C-reactive protein ({CRP}) concentrations. {RESULTS}: On multivariate analysis of the significant individual covariates, T stage (hazard ratio 2.38, 95\% confidence interval 1.06- 5.36, P = 0.037), necrosis (3.73, 1.26-11.05, P = 0.018) and {CRP} (4.31, 1.20-15.49, P = 0.025) were significant independent predictors of relapse-free survival. On multivariate analysis of significant scoring systems and {CRP}, only {UISS} (3.50, 1.66-7.40, P = 0.001), {SSIGN} (2.83, 1.19-6.72, P = 0.018) and {CRP} (4.14, 1.16-14.73, P = 0.028) were significant independent predictors of relapse-free survival. {CONCLUSION}: Elevated circulating {CRP} levels appear to be better than other markers of the systemic inflammatory response, and independent of established scoring systems, in predicting relapse-free and cancer-specific survival in patients undergoing potentially curative nephrectomy for renal cancer.},
	pages = {959--963},
	number = {8},
	journaltitle = {{BJU} international},
	shortjournal = {{BJU} Int},
	author = {Ramsey, Sara and Lamb, Gavin W. A. and Aitchison, Michael and {McMillan}, Donald C.},
	date = {2008-04},
	pmid = {18190639},
	keywords = {Adult, Aged, Carcinoma, Renal Cell/metabolism/mortality/*surgery, C-Reactive Protein/*metabolism, Epidemiologic Methods, Female, Humans, Kidney Neoplasms/metabolism/mortality/*surgery, Male, Middle Aged, Nephrectomy/*methods/mortality, Nephritis/metabolism/mortality, Prognosis, Systemic Inflammatory Response Syndrome/*complications/metabolism}
}

@article{qu_clinical_2013,
	title = {Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy: A systematic review and meta-analysis},
	volume = {39},
	issn = {07487983},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0748798312013492},
	doi = {10.1016/j.ejso.2012.12.010},
	shorttitle = {Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy},
	pages = {213--223},
	number = {3},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	author = {Qu, H. and Sun, G.R. and Zhou, S.Q. and He, Q.S.},
	urldate = {2014-01-27},
	date = {2013-03},
	file = {Qu et al. - 2013 - Clinical risk factors of delayed gastric emptying .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ECHB4F89\\Qu et al. - 2013 - Clinical risk factors of delayed gastric emptying .pdf:application/pdf}
}

@article{shen_visceral_2004,
	title = {Visceral adipose tissue: relations between single-slice areas and total volume},
	volume = {80},
	url = {http://ajcn.nutrition.org/content/80/2/271.short},
	shorttitle = {Visceral adipose tissue},
	pages = {271--278},
	number = {2},
	journaltitle = {The American journal of clinical nutrition},
	author = {Shen, Wei and Punyanitya, Mark and Wang, {ZiMian} and Gallagher, Dympna and St-Onge, Marie-Pierre and Albu, Jeanine and Heymsfield, Steven B. and Heshka, Stanley},
	urldate = {2014-01-27},
	date = {2004},
	file = {Shen et al. - 2004 - Visceral adipose tissue relations between single-.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\68DX94JU\\Shen et al. - 2004 - Visceral adipose tissue relations between single-.pdf:application/pdf}
}

@article{mansouri_impact_2013-1,
	title = {The impact of aspirin, statins and {ACE}-inhibitors on the presentation of colorectal neoplasia in a colorectal cancer screening programme.},
	volume = {109},
	doi = {10.1038/bjc.2013.292},
	abstract = {{BACKGROUND}: There is increasing evidence that aspirin, statins and {ACE}-inhibitors can reduce the incidence of colorectal cancer. The aim of the present study was to assess the impact of these medications on an individual's risk of advanced neoplasia in a colorectal cancer screening programme. {METHODS}: A prospectively maintained database of the first round of screening in our geographical area was  analysed. The outcome measure was advanced neoplasia (cancer or intermediate or high risk adenomata). {RESULTS}: Of the 4188 individuals who underwent colonoscopy  following a positive occult blood stool test, colorectal pathology was present in 3043(73\%). Of the 3043 patients with colorectal pathology, 1704(56\%) had advanced neoplasia. Patients with advanced neoplasia were more likely to be older ({OR} 1.38; 95\% {CI} 1.19-1.59) and male ({OR} 1.66; 95\% {CI} 1.43-1.94) (both P{\textless}0.001). In contrast, those on aspirin ({OR} 0.68; 95\% {CI} 0.56-0.83), statins ({OR} 0.65; 95\% {CI}  0.55-0.78) or {ACE} inhibitors ({OR} 0.71; 95\% {CI} 0.57-0.89) were less likely to have advanced neoplasia at colonoscopy (all P{\textless}0.05). {CONCLUSION}: In patients undergoing colonoscopy following a positive occult blood stool test with documented evidence of aspirin, statin or {ACE}-inhibitor usage, advanced neoplasia is less likely, suggesting that the usage of these medications may have a chemopreventative effect.},
	pages = {249--256},
	number = {1},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Mansouri, D. and {McMillan}, D. C. and Roxburgh, C. S. D. and Crighton, E. M. and Horgan, P. G.},
	date = {2013-07-09},
	pmid = {23778525},
	pmcid = {PMC3708580},
	keywords = {Aged, Angiotensin-Converting Enzyme Inhibitors/*pharmacology, Anti-Inflammatory Agents, Non-Steroidal/*pharmacology, Aspirin/*pharmacology, Chemoprevention, Colonoscopy, Colorectal Neoplasms/*diagnosis/prevention \& control, Early Detection of Cancer, Female, Humans, Hydroxymethylglutaryl-{CoA} Reductase Inhibitors/*pharmacology, Male, Mass Screening, Middle Aged, Occult Blood, Prospective Studies, Risk}
}

@article{jollow_oxidative_2001,
	title = {Oxidative stress, glucose-6-phosphate dehydrogenase and the red cell.},
	volume = {500},
	abstract = {As discussed above, the process by which normal senescent red cells are selected  for removal from the circulation is the subject of much ongoing research and is not yet well understood. This in turn creates a problem for studies on the enhanced removal that occurs in xenobiotic-induced hemolytic states; specifically, whether the enhanced removal should be considered as an increase in rate of the normal sequestration mechanism or as an unrelated process, in part or in whole. This difficulty bears directly on the interpretation of much of the mechanistic hemolytic literature. Because of its dual in vivo and in vitro hemolytic capability, and because of its capacity to induce frank lysis in the incubation mixture, phenylhydrazine has been used extensively as a model compound for mechanistic studies. These data have contributed heavily to our current concepts of how chemicals induce damage in the red cell. The comparison studies presented above cast doubt on the relevance of many of these phenylhydrazine studies for the in vivo hemolytic response. Phenylhydrazine, like divicine and},
	journaltitle = {Advances in experimental medicine and biology},
	shortjournal = {Adv Exp Med Biol},
	author = {Jollow, D. J. and {McMillan}, D. C.},
	date = {2001},
	pmid = {11765001},
	keywords = {*Oxidative Stress, Dapsone/*analogs \& derivatives/pharmacology, Erythrocytes/drug effects/*metabolism, Free Radicals/metabolism, Glucosephosphate Dehydrogenase/*metabolism, Humans, Oxidants/pharmacology, Phenylhydrazines/pharmacology, Pyrimidinones/pharmacology}
}

@article{pratt_risk_2008,
	title = {Risk prediction for development of pancreatic fistula using the {ISGPF} classification scheme},
	volume = {32},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18175170},
	abstract = {{BACKGROUND}: The International Study Group on Pancreatic Fistula ({ISGPF}) classification scheme has become a useful system for characterizing the clinical impact of pancreatic fistula. We sought to identify predictive factors that predispose patients to fistula, specifically those with clinical relevance (grades B/C), and to describe the clinical and economic significance of risk stratification within this framework. {METHODS}: Overall, 233 consecutive pancreatoduodenectomies were performed between October 2001 and March 2007 in our institution. Pancreatic fistula is defined according to the {ISGPF} classification scheme. Logistic regression analysis was performed to identify risk factors for pancreatic fistula development. These features were then analyzed to determine whether additive risk severity equates to worsening clinical and economic impact. {RESULTS}: Fistulas of any extent occurred in 60 patients, but only 31 (14\%) were clinically relevant. There are no identifiable risk factors for grade A biochemical fistulas. Multivariate analysis shows that small pancreatic duct size ({\textless}3 mm); soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss ({\textgreater}1,000 ml) are associated with clinically relevant fistulae. An additive effect is further illustrated, in which clinical and economic outcomes progressively worsen as risk profile increases. Each additional risk factor increases the odds of developing a clinically relevant fistula by 52\%. {CONCLUSIONS}: For pancreatoduodenectomy, small duct size; soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss are convincing risk factors for the development clinically relevant fistulae as judged by {ISGPF} classification. As risk profile accrues, patients suffer more complications, encounter longer hospital stays, and incur greater hospital costs. These outcomes can be predicted in the operating room through accurate delineation of high-risk glands.},
	pages = {419--28},
	number = {3},
	journaltitle = {World J Surg},
	author = {Pratt, Wande B and Callery, Mark P and Vollmer, Charles M Jr},
	date = {2008-03}
}

@article{barut_diagnostic_2014,
	title = {The diagnostic value of C-reactive protein in bacterial translocation in experimental biliary obstruction},
	volume = {23},
	issn = {1899-5276},
	abstract = {{BACKGROUND}: Many experimental studies have verified that obstructive jaundice ({OJ}) causes bacterial translocation ({BT}).
{OBJECTIVES}: The aim of this study was to assess to whether C-Reactive Protein ({CRP}) can be used to detect bacterial translocation induced by biliary obstruction.
{MATERIAL} {AND} {METHODS}: Twenty rats were divided into two groups containing 10 rats each: sham-operated controls and the obstructive jaundice ({OJ}) group. All procedures were performed aseptically. After an upper midline incision, the common bile duct ({CBD}) was identified, mobilized, ligated and divided. The sham-operated animals had a similar incision, followed by mobilization of the {CBD}, without ligation or division. Ten days after the first operation, a second laparotomy was performed. Blood samples were collected for culture and serum {CRP} analysis. In addition, liver, spleen, and mesenteric lymph node ({MLN}) specimens were taken for microbiological culture to determine the presence of {BT}. {BT} was considered positive if there was any bacterial growth in the {MLN}, liver, spleen, or blood cultures; a lack of bacterial growth indicated a negative {BT}.
{RESULTS}: The {OJ} group had significantly higher rates of bacterial translocation than the sham-operated group (p = 0.002). Mean {CRP} levels (ng/{mL}) were 8.7 ± 11.8 and 18.6 ± 17.2 in the sham-operated group and the {OJ} group respectively. There was no significant difference in mean {CRP} levels between the two groups (p = 0.257). Mean {CRP} levels were 4.5 ± 4.3 and 24.9 ± 16.4 in the {BT} (-) and {BT} (+) groups respectively (p = 0.003). A marked increase in {CRP} levels paralleled an increase in {BT}.
{CONCLUSIONS}: This study has demonstrated a direct relationship between {BT} and {CRP} levels in an experimental {OJ} model.},
	pages = {197--203},
	number = {2},
	journaltitle = {Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University},
	shortjournal = {Adv Clin Exp Med},
	author = {Barut, Ibrahim and Kaya, Selcuk},
	date = {2014-04},
	pmid = {24913110},
	keywords = {Animals, Bacterial Translocation, C-Reactive Protein, {JAUNDICE}, Obstructive, Rats, Rats, Wistar},
	file = {Barut and Kaya - 2014 - The diagnostic value of C-reactive protein in bact.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BGT582WR\\Barut and Kaya - 2014 - The diagnostic value of C-reactive protein in bact.pdf:application/pdf}
}

@article{dandona_influence_2011,
	title = {Influence of obesity and other risk factors on survival outcomes in patients undergoing pancreaticoduodenectomy for pancreatic cancer},
	volume = {40},
	issn = {1536-4828},
	doi = {10.1097/MPA.0b013e318215a9b1},
	abstract = {{OBJECTIVES}: Established risk factors for the development of pancreatic cancer include tobacco use, family history of pancreatic cancer, personal history of diabetes, and obesity. The impact of risk factors on prognosis in patients with pancreatic cancer, particularly obesity, has recently become controversial.
{METHODS}: We conducted a retrospective analysis of patients with pancreatic adenocarcinoma who underwent pancreaticoduodenectomy between 1995 and 2009. Patients were categorized by body mass index ({BMI}) as normal (18.5-24.9 kg/m), overweight (25-29.9 kg/m), or obese (≥30 kg/m). Univariate analysis was performed to evaluate the association of obesity and other risk factors on overall survival.
{RESULTS}: Of the 355 patients evaluated, 149 (42.0\%) had normal {BMI}, 131 (36.9\%) were overweight, and 75 (21.1\%) were obese. Overall survival for normal, overweight, and obese groups was 17.3 months (95\% confidence interval [{CI}], 14.2-20.8 months), 20.0 months (95\% {CI}, 16.6-23.6 months), and 22.1 months (95\% {CI}, 16.5-36.4 months), respectively (P = 0.58). Hazard ratios for tobacco use, family history of pancreatic cancer, and history of diabetes were 1.07, 1.38, and 0.87, respectively.
{CONCLUSIONS}: Obesity and other risk factors have no impact on overall survival in patients with adenocarcinoma after pancreaticoduodenectomy. Further studies investigating the relationship between risk factors and their prognostic significance in patients with pancreatic cancer are warranted.},
	pages = {931--937},
	number = {6},
	journaltitle = {Pancreas},
	shortjournal = {Pancreas},
	author = {Dandona, Monica and Linehan, David and Hawkins, William and Strasberg, Steven and Gao, Feng and Wang-Gillam, Andrea},
	date = {2011-08},
	pmid = {21747317},
	keywords = {Aged, Carcinoma, Pancreatic Ductal, Diabetes Complications, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Obesity, Pancreatic Neoplasms, Pancreaticoduodenectomy, prognosis, Retrospective Studies, Risk Factors, Smoking},
	file = {Dandona et al. - 2011 - Influence of obesity and other risk factors on sur.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IM4VUCPH\\Dandona et al. - 2011 - Influence of obesity and other risk factors on sur.pdf:application/pdf}
}

@article{ortega-deballon_preoperative_2013,
	title = {Preoperative adipocytokines as a predictor of surgical infection after colorectal surgery: a prospective survey},
	volume = {29},
	issn = {0179-1958, 1432-1262},
	url = {http://link.springer.com/article/10.1007/s00384-013-1782-x},
	doi = {10.1007/s00384-013-1782-x},
	shorttitle = {Preoperative adipocytokines as a predictor of surgical infection after colorectal surgery},
	abstract = {Background Infections are the leading cause of morbidity and mortality after colorectal surgery. Obesity is a well-known risk factor for wound infection, but it does not seem to increase the risk of other infectious complications. The aim of this study was to look for a relationship between the fatty tissue metabolism measured by adipocytokine levels and the risk of postoperative infection. Patients and methods Preoperative plasma levels of eight adipocytokines, cholesterol, triglycerides, insulin and C-reactive protein ({CRP}) were measured in consecutive patients undergoing elective colorectal surgery between June 2008 and June 2011. Information about epidemiological and clinical characteristics was obtained for each patient. All infections in the 30 days following surgery were recorded. Results Among the 174 patients included, 49 (28 \%) presented with a postoperative infection: 41 surgical site infections and 8 other infections. Preoperative leptin, insulin and {CRP} were significantly higher in patients with postoperative infection (p = 0.025, p = 0.020 and p = 0.044, respectively), but only leptin was predictive of infection in multivariate analysis (odds ratio ({OR}) = 1.89, 95 \% confidence interval ({CI}) 1.18–3.03, p = 0.008). The predictive value of leptin was slightly lower for surgical site infection ({OR} = 1.65, 95 \% {CI} 1.06–2.55, p = 0.025). Leptin levels were independent of the other adipocytokine levels but not of the body mass index. Conclusion Although markers of inflammation and insulin resistance are also related to the onset of surgical infection, leptin correlates more closely with the risk of infection than does any other factor. However, its effect could be partially mediated by the body mass index.},
	pages = {23--29},
	number = {1},
	journaltitle = {International Journal of Colorectal Disease},
	shortjournal = {Int J Colorectal Dis},
	author = {Ortega-Deballon, Pablo and Duvillard, Laurence and Scherrer, Marie-Lorraine and Deguelte-Lardière, Sophie and Bourredjem, Abderrahmanne and Petit, Jean-Michel and Bonithon-Kopp, Claire and Group, for the {AGARIC} Study},
	urldate = {2015-08-20},
	date = {2013-10-17},
	langid = {english},
	keywords = {Adipocytokines, Adiponectin, Anastomotic leak, Gastroenterology, Hepatology, Inflammatory markers, Internal Medicine, Intra-abdominal infection, Leptin, postoperative complications, Proctology, Resistin, surgery, Surgical site infection, Wound infection},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8NXIW8VA\\Ortega-Deballon et al. - 2013 - Preoperative adipocytokines as a predictor of surg.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D4HXUNNT\\10.html:text/html}
}

@article{sattar_acute-phase_1997,
	title = {Acute-phase reactants and plasma trace element concentrations in non-small cell lung cancer patients and controls.},
	volume = {28},
	doi = {10.1080/01635589709514592},
	abstract = {This study examined the effect of an acute-phase response on plasma trace element concentrations of non-small cell lung cancer ({NSCLC}) patients. In normal subjects (n = 13) and {NSCLC} patients (n = 22), fasting concentrations of albumin,},
	pages = {308--312},
	number = {3},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {Sattar, N. and Scott, H. R. and {McMillan}, D. C. and Talwar, D. and O'Reilly, D. S. and Fell, G. S.},
	date = {1997},
	pmid = {9343841},
	keywords = {Acute-Phase Proteins/*analysis, Aged, Carcinoma, Non-Small-Cell Lung/*blood, Ceruloplasmin/analysis, Copper/blood, C-Reactive Protein/analysis, Female, Glutathione Peroxidase/blood, Humans, Iron/blood, Lung Neoplasms/*blood, Male, Middle Aged, Selenium/blood, Serum Albumin/analysis, Trace Elements/*blood, Transferrin/analysis, Zinc/blood}
}

@article{van_wyk_detection_2014,
	title = {The detection and role of lymphatic and blood vessel invasion in predicting survival in patients with node negative operable primary colorectal cancer.},
	volume = {90},
	rights = {Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.},
	doi = {10.1016/j.critrevonc.2013.11.004},
	abstract = {Although vascular invasion in colorectal cancer has been recognised since 1938, detection methods and results remain inconsistent. Vascular invasion is currently an independent prognostic factor in colorectal cancer influencing disease progression and survival. The vascular system consists of three components, arterial, venous and lymphatic vessels, all of which can be invaded but accurate  distinction between the components remains difficult with routine staining techniques. Even though higher detection rates with elastica staining, for large  vessel invasion, and recent techniques for immunohistochemistry for small vessel  invasion, have been reported, a standardised method of detection has not been agreed upon which is reflected in the variability of published results. As a result of the Bowel Cancer Screening Programme in the {UK} it will be necessary to  attempt to identify and stratify patients better, to be able to handle the stage  migration to early node negative colorectal cancer. At present up to a third of patients, with node-negative colorectal cancer on conventional histopathological  analysis, ultimately die of recurrent disease. It is therefore important to develop and standardised methods to identify lymphatic and blood vessel invasion  which will influence ultimate survival. The present review summarises the current status of detection methods for these components of vascular invasion.},
	number = {1},
	journaltitle = {Critical reviews in oncology/hematology},
	shortjournal = {Crit Rev Oncol Hematol},
	author = {van Wyk, Hester C. and Roxburgh, Campbell S. and Horgan, Paul G. and Foulis, Alan F. and {McMillan}, Donald C.},
	date = {2014-04},
	pmid = {24332522},
	keywords = {Colorectal Neoplasms/blood supply/*mortality/pathology/surgery, Humans, Lymphatic Metastasis, Lymph Nodes/*pathology, Neoplasm Invasiveness, Neoplastic Cells, Circulating/*pathology, Prognosis, Survival Rate}
}

@article{grose_comorbidities_2014,
	title = {Comorbidities in lung cancer: prevalence, severity and links with socioeconomic status and treatment.},
	volume = {90},
	rights = {Published by the {BMJ} Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
	doi = {10.1136/postgradmedj-2013-132186},
	abstract = {{BACKGROUND}: Survival from lung cancer remains poor in Scotland, {UK}. Although the  presence of comorbidities is known to influence outcomes, detailed quantification of comorbidities is not available in routinely collected audit or cancer registry data. The aim of the present study was to assess the prevalence and severity of comorbidities in patients with newly diagnosed lung cancer across four centres throughout Scotland using validated criteria. {METHODS}: Between 2005 and 2008, all patients with newly diagnosed lung cancer coming through the multidisciplinary teams in four Scottish centres were included in the study. Patient demographics,  {WHO}/Eastern Cooperative Oncology Group performance status, clinicopathological features and primary treatment modality were recorded. {RESULTS}: Details of 882 patients were collected prospectively. The majority of patients (87.3\%) had at least one comorbidity, the most common being weight loss (53\%), chronic obstructive pulmonary disease (43\%), renal impairment (28\%) and ischaemic heart disease (27\%). A composite score was produced that included both number and severity of comorbidities. One in seven patients (15.3\%) had severe comorbidity scores. There were statistically significant variations in comorbidity scores between treatment centres and between non-small cell lung carcinoma treatment groups. Disease stage was not associated with comorbidity score. {CONCLUSIONS}: There is a high prevalence of multiple, severe comorbidities in Scottish patients with lung cancer, and these vary by site and treatment group. Further research is needed to determine the relationship between comorbidity scores and survival in these patients.},
	pages = {305--310},
	number = {1064},
	journaltitle = {Postgraduate medical journal},
	shortjournal = {Postgrad Med J},
	author = {Grose, Derek and Morrison, David S. and Devereux, Graham and Jones, Richard and Sharma, Dave and Selby, Colin and Docherty, Kirsty and {McIntosh}, David and Louden, Greig and Nicolson, Marianne and {McMillan}, Donald C. and Milroy, Robert},
	date = {2014-06},
	pmid = {24676985},
	keywords = {*Weight Loss, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung/*epidemiology/physiopathology, Comorbidity, Female, Humans, Lung Neoplasms/*epidemiology/physiopathology, Male, Middle Aged, Myocardial Ischemia/*epidemiology, Needs Assessment, Prevalence, Prognosis, Prospective Studies, Pulmonary Disease, Chronic Obstructive/*epidemiology, Renal Insufficiency, Chronic/*epidemiology, Scotland/epidemiology, Severity of Illness Index, Social Class, Survival Analysis}
}

@article{elahi_score_2004,
	title = {Score based on hypoalbuminemia and elevated C-reactive protein predicts survival  in patients with advanced gastrointestinal cancer.},
	volume = {48},
	doi = {10.1207/s15327914nc4802_6},
	abstract = {The presence of a systemic inflammatory response (as evidenced by elevated},
	pages = {171--173},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {Elahi, Maqsood M. and {McMillan}, Donald C. and {McArdle}, Colin S. and Angerson, Wilson J. and Sattar, Naveed},
	date = {2004},
	pmid = {15231451},
	keywords = {Aged, Analysis of Variance, Colorectal Neoplasms/blood/*mortality, C-Reactive Protein/*analysis, Female, Humans, Hypoalbuminemia/mortality, Male, Predictive Value of Tests, Prognosis, Serum Albumin/*analysis, Severity of Illness Index, Stomach Neoplasms/blood/*mortality, Survival Analysis, Time Factors}
}

@article{parker_serum_2014,
	title = {Serum bilirubin and cardiopulmonary exercise parameters in patients presenting for elective pancreato-duodenectomy},
	volume = {113},
	issn = {0007-0912},
	pages = {331--332},
	number = {2},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Parker, M. and Bryan, A. and Siriwardena, A.},
	date = {2014-08},
	note = {{WOS}:000340017500062}
}

@article{wullstein_high_2004,
	title = {High levels of C-reactive protein after simultaneous pancreas-kidney transplantation predict pancreas graft-related complications and graft survival:},
	volume = {77},
	issn = {0041-1337},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00007890-200401150-00011},
	doi = {10.1097/01.TP.0000100683.92689.27},
	shorttitle = {High levels of C-reactive protein after simultaneous pancreas-kidney transplantation predict pancreas graft-related complications and graft survival},
	pages = {60--64},
	number = {1},
	journaltitle = {Transplantation},
	author = {Wullstein, C. and Drognitz, O. and Woeste, G. and Schareck, W. D. and Bechstein, W. O. and Hopt, U. T. and Benz, S.},
	urldate = {2015-07-14},
	date = {2004-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H26GFKNB\\C et al. - 2004 - High levels of c-reactive protein after simultaneo.pdf:application/pdf}
}

@article{ridgway_cardiopulmonary_2010,
	title = {Cardiopulmonary exercise testing: a review of methods and applications in surgical patients},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20689441},
	abstract = {Cardiopulmonary exercise ({CPX}) testing has a number of medical applications, including the assessment of heart failure and the investigation of unexplained breathlessness. Over the past decade, it has become an important preoperative assessment tool to evaluate functional capacity and predict outcomes in patients undergoing both cardiac and noncardiac surgery. A {CPX} test is an incremental exercise test during which respiratory variables, including oxygen uptake and carbon dioxide excretion are measured and the {ECG} is monitored. Among the variables reported from a {CPX} test are oxygen uptake at anaerobic threshold and peak oxygen uptake. A limited functional capacity as indicated by a low anaerobic threshold or {VO}(2peak) has been shown to be associated with an increased incidence of perioperative complications in a number of surgical settings. Other reported variables, including the ventilatory equivalents for oxygen ({VE}/{VO}(2)) and carbon dioxide ({VE}/{VCO}(2)) and the millilitre of oxygen delivered per heartbeat or oxygen pulse [{VO}(2)/heart rate ({HR})] may give indications as to the reasons for exercise limitation. {ECG} evidence of myocardial ischaemia with increasing workload is also an important indicator of increased perioperative risk. As a noninvasive, low-risk, test of the integrated responses to increasing cardiovascular stress, anaesthesiologists involved in preoperative assessment should have an understanding of its current uses and test outcomes. This review presents the physiological basis for {CPX} testing, methodology, advantages over other preoperative tests of cardiovascular function and guidance on the interpretation of {CPX} results in the perioperative setting.},
	pages = {858--65},
	number = {10},
	journaltitle = {Eur J Anaesthesiol},
	author = {Ridgway, Zoe A and Howell, Simon J},
	date = {2010-10}
}

@article{jiang_effect_2014,
	title = {Effect of complication grade on survival following curative gastrectomy for carcinoma},
	volume = {20},
	issn = {2219-2840},
	doi = {10.3748/wjg.v20.i25.8244},
	abstract = {{AIM}: To elucidate the potential impact of the grade of complications on long-term survival of gastric cancer patients after curative surgery.
{METHODS}: A total of 751 gastric cancer patients who underwent curative gastrectomy between January 2002 and December 2006 in our center were enrolled in this study. Patients were divided into four groups: no complications, Grade I, Grade {II} and Grade {III} complications, according to the following classification systems: T92 (Toronto 1992 or Clavien), Accordion Classification, and Revised Accordion Classification. Clinicopathological features were compared among the four groups and potential prognostic factors were analyzed. The Log-rank test was used to assess statistical differences between the groups. Independent prognostic factors were identified using the Cox proportional hazards regression model. Stratified analysis was used to investigate the impact of complications of each grade on survival.
{RESULTS}: Significant differences were found among the four groups in age, sex, other diseases (including hypertension, diabetes and chronic obstructive pulmonary disease), body mass index ({BMI}), intraoperative blood loss, tumor location, extranodal metastasis, lymph node metastasis, tumor-node-metastasis ({TNM}) stage, and chemotherapy. Overall survival ({OS}) was significantly influenced by the complication grade. The 5-year {OS} rates were 43.0\%, 42.5\%, 25.5\% and 9.6\% for no complications, and Grade I, Grade {II} and Grade {III} complications, respectively (P {\textless} 0.001). Age, tumor size, intraoperative blood loss, lymph node metastasis, {TNM} stage and complication grade were independent prognostic factors in multivariate analysis. With stratified analysis, lymph node metastasis, tumor size, and intraoperative blood loss were independent prognostic factors for Grade I complications (P {\textless} 0.001, P = 0.031, P = 0.030). Age and lymph node metastasis were found to be independent prognostic factors for {OS} of gastric cancer patients with Grade {II} complications (P = 0.034, P = 0.001). Intraoperative blood loss, {TNM} stage, and chemotherapy were independent prognostic factors for {OS} of gastric cancer patients with Grade {III} complications (P = 0.003, P = 0.005, P {\textless} 0.001). There were significant differences among patients with Grade I, Grade {II} and Grade {III} complications in {TNM} stage {II} and {III} cancer (P {\textless} 0.001, P = 0.001).
{CONCLUSION}: Complication grade may be an independent prognostic factor for gastric cancer following curative resection. Treatment of complications can improve the long-term outcome of gastric cancer patients.},
	pages = {8244--8252},
	number = {25},
	journaltitle = {World journal of gastroenterology: {WJG}},
	shortjournal = {World J. Gastroenterol.},
	author = {Jiang, Nan and Deng, Jing-Yu and Ding, Xue-Wei and Zhang, Li and Liu, Hong-Gen and Liang, Yue-Xiang and Liang, Han},
	date = {2014-07-07},
	pmid = {25009399},
	pmcid = {PMC4081699},
	keywords = {Adenocarcinoma, Aged, Chi-Square Distribution, Female, Gastrectomy, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, postoperative complications, Proportional Hazards Models, Prospective Studies, Risk Factors, Severity of Illness Index, Stomach Neoplasms, Time Factors, Treatment Outcome},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BB9SJHRW\\Jiang et al. - 2014 - Effect of complication grade on survival following.pdf:application/pdf;PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WPM45WS9\\Jiang et al. - 2014 - Effect of complication grade on survival following.pdf:application/pdf}
}

@article{goodyear_risk_2013,
	title = {Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery: a cohort study},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964330/},
	doi = {10.1186/2047-0525-2-10},
	shorttitle = {Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery},
	abstract = {Background
In 2009, the {NHS} evidence adoption center and National Institute for Health and Care Excellence ({NICE}) published a review of the use of endovascular aneurysm repair ({EVAR}) of abdominal aortic aneurysms ({AAAs}). They recommended the development of a risk-assessment tool to help identify {AAA} patients with greater or lesser risk of operative mortality and to contribute to mortality prediction., A low anaerobic threshold ({AT}), which is a reliable, objective measure of pre-operative cardiorespiratory fitness, as determined by pre-operative cardiopulmonary exercise testing ({CPET}) is associated with poor surgical outcomes for major abdominal surgery. We aimed to assess the impact of a {CPET}-based risk-stratification strategy upon perioperative mortality, length of stay and non-operative costs for elective (open and endovascular) infra-renal {AAA} patients.

Methods
A retrospective cohort study was undertaken. Pre-operative {CPET}-based selection for elective surgical intervention was introduced in 2007. An anonymized cohort of 230 consecutive infra-renal {AAA} patients (2007 to 2011) was studied. A historical control group of 128 consecutive infra-renal {AAA} patients (2003 to 2007) was identified for comparison., Comparative analysis of demographic and outcome data for {CPET}-pass ({AT} ≥ 11 ml/kg/min), {CPET}-fail ({AT} {\textless} 11 ml/kg/min) and {CPET}-submaximal (no {AT} generated) subgroups with control subjects was performed. Primary outcomes included 30-day mortality, survival and length of stay ({LOS}); secondary outcomes were non-operative inpatient costs.

Results
Of 230 subjects, 188 underwent {CPET}: {CPET}-pass n = 131, {CPET}-fail n = 35 and {CPET}-submaximal n = 22. When compared to the controls, {CPET}-pass patients exhibited reduced median total {LOS} (10 vs 13 days for open surgery, n = 74, P {\textless} 0.01 and 4 vs 6 days for {EVAR}, n = 29, P {\textless} 0.05), intensive therapy unit requirement (3 vs 4 days for open repair only, P {\textless} 0.001), non-operative costs (£5,387 vs £9,634 for open repair, P {\textless} 0.001) and perioperative mortality (2.7\% vs 12.6\% (odds ratio: 0.19) for open repair only, P {\textless} 0.05). {CPET}-stratified (open/endovascular) patients exhibited a mid-term survival benefit (P {\textless} 0.05).

Conclusion
In this retrospective cohort study, a pre-operative {AT} {\textgreater} 11 ml/kg/min was associated with reduced perioperative mortality (open cases only), {LOS}, survival and inpatient costs (open and endovascular repair) for elective infra-renal {AAA} surgery.},
	pages = {10},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Goodyear, Stephen J and Yow, Heng and Saedon, Mahmud and Shakespeare, Joanna and Hill, Christopher E and Watson, Duncan and Marshall, Colette and Mahmood, Asif and Higman, Daniel and Imray, Christopher {HE}},
	urldate = {2015-05-05},
	date = {2013-05-19},
	pmid = {24472159},
	pmcid = {PMC3964330},
	file = {Goodyear et al. - 2013 - Risk stratification by pre-operative cardiopulmona.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9G3XE8XM\\Goodyear et al. - 2013 - Risk stratification by pre-operative cardiopulmona.pdf:application/pdf}
}

@article{mcmillan_interleukin-6_1994,
	title = {Interleukin-6, neutrophilia and the acute phase protein response in colorectal cancer patients.},
	volume = {20},
	abstract = {White blood cell counts and circulating interleukin-6 concentrations were measured in male colorectal cancer patients with (n = 12) and without (n = 15) evidence of an acute phase protein response. In the group with an acute phase protein response circulating neutrophils were increased whereas serum interleukin-6 concentrations were not. These results suggest that in colorectal cancer patients although an acute phase protein response is associated with neutrophilia, both events can occur independent of circulating interleukin-6 concentrations.},
	pages = {151--154},
	number = {2},
	journaltitle = {European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology},
	shortjournal = {Eur J Surg Oncol},
	author = {{McMillan}, D. C. and Graham, A. F. and Smith, J. and Wotherspoon, H. A. and Fearon, K. C. and {McArdle}, C. S.},
	date = {1994-04},
	pmid = {8181581},
	keywords = {*Neutrophils, Aged, Colorectal Neoplasms/*immunology, C-Reactive Protein/*immunology, Humans, Interleukin-6/*blood, Leukocyte Count, Male, Middle Aged}
}

@article{dutta_possum_2010,
	title = {{POSSUM} and its related models as predictors of postoperative mortality and morbidity in patients undergoing surgery for gastro-oesophageal cancer: a systematic review.},
	volume = {34},
	doi = {10.1007/s00268-010-0685-z},
	abstract = {{BACKGROUND}: Gastro-oesophageal surgery is associated with appreciable postoperative morbidity and mortality. {POSSUM} (Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity) and its related models P-{POSSUM} and O-{POSSUM} have been developed to predict such events in general surgery. The aim was to undertake the first systematic review of the use  of these models in gastro-oesophageal surgery patients. {METHODS}: An online database search was carried out from 1991 to December 2008. {RESULTS}: Twenty-two published studies in gastro-oesophageal cancer surgery were identified. Twelve studies were found not to address the above aim, leaving ten relevant publications for analysis. Pooled data from these studies showed the weighted observed-to-expected ratio (O/E) for postoperative mortality using {POSSUM} (n = 1189), P-{POSSUM} (n = 2314), and O-{POSSUM} (n = 1755) was 0.37, 0.83, and 0.51, respectively. The weighted O/E for morbidity using {POSSUM} (n = 1038) was 0.86. {CONCLUSION}: {POSSUM} and O-{POSSUM} most significantly overestimated postoperative mortality in gastro-oesophageal cancer patients. In contrast, P-{POSSUM} had the least overestimation and may be the most useful predictor of likely postoperative mortality in these patients.},
	pages = {2076--2082},
	number = {9},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Dutta, Sumanta and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2010-09},
	pmid = {20556607},
	keywords = {*Severity of Illness Index, Aged, Area Under Curve, Digestive System Surgical Procedures/*mortality, Esophageal Neoplasms/mortality/*surgery, Humans, Male, Middle Aged, Stomach Neoplasms/mortality/*surgery}
}

@article{mullen_pancreaticoduodenectomy_2005,
	title = {Pancreaticoduodenectomy after placement of endobiliary metal stents},
	volume = {9},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16269380},
	abstract = {Contemporary treatment programs for patients with potentially resectable pancreatic cancer often involve preoperative therapy. When the duration of preoperative therapy exceeds 2 months, the risk of plastic endobiliary stent occlusion increases. Metal stents have much better patency but may complicate subsequent pancreaticoduodenectomy ({PD}). We evaluated rates of perioperative morbidity, mortality, and stent complications in 272 consecutive patients who underwent {PD} at our institution from May 2001 to November 2004. Of these 272 patients, 29 (11\%) underwent {PD} after placement of a metal stent, 141 underwent {PD} after placement of a plastic stent, 10 had {PD} after biliary bypass without stenting, and 92 had {PD} without any form of biliary decompression. No differences were found between the Metal Stent group and all other patients in median operative time, intraoperative blood loss, or length of hospital stay. No perioperative deaths occurred in the Metal Stent group versus 3 (1.2\%) deaths in the other 243 patients. The incidence of major perioperative complications was similar between the two groups, including the rates of pancreatic fistula, intra-abdominal abscess, and wound infection. Furthermore, there were no differences in the perioperative morbidity or mortality rates between patients who underwent preoperative biliary decompression with a stent of any kind (metal or plastic) and those patients who underwent no biliary decompression at all. Metal stent-related complications occurred in 2 (7\%) of 29 patients during a median preoperative interval of 4.1 months; in contrast, 75 (45\%) of the 166 patients who had had plastic stents experienced complications, including 98 stent occlusions, during a median preoperative interval of 3.9 months (P {\textless} 0.001). We conclude that the use of expandable metal stents does not increase {PD}-associated perioperative morbidity or mortality, and as such an expandable metal stent is our preferred method of biliary decompression in patients with symptomatic malignant distal bile duct obstruction in whom surgery is not anticipated, or in whom there is a significant delay in the time to surgery.},
	pages = {1094--104; discussion 1104--5},
	number = {8},
	journaltitle = {J Gastrointest Surg},
	author = {Mullen, John T and Lee, Jeffrey H and Gomez, Henry F and Ross, William A and Fukami, Norio and Wolff, Robert A and Abdalla, Eddie K and Vauthey, Jean-Nicolas and Lee, Jeffrey E and Pisters, Peter W T and Evans, Douglas B},
	date = {2005-11}
}

@article{haarbo_validation_1991,
	title = {Validation of body composition by dual energy X-ray absorptiometry ({DEXA})},
	volume = {11},
	issn = {1365-2281},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1475-097X.1991.tb00662.x/abstract},
	doi = {10.1111/j.1475-097X.1991.tb00662.x},
	abstract = {Summary.  The present study validates the use of dual energy X-ray absorptiometry ({DEXA}) for measurement of body composition. The precision error was expressed as the {SD} ({CV}\%) for fat mass, {FAT}\%, lean tissue mass, and total body bone mineral: 1·1 kg (6·4\%), 1·6\% (5·7\%), 1·4 kg (3·1\%), and 0·03 kg (1·2\%), respectively. The accuracy study in vitro used (1) mixtures of water and alcohol, (2) mixtures of ox muscle and lard, and (3) dried bones. In the clinically relevant range of values there were only small influences on {DEXA} measurements of variations in amount and composition of the soft tissue equivalents. The accuracy study in vivo compared the components of body composition measured recently by {DEXA} and earlier by dual photon absorptiometry, counting of naturally occurring total body 40K, and body density by underwater weighing in 25 healthy adult subjects. We found agreement between fat percentage (and lean body mass) by {DEXA} and the three established measurements modalities; mean differences were (-5·3 to -0·4\%) and (-0·7 to 2·5 kg) for fat percentage and lean body mass, respectively. We conclude that {DEXA} provides a new method of measuring body composition with precision and accuracy errors, which are compatible with the application of {DEXA} in group research studies and probably also in clinical measurements of the single subject.},
	pages = {331--341},
	number = {4},
	journaltitle = {Clinical Physiology},
	author = {Haarbo, J. and Gotfredsen, A. and Hassager, C. and Christiansen, C.},
	urldate = {2015-08-08},
	date = {1991-07-01},
	langid = {english},
	keywords = {body density, bone, dual photon absorptiometry, fat, lean body mass, total body potassium, X-rays},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\43AI9V5C\\abstract.html:text/html}
}

@article{hulens_exercise_2001,
	title = {Exercise capacity in lean versus obese women},
	volume = {11},
	issn = {0905-7188},
	abstract = {The aim of this study was to assess the nature and magnitude of the differences in submaximal and maximal exercise capacity parameters between lean and obese women. A total of 225 healthy obese women 18-65 years ({BMI}{\textgreater} or=30 kg/m(2)) and 81 non-athletic lean women ({BMI}{\textless} or=26 kg/m(2)) were selected. Anthropometric measurements (weight and height), body composition assessment (bioelectrical impedance method) and a maximal exercise capacity test on a bicycle ergometer were performed. Oxygen uptake ({VO}(2)), carbon dioxide production ({VCO}(2)), expired ventilation ({VE}), respiratory quotient ({RQ}), breathing efficiency ({VE}/{VO}(2)), mechanical efficiency ({ME}) and anaerobic threshold ({AT}) were calculated. At a submaximal intensity load of 70 W, {VO}(2) (l/min) was larger in the obese women and was already 78\% of their peak {VO}(2), whereas in the non-obese it was only 69\% (P=0.0001). {VE} (l/min) was larger, {VE}/{VO}(2) did not differ and {ME} was lower in obese compared to the lean women. {AT} occurred at the same percentage of peak {VO}(2) in both lean and obese women. At peak effort, achieved load, terminal {VO}(2) (l min(-1) kg(-1)), {VE}, heart rate, {RQ} respiratory exchange ratio and perceived exertion were lower in obese subjects compared to the non-obese. Obese subjects mentioned significantly more musculoskeletal pain as a reason to end the test, whereas in lean subjects it was leg fatigue. Lean women recovered better as after 2 min they were already at 35\% of the peak {VO}(2), whereas in the obese women it was 47\% (P=0.0001). Our results confirm that exercise capacity is decreased in obesity, both at submaximal and peak intensity, and during recovery. Moreover, at peak effort musculoskeletal pain was an important reason to end the test and not true leg fatigue. These findings are important when designing exercise programs for obese subjects.},
	pages = {305--309},
	number = {5},
	journaltitle = {Scandinavian journal of medicine \& science in sports},
	shortjournal = {Scand J Med Sci Sports},
	author = {Hulens, M and Vansant, G and Lysens, R and Claessens, A L and Muls, E},
	date = {2001-10},
	pmid = {11696216},
	keywords = {Adult, Body Composition, Body Mass Index, Body Weight, Case-Control Studies, Exercise, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Regression Analysis, Respiration, Thinness}
}

@article{mcilroy_evaluation_1996,
	title = {An evaluation of the {POSSUM} surgical scoring system},
	volume = {83},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8944488},
	pages = {1483--4},
	number = {10},
	journaltitle = {Br J Surg},
	author = {{McIlroy}, B S and Copeland, G P},
	date = {1996-10}
}

@article{shirahatti_palliative_1997,
	title = {Palliative surgery in malignant obstructive jaundice: prognostic indicators of early mortality},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9276557},
	abstract = {A prospective analysis of 50 patients undergoing palliative bypass surgery for incurable malignant obstructive jaundice was carried out in an attempt to identify factors predicting post-operative mortality. Five clinical and nine laboratory parameters were studied. Fourteen patients died within 30 days of surgery. It was seen that levels of haemoglobin, hematocrit and serum albumin levels were significantly lower while serum bilirubin was significantly higher in patients who died compared with the survivors. Patients having Hb {\textless} 10 Gm/{dL}, serum bilirubin {\textgreater} 350 micromol/{dL}, serum albumin {\textless} 2.5 g/{dL} and prothrombin index {\textless} 60\% exhibited a higher percentage of mortality. On multivariate analysis, levels of haemoglobin, serum albumin and serum bilirubin could be used to independently predict the outcome with an accuracy of 86\%. This was validated by prospectively applying the regression equation derived from the first 30 patients to the next 20 patients. It was seen that the predicted outcome correlated with the actual outcome with a correlation coefficient of 0.5098 (P = 0.01). It is concluded that in patients with high bilirubin, low haemoglobin and low albumin levels palliative surgical procedures carry a high risk of post-operative mortality and non-surgical methods may be more suitable.},
	pages = {238--43},
	number = {4},
	journaltitle = {J R Coll Surg Edinb},
	author = {Shirahatti, R G and Alphonso, N and Joshi, R M and Prasad, K V and Wagle, P K},
	date = {1997-08}
}

@article{turrini_pancreatectomy_2013,
	title = {Pancreatectomy for adenocarcinoma in elderly patients: Postoperative outcomes and long term results: A study of the French Surgical Association},
	volume = {39},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798312012164},
	doi = {10.1016/j.ejso.2012.08.017},
	shorttitle = {Pancreatectomy for adenocarcinoma in elderly patients},
	abstract = {Aim
To determine the benefit of surgery for resectable pancreatic adenocarcinomas ({PAs}) in elderly patients.
Methods
From 2004 to 2009, 932 patients with resectable {PAs} underwent pancreatectomies without neoadjuvant treatment in 37 institutions. The patients were divided into three groups according to age: \<70 years (control group; n = 580); 70–79 years (70s group, n = 288), and ≥80 years (80s group; n = 64). Preoperative, intraoperative, postoperative, and histological data were recorded to assess the postoperative course and survival.
Results
Preoperative or intraoperative characteristics, and the histological findings were comparable in the three groups. Postoperative mortality and morbidity rates did not differ in the three groups. Adjuvant therapies were more frequently used in younger patients than in elderly patients (p \< 0.01). The overall 1-year, 3-year, and 5-year survival rates of control group/70's group/80's group were 82.2\%/75.7\%/75.7\%, 49.9\%/41.8\%/31\%, and 38.7\%/33.2\%/0\%, respectively (p = 0.16). The median survival of the control, 70s, and 80s groups was 24 months, 35.3 months, and 30 months, respectively. Four independent prognostic indicators were identified by multivariate analysis: venous invasion (hazard ratio ({HR}) = 2.12), arterial invasion ({HR} = 2.96), positive lymph nodes ({HR} = 2.25), and adjuvant treatment ({HR} = 0.65).
Conclusions
Fit elderly patients with resectable {PAs} should not be excluded from surgical resection of {PA} solely because of their real age. Moreover, elderly patients seem to obtain similar advantages from pancreatectomies than younger patients.},
	pages = {171--178},
	number = {2},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {Turrini, O. and Paye, F. and Bachellier, P. and Sauvanet, A. and Sa Cunha, A. and Le Treut, Y. P. and Adham, M. and Mabrut, J. Y. and Chiche, L. and Delpero, J. R.},
	urldate = {2015-05-26},
	date = {2013-02},
	keywords = {Elderly, Pancreatectomy, Pancreatic adenocarcinoma},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4JXJEFZT\\Turrini et al. - 2013 - Pancreatectomy for adenocarcinoma in elderly patie.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\49BZ6DD8\\S0748798312012164.html:text/html}
}

@article{fearon_elevated_1991,
	title = {Elevated circulating interleukin-6 is associated with an acute-phase response but reduced fixed hepatic protein synthesis in patients with cancer.},
	volume = {213},
	abstract = {It has been suggested that, as part of the inflammatory response to the presence  of a tumor, various cytokines are produced and these induce hepatic synthesis of  acute-phase proteins ({APP}). Under these circumstances it is not known what changes occur in the fixed component of hepatic protein synthesis. The aim of this study was to compare circulating interleukin-1 ({IL}-1), interleukin-6 ({IL}-6), and tumor necrosis factor ({TNF}) concentrations and fixed hepatic protein synthesis rates in a group of healthy controls (n = 6) with a group of patients with an established {APP} response secondary to hepatic metastasis from colorectal  cancer (n = 6). Fixed hepatic protein synthesis rates were measured following a primed, constant 20-hour infusion of 15N-glycine. The liver was biopsied at laparotomy. The {APP} response was assessed by serum C-reactive protein concentration and cytokines were assayed by a combination of immunoassay and bioassay. The patients with advanced cancer and an on-going {APP} response had elevated circulating {IL}-6 concentrations (p less than 0.01). Rates of fixed hepatic protein synthesis were 30\% lower than those observed in controls (p less  than 0.01). These findings demonstrate that in patients with hepatic metastasis,  although the synthesis of certain acute-phase export proteins can be increased, fixed protein synthesis is reduced. Whether these changes in the distribution of  hepatic protein synthesis are mediated by {IL}-6 will require further investigation.},
	number = {1},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Fearon, K. C. and {McMillan}, D. C. and Preston, T. and Winstanley, F. P. and Cruickshank, A. M. and Shenkin, A.},
	date = {1991-01},
	pmid = {1898691},
	pmcid = {PMC1358306},
	keywords = {Acute-Phase Reaction/*blood/metabolism, Adenocarcinoma/*blood/metabolism/secondary, Adult, Aged, Colonic Neoplasms/blood, C-Reactive Protein/analysis, Cytokines/*blood/metabolism, Female, Humans, Interleukin-1/blood/metabolism, Interleukin-6/*blood, Liver/metabolism, Liver Neoplasms/*blood/metabolism/secondary, Male, Middle Aged, Tumor Necrosis Factor-alpha/analysis}
}

@article{yeo_pancreatic_2010,
	title = {Pancreatic surgery 101: drain, no drain, early drain removal, or late drain removal. What are the data? Where do we go from here?},
	volume = {252},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20622651},
	pages = {215--6},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Yeo, Charles J},
	date = {2010-08}
}

@article{mckernan_relationship_2008,
	title = {The relationship between quality of life ({EORTC} {QLQ}-C30) and survival in patients with gastro-oesophageal cancer.},
	volume = {98},
	doi = {10.1038/sj.bjc.6604248},
	abstract = {It remains unclear whether any aspect of quality of life has a role in predicting survival in an unselected cohort of patients with gastro-oesophageal cancer. Therefore the aim of the present study was to examine the relationship between quality of life ({EORTC} {QLQ}-C30), clinico-pathological characteristics and survival in patients with gastro-oesophageal cancer. Patients presenting with gastric or oesophageal cancer, staged using the {UICC} tumour node metastasis ({TNM}) classification and who received either potentially curative surgery or palliative treatment between November 1997 and December 2002 (n=152) participated in a quality of life study, using the {EORTC} {QLQ}-C30 core questionnaire. On univariate  analysis, age (P{\textless}0.01), tumour length (P{\textless}0.0001), {TNM} stage (P{\textless}0.0001), weight loss (P{\textless}0.0001), dysphagia score (P{\textless}0.001), performance status (P{\textless}0.1) and treatment (P{\textless}0.0001) were significantly associated with cancer-specific survival. {EORTC} {QLQ}-C30, physical functioning (P{\textless}0.0001), role functioning (P{\textless}0.001), cognitive functioning (P{\textless}0.01), social functioning (P{\textless}0.0001), global quality of  life (P{\textless}0.0001), fatigue (P{\textless}0.0001), nausea/vomiting (P{\textless}0.01), pain (P{\textless}0.001), dyspnoea (P{\textless}0.0001), appetite loss (P{\textless}0.0001) and constipation (P{\textless}0.05) were also significantly associated with cancer-specific survival. On multivariate survival  analysis, tumour stage (P{\textless}0.0001), treatment (P{\textless}0.001) and appetite loss (P{\textless}0.0001) were significant independent predictors of cancer-specific survival. The present study highlights the importance of quality of life ({EORTC} {QLQ}-C30) measures, in particular appetite loss, as a prognostic factor in these patients.},
	pages = {888--893},
	number = {5},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McKernan}, M. and {McMillan}, D. C. and Anderson, J. R. and Angerson, W. J. and Stuart, R. C.},
	date = {2008-03-11},
	pmid = {18268490},
	pmcid = {PMC2266859},
	keywords = {*Quality of Life, Adult, Aged, C-Reactive Protein/analysis, Esophageal Neoplasms/*mortality/pathology/*psychology, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Stomach Neoplasms/*mortality/pathology/*psychology}
}

@article{lanone_bilirubin_2005,
	title = {Bilirubin decreases nos2 expression via inhibition of {NAD}(P)H oxidase: implications for protection against endotoxic shock in rats},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16129699},
	abstract = {We investigated a possible beneficial role for bilirubin, one of the products of heme degradation by the cytoprotective enzyme heme oxygenase-1 in counteracting Escherichia coli endotoxin-mediated toxicity. Homozygous jaundice Gunn rats, which display high plasma bilirubin levels due to deficiency of glucuronyl transferase activity, and Sprague-Dawley rats subjected to sustained exogenous bilirubin administration were more resistant to endotoxin ({LPS})-induced hypotension and death compared with nonhyperbilirubinemic rats. {LPS}-stimulated production of nitric oxide ({NO}) was significantly decreased in hyperbilirubinemic rats compared with normal animals; this effect was associated with reduction of inducible {NO} synthase ({NOS}2) expression in renal, myocardial, and aortic tissues. Furthermore, {NOS}2 protein expression and activity were reduced in murine macrophages stimulated with {LPS} and preincubated with bilirubin at concentrations similar to that found in the serum of hyperbilirubinemic animals. This effect was secondary to inhibition of {NAD}(P)H oxidase since 1) inhibition of {NAD}(P)H oxidase attenuated {NOS}2 induction by {LPS}, 2) bilirubin decreased {NAD}(P)H oxidase activity in vivo and in vitro, and 3) down-regulation of {NOS}2 by bilirubin was reversed by addition of {NAD}(P)H. These findings indicate that bilirubin can act as an effective agent to reduce mortality and counteract hypotension elicited by endotoxin through mechanisms involving a decreased {NOS}2 induction secondary to inhibition of {NAD}(P)H oxidase.},
	pages = {1890--2},
	number = {13},
	journaltitle = {{FASEB} J},
	author = {Lanone, Sophie and Bloc, Sébastien and Foresti, Roberta and Almolki, Abdelhamid and Taillé, Camille and Callebert, Jacques and Conti, Marc and Goven, Delphine and Aubier, Michel and Dureuil, Bertrand and El-Benna, Jamel and Motterlini, Roberto and Boczkowski, Jorge},
	date = {2005-11}
}

@article{jones_comparison_1992,
	title = {Comparison of {POSSUM} with {APACHE} {II} for prediction of outcome from a surgical high-dependency unit},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1486421},
	abstract = {{POSSUM} and {APACHE} {II} scores from 117 consecutive admissions to a high-dependency unit after major surgery were correlated with 30-day morbidity and mortality rates. Thirteen patients (11 per cent) died and 59 (50 per cent) developed a postoperative complication. Receiver-operating characteristic curve analysis showed {POSSUM} to have good predictive value for mortality (area under curve 0.75) and morbidity (area under curve 0.82). {APACHE} {II} scores had a significantly inferior predictive value for mortality (area under curve 0.54) (P {\textless} 0.002). {POSSUM} was superior to {APACHE} {II} in prediction of mortality in patients admitted to a high-dependency unit after general surgery. Prediction of postoperative complications by {POSSUM} is accurate and may be useful for audit.},
	pages = {1293--6},
	number = {12},
	journaltitle = {Br J Surg},
	author = {Jones, D R and Copeland, G P and de Cossart, L},
	date = {1992-12}
}

@article{modolell_vagaries_1999,
	title = {Vagaries of clinical presentation of pancreatic and biliary tract cancer},
	volume = {10},
	url = {http://annonc.oxfordjournals.org/content/10/suppl_4/S82.short},
	pages = {S82--S84},
	issue = {suppl 4},
	journaltitle = {Annals of oncology},
	author = {Modolell, I. and Guarner, L. and Malagelada, J. R.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Modolell et al. - 1999 - Vagaries of clinical presentation of pancreatic an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\33FHBWHJ\\Modolell et al. - 1999 - Vagaries of clinical presentation of pancreatic an.pdf:application/pdf}
}

@article{oliphant_deprivation_2013,
	title = {Deprivation and colorectal cancer surgery: longer-term survival inequalities are  due to differential postoperative mortality between socioeconomic groups.},
	volume = {20},
	doi = {10.1245/s10434-013-2959-9},
	abstract = {{BACKGROUND}: Deprivation is associated with poorer survival after surgery for colorectal cancer, but determinants of this socioeconomic inequality are poorly understood. {METHODS}: A total of 4,296 patients undergoing surgery for colorectal  cancer in 16 hospitals in the West of Scotland between 2001 and 2004 were identified from a prospectively maintained regional audit database. Postoperative mortality ({\textless}30 days) and 5-year relative survival by socioeconomic circumstances, measured by the area-based Scottish Index of Multiple Deprivation 2006, were examined. {RESULTS}: There was no difference in age, gender, or tumor characteristics between socioeconomic groups. Compared with the most affluent group, patients from the most deprived group were more likely to present as an emergency (23.5 vs 19.5 \%; p = .033), undergo palliative surgery (20.0 vs 14.5 \%; p {\textless} .001), have higher levels of comorbidity (p = .03), have {\textless}12 lymph nodes examined (56.7 vs 53.1 \%; p = .016) but were more likely to receive surgery under the care of a specialist surgeon (76.3 vs 72.0 \%; p = .001). In multivariate analysis, deprivation was independently associated with increased postoperative mortality [adjusted odds ratio 2.26 (95 \% {CI}, 1.45-3.53; p {\textless} .001)], and poorer},
	pages = {2132--2139},
	number = {7},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Oliphant, Raymond and Nicholson, Gary A. and Horgan, Paul G. and Molloy, Richard G. and {McMillan}, Donald C. and Morrison, David S.},
	date = {2013-07},
	pmid = {23529783},
	keywords = {*Poverty, Adult, Aged, Aged, 80 and over, Age Factors, Colorectal Neoplasms/*mortality/pathology/*surgery, Comorbidity, Confidence Intervals, Emergencies, Female, Healthcare Disparities, Hospitalization/statistics \& numerical data, Humans, Lymph Nodes/pathology, Male, Middle Aged, Multivariate Analysis, Neoplasm Grading, Neoplasm Staging, Odds Ratio, Oncology, Palliative Care/statistics \& numerical data, Scotland/epidemiology, Socioeconomic Factors, surgery, Surgical Oncology, Survival Analysis, Time Factors, Young Adult},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\W2SCWR8N\\Oliphant et al. - 2013 - Deprivation and Colorectal Cancer Surgery Longer-.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VP8XHXZQ\\10.html:text/html}
}

@article{osman_incremental_2000,
	title = {The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure},
	volume = {36},
	url = {http://content.onlinejacc.org/article.aspx?articleid=1126843},
	pages = {2126--2131},
	number = {7},
	journaltitle = {Journal of the American College of Cardiology},
	author = {Osman, Ahmed F. and Mehra, Mandeep R. and Lavie, Carl J. and Nunez, Eduardo and Milani, Richard V.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Osman et al. - 2000 - The incremental prognostic importance of body fat .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WQK7FKC4\\Osman et al. - 2000 - The incremental prognostic importance of body fat .pdf:application/pdf}
}

@article{baron_endotherapy_2012,
	title = {Endotherapy for organized pancreatic necrosis: perspectives after 20 years},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22835575},
	abstract = {It has been nearly 20 years since the first peroral endoscopic necrosectomy was performed for patients with pancreatitis. We have since increased our understanding of pancreatitis, and the nomenclature has changed to define disease in which necrosis becomes organized (called "walled-off"). Endoscopic approaches to evaluate and treat pancreatitis have progressed from making small transmural tracts for irrigation to making large tracts, which allow the endoscope to move directly into necrotic cavities and perform endoscopic necrosectomy. The purpose of endoscopic debridement is to irrigate and/or remove areas of necrosis. Collaboration between therapeutic endoscopists and interventional radiologists has led to a combined approach to organized pancreatic necrosis. We discuss the history of peroral endoscopic treatment of organized (walled-off) pancreatic necrosis and current endoscopic approaches to therapy.},
	pages = {1202--7},
	number = {11},
	journaltitle = {Clin Gastroenterol Hepatol},
	author = {Baron, Todd H and Kozarek, Richard A},
	date = {2012-11}
}

@article{fleming_influence_2009,
	title = {Influence of obesity on cancer-related outcomes after pancreatectomy to treat pancreatic adenocarcinoma},
	volume = {144},
	issn = {1538-3644},
	doi = {10.1001/archsurg.2008.580},
	abstract = {{OBJECTIVE}: To examine the influence of obesity, as measured by body mass index ({BMI}) (calculated as weight in kilograms divided by height in meters squared), on clinicopathologic factors and survival after pancreatectomy to treat adenocarcinoma.
{DESIGN}: Retrospective review and statistical analysis using prospectively collected data.
{SETTING}: Referral center with a dedicated multidisciplinary pancreas cancer program.
{PATIENTS}: Two hundred eighty-five consecutive patients with data available for {BMI} calculation who underwent potentially curative pancreas resection to treat adenocarcinoma from January 1, 1999, to October 31, 2006.
{MAIN} {OUTCOME} {MEASURE}: Influence of {BMI} and other known prognostic variables on the incidence of lymph node metastasis and disease-free and overall survival.
{RESULTS}: We identified a subset of obese patients ({BMI} {\textgreater}35) who were at 12-fold risk of lymph node metastasis compared with nonobese patients ({BMI} {\textless} or =35). The estimated disease-free and overall survival rates were decreased in the obese patients, and the risk of cancer recurrence and death after pancreatectomy was nearly twice that in nonobese patients.
{CONCLUSIONS}: Obese patients with a {BMI} of more than 35 are more likely to have node-positive pancreatic cancer and decreased survival after surgical resection. Data suggest that the negative influence of {BMI} of more than 35 on cancer-related end points is unrelated to the potential complexity of performing major oncologic surgery in obese patients.},
	pages = {216--221},
	number = {3},
	journaltitle = {Archives of Surgery (Chicago, Ill.: 1960)},
	shortjournal = {Arch Surg},
	author = {Fleming, Jason B. and Gonzalez, Ricardo J. and Petzel, Maria Q. B. and Lin, E. and Morris, Jeffrey S. and Gomez, Henry and Lee, Jeffrey E. and Crane, Christopher H. and Pisters, Peter W. T. and Evans, Douglas B.},
	date = {2009-03},
	pmid = {19289659},
	keywords = {Adenocarcinoma, Aged, Body Mass Index, Female, Humans, Lymph Nodes, Male, Middle Aged, Neoplasm Staging, Obesity, Pancreatectomy, Pancreatic Neoplasms, prognosis, Survival Analysis, Treatment Outcome}
}

@article{mohri_correlation_2014,
	title = {Correlation between preoperative systemic inflammation and postoperative infection in patients with gastrointestinal cancer: a multicenter study},
	volume = {44},
	issn = {1436-2813},
	doi = {10.1007/s00595-013-0622-5},
	shorttitle = {Correlation between preoperative systemic inflammation and postoperative infection in patients with gastrointestinal cancer},
	abstract = {{PURPOSE}: Our aim was to examine the association between postoperative infection and preoperative systemic inflammation in patients undergoing resection of gastrointestinal cancer.
{METHODS}: We studied 862 patients who underwent elective gastrointestinal cancer surgery at six institutions. The levels of C-reactive protein and albumin were included as parameters of preoperative systemic inflammation measured using the Glasgow prognostic score. The Glasgow prognostic score was calculated based on the admission data as follows: patients with an elevated level of C-reactive protein ({\textgreater}1.0 mg/dl) and hypoalbuminemia ({\textless}3.5 g/dl) were allocated a score of 2, while patients showing one or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. The significance of the Glasgow prognostic score for predicting postoperative infection was analyzed using a multivariate analysis.
{RESULTS}: After surgery, 182 (21 \%) patients developed postoperative infections. According to a multivariate analysis, the Glasgow prognostic score (p {\textless} 0.01) was independently associated with an increased risk of developing a postoperative infection. When the postoperative infections were divided into surgical site infections and remote site infections, the Glasgow prognostic score was significantly associated with an increased risk of developing remote site infections.
{CONCLUSIONS}: Preoperative systemic inflammation is associated with postoperative infection in patients undergoing resection of gastrointestinal cancer.},
	pages = {859--867},
	number = {5},
	journaltitle = {Surgery Today},
	shortjournal = {Surg. Today},
	author = {Mohri, Yasuhiko and Miki, Chikao and Kobayashi, Minako and Okita, Yoshiki and Inoue, Mikihiro and Uchida, Keiichi and Tanaka, Koji and Inoue, Yasuhiro and Kusunoki, Masato},
	date = {2014-05},
	pmid = {23722282},
	keywords = {Aged, Biological Markers, C-Reactive Protein, Digestive System Surgical Procedures, Elective Surgical Procedures, Female, Gastrointestinal cancer, Gastrointestinal Neoplasms, Humans, Hypoalbuminemia, Infection, Inflammation, Male, Middle Aged, Multivariate Analysis, Postoperative complication, postoperative complications, Preoperative Period, prognosis, Retrospective Studies, Risk, surgery, Surgical Oncology, systemic inflammation},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7M82Z2BB\\Mohri et al. - 2013 - Correlation between preoperative systemic inflamma.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WTTC5TPU\\10.html:text/html}
}

@article{sattar_inhibitors_1998,
	title = {Inhibitors of angiotensin-I-converting enzyme and risk of cancer.},
	volume = {352},
	doi = {10.1016/S0140-6736(05)79800-7},
	number = {9134},
	journaltitle = {Lancet},
	shortjournal = {Lancet},
	author = {Sattar, N. and {McMillan}, D. C.},
	date = {1998-10-03},
	pmid = {9798623},
	keywords = {Angiotensin-Converting Enzyme Inhibitors/*therapeutic use, C-Reactive Protein/metabolism, Humans, Neoplasms/*prevention \& control, Risk Factors}
}

@article{ogorman_impact_1998,
	title = {Impact of weight loss, appetite, and the inflammatory response on quality of life in gastrointestinal cancer patients.},
	volume = {32},
	doi = {10.1080/01635589809514722},
	abstract = {The relationship between weight loss, appetite, the inflammatory response, and quality of life in patients with advanced gastrointestinal cancer was examined. Height, weight, and skinfold anthropometry were measured in 119 patients. Blood was taken for analysis of C-reactive protein and albumin. Appetite, performance status, and quality of life were assessed using {EuroQol} {EQ}-5D and {EORTC} {QLQ}-C30 questionnaires. Weight loss was {\textgreater} 5\% (median 17.1\%) of their preillness weight in 97 patients; the remaining 22 patients were weight stable. Anthropometric measurements and circulating albumin concentrations were significantly lower (p {\textless} 0.01) and circulating concentrations of C-reactive protein were significantly higher in the weight-losing than in the weight-stable group (p {\textless} 0.001). Appetite scores, performance status, and {EuroQol} {EQ}-5D and {EORTC} {QLQ}-C30 scores were also  lower in the weight-losing group (p {\textless} 0.01). When the weight-losing cancer patients were divided on the basis of whether they had a marked inflammatory response, albumin concentrations, appetite, and Karnofsky performance status were significantly lower (p {\textless} 0.05) in the group with a marked inflammatory response.  The results of the present study are consistent with weight loss, reduction of appetite, and an elevated inflammatory response being important related factors in lowering the quality of life of gastrointestinal cancer patients.},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {O'Gorman, P. and {McMillan}, D. C. and {McArdle}, C. S.},
	date = {1998},
	pmid = {9919615},
	keywords = {*Appetite, *Quality of Life, *Weight Loss, Aged, Aged, 80 and over, Body Height, C-Reactive Protein/analysis, Female, Gastrointestinal Neoplasms/*complications, Humans, Inflammation/*complications, Male, Middle Aged, Questionnaires, Serum Albumin/analysis, Skinfold Thickness}
}

@article{myers_randomized_2014,
	title = {A randomized trial of exercise training in abdominal aortic aneurysm disease},
	volume = {46},
	issn = {1530-0315},
	doi = {10.1249/MSS.0b013e3182a088b8},
	abstract = {{PURPOSE}: Screening programs and greater public awareness have increased the recognition of early abdominal aortic aneurysm ({AAA}) disease. No medical therapy has proven effective in limiting {AAA} progression, and little is known regarding the safety and efficacy of exercise training in these patients. We evaluated the safety and efficacy of up to 3 yr of training in patients with early (≤5.5 cm) {AAA} disease.
{METHODS}: One hundred and forty patients with small {AAAs} (72 ± 8 yr) were randomized to exercise training (n = 72) or usual care (n = 68). Exercise subjects participated in a combination of in-house and home training for up to 3 yr. Cardiopulmonary exercise testing ({CPX}) was performed at baseline and 3, 12, 24, and 36 months. Comparisons were made for {AAA} expansion, safety, {CPX} responses, and weekly energy expenditure.
{RESULTS}: The average duration of participation was 23.4 ± 9.6 months; 81\% of subjects completed ≥1 year. No adverse clinical events or excessive {AAA} growth rates related to training occurred. Exercise subjects expended a mean 1999 ± 1030 kcal·wk. Increases in peak exercise time and estimated {METs} occurred at the 3-month and 1-, 2-, and 3-yr evaluations (P {\textless} 0.01 between groups). A significant between-group interaction occurred for V˙O2 at the ventilatory threshold (P = 0.02), and submaximal heart rate was significantly reduced among exercise subjects. Neither exercise status nor level of fitness significantly influenced rate of {AAA} enlargement.
{CONCLUSIONS}: These results support the safety and efficacy of training in patients with small {AAA}, a population for which few previous data are available. Despite advanced age and comorbidities, training up to 3 yr was well tolerated and sustainable in {AAA} patients. Training did not influence rate of {AAA} enlargement.},
	pages = {2--9},
	number = {1},
	journaltitle = {Medicine and Science in Sports and Exercise},
	shortjournal = {Med Sci Sports Exerc},
	author = {Myers, Jonathan and {McElrath}, Mary and Jaffe, Alyssa and Smith, Kimberly and Fonda, Holly and Vu, Andrew and Hill, Bradley and Dalman, Ronald},
	date = {2014-01},
	pmid = {23793234},
	keywords = {Aged, Aortic Aneurysm, Abdominal, Energy Metabolism, Exercise Test, Exercise Therapy, Female, Heart Rate, Humans, Longitudinal Studies, Male, Middle Aged, Oxygen Consumption, Physical Endurance, physical exertion, Physical fitness}
}

@article{yang_clinical_2010,
	title = {A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice: Obstructive jaundice and sensitivity to isoflurane/remifentanil anesthesia},
	volume = {54},
	issn = {00015172, 13996576},
	url = {http://doi.wiley.com/10.1111/j.1399-6576.2010.02222.x},
	doi = {10.1111/j.1399-6576.2010.02222.x},
	shorttitle = {A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice},
	pages = {871--877},
	number = {7},
	journaltitle = {Acta Anaesthesiologica Scandinavica},
	author = {Yang, L.-Q. and Song, J.-C. and Irwin, M. G. and Song, J.-G. and Sun, Y.-M. and Yu, W.-F.},
	urldate = {2015-06-02},
	date = {2010-03-10},
	langid = {english},
	file = {j.1399-6576.2010.02222.x.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UIHVP4PX\\j.1399-6576.2010.02222.x.pdf:application/pdf}
}

@article{lemaitre_maximum_2006,
	title = {Maximum oxygen uptake corrected for skeletal muscle mass accurately predicts functional improvements following exercise training in chronic heart failure},
	volume = {8},
	issn = {13889842},
	url = {http://eurjhf.oxfordjournals.org/cgi/doi/10.1016/j.ejheart.2005.07.011},
	doi = {10.1016/j.ejheart.2005.07.011},
	pages = {243--248},
	number = {3},
	journaltitle = {European Journal of Heart Failure},
	author = {Lemaitre, J and Harris, S and Hannan, J and Fox, K and Denvir, M},
	urldate = {2014-01-27},
	date = {2006-05},
	file = {Lemaitre et al. - 2006 - Maximum oxygen uptake corrected for skeletal muscl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VA5XGEAH\\Lemaitre et al. - 2006 - Maximum oxygen uptake corrected for skeletal muscl.pdf:application/pdf}
}

@article{okusaka_abdominal_2001,
	title = {Abdominal pain in patients with resectable pancreatic cancer with reference to clinicopathologic findings},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11291930},
	abstract = {Abdominal and/or back pain is one of the most common symptoms in patients with pancreatic cancer. However, the cause of the pain and the clinicopathologic features of patients with pain have not been fully elucidated. We retrospectively determined the factors related to preoperative abdominal and/or back pain in 95 patients with resectable pancreatic cancer. Pancreatic tumor size, invasion of the intrapancreatic nerves, invasion of the anterior pancreatic capsule, and lymph node metastasis were determined to be variables related to the pain. Pancreatic tumor size, invasion of anterior pancreatic capsule, and lymph node metastasis were also variables significantly correlating to pain intensity. Survival also correlated with pain intensity: the median survival periods were 29 months in patients without pain, 19 months in those with mild pain, and 9 months in those with severe pain who required analgesics. Larger pancreatic tumors, invasion of the intrapancreatic nerves, and invasion of the anterior pancreatic capsule may cause abdominal and/or back pain in patients with resectable pancreatic cancer. This study also suggests clinical implications of the pain intensity as a prognostic factor in patients with resectable pancreatic cancer.},
	pages = {279--84},
	number = {3},
	journaltitle = {Pancreas},
	author = {Okusaka, T and Okada, S and Ueno, H and Ikeda, M and Shimada, K and Yamamoto, J and Kosuge, T and Yamasaki, S and Fukushima, N and Sakamoto, M},
	date = {2001-04},
	file = {Okusaka et al. - 2001 - Abdominal pain in patients with resectable pancrea.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QJ54DN38\\Okusaka et al. - 2001 - Abdominal pain in patients with resectable pancrea.pdf:application/pdf}
}

@article{younes_obstructive_2007,
	title = {Obstructive jaundice induces early depression of mitochondrial respiration in rat hepatocytes},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17625661},
	abstract = {{INTRODUCTION}: Oxidative phosphorylation dysfunction of hepatocyte mitochondria is involved in the pathophysiology of organ dysfunction following obstructive jaundice ({OJ}). However the time period from biliary occlusion to the occurrence of the dysfunction has not been determined decisively. {PURPOSE}: To evaluate the early effects (1 d and 7 d) of {OJ} on liver mitochondria respiratory function in rats. {METHODS}: Male Wistar rats (200-250 g) were randomly divided into the following 3 groups: laparotomy plus {OJ} for 24 h (1d group) (n = 10); laparotomy plus {OJ} for 7 d (7d group) (n = 10); sham control procedure ({CTR} group) (n = 12). At the end of {OJ} periods, total serum bilirubin level, hepatic enzyme activity levels ({GOT}, {GTP}, Gama-{GT}, {ALP}), mitochondrial respiration phases S3 and S4, as well as the respiratory control ratio ({RC} = S3/S4), and {ADP} consumption/oxygen consumption ({ADP}/O) ratio, were determined. {RESULTS}: Total serum bilirubin, activity of most hepatic enzymes, and O2 consumption during basal (S4) respiration were increased in the 1d and 7d groups ({ANOVA}, p = 0.05 vs. {CTR}). After {ADP} addition, the O2 consumption rate (S3) in the 1d group remained similar to the {CTR} rate ({ANOVA} p {\textgreater} .05), while the {RC} rate was reduced ({ANOVA}, p = 0.001) vs. {CTR}. The effects observed on mitochondrial respiration in the 1d group were exacerbated in the 7d group. {CONCLUSION}: These results indicate that {OJ} induces early (24 h) depression of liver mitochondria respiration, and thus may lead to early reduction in the production of high energy bonds.},
	pages = {251--4},
	number = {4},
	journaltitle = {Acta Cir Bras},
	author = {Younes, Riad Naim and Poggetti, Renato Sergio and Fontes, Belchor and Itinoshe, Mario Matsuo and Yoshida, Vanda Mitie and Carvalho, Maria Elisa A and Birolini, Dario},
	date = {2007-08},
	file = {Younes et al. - 2007 - A icterícia obstrutiva induz depressão precoce da .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4DTBA2ZT\\Younes et al. - 2007 - A icterícia obstrutiva induz depressão precoce da .pdf:application/pdf}
}

@article{robbins_sex-specific_2009,
	title = {A sex-specific relationship between capillary density and anaerobic threshold},
	volume = {106},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19164774},
	abstract = {Although both capillary density and peak oxygen consumption (Vo(2)) improve with exercise training, it is difficult to find a relationship between these two measures. It has been suggested that peak Vo(2) may be more related to central hemodynamics than to the oxidative potential of skeletal muscle, which may account for this observation. We hypothesized that change in a measure of submaximal performance, anaerobic threshold, might be related to change in skeletal muscle capillary density, a marker of oxidative potential in muscle, with training. Due to baseline differences among these variables, we also hypothesized that relationships might be sex specific. A group of 21 subjects completed an inactive control period, whereas 28 subjects (17 men and 11 women) participated in a 6-mo high-intensity exercise program. All subjects were sedentary, overweight, and dyslipidemic. Potential relationships were assessed between change in capillary density with both change in Vo(2) at peak and at anaerobic threshold with exercise training. All variables and relationships were assessed for sex-specific effects. Change in peak Vo(2) was not related to change in capillary density after exercise training in either sex. Men had a positive correlation between change in Vo(2) at anaerobic threshold and change in capillary density with exercise training (r = 0.635; P {\textless} 0.01), whereas women had an inverse relationship (r = -0.636; P {\textless} 0.05) between the change in these variables. These findings suggest that, although enhanced capillary density is associated with training-induced improvements in submaximal performance in men, this relationship is different in women.},
	pages = {1181--6},
	number = {4},
	journaltitle = {J Appl Physiol},
	author = {Robbins, Jennifer L and Duscha, Brian D and Bensimhon, Daniel R and Wasserman, Karlman and Hansen, James E and Houmard, Joseph A and Annex, Brian H and Kraus, William E},
	date = {2009-04},
	file = {Robbins et al. - 2009 - A sex-specific relationship between capillary dens.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SEAGZNR6\\Robbins et al. - 2009 - A sex-specific relationship between capillary dens.pdf:application/pdf}
}

@article{brito_unconjugated_2008,
	title = {Unconjugated bilirubin differentially affects the redox status of neuronal and astroglial cells},
	volume = {29},
	issn = {09699961},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S096999610700174X},
	doi = {10.1016/j.nbd.2007.07.023},
	pages = {30--40},
	number = {1},
	journaltitle = {Neurobiology of Disease},
	author = {Brito, Maria A. and Rosa, Alexandra I. and Falcão, Ana S. and Fernandes, Adelaide and Silva, Rui F.M. and Butterfield, D. Allan and Brites, Dora},
	urldate = {2014-01-27},
	date = {2008-01},
	file = {Brito et al. - 2008 - Unconjugated bilirubin differentially affects the .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\88W88Q3W\\Brito et al. - 2008 - Unconjugated bilirubin differentially affects the .pdf:application/pdf}
}

@article{pitt_does_1985,
	title = {Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?},
	volume = {201},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2986562},
	abstract = {Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage ({PTD}) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative {PTD} on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1\% among 37 patients undergoing preoperative {PTD}, compared to 5.3\% for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative {PTD}, (57\% versus 53\%). However, total hospital stay was significantly longer (p less than 0.005) in the {PTD} group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the {PTD} procedure at our university medical center was over +8000 per patient. The authors conclude that preoperative {PTD} does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.},
	pages = {545--53},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Pitt, H A and Gomes, A S and Lois, J F and Mann, L L and Deutsch, L S and Longmire, W P Jr},
	date = {1985-05},
	note = {Cochrane review paper}
}

@article{nini_[should_2003,
	title = {[Should preoperative biliary drainage be performed before pancreatoduodenectomy?]},
	volume = {128},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14706884},
	pages = {714--5},
	number = {10},
	journaltitle = {Ann Chir},
	author = {Nini, E and Slim, K and Belghiti, J},
	date = {2003-12}
}

@article{andersen_pancreaticoduodenectomy_1994,
	title = {Pancreaticoduodenectomy for periampullary adenocarcinoma},
	volume = {179},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7952456},
	abstract = {{BACKGROUND}: This study evaluates the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients for treatment of periampullary adenocarcinoma. {STUDY} {DESIGN}: Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumor. Postoperative follow-up of clinical symptoms was done after one year. {RESULTS}: The postoperative mortality rate after Whipple's operation was 8 percent (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15 percent (confidence limits, 5 to 25 percent). The five year survival rate for patients without tumor extension beyond the pancreas was 25 percent (confidence limits, 5 to 50 percent), and in patients with adenocarcinoma of the ampulla of Vater, 34 percent (confidence limits, 3 to 65 percent). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Most patients surviving more than one year were doing well, although 60 percent needed exocrine pancreatic substitution therapy. {CONCLUSIONS}: Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25 percent and a postoperative mortality rate of less than 5 percent.},
	pages = {545--52},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Andersen, H B and Baden, H and Brahe, N E and Burcharth, F},
	date = {1994-11}
}

@article{diakos_cancer-related_2014,
	title = {Cancer-related inflammation and treatment effectiveness.},
	volume = {15},
	rights = {Copyright (c) 2014 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/S1470-2045(14)70263-3},
	abstract = {Inflammation is a recognised hallmark of cancer that substantially contributes to the development and progression of malignancies. In established cancers, there is increasing evidence for the roles that local immune response and systemic inflammation have in progression of tumours and survival of patients with cancer. This knowledge provides an opportunity to target these inflammatory responses to  improve patient outcomes. In this Review, we examine the complex interplay between local immune responses and systemic inflammation, and their influence on  clinical outcomes, and propose potential anti-inflammatory interventions for patients with cancer.},
	number = {11},
	journaltitle = {The Lancet. Oncology},
	shortjournal = {Lancet Oncol},
	author = {Diakos, Connie I. and Charles, Kellie A. and {McMillan}, Donald C. and Clarke, Stephen J.},
	date = {2014-10},
	pmid = {25281468},
	keywords = {*Disease Progression, Antineoplastic Agents, Hormonal/therapeutic use, Female, Humans, Immunity, Innate, Inflammation/immunology/*pathology/*therapy, Male, Neoplasm Invasiveness/pathology, Neoplasms/immunology/*pathology/*therapy, Neoplasm Staging, Prostatectomy/methods, Radiotherapy, Conformal/methods, Risk Assessment, Survival Analysis, Treatment Outcome, Watchful Waiting/methods}
}

@article{shirakawa_pancreatic_2012,
	title = {Pancreatic Volumetric Assessment as a Predictor of New-Onset Diabetes Following Distal Pancreatectomy},
	volume = {16},
	issn = {1091-255X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508270/},
	doi = {10.1007/s11605-012-2039-7},
	abstract = {Introduction
Pancreatogenic diabetes after pancreatectomy is of growing importance due to the increasing life expectancy of pancreatectomized patients. Although reduction of pancreatic volume is thought to affect glucose metabolism, a consistent relationship has yet to be determined. This study aimed to investigate functional consequences of distal pancreatectomy ({DP}) in preoperatively non-diabetic patients.

Methods
This study included 61 non-diabetic patients who underwent {DP}. Clinical data were obtained, and the percent resected volume ({PRV}) of each pancreas was determined via multi-detector row computed tomography volumetry.

Results
During the follow-up period (median 26 months), 22 patients (36 \%) developed new-onset diabetes within a median onset time of 8 months (range 0.5–42 months) postoperatively. The remaining 39 patients also showed impaired glucose metabolism. Multivariate analysis identified preoperative hemoglobin A1c ≥ 5.7 \% (odds ratio 15.6, p = 0.001) and {PRV} {\textgreater} 44 \% (odds ratio 11.3, p = 0.004) as independent risk factors for new-onset diabetes.

Conclusions
Key determinants of postoperative glycemic control include preoperative functional reserve of the endocrine pancreas and the volume reduction of pancreatic parenchyma. Our findings enable reliable preoperative evaluation of the risk of postoperative diabetes and appropriate postoperative surveillance, which is helpful for early intervention in high risk patients.},
	pages = {2212--2219},
	number = {12},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Shirakawa, Sachiyo and Matsumoto, Ippei and Toyama, Hirochika and Shinzeki, Makoto and Ajiki, Tetsuo and Fukumoto, Takumi and Ku, Yonson},
	urldate = {2014-03-16},
	date = {2012-12},
	pmid = {23054900},
	pmcid = {PMC3508270},
	file = {Shirakawa et al. - 2012 - Pancreatic Volumetric Assessment as a Predictor of.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WWP799IB\\Shirakawa et al. - 2012 - Pancreatic Volumetric Assessment as a Predictor of.pdf:application/pdf}
}

@article{mcmillan_metabolism_1990,
	title = {Metabolism of the arylamide herbicide propanil. I. Microsomal metabolism and in vitro methemoglobinemia.},
	volume = {103},
	abstract = {Methemoglobinemia produced by exposure to the herbicide propanil (3,4-dichloropropionanilide) is thought to be mediated by toxic metabolites formed during the hepatic clearance of the parent compound. We examined the metabolism of propanil and 3,4-dichloroaniline in rat liver microsomes to identify metabolites that may be involved in propanil-induced methemoglobinemia.  The major pathway of propanil metabolism in microsomal incubations was acylamidase-catalyzed hydrolysis to 3,4-dichloroaniline. The reaction did not require {NADPH}, and was inhibited by the acylamidase inhibitors paraoxon and sodium fluoride. Oxidized metabolites were isolated by high-performance liquid chromatography, and identified as 2'-hydroxypropanil and 6-hydroxypropanil by comparison of their mass and nuclear magnetic resonance spectra to those of synthetic standards. Major microsomal metabolites of 3,4-dichloroaniline were},
	number = {1},
	journaltitle = {Toxicology and applied pharmacology},
	shortjournal = {Toxicol Appl Pharmacol},
	author = {{McMillan}, D. C. and Freeman, J. P. and Hinson, J. A.},
	date = {1990-03-15},
	pmid = {2315934},
	keywords = {Anilides/*metabolism, Animals, Chromatography, High Pressure Liquid, Male, Mass Spectrometry, Methemoglobin/biosynthesis, Methemoglobinemia/*chemically induced, Microsomes, Liver/*metabolism, Propanil/*metabolism/toxicity, Rats, Rats, Inbred Strains}
}

@article{sattar_association_1998,
	title = {Association between plasma plasminogen activator inhibitor-1 and survival in colorectal cancer. Measuring C reactive protein concentrations may be more useful.},
	volume = {317},
	pages = {750--751},
	number = {7160},
	journaltitle = {{BMJ} (Clinical research ed.)},
	shortjournal = {{BMJ}},
	author = {Sattar, N. and {McMillan}, D. C.},
	date = {1998-09-12},
	pmid = {9732351},
	pmcid = {PMC1113880},
	keywords = {Colorectal Neoplasms/*mortality, C-Reactive Protein/*analysis, Disease Progression, Humans, Plasminogen Activator Inhibitor 1/*blood, Tumor Markers, Biological/*blood}
}

@article{carli_randomized_2010,
	title = {Randomized clinical trial of prehabilitation in colorectal surgery},
	volume = {97},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.7102},
	doi = {10.1002/bjs.7102},
	pages = {1187--1197},
	number = {8},
	journaltitle = {British Journal of Surgery},
	author = {Carli, F. and Charlebois, P. and Stein, B. and Feldman, L. and Zavorsky, G. and Kim, D. J. and Scott, S. and Mayo, N. E.},
	urldate = {2014-01-27},
	date = {2010-08},
	file = {Carli et al. - 2010 - Randomized clinical trial of prehabilitation in co.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\G75N7AU3\\Carli et al. - 2010 - Randomized clinical trial of prehabilitation in co.pdf:application/pdf}
}

@article{stevens_prognostic_2015,
	title = {Prognostic significance of pre-operative C-reactive protein and the neutrophil–lymphocyte ratio in resectable pancreatic cancer: a systematic review},
	volume = {17},
	rights = {© 2014 International Hepato-Pancreato-Biliary Association},
	issn = {1477-2574},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/hpb.12355/abstract},
	doi = {10.1111/hpb.12355},
	shorttitle = {Prognostic significance of pre-operative C-reactive protein and the neutrophil–lymphocyte ratio in resectable pancreatic cancer},
	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.},
	pages = {285--291},
	number = {4},
	journaltitle = {{HPB}},
	shortjournal = {{HPB}},
	author = {Stevens, Lewis and Pathak, Samir and Nunes, Quentin M. and Pandanaboyana, Sanjay and Macutkiewicz, Christian and Smart, Neil and Smith, Andrew M.},
	urldate = {2015-05-18},
	date = {2015-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HQIHDVVT\\Stevens et al. - 2015 - Prognostic significance of pre-operative C-reactiv.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\S7H52U5G\\abstract.html:text/html}
}

@article{otto_association_2013,
	title = {Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964342/},
	doi = {10.1186/2047-0525-2-18},
	shorttitle = {Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables},
	abstract = {Background
Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V˙O2 peak) and anaerobic threshold ({AT}) in elective surgical patients.

Methods
Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V˙O2 peak and {AT} were analysed by linear regression and covariance.

Results
In 436 (24.5\%) patients, [Hb] was {\textless}12 g dl-1 and, in 83 of these, {\textless}10 g dl-1. Both {AT} and V˙O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P {\textless}0.0001 and r2 = 0.30, P {\textless}0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7\% increase in V˙O2 peak, and a rise of 4.4 to 6.0\% in {AT}. Haemoglobin concentration accounted for 9\% and 6\% of the variation in V˙O2 peak and {AT} respectively.

Conclusions
To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative.},
	pages = {18},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Otto, James M and O’Doherty, Alasdair F and Hennis, Philip J and Cooper, Jackie A and Grocott, Michael {PW} and Snowdon, Chris and Carlisle, John B and Swart, Michael and Richards, Toby and Montgomery, Hugh E},
	urldate = {2015-05-05},
	date = {2013-09-13},
	pmid = {24472426},
	pmcid = {PMC3964342},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WRX6KBRS\\Otto et al. - 2013 - Association between preoperative haemoglobin conce.pdf:application/pdf}
}

@article{von_haehling_ursodeoxycholic_2012,
	title = {Ursodeoxycholic acid in patients with chronic heart failure: a double-blind, randomized, placebo-controlled, crossover trial},
	volume = {59},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22300693},
	abstract = {This study sought to assess the effects of ursodeoxycholic acid ({UDCA}) on endothelial function and inflammatory markers in patients with chronic heart failure ({CHF}).},
	pages = {585--92},
	number = {6},
	journaltitle = {J Am Coll Cardiol},
	author = {von Haehling, Stephan and Schefold, Joerg C and Jankowska, Ewa A and Springer, Jochen and Vazir, Ali and Kalra, Paul R and Sandek, Anja and Fauler, Günter and Stojakovic, Tatjana and Trauner, Michael and Ponikowski, Piotr and Volk, Hans-Dieter and Doehner, Wolfram and Coats, Andrew J S and Poole-Wilson, Philip A and Anker, Stefan D},
	date = {2012-02}
}

@article{speer_randomised_1987,
	title = {Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2439854},
	abstract = {Patients with biliary obstruction due to malignant disease, and judged unfit for open operation, were randomised to have a biliary stent inserted either endoscopically via the papilla of Vater or percutaneously. Analysis after 75 patients had been entered showed that the endoscopic method had a significantly higher success rate for relief of jaundice (81\% versus 61\%, p = 0.017) and a significantly lower 30-day mortality (15\% versus 33\%, p = 0.016). The higher mortality after percutaneous stents was due to complications associated with liver puncture (haemorrhage and bile leaks). When stenting is indicated in elderly and frail patients the endoscopic method should be tried first.},
	pages = {57--62},
	number = {8550},
	journaltitle = {Lancet},
	author = {Speer, A G and Cotton, P B and Russell, R C and Mason, R R and Hatfield, A R and Leung, J W and {MacRae}, K D and Houghton, J and Lennon, C A},
	date = {1987-07}
}

@article{jamieson_comparison_2003,
	title = {Comparison of simple acid-ethanol precipitation with gel exclusion chromatography for measuring leptin binding in serum of normal subjects and cancer patients.},
	volume = {40},
	doi = {10.1258/000456303763046157},
	abstract = {{BACKGROUND}: In humans, leptin circulates in a free form and is also bound to macromolecules. The aim of the present study was to compare a rapid acid-ethanol  precipitation ({AEP}) method of measuring bound leptin with the more laborious gel  exclusion chromatography ({GEC}) reference procedure. Serum samples collected from  healthy subjects and cancer patients were used in this comparison. {METHODS}: {AEP} and {GEC} methods for measuring leptin binding in serum (from 14 healthy volunteers and 14 patients with advanced non-small cell lung cancer) were adapted from previously published procedures. {RESULTS}: Intra- and inter-assay precision of the {AEP} method were 6\% (n = 10) and 8\% (n = 10), respectively. Bland-Altman analysis  of results obtained from the {AEP} and {GEC} methods indicated no significant difference in healthy controls. However, significantly higher results were obtained by the {AEP} method in the cancer patients. {CONCLUSIONS}: Evaluation of the {AEP} method revealed that on examination of normal subjects the method was less precise than had previously been reported. Moreover, the method gave differing results in the cancer patients when compared with the {GEC} method. This study indicates that careful evaluation of any new method for measuring leptin binding  requires comparison with a {GEC} method using the sample matrix of interest.},
	pages = {185--187},
	issue = {Pt 2},
	journaltitle = {Annals of clinical biochemistry},
	shortjournal = {Ann Clin Biochem},
	author = {Jamieson, Nigel B. and {McMillan}, Donald C. and Brown, Duncan J. F. and Wallace, A. Michael},
	date = {2003-03},
	pmid = {12662410},
	keywords = {Aged, Carcinoma, Non-Small-Cell Lung/blood, Case-Control Studies, Chemistry, Clinical/*methods, Chromatography, Ethanol/*pharmacology, Female, Humans, Leptin/blood/*metabolism, Lung Neoplasms/blood, Male, Middle Aged, Reproducibility of Results, Statistics as Topic}
}

@article{quasim_negative_2001,
	title = {Negative fluid balance as predictor of mortality.},
	volume = {120},
	pages = {1424--1425},
	number = {4},
	journaltitle = {Chest},
	shortjournal = {Chest},
	author = {Quasim, T. and {McMillan}, D. C. and Kinsella, J.},
	date = {2001-10},
	pmid = {11591598},
	keywords = {*Critical Care, {APACHE}, Hospital Mortality, Humans, Postoperative Complications/*mortality, Risk Factors, Survival Analysis, Water-Electrolyte Imbalance/*mortality}
}

@article{karsten_preoperative_1996,
	title = {Preoperative biliary drainage, colonisation of bile and postoperative complications in patients with tumours of the pancreatic head: a retrospective analysis of 241 consecutive patients},
	volume = {162},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8956957},
	abstract = {{OBJECTIVE}: To analyse the outcome of preoperative biliary drainage in patients being operated on for a tumour in the pancreatic head. {DESIGN}: Retrospective study. {SETTING}: University hospital, The Netherlands. {SUBJECTS}: Consecutive series of 241 patients. {MAIN} {OUTCOME} {MEASURES}: Decline in bilirubin concentrations and bacterial contamination of bile as a result of preoperative drainage. Incidence of postoperative complications in patients who underwent preoperative drainage and those who did not. {RESULTS}: 184/241 patients underwent preoperative biliary drainage. Endoscopic drainage was the most effective, shown by a median reduction in bilirubin concentrations of 82\%, 74\%, and 50\% after endoscopic drainage (n = 149), papillotomy (n = 25) and external drainage (n = 10), respectively. Bacterial contamination of bile was significantly more common when an endoprosthesis was used, but did not result in a higher rate of infective complications. 163 Whipple's resections, 33 total pancreatectomies, and 45 biliary-enteric bypasses were performed. 137/241 (57\%) patients had postoperative complications. There was no significant difference in the incidence of postoperative complications between patients who had preoperative biliary drainage and those who did not (p = 0.4).},
	pages = {881--8},
	number = {11},
	journaltitle = {Eur J Surg},
	author = {Karsten, T M and Allema, J H and Reinders, M and van Gulik, T M and de Wit, L T and Verbeek, P C and Huibregtse, K and Tytgat, G N and Gouma, D J},
	date = {1996-11}
}

@article{savonen_current_2012,
	title = {The current standard measure of cardiorespiratory fitness introduces confounding by body mass: the {DR}'s {EXTRA} study},
	volume = {36},
	issn = {1476-5497},
	doi = {10.1038/ijo.2011.212},
	shorttitle = {The current standard measure of cardiorespiratory fitness introduces confounding by body mass},
	abstract = {{OBJECTIVE}: Cardiorespiratory fitness is currently estimated by dividing maximal oxygen consumption ({VO}(2max)) by body weight (per-weight standard). However, the statistically correct way to neutralize the effect of weight on {VO}(2max) in a given population is adjustment for body weight by regression techniques (adjusted standard). Our objective is to quantify the bias introduced by the per-weight standard in a population distributed across different categories of body mass.
{DESIGN}: This is a cross-sectional study.
{SUBJECTS} {AND} {METHODS}: Baseline measures from participants of the Dose-Responses to Exercise Training Study ({DR}'s {EXTRA}), 635 men (body mass index ({BMI}): 19-47 kg m⁻²) and 638 women ({BMI}: 16-49 kg m⁻²) aged 57-78 years who performed oral glucose tolerance tests and maximal exercise stress tests with direct measurement of {VO}(2max). We compare the increase in {VO}(2max) implied by the per-weight standard with the real increase of {VO}(2max) per kg body weight. A linear logistic regression model estimates odds for abnormal glucose metabolism (either impaired fasting glycemia or impaired glucose tolerance or Type 2 diabetes) of the least-fit versus most-fit quartile according to both per-weight standard and adjusted standard.
{RESULTS}: The per-weight standard implies an increase of {VO}(2max) with 20.9 ml min⁻¹ in women and 26.4 ml min⁻¹ in men per additional kg body weight. The true increase per kg is only 7.0 ml min⁻¹ (95\% confidence interval: 5.3-8.8) and 8.0 ml min⁻¹ (95\% confidence interval: 5.3-10.7), respectively. Risk for abnormal glucose metabolism in the least-fit quartile of the population is overestimated by 52\% if the per-weight standard is used.
{CONCLUSIONS}: In comparisons across different categories of body mass, the per-weight standard systematically underestimates cardiorespiratory fitness in obese subjects. Use of the per-weight standard markedly inflates associations between poor fitness and co-morbidities of obesity.},
	pages = {1135--1140},
	number = {8},
	journaltitle = {International Journal of Obesity (2005)},
	shortjournal = {Int J Obes (Lond)},
	author = {Savonen, K. and Krachler, B. and Hassinen, M. and Komulainen, P. and Kiviniemi, V. and Lakka, T. A. and Rauramaa, R.},
	date = {2012-08},
	pmid = {22105518},
	keywords = {Aged, Aging, Body Mass Index, Body Weight, Cross-Sectional Studies, Exercise Test, Exercise Tolerance, Female, Glucose Tolerance Test, Humans, Male, Middle Aged, Obesity, Oxygen Consumption, Reproducibility of Results},
	file = {Savonen et al. - 2012 - The current standard measure of cardiorespiratory .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PHUE9VR9\\Savonen et al. - 2012 - The current standard measure of cardiorespiratory .pdf:application/pdf}
}

@article{dervenis_diagnosis_1999,
	title = {Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference},
	volume = {25},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10453421},
	abstract = {The diagnosis, early assessment, and management of severe acute pancreatitis remain difficult clinical problems. This article presents the consensus obtained at a meeting convened to consider the evidence in these areas. The aim of the article is to provide outcome statements to guide clinical practice, with an assessment of the supporting evidence for each statement.},
	author = {Dervenis, C and Johnson, C D and Bassi, C and Bradley, E and Imrie, C W and {McMahon}, M J and Modlin, I},
	date = {1999-06}
}

@article{egawa_clinicopathological_2004,
	title = {Clinicopathological aspects of small pancreatic cancer},
	volume = {28},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15084963},
	abstract = {Small pancreatic cancers, intractable diseases, offer the possibility of cure. Can this be true? Through the National Pancreatic Cancer Registry, the Japan Pancreas Society ({JPS}) has collected 822 cases of invasive cancer with tumors {\textless}2 cm in diameter ({TS}1 pancreatic cancer). Papillary adenocarcinoma and the well-differentiated type of tubular adenocarcinoma are more frequent in {TS}1 pancreatic cancer than the larger tumors, suggesting that further genetic and phenotypic changes occur during their progression. Patients with {TS}1 pancreatic cancer presented with abdominal pain, jaundice, and exacerbation of diabetes, while 17.3\% of them had no symptoms. Further imaging diagnosis should be employed to detect {TS}1 pancreatic cancer, but conventional {US} and {ERCP} play an important role in the diagnostic process. In this study, of 822 patients with {TS}1 pancreatic cancer, only 216 patients (26.3\%) had T1 tumors because of invasion to adjacent tissue. There were 306 patients (37.2\%) with lymph node metastasis, of whom 63 (7.7\%) had N3 metastasis that is counted as a distant metastasis. As a result, only 136 patients (16.5\%) had stage I disease with a median survival time of 78.2 months and a 5-year survival rate of 58.1\%. Small pancreatic cancer does not necessarily mean early pancreatic cancer, and surgery alone is not sufficient to cure this disease.},
	pages = {235--40},
	number = {3},
	journaltitle = {Pancreas},
	author = {Egawa, Shinichi and Takeda, Kazunori and Fukuyama, Shoji and Motoi, Fuyuhiko and Sunamura, Makoto and Matsuno, Seiki},
	date = {2004-04},
	file = {Egawa et al. - 2004 - Clinicopathological aspects of small pancreatic ca.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C9S47JMI\\Egawa et al. - 2004 - Clinicopathological aspects of small pancreatic ca.pdf:application/pdf}
}

@article{nakai_comorbidity_2011,
	title = {Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy},
	volume = {78},
	issn = {1040-8428},
	url = {http://www.sciencedirect.com/science/article/pii/S1040842810001393},
	doi = {10.1016/j.critrevonc.2010.05.007},
	abstract = {Objective
To evaluate the impact of age and comorbidity on clinical outcomes in advanced pancreatic cancer.
Methods
Consecutive 237 patients with advanced pancreatic cancer were studied. Comorbidity was scored by Charlson comorbidity index ({CCI}). We compared the clinical outcomes by age or comorbidity.
Results
Sixty-nine patients were elderly (≥75 years), and {CCI} was 0 in 69 patients, 1 in 98, and ≥2 in 70. Gemcitabine-based chemotherapy was administered in 183 patients and was well tolerated in both elderly group and in those with comorbidities. In a multivariate analysis, {CCI}, not age, was prognostic in addition to {PS}, distant metastasis, chemotherapy and {CA}19-9: the hazard ratios of {CCI} 1 and ≥2 were 1.25 and 1.55, compared with {CCI} 0 (p = 0.027).
Conclusions
Gemcitabine-based chemotherapy can be an effective treatment, without significant toxicity, in elderly patients. Comorbidity, not age, was prognostic in patients with advanced pancreatic cancer.},
	pages = {252--259},
	number = {3},
	journaltitle = {Critical Reviews in Oncology/Hematology},
	shortjournal = {Critical Reviews in Oncology/Hematology},
	author = {Nakai, Yousuke and Isayama, Hiroyuki and Sasaki, Takashi and Sasahira, Naoki and Tsujino, Takeshi and Kogure, Hirofumi and Yagioka, Hiroshi and Yashima, Yoko and Togawa, Osama and Arizumi, Toshihiko and Matsubara, Saburo and Hirano, Kenji and Tada, Minoru and Omata, Masao and Koike, Kazuhiko},
	urldate = {2015-05-26},
	date = {2011-06},
	keywords = {age, Chemotherapy, Comorbidity, Gemcitabine, pancreatic cancer},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JI8SJDF9\\Nakai et al. - 2011 - Comorbidity, not age, is prognostic in patients wi.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J6TW3AW8\\S1040842810001393.html:text/html}
}

@article{isenberg_-going_2002,
	title = {The on-going debate about perioperative biliary drainage in jaundiced patients undergoing pancreaticoduodenectomy},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12173585},
	pages = {310--5},
	number = {2},
	journaltitle = {Gastrointest Endosc},
	author = {Isenberg, Gerard and Gouma, Dirk J and Pisters, Peter W T},
	date = {2002-08}
}

@article{ausania_double_2012,
	title = {Double bypass for inoperable pancreatic malignancy at laparotomy: postoperative complications and long-term outcome},
	volume = {94},
	issn = {1478-7083},
	doi = {10.1308/003588412X13373405386934},
	shorttitle = {Double bypass for inoperable pancreatic malignancy at laparotomy},
	abstract = {{INTRODUCTION}: Between 4\% and 13\% of patients with operable pancreatic malignancy are found unresectable at the time of surgery. Double bypass is a good option for fit patients but it is associated with a high risk of postoperative complications. The aim of this study was to identify pre-operatively which patients undergoing double bypass are at high risk of complications and to assess their long-term outcome.
{METHODS}: Of the 576 patients undergoing pancreatic resections between 2006 and 2011, 50 patients who underwent a laparotomy for a planned pancreaticoduodenectomy had a double bypass procedure for inoperable disease. Demographic data, risk factors for postoperative complications and pre-operative anaesthetic assessment data including the Portsmouth Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity (P-{POSSUM}) and cardiopulmonary exercise testing ({CPET}) were collected.
{RESULTS}: Fifty patients (33 men and 17 women) were included in the study. The median patient age was 64 years (range: 39-79 years). The complication rate was 50\% and the in-hospital mortality rate was 4\%. The P-{POSSUM} physiology subscore and low anaerobic threshold at {CPET} were significantly associated with postoperative complications (p =0.005 and p =0.016 respectively) but they were unable to predict them. Overall long-term survival was significantly shorter in patients with postoperative complications (9 vs 18 months). Postoperative complications were independently associated with poorer long-term survival (p =0.003, odds ratio: 3.261).
{CONCLUSIONS}: P-{POSSUM} and {CPET} are associated with postoperative complications but the possibility of using them for risk prediction requires further research. However, postoperative complications following double bypass have a significant impact on long-term survival and this type of surgery should therefore only be performed in specialised centres.},
	pages = {563--568},
	number = {8},
	journaltitle = {Annals of the Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Ausania, F. and Vallance, A. E. and Manas, D. M. and Prentis, J. M. and Snowden, C. P. and White, S. A. and Charnley, R. M. and French, J. J. and Jaques, B. C.},
	date = {2012-11},
	pmid = {23131226},
	pmcid = {PMC3954282},
	keywords = {Adult, Anastomosis, Roux-en-Y, Female, Gastroenterostomy, Humans, length of stay, Male, Middle Aged, Palliative Care, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, preoperative care, Prospective Studies, Risk assessment, Stents, Survival Analysis, Treatment Outcome, Young Adult},
	file = {Ausania et al. - 2012 - Double bypass for inoperable pancreatic malignancy.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GVFP9M53\\Ausania et al. - 2012 - Double bypass for inoperable pancreatic malignancy.pdf:application/pdf}
}

@article{delogu_interleukin-10_2001,
	title = {Interleukin-10 and apoptotic death of circulating lymphocytes in surgical/anesthesia trauma},
	volume = {51},
	issn = {0022-5282},
	abstract = {{OBJECTIVE}: To examine the relationship between circulating interleukin-10 ({IL}-10) and the occurrence of lymphocyte apoptosis after surgical/anesthesia trauma.
{METHODS}: Data were collected prospectively on 18 adult patients undergoing elective major surgery. Blood sampling for assessment of lymphocyte apoptosis and {IL}-10 levels was performed on the day before surgery (t(0)) and at 24 and 96 hours after operation (t(1) and t(2), respectively). After lymphocyte isolation, quantification of apoptosis was made by staining apoptotic cells with 7-amino-actinomycin D. Plasma {IL}-10 concentrations were measured using enzyme-linked immunosorbent assay.
{RESULTS}: A significantly increased frequency of apoptotic {CD}4(+) and {CD}8(+) cells (p {\textless} 0.05) was observed at t1 measurement (8.10\% +/- 0.58\% and 12.21\% +/- 1.47\% for {CD}4(+) and {CD}8(+), respectively) compared with preoperative values (1.53\% +/- 0.38\% and 1.32\% +/- 0.45\% for {CD}4(+) and {CD}8(+), respectively). Plasma {IL}-10 levels showed a significant elevation at both t(1) and t(2) times, peaking at t(1). At t(1), {IL}-10 levels were correlated with the frequency of {CD}4(+) and {CD}8(+) apoptotic lymphocytes (r = 0.78, p = 0.0005 for {IL}-10 vs. apoptotic {CD}4(+); r = 0.71, p = 0.003 for {IL}-10 vs. apoptotic {CD}8(+)).
{CONCLUSION}: Surgical trauma is associated with a significant but transient increase in lymphocyte commitment to apoptosis and {IL}-10 production. The exact relationship linking the overproduction of {IL}-10 with lymphocyte apoptosis after a surgical operation is still elusive and requires further investigation.},
	pages = {92--97},
	number = {1},
	journaltitle = {The Journal of Trauma},
	shortjournal = {J Trauma},
	author = {Delogu, G. and Famularo, G. and Moretti, S. and De Luca, A. and Tellan, G. and Antonucci, A. and Marandola, M. and Signore, L.},
	date = {2001-07},
	pmid = {11468474},
	keywords = {Adult, Aged, Anesthesia, General, Apoptosis, {CD}4-Positive T-Lymphocytes, {CD}8-Positive T-Lymphocytes, Female, Humans, Immune Tolerance, Interleukin-10, Lymphocyte Count, Lymphocytes, Male, Middle Aged, postoperative complications, Reference Values}
}

@article{pine_serum_2009,
	title = {Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas},
	volume = {35},
	issn = {07487983},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0748798308018519},
	doi = {10.1016/j.ejso.2008.12.002},
	pages = {605--610},
	number = {6},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	author = {Pine, J.K. and Fusai, K.G. and Young, R. and Sharma, D. and Davidson, B.R. and Menon, K.V. and Rahman, S.H.},
	urldate = {2014-01-27},
	date = {2009-06},
	file = {Pine et al. - 2009 - Serum C-reactive protein concentration and the pro.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N6AXJSRX\\Pine et al. - 2009 - Serum C-reactive protein concentration and the pro.pdf:application/pdf}
}

@article{jollow_trichloroethylene_2009,
	title = {Trichloroethylene risk assessment: a review and commentary.},
	volume = {39},
	doi = {10.3109/10408440903222177},
	abstract = {Trichloroethylene ({TCE}) is a widespread environmental contaminant that is carcinogenic when given in high, chronic doses to certain strains of mice and rats. The capacity of {TCE} to cause cancer in humans is less clear. The current maximum contaminant level ({MCL}) of 5 ppb (microg/L) is based on an {US} Environment Protection Agency ({USEPA}) policy decision rather than the underlying science. In  view of major advances in understanding the etiology and mechanisms of chemically induced cancer, {USEPA} began in the late 1990s to revise its guidelines for cancer risk assessment. {TCE} was chosen as the pilot chemical. The {USEPA} (2005) final guidelines emphasized a "weight-of-evidence" approach with consideration of dose-response relationships, modes of action, and metabolic/toxicokinetic processes. Where adequate data are available to support reversible binding of the carcinogenic moiety to biological receptors as the initiating event (i.e., a threshold exists), a nonlinear approach is to be used. Otherwise, the default assumption of a linear (i.e., nonthreshold) dose-response is utilized. When validated physiologically based pharmacokinetic ({PBPK}) models are available, they are to be used to predict internal dosimetry as the basis for species and dose extrapolations. The present article reviews pertinent literature and discusses areas where research may resolve some outstanding issues and facilitate the reassessment process. Key research needs are proposed, including role of dichloroacetic acid ({DCA}) in {TCE}-induced liver tumorigenesis in humans; extension of current {PBPK} models to predict target organ deposition of trichloroacetic acid ({TCA}) and {DCA} in humans ingesting {TCE} in drinking water; use of human hepatocytes to ascertain metabolic rate constants for use in {PBPK} models that incorporate variability in metabolism of {TCE} by potentially sensitive subpopulations; measurement of the efficiency of first-pass elimination of trace levels of {TCE} in drinking water; and assessment of exogenous factors' (e.g., alcohol, drugs) ability to alter metabolic activation and risks at such low-level exposure.},
	pages = {782--797},
	number = {9},
	journaltitle = {Critical reviews in toxicology},
	shortjournal = {Crit Rev Toxicol},
	author = {Jollow, David J. and Bruckner, James V. and {McMillan}, David C. and Fisher, Jeffrey W. and Hoel, David G. and Mohr, Lawrence C.},
	date = {2009},
	pmid = {19852561},
	keywords = {Animals, Environmental Exposure/*adverse effects, Humans, Models, Biological, Neoplasms/chemically induced/epidemiology, Risk Assessment, Trichloroethylene/pharmacokinetics/*toxicity, Water Pollutants, Chemical/pharmacokinetics/*toxicity}
}

@article{prentis_submaximal_2012,
	title = {Submaximal exercise testing predicts perioperative hospitalization after aortic aneurysm repair},
	volume = {56},
	issn = {1097-6809},
	doi = {10.1016/j.jvs.2012.05.097},
	abstract = {{BACKGROUND}: Aortic aneurysm repair is a high-risk surgical procedure. Patients are often elderly, with multiple comorbidities that predispose them to perioperative morbidity. Use of endovascular aneurysm repair ({EVAR}) has increased due to reduced early perioperative risk. This study assessed whether preoperative cardiopulmonary exercise testing ({CPET}) could be used to predict morbidity and hospital length of stay ({LOS}) after aortic aneurysm repair.
{METHODS}: A total of 185 patients underwent surgical repair (84 open repairs, 101 {EVAR}) and had adequate determination of a submaximal {CPET} parameter (anaerobic threshold).
{RESULTS}: Patient comorbidities and cardiorespiratory fitness, derived from {CPET}, were similar between surgical procedures. Patients undergoing {EVAR} had fewer complications (10\% vs 32\%; P{\textless}.0001) and shorter mean (standard deviation [{SD}]) hospital {LOS} of 5.7 (9.3) days vs 14.4 (10.9) days compared with open repair (P{\textless}.0001). The hospital {LOS} was significantly increased in patients with one or more complications in both groups compared with those with no complications. In the open repair group, the level of fitness, as defined by anaerobic threshold, was an independent predictor of postoperative morbidity and hospital {LOS}. When the optimal anaerobic threshold (10 {mL}/min/kg) derived from receiver operator curve analysis was used as a cutoff value, unfit patients stayed significantly longer than fit patients in critical care (mean, 6.4 [{SD}, 6.9] days vs 2.4 [{SD}, 2.9] days; P=.002) and in the hospital (mean, 23.1 [{SD}, 14.8] days vs 11.0 [{SD}, 6.1] days; P{\textless}.0001). In contrast, fitness in the {EVAR} group was not predictive of postoperative morbidity but did have predictive value for hospital {LOS}.
{CONCLUSIONS}: Cardiorespiratory fitness holds significant clinical value before aortic aneurysm repair in predicting postsurgical complications and duration of critical care and hospital {LOS}. Preoperative measurement of fitness could then direct clinical management with regard to operative choice, postoperative resource allocation, and informed patient decision making.},
	pages = {1564--1570},
	number = {6},
	journaltitle = {Journal of Vascular Surgery},
	shortjournal = {J. Vasc. Surg.},
	author = {Prentis, James M. and Trenell, Michael I. and Jones, Dave J. and Lees, Tim and Clarke, Mike and Snowden, Chris P.},
	date = {2012-12},
	pmid = {22858436},
	keywords = {Aged, Aged, 80 and over, anaerobic threshold, Aortic Aneurysm, Abdominal, Blood Vessel Prosthesis Implantation, Cohort Studies, Elective Surgical Procedures, endovascular procedures, Exercise Test, Exercise Tolerance, Female, Humans, length of stay, Male, Middle Aged, Predictive Value of Tests, Treatment Outcome}
}

@article{talwar_effect_1997,
	title = {Effect of inflammation on measures of antioxidant status in patients with non-small cell lung cancer.},
	volume = {66},
	abstract = {This study examined the effect of an inflammatory response on measures of antioxidant status in patients with non-small cell lung cancer ({NSCLC}). In healthy, control subjects (n = 13) and {NSCLC} patients (n = 22) fasting concentrations of albumin, C-reactive protein, cholesterol, and the antioxidants  alpha-tocopherol, retinol, lutein, lycopene, and alpha- and beta-carotene were measured. The two groups were similar in terms of age, sex, and body mass index.  However, the cancer group had an inflammatory response as evidenced by significantly increased C-reactive protein concentrations. Concentrations of all  the measured antioxidants of the {NSCLC} group were significantly lower than those  of the control group (P {\textless} 0.01). The lowest concentrations were those of the carotenoids lycopene and alpha- and beta-carotene. In the cancer group there were significant negative correlations between concentrations of C-reactive protein and retinol (r = -0.682, P {\textless} 0.01), alpha-tocopherol (r = -0.464, P {\textless} 0.05), and  lutein (r = -0.599, P {\textless} 0.01). The results of this study have implications for the interpretation of circulating antioxidant concentrations in patients with {NSCLC}.},
	pages = {1283--1285},
	number = {5},
	journaltitle = {The American journal of clinical nutrition},
	shortjournal = {Am J Clin Nutr},
	author = {Talwar, D. and Ha, T. K. and Scott, H. R. and Cooney, J. and Fell, G. S. and O'Reilly, D. S. and Lean, M. E. and {McMillan}, D. C.},
	date = {1997-11},
	pmid = {9356549},
	keywords = {Aged, Aged, 80 and over, Antioxidants/*metabolism, Carcinoma, Non-Small-Cell Lung/*blood/immunology, Case-Control Studies, C-Reactive Protein/metabolism, Fasting/blood, Female, Humans, Inflammation/*blood, Lung Neoplasms/*blood, Male, Middle Aged, Neoplasm Staging}
}

@article{guthrie_systemic_2013,
	title = {The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer.},
	volume = {88},
	rights = {Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.},
	doi = {10.1016/j.critrevonc.2013.03.010},
	abstract = {There is increasing and consistent evidence that cancer-associated inflammation is a key determinant of outcome in patients with cancer. Various markers of inflammation have been examined over the past decade in an attempt to refine stratification of patients to treatment and predict survival. One routinely available marker of the systemic inflammatory response is the neutrophil-lymphocyte ratio ({NLR}), which is derived from the absolute neutrophil  and absolute lymphocyte counts of a full blood count. To date, over 60 studies ({\textgreater}37,000 patients) have examined the clinical utility of the {NLR} to predict patient outcomes in a variety of cancers. The present systematic review examines  and comments on the clinical utility of the {NLR}. The {NLR} had independent prognostic value in (a) unselected cohorts (1 study of {\textgreater}12,000 patients), (b) operable disease (20 studies, {\textgreater}4000 patients), (c) patients receiving neoadjuvant treatment and resection (5 studies, {\textgreater}1000 patients), (d) patients receiving chemo/radiotherapy (12 studies, {\textgreater}2000 patients) and (e) patients with inoperable  disease (6 studies, {\textgreater}1200 patients). These studies originated from ten different  countries, in particular {UK}, Japan, and China. Further, correlative studies (15 studies, {\textgreater}8500 patients) have shown that {NLR} is elevated in patients with more advanced or aggressive disease evidenced by increased tumour stage, nodal stage,  number of metastatic lesions and as such these patients may represent a particularly high-risk patient population. Further studies investigating the tumour and host-derived factors regulating the systemic inflammatory response, in particular the {NLR}, may identify novel treatment strategies for patients with cancer.},
	pages = {218--230},
	number = {1},
	journaltitle = {Critical reviews in oncology/hematology},
	shortjournal = {Crit Rev Oncol Hematol},
	author = {Guthrie, Graeme J. K. and Charles, Kellie A. and Roxburgh, Campbell S. D. and Horgan, Paul G. and {McMillan}, Donald C. and Clarke, Stephen J.},
	date = {2013-10},
	pmid = {23602134},
	keywords = {Humans, Inflammation/*immunology/*pathology, Leukocyte Count, Lymphocytes, Tumor-Infiltrating/*immunology, Neoplasms/*immunology/mortality/*pathology/therapy, Neoplasm Staging, Neutrophil Infiltration/*immunology, Prognosis}
}

@article{snellen_influence_1985,
	title = {The influence of preoperative jaundice, biliary drainage and age on postoperative morbidity and mortality after pancreatoduodenectomy and total pancreatectomy},
	volume = {37},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4022420},
	abstract = {Details are given of the postoperative course of 56 patients after pancreatoduodenectomy, and 11 after total pancreatectomy. The main indication was adenocarcinoma (56 cases). The most serious complication was leakage from the pancreatojejunostomy, which occurred in nine patients and was fatal in seven of these (10\%). This was the only cause of death in the group. The observed mortality was appreciably higher (38\%) in the 13 patients aged over 70 years. Contrary to recent reports, jaundice was not found to influence postoperative mortality adversely, nor was preoperative biliary drainage found to reduce mortality.},
	pages = {83--6},
	number = {3},
	journaltitle = {Neth J Surg},
	author = {Snellen, J P and Obertop, H and Bruining, H A and Schattenkerk, M E and Eggink, W F and Jeekel, J and van Houten, H},
	date = {1985-06}
}

@article{wallace_co-ordinated_2000,
	title = {The co-ordinated cytokine/hormone response to acute injury incorporates leptin.},
	volume = {12},
	rights = {Copyright 2000 Academic Press.},
	doi = {10.1006/cyto.2000.0674},
	abstract = {Recent studies have implicated leptin as a "stress" hormone and highlighted its association with increases in inflammatory cytokines, C-reactive protein and cortisol. In order to investigate the exact temporal leptin response to stress we undertook a detailed longitudinal study of circulating leptin concentrations during the well defined surgical injury of cholecystectomy. Circulating concentrations of cortisol, free fatty acids, leptin and C-reactive protein were  measured at 3, 6, 9, 12, 18, 24, 48 and 72 h from the start of surgery in nine patients. There was a significant correlation between baseline concentrations of  leptin and {BMI} (r=0. 893, P{\textless}0.001). Over the 72 h from the start of surgery there were significant (P{\textless}0.05) increases in the concentrations of all analytes (peak median concentrations); cortisol (6 h), free fatty acids (9 h), leptin (18 h) and},
	pages = {1042--1045},
	number = {7},
	journaltitle = {Cytokine},
	shortjournal = {Cytokine},
	author = {Wallace, A. M. and Sattar, N. and Mcmillan, D. C.},
	date = {2000-07},
	pmid = {10880250},
	keywords = {Cholecystectomy, C-Reactive Protein/*analysis, Cytokines/blood, Fatty Acids, Nonesterified/*blood, Female, Hormones/blood, Humans, Hydrocortisone/*blood, Laparotomy, Leptin/*blood, Longitudinal Studies, Male, Stress, Physiological/blood}
}

@article{faist_immunosuppression_1997,
	title = {Immunosuppression and immunomodulation in surgical patients},
	volume = {3},
	issn = {1070-5295},
	abstract = {Following major surgical interventions or severe trauma a dramatic depression of humoral and cell-mediated immune functions has been reported. This immune dysfunction represents a major determinant of increased susceptibility to septic complications and the ensuing multiple organ failure syndrome. This paper reviews the reported immunological alterations following major trauma or surgery. Furthermore, an overview of the therapeutic immunological interventions which have been studied or that are under clinical investigation is given. Despite the dramatic progress in the field of surgical immunology we still do not possess the "magic bullet" for the optimal stage-oriented treatment of trauma-induced immune dysfunction. Clinical research, therefore, has to focus on the development of methods to timely determine the state of activation of the host immune system. This will then enable us to design adequate immunotherapeutic interventions for the treatment of immunosuppression in surgical patients., (C) Lippincott-Raven Publishers.},
	pages = {293--298},
	number = {4},
	journaltitle = {Current Opinion in Critical Care},
	author = {Faist, Eugen and Wichmann, Matthias and Kim, Caroline},
	date = {1997-08},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2QTHKNCT\\Faist et al. - 1997 - Immunosuppression and immunomodulation in surgical.pdf:application/pdf}
}

@article{whipple_radical_1950,
	title = {Radical Surgery in the Treatment of Cancer},
	volume = {131},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616594/},
	pages = {812--818},
	number = {6},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O.},
	urldate = {2015-05-12},
	date = {1950-06},
	pmid = {15413940},
	pmcid = {PMC1616594},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\A58VZZ2W\\Whipple - 1950 - Radical Surgery in the Treatment of Cancer.pdf:application/pdf}
}

@article{heidenreich_kidney_1987,
	title = {The kidney and cardiovascular system in obstructive jaundice: functional and metabolic studies in conscious rats},
	volume = {73},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2826070},
	abstract = {1. The effects of jaundice on renal and circulatory function were investigated in chronic bile duct ligated ({CBDL}) rats 6 days after surgery. Sham operated ({SO}) animals served as controls. 2. Body weight was significantly reduced, whereas blood pressure remained unaltered, 6 days after bile duct ligation when serum bilirubin had risen to 169 +/- 18 ({SEM}) as compared with 2.8 +/- 0.3 mumol/l in {SO} rats. When compared with control values before surgery, urinary volume had significantly increased and absolute excretion of sodium, potassium, chloride and phosphate had decreased on day 6 after {CBDL}. Endogenous creatinine clearance was markedly depressed when compared with {SO} rats. Whereas fractional excretion of potassium remained unaltered, fractional excretion of sodium and of phosphate was significantly increased. 3. Except for a significant increase in urinary thromboxane B2 ({TXB}2) excretion in {CBDL} rats, no significant changes were observed in urinary excretion of prostaglandin ({PG}) E2, in the synthesis of {PGE}2, 6-keto-{PGF}1 alpha and {TXB}2 by isolated aortic tissue in vitro, nor in renal and cardiac adenosine triphosphatase activities or renal cortical mitochondrial function. 4. The adenosine triphosphate content of kidney cortex and cardiac mitochondrial function were significantly depressed in {CBDL} rats. 5. The results demonstrate that jaundice in {CBDL} rats is associated with functional and metabolic disturbances of the kidney and cardiac muscle, which may contribute to the renal and haemodynamic characteristics observed in jaundiced animals and humans.},
	pages = {593--9},
	number = {6},
	journaltitle = {Clin Sci (Lond)},
	author = {Heidenreich, S and Brinkema, E and Martin, A and Düsing, R and Kipnowski, J and Kramer, H J},
	date = {1987-12}
}

@article{selberg_palmitate_1990,
	title = {Palmitate turnover and its response to glucose infusion in weight-losing cancer patients.},
	volume = {9},
	abstract = {Palmitate turnover in weight-stable control subjects (n = 4) and weight-losing patients with progressive malignant disease (n = 4) has been determined. Measurements were made after an overnight fast and during glucose infusion (3.5 mg/kg/min). Turnover rates were calculated from plateau isotopic enrichment of palmitate in plasma during a continuous infusion of 1-13C palmitate. Palmitate turnover was higher in the cancer group before (180\%) and during glucose loading  (170\%) compared with the control group. Palmitate turnover was reduced during glucose administration by approximately 34\% in both groups. Plasma concentration  of insulin was decreased and of cortisol was increased in the cancer group compared with the control group before and during glucose infusion. We conclude that cancer patients with weight loss have increased rates of fatty acid turnover indicative of enhanced mobilisation of body fat stores. Altered plasma concentrations of insulin and cortisol may mediate this effect. Nonetheless, even at more advanced stages of cachexia cancer patients have normal control mechanisms for inhibiting fatty acid turnover following administration of carbohydrate.},
	pages = {150--156},
	number = {3},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {Selberg, O. and {McMillan}, D. C. and Preston, T. and Carse, H. and Shenkin, A. and Burns, H. J.},
	date = {1990-06},
	pmid = {16837347}
}

@article{miki_comparison_2010,
	title = {Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer},
	volume = {251},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20040845},
	pages = {389--90; author reply 390--1},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Miki, Chikao and Tanaka, Kouji and Toiyama, Yuji and Inoue, Yasuhiro and Uchida, Keiichi and Mohri, Yasuhiko and Kusunoki, Masato},
	date = {2010-02}
}

@article{kalser_pancreatic_1985,
	title = {Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection},
	volume = {120},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4015380},
	abstract = {The efficacy of combined radiation and fluorouracil as adjuvant therapy for pancreatic cancer is suggested by a prospective randomized study conducted by the Gastrointestinal Tumor Study Group ({GITSG}). Twenty-two patients randomized to no adjuvant treatment and 21 to combined therapy were analyzed. Neither life-threatening toxic reaction nor death due to toxic effect was encountered. The study was terminated prematurely because of an unacceptably low rate of accrual combined with the observation of increasingly large survival differences between the study arms. Median survival for the treatment group (20 months) was significantly longer than that observed for the control group (11 months). Four patients, three in the treated and one in the control group, have survived five years or longer following surgery. The extent of the tumor and initial performance status were significantly and independently related to survival.},
	pages = {899--903},
	number = {8},
	journaltitle = {Arch Surg},
	author = {Kalser, M H and Ellenberg, S S},
	date = {1985-08}
}

@article{peter_feasibility_2009,
	title = {Feasibility of combined {EUS}-{FNA} and {ERCP} for obstructive jaundice from presumed pancreatic malignancy},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19204740},
	abstract = {The management of patients with pancreatic cancer begins with confirmation of the diagnosis by cytology, which is followed by accurate preoperative staging and biliary drainage. Endoscopic ultrasonography with fine-needle aspiration ({EUS}-{FNA}) followed by endoscopic retrograde cholangiopancreatography ({ERCP}) helps to achieve these goals and primes the patient for various treatment options. We discuss the findings of a study by Ross and colleagues that aimed to determine the feasibility and outcomes of combining {EUS}-{FNA} and therapeutic {ERCP} in a single session. The authors concluded that combined {EUS}-{FNA} and {ERCP} was technically feasible, and could safely and effectively achieve a diagnosis and biliary drainage. The adverse event rate was acceptable; pancreatitis was the most common complication. Such a one-step approach is, therefore, beneficial and calls for the founding of well-equipped units with adequately skilled endoscopy and support staff.},
	pages = {132--3},
	number = {3},
	journaltitle = {Nat Clin Pract Gastroenterol Hepatol},
	author = {Peter, Shajan and Eloubeidi, Mohamad A},
	date = {2009-03}
}

@article{scott_prospective_2003,
	title = {A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer.},
	volume = {40},
	abstract = {The relationship between weight loss, the systemic inflammatory response and quality of life in patients with inoperable non-small cell lung cancer ({NSCLC}) was studied. The extent of weight loss, the systemic inflammatory response (C-reactive protein) and quality of life ({EORTC}-{QLQ}-C30) was measured in 106 patients with inoperable {NSCLC} (stage {III} and {IV}). Approximately 40\% had more than 5\% weight loss and almost 80\% had elevated circulating C-reactive protein concentrations ({\textgreater}10 mg/l). The functional scale scores of the {EORTC}-{QLQ}-C30 were  poor (50 or less) and the fatigue symptom score was also poor (50 or more). When  patients were grouped according to whether or not they had experienced more than  5\% weight loss, Karnofsky performance status and global quality of life were lower (P{\textless}0.05) and symptom scores fatigue (P{\textless}0.05) and pain (P{\textless}0.01) were greater in the weight-losing group. When the weight-stable cancer patients were grouped according to whether or not they had evidence of a systemic inflammatory response, the symptom fatigue was higher in the inflammatory group (P{\textless}0.05). In the weight-stable cancer patients C-reactive protein concentration was correlated with fatigue r=0.31 (P{\textless}0.05). The results of the present study indicate that both weight loss and the systemic inflammatory response impact on different aspects of quality of life. In particular, fatigue is associated with the presence of a systemic inflammatory response independent of weight loss.},
	pages = {295--299},
	number = {3},
	journaltitle = {Lung cancer (Amsterdam, Netherlands)},
	shortjournal = {Lung Cancer},
	author = {Scott, Hazel R. and {McMillan}, Donald C. and Brown, Duncan J. F. and Forrest, Lynn M. and {McArdle}, Colin S. and Milroy, Robert},
	date = {2003-06},
	pmid = {12781428},
	keywords = {*Inflammation, *Quality of Life, *Weight Loss, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung/*pathology, C-Reactive Protein/analysis, Fatigue, Female, Humans, Lung Neoplasms/*pathology, Male, Middle Aged, Prospective Studies}
}

@article{copeland_risk-adjusted_1995,
	title = {Risk-adjusted analysis of surgeon performance: a 1-year study},
	volume = {82},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7796028},
	abstract = {A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital. Using the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) scoring system 3004 patients were assessed. From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of observed to expected numbers of deaths and complications (O:E ratio) was determined for each surgeon, both overall and within specialty zones. The present study demonstrates the serious hazard in using 'raw' uncorrected mortality and morbidity statistics to compare surgeon performance. Mortality rates varied from 1.0 to 4.9 per cent whereas O:E ratios ranged from 0.83 to 1.06; morbidity rates varied from 5.3 to 12.6 per cent with O:E ratios 0.86-1.02. Great misunderstanding may result from the publication of surgeon or hospital 'league tables'. The present study demonstrates a technique that might allow surgeon performance to be monitored adequately and accurately.},
	pages = {408--11},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Copeland, G P and Sagar, P and Brennan, J and Roberts, G and Ward, J and Cornford, P and Millar, A and Harris, C},
	date = {1995-03}
}

@article{naranjo_renal_2011,
	title = {Renal function after dopamine and fluid administration in patients with malignant obstructive jaundice. A prospective randomized study},
	volume = {20},
	url = {http://www.jgld.ro/2011/2/11.pdf},
	pages = {161--167},
	number = {2},
	journaltitle = {J Gastrointestin Liver Dis},
	author = {Naranjo, Antonio and Cruz, Adolfo and López, Patricia and Chicano, Maite and Martín-Malo, Alejandro and Sitges-Serra, Antonio and Muntané, Jordi and Padillo, Javier},
	urldate = {2015-06-03},
	date = {2011},
	file = {11.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M3X6T4HB\\11.pdf:application/pdf}
}

@article{christou_estimating_1989,
	title = {Estimating mortality risk in preoperative patients using immunologic, nutritional, and acute-phase response variables.},
	volume = {210},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357768/},
	abstract = {We measured the delayed type hypersensitivity ({DTH}) skin test response, along with additional variables of host immunocompetence in 245 preoperative patients to determine which variables are associated with septic-related deaths following operation. Of the 14 deaths (5.7\%), 12 were related to sepsis and in 2 sepsis was contributory. The {DTH} response (p less than 0.00001), age (p less than 0.0002), serum albumin (p less than 0.003), hemoglobin (p less than 0.02), and total hemolytic complement (p less than 0.03), were significantly different between those who died and those who lived. By logistic regression analysis, only the {DTH} skin test response (log likelihood = 41.7, improvement X2 = 6.24, p less than 0.012) and the serum albumin (log likelihood = 44.8, improvement X2 = 17.7, p less than 0.001) were significantly and independently associated with the deaths. The resultant probability of mortality calculation equation was tested in a separate validation group of 519 patients (mortality = 5\%) and yielded a good predictive capability as assessed by (1) X2 = 0.08 between observed and expected deaths, {NS}; (2) Goodman-Kruskall G statistic = 0.673) Receiver-Operating-Characteristic ({ROC}) curve analysis with an area under the {ROC} curve, Az = 0.79 +/- 0.05. We conclude that a reduced immune response ({DTH} skin test anergy) plus a nutritional deficit and/or acute-phase response change are both associated with increased septic-related deaths in elective surgical patients.},
	pages = {69--77},
	number = {1},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Christou, N V and Tellado-Rodriguez, J and Chartrand, L and Giannas, B and Kapadia, B and Meakins, J and Rode, H and Gordon, J},
	urldate = {2015-08-20},
	date = {1989-07},
	pmid = {2472781},
	pmcid = {PMC1357768},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FKEDP8MV\\Christou et al. - 1989 - Estimating mortality risk in preoperative patients.pdf:application/pdf}
}

@article{mcallister_acute_1990,
	title = {Acute inhibition of respiratory capacity of muscle reduces peak oxygen consumption},
	volume = {259},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2175546},
	abstract = {Electron transport capacity of skeletal muscle was inhibited in situ in an acute dose-dependent manner with myxothiazol, a tight-binding inhibitor of ubiquinone-cytochrome c reductase, complex {III} of the respiratory chain. Peak oxygen consumption of rat hindlimb muscle was determined via consecutive 10-min isometric contraction (100 ms at 100 Hz) periods of increasing energy demands (4, 8, 15, 30, 45, and 60 tetani/min), using an isolated hindlimb preparation perfused with a high oxygen delivery (approximately 6-8 mumol.min-1.g-1). Peak oxygen consumption decreased from 4.61 +/- 0.19 mumol.min-1.g-1 (control) in a dose-dependent manner to 0.73 +/- 0.07 mumol.min-1.g-1 at 0.50 {microM} myxothiazol in blood. Oxygen extraction decreased from 65 to 12\% of delivered oxygen. Furthermore, the reduction in peak respiratory rate became evident at lower energy demands of the contraction sequence. Myxothiazol inhibition of respiration was not dependent on the presence of muscle contractions but was evident when mitochondria were uncoupled with carbonyl cyanide m-chlorophenylhydrazone. A 50\% effective dosage ({ED}50) of 0.21 {microM} myxothiazol for inhibition of peak oxygen consumption closely resembled the inhibition of {NADH}-cytochrome c reductase activity ({ED}50 of 0.27 {microM}) determined from homogenates of the same muscles. This suggests that the peak oxygen consumption of skeletal muscle is tightly coupled to the capacity for electron transport evaluated by flux through {NADH}-cytochrome c reductase. If the enzyme activity measured in vitro correctly represents available enzymatic capacity within contracting muscle, approximately 75\% of electron transport capacity for handling reducing equivalents generated from {NADH} is utilized during peak oxygen consumption of rat hindlimb muscle contracting in situ.},
	pages = {C889--96},
	number = {6},
	journaltitle = {Am J Physiol},
	author = {{McAllister}, R M and Terjung, R L},
	date = {1990-12}
}

@article{eshuis_therapeutic_2010,
	title = {Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage},
	volume = {252},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21037440},
	abstract = {{OBJECTIVE}: To evaluate the relation between delay in surgery because of preoperative biliary drainage ({PBD}) and survival in patients scheduled for surgery for pancreatic head cancer. {BACKGROUND}: Patients with obstructive jaundice due to pancreatic head cancer can undergo {PBD}. The associated delay of surgery can lead to more advanced cancer stages at surgical exploration, affecting resection rate and survival. {METHODS}: We conducted a multicenter, randomized controlled clinical trial to compare {PBD} with early surgery ({ES}) for pancreatic head cancer for complications. We obtained Kaplan-Meier estimates of overall survival for patients with pathology-proven malignancy and compared survival functions of {ES} and {PBD} groups using log-rank test statistics. Multivariable Cox regression analyses were performed to evaluate the prognostic role of time to surgery for overall survival. {RESULTS}: Mean times from randomization to surgery were 1.2 (0.9-1.5) and 5.1 (4.8-5.5) weeks in the {ES} and {PBD} groups, respectively (P {\textless} 0.001). In the {ES} group, 60 (67\%) of 89 patients underwent resection, versus 53 (58\%) of 91 patients in the {PBD} group (P = 0.20). Median survival after randomization was 12.2 (9.1-15.4) months in the {ES} group versus 12.7 (8.9-16.6) months in the {PBD} group (P = 0.91). A longer time to surgery was significantly associated with slightly lower mortality rate after surgery (hazard ratio = 0.90, 95\% {CI}, 0.83-0.97), when taking into account resection, bilirubin, complications, pancreatic adenocarcinoma, tumor-positive lymph nodes, and microscopically residual disease. {CONCLUSIONS}: In patients with pancreatic head cancer, the delay in surgery associated with {PBD} does not impair or benefit survival rate.},
	pages = {840--9},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Eshuis, Wietse J and van der Gaag, Niels A and Rauws, Erik A J and van Eijck, Casper H J and Bruno, Marco J and Kuipers, Ernst J and Coene, Peter P and Kubben, Frank J G M and Gerritsen, Josephus J G M and Greve, Jan Willem and Gerhards, Michael F and de Hingh, Ignace H J T and Klinkenbijl, Jean H and Nio, C Y and de Castro, Steve M M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2010-11},
	note = {Delay due to {BD} does not affect survival},
	file = {Eshuis et al. - 2010 - Therapeutic delay and survival after surgery for c.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MU2R7KBF\\Eshuis et al. - 2010 - Therapeutic delay and survival after surgery for c.pdf:application/pdf}
}

@article{valentijn_impact_2013,
	title = {Impact of Obesity on Postoperative and Long-term Outcomes in a General Surgery Population: A Retrospective Cohort Study},
	volume = {37},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/s00268-013-2162-y},
	doi = {10.1007/s00268-013-2162-y},
	shorttitle = {Impact of Obesity on Postoperative and Long-term Outcomes in a General Surgery Population},
	abstract = {Background The obesity paradox has been demonstrated postoperatively in several surgical populations, but only a few studies have reported long-term survival. This study evaluates the presence of the obesity paradox in a general surgery population, reporting both postoperative and long-term survival. Methods This retrospective study included 10,427 patients scheduled for elective, noncardiac surgery. Patients were classified as underweight (body mass index ({BMI}) {\textless} 18.5 kg/m2); normal weight ({BMI} 18.5–24.9 kg/m2); overweight ({BMI} 25.0–29.9 kg/m2); obesity class I ({BMI} 30.0–34.9 kg/m2); obesity class {II} ({BMI} 35.0–39.9 kg/m2); and obesity class {III} ({BMI} ≥ 40.0 kg/m2). Study endpoints were 30-day postoperative and long-term mortality, including cause-specific mortality. Multivariable analyses were used to evaluate mortality risks for each {BMI} category. Results Within 30 days after surgery, 353 (3.4 \%) patients died. Overweight was the only category associated with postoperative mortality, showing improved survival [odds ratio 0.7; 95 \% confidence interval ({CI}) 0.6–0.9]. During the long-term follow-up 4,884 (47 \%) patients died. Underweight patients had the highest mortality risk [hazard ratio ({HR}) 1.4; 95 \% {CI} 1.2–1.6), particularly due to high cancer-related deaths. In contrast, overweight and obese patients demonstrated improved survival (overweight: {HR} 0.8, 95 \% {CI} 0.8–0.9; obesity class I: {HR} 0.7, 95 \% {CI} 0.7–0.8; obesity class {II}: {HR} 0.7, 95 \% {CI} 0.6–0.9; obesity class {III}: {HR} 0.7, 95 \% {CI} 0.5–1.0), mainly because of a strongly reduced risk of cancer-related death. Conclusions In this surgical population the obesity paradox was validated at the long term, mainly because of decreased cancer-related deaths among obese patients.},
	pages = {2561--2568},
	number = {11},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J Surg},
	author = {Valentijn, Tabita M. and Galal, Wael and Hoeks, Sanne E. and Gestel, Yvette R. van and Verhagen, Hence J. and Stolker, Robert J.},
	urldate = {2015-08-04},
	date = {2013-07-26},
	langid = {english},
	keywords = {Abdominal Surgery, Cardiac Surgery, general surgery, surgery, Thoracic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X548HTN3\\Valentijn et al. - 2013 - Impact of Obesity on Postoperative and Long-term O.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MIVWFJGJ\\10.html:text/html}
}

@article{horgan_surgeons_2010,
	title = {Surgeons and selection of adjuvant therapy for node-negative colonic cancer.},
	volume = {97},
	doi = {10.1002/bjs.7254},
	pages = {1459--1460},
	number = {10},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Horgan, P. G. and {McMillan}, D. C.},
	date = {2010-10},
	pmid = {20715293},
	keywords = {Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Chemotherapy, Adjuvant, Colonic Neoplasms/*drug therapy/surgery, Humans}
}

@article{macgregor_is_2009,
	title = {Is there a role for cardiopulmonary exercise testing before major urological surgery},
	volume = {104},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19426186},
	pages = {579--80},
	number = {5},
	journaltitle = {{BJU} Int},
	author = {{MacGregor}, Thomas and Patel, Nilay and Blick, Christopher and Arya, Manit and Muneer, Asif},
	date = {2009-09},
	file = {macgregor_2008_bju_is_there_a_role_for_cardiopulmonary_exercise_testing_before_major_urological_surgery.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2BJ2XJFW\\macgregor_2008_bju_is_there_a_role_for_cardiopulmonary_exercise_testing_before_major_urological_surgery.pdf:application/pdf}
}

@article{wong_cardiac_2001,
	title = {The cardiac response to exercise in cirrhosis},
	volume = {49},
	url = {http://gut.bmj.com/content/49/2/268.abstract},
	pages = {268--275},
	number = {2},
	journaltitle = {Gut},
	author = {Wong, F. and Girgrah, N. and Graba, J. and Allidina, Y. and Liu, P. and Blendis, L.},
	urldate = {2014-01-27},
	date = {2001},
	file = {Wong et al. - 2001 - The cardiac response to exercise in cirrhosis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3PXX97S3\\Wong et al. - 2001 - The cardiac response to exercise in cirrhosis.pdf:application/pdf}
}

@article{al_murri_relationship_2004,
	title = {The relationship between deprivation, tumour stage and the systemic inflammatory  response in patients with primary operable breast cancer.},
	volume = {91},
	doi = {10.1038/sj.bjc.6602096},
	abstract = {The extent of deprivation (Carstairs deprivation index) was directly associated with the magnitude of the systemic inflammatory response (reduced albumin and elevated C-reactive protein, P{\textless}0.01) in patients with primary operable breast cancer (n=314). Deprivation was not associated with age, tumour size, tumour type, grade, and the proportion of patients with involved lymph nodes and oestrogen receptor status.},
	pages = {1063--1065},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Al Murri, A. M. and Doughty, J. C. and Lannigan, A. and Wilson, C. and {McArdle}, C. S. and {McMillan}, D. C.},
	date = {2004-09-13},
	pmid = {15305191},
	pmcid = {PMC2747685},
	keywords = {Breast Neoplasms/economics/*pathology/physiopathology/surgery, C-Reactive Protein/analysis, Female, Great Britain, Humans, Lymphatic Metastasis, Middle Aged, Socioeconomic Factors}
}

@article{chandrabalan_pre-operative_2013,
	title = {Pre-operative cardiopulmonary exercise testing predicts adverse post-operative events and non-progression to adjuvant therapy after major pancreatic surgery},
	issn = {1477-2574},
	doi = {10.1111/hpb.12060},
	abstract = {{BACKGROUND}: Surgery followed by chemotherapy is the primary modality of cure for patients with resectable pancreatic cancer but is associated with significant morbidity. The aim of the present study was to evaluate the role of cardiopulmonary exercise testing ({CPET}) in predicting post-operative adverse events and fitness for chemotherapy after major pancreatic surgery. {METHODS}: Patients who underwent a pancreaticoduodenectomy or total pancreatectomy for pancreatic head lesions and had undergone pre-operative {CPET} were included in this retrospective study. Data on patient demographics, comorbidity and results of pre-operative evaluation were collected. Post-operative adverse events, hospital stay and receipt of adjuvant therapy were outcome measures. {RESULTS}: One hundred patients were included. Patients with an anaerobic threshold less than 10 ml/kg/min had a significantly greater incidence of a post-operative pancreatic fistula [International Study Group for Pancreatic Surgery ({ISGPS}) Grades A-C, 35.4\% versus 16\%, P = 0.028] and major intra-abdominal abscesses [Clavien-Dindo ({CD}) Grades {III}-V, 22.4\% versus 7.8\%, P = 0.042] and were less likely to receive adjuvant therapy [hazard ratio ({HR}) 6.30, 95\% confidence interval ({CI}) 1.25-31.75, P = 0.026]. A low anaerobic threshold was also associated with a prolonged hospital stay (median 20 versus 14 days, P = 0.005) but not with other adverse events. {DISCUSSION}: {CPET} predicts a post-operative pancreatic fistula, major intra-abdominal abscesses as well as length of hospital stay after major pancreatic surgery. Patients with a low anaerobic threshold are less likely to receive adjuvant therapy.},
	journaltitle = {{HPB}: the official journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Chandrabalan, Vishnu V and {McMillan}, Donald C and Carter, Roger and Kinsella, John and {McKay}, Colin J and Carter, C Ross and Dickson, Euan J},
	date = {2013-02-20},
	pmid = {23458160},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DWVUXX4Q\\abstract\;jsessionid=AF9343A68E286B5A5263D92D59235051.html:text/html}
}

@article{mcmillan_effect_1994,
	title = {Effect of megestrol acetate on weight loss, body composition and blood screen of  gastrointestinal cancer patients.},
	volume = {13},
	abstract = {Reduced food intake is probably the major cause of continuing weight loss in cancer patients. Therefore, agents which stimulate food intake may be of significant benefit to such patients. To examine this, a randomized double-blind  placebo controlled study of megestrol acetate was carried out. 38 gastrointestinal cancer patients with weight loss (8-43\% of pre-illness stable weight) were entered into the study. 26 were evaluable at 6 weeks and 21 at 12 weeks. Clinical details, serum biochemistry and haematology were examined at 6 and 12 weeks and total body water, total body potassium at 12 weeks after the baseline assessment. There was no significant weight change in either group over  the 6 or 12 weeks. Furthermore, there was no significant difference in total body water, total body potassium, blood biochemistry or haematology between the groups over the study period. It does not appear that megestrol acetate at a dose of 480 mg/day results in weight gain in advanced gastrointestinal cancer patients with weight loss.},
	pages = {85--89},
	number = {2},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {{McMillan}, D. C. and Simpson, J. M. and Preston, T. and Watson, W. S. and Fearon, K. C. and Shenkin, A. and Burns, H. J. and {McArdle}, C. S.},
	date = {1994-04},
	pmid = {16843365}
}

@article{sato_risk_1998,
	title = {Risk analysis of pancreatic fistula after pancreatic head resection},
	volume = {133},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9790207},
	abstract = {To evaluate the risk factors for pancreatic fistula after pancreatic head resection.},
	pages = {1094--8},
	number = {10},
	journaltitle = {Arch Surg},
	author = {Sato, N and Yamaguchi, K and Chijiiwa, K and Tanaka, M},
	date = {1998-10}
}

@article{junejo_peripheral_2014,
	title = {Peripheral oxygen extraction in patients with malignant obstructive jaundice},
	volume = {69},
	rights = {© 2013 The Association of Anaesthetists of Great Britain and Ireland},
	issn = {1365-2044},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/anae.12478/abstract},
	doi = {10.1111/anae.12478},
	abstract = {Malignant obstructive jaundice is associated with poor aerobic capacity. We measured oxygen consumption and oxygen extraction (arterial-venous oxygen content) in the legs of nine patients during cardiopulmonary exercise testing before pancreaticoduodenectomy. The median ({IQR} [range]) peak oxygen consumption was 67 (49–77 [32–84])\% of predicted. Normal patterns of oxygen extraction were seen with increasing power towards lactate threshold. Near maximal oxygen extraction occurred at peak exercise. Femoral venous oxygen pressure and saturation exceeded baseline values whilst recovering from exercise. These findings suggest that peripheral oxygen extraction is normal during exercise in patients with malignant obstructive jaundice. The primary limitation in oxygen consumption is reduced oxygen delivery.},
	pages = {32--36},
	number = {1},
	journaltitle = {Anaesthesia},
	shortjournal = {Anaesthesia},
	author = {Junejo, M. A. and Siriwardena, A. K. and Parker, M. J.},
	urldate = {2015-08-09},
	date = {2014-01-01},
	langid = {english},
	keywords = {cardiac-failure, chronic heart-failure, cytokines, elderly-patients, endotoxin, Exercise, internal biliary drainage, surgery, trial},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4XN24I43\\Junejo et al. - 2014 - Peripheral oxygen extraction in patients with mali.pdf:application/pdf;Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P3QZHSPT\\Junejo et al. - 2014 - Peripheral oxygen extraction in patients with mali.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8B6IGUSX\\abstract.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X83KWG2B\\abstract.html:text/html}
}

@article{hole_impact_2002,
	title = {Impact of socioeconomic deprivation on outcome after surgery for colorectal cancer},
	volume = {89},
	rights = {© 2002 British Journal of Surgery Society Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2168.2002.02073.x/abstract},
	doi = {10.1046/j.1365-2168.2002.02073.x},
	abstract = {Background:
Previous studies have demonstrated that socioeconomic deprivation is associated with poorer survival in patients with colorectal cancer. These differences have been attributed to more advanced disease at presentation.
Methods:
A total of 2269 patients undergoing resection for colorectal cancer in hospitals in central Scotland between 1991 and 1994 were studied. Socioeconomic status was defined using the Carstairs deprivation index. The impact of deprivation on case mix, treatment and outcome was analysed.
Results:
There were no significant differences in mode of presentation, extent of disease at presentation, type of resection and postoperative mortality rate among the socioeconomic groups. Following curative resection, the overall survival rate at 5 years was 47·0 per cent in deprived patients, compared with 55·4 per cent in affluent patients (P = 0·05); the cancer-specific survival rate was 62·6 per cent in the deprived and 68·1 per cent in the affluent (P = 0·05). Compared with the affluent, the adjusted hazard ratios for the deprived were 1·36 (95 per cent confidence interval (c.i.) 1·09 to 1·69) for overall mortality and 1·26 (95 per cent c.i. 0·95 to 1·67) for cancer-specific mortality. Following palliative resection, there was no difference in survival between the affluent and deprived for either overall (P = 0·27) or cancer-specific (P = 0·89) mortality.
Conclusion:
These findings confirm that the cancer-specific survival rate following surgery for colorectal cancer is lower in deprived patients. Stage of disease at presentation and type of operation did not account for this difference. The excess mortality was confined to patients undergoing apparently curative resection. © 2002 British Journal of Surgery Society Ltd},
	pages = {586--590},
	number = {5},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Hole, D. J. and {McArdle}, C. S.},
	urldate = {2015-05-26},
	date = {2002-05-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RM2HKVMU\\Hole and McArdle - 2002 - Impact of socioeconomic deprivation on outcome aft.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\G574RSSI\\abstract.html:text/html}
}

@article{forrest_comparison_2004,
	title = {Comparison of an inflammation-based prognostic score ({GPS}) with performance status ({ECOG}) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer.},
	volume = {90},
	doi = {10.1038/sj.bjc.6601789},
	abstract = {The value of an inflammation-based prognostic score ({GPS}) was compared with performance status ({ECOG}) in patients (n=109) receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. On multivariate analysis  with {ECOG}, white cell count and the {GPS} entered as covariates, only the {GPS} was a significant independent predictor of survival ({HR} 1.88, 95\% {CI} 1.25-2.84, P=0.002).},
	pages = {1704--1706},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Forrest, L. M. and {McMillan}, D. C. and {McArdle}, C. S. and Angerson, W. J. and Dunlop, D. J.},
	date = {2004-05-04},
	pmid = {15150622},
	pmcid = {PMC2409737},
	keywords = {Adult, Antineoplastic Agents/*therapeutic use, Carcinoma, Non-Small-Cell Lung/drug therapy/*mortality/pathology, C-Reactive Protein/analysis, Female, Humans, Hypoalbuminemia/blood, Inflammation/*blood/pathology, Lung Neoplasms/drug therapy/*mortality/pathology, Male, Middle Aged, Platinum Compounds/*therapeutic use, Prognosis, Survival Analysis, Tumor Markers, Biological/*blood}
}

@article{sonnenberg_personal_2006,
	title = {Personal view: the paradox of runaway competitions in gastroenterology},
	volume = {23},
	issn = {1365-2036},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006.02833.x/abstract},
	doi = {10.1111/j.1365-2036.2006.02833.x},
	shorttitle = {Personal view},
	abstract = {Occasionally, gastroenterologists harbour reservations about the appropriateness of various procedures and management options, yet find themselves drawn into a competition and forced by outside exigencies to provide such services. The aim of the present analysis was to describe patterns of runaway competitions and factors that influence their occurrence in gastroenterology. The interactions between two physicians or physician and patient are modelled as non-zero-sum games of two players. The outcomes associated with two behavioural strategies of two players are arranged in a two-by-two game matrix. Many scenarios of clinical gastroenterology and social interactions among gastroenterologists are characterized by the underlying game of prisoner's dilemma, where two players can choose to co-operate or compete with each other. Although from their joint perspective co-operation results in a higher joint utility, the perspective of each individual favours competition. Following the inescapable logic of their individual perspective, the players end up with a worse outcome than through co-operation. A runaway competition ensues if the game is played repeatedly with players successively increasing their stakes. Ultimately, each player tries to outdo the opponent while heading in the wrong direction. Recognizing the hallmarks of the game of prisoner's dilemma may help gastroenterologists to avoid such competitions.},
	pages = {871--878},
	number = {7},
	journaltitle = {Alimentary Pharmacology \& Therapeutics},
	author = {Sonnenberg, A.},
	urldate = {2015-06-06},
	date = {2006-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RDZEW5IV\\Sonnenberg - 2006 - Personal view the paradox of runaway competitions.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WGZTVZS9\\abstract\;jsessionid=7890273C8322FA730FDAFA81AB720AC3.html:text/html}
}

@article{boyd_whose_1990,
	title = {Whose Utilities for Decision Analysis?},
	volume = {10},
	issn = {0272-989X, 1552-681X},
	url = {http://mdm.sagepub.com/content/10/1/58},
	doi = {10.1177/0272989X9001000109},
	abstract = {The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of treatment for that disease. After preparing and validating a description of colostomy and its effects on patients' lives, utilities for the state were obtained from five groups of individuals. These comprised two groups of patients who received treatment for rectal cancer, a group of physicians and surgeons specializing in the treatment of this disease, and two groups of healthy subjects, none of whom were health professionals. Of the patients who had been treated for rectal cancer, one group had been treated surgically with the formation of colostomies and the other had been treated with radiotherapy and none had a colostomy. Utilities for colostomy were elicited using the standard gamble, category rating, and a treatment choice question naire. The groups differed substantially in the utilities assigned to colostomy. In general, patients with colostomies and physicians assigned significantly higher utilities than did pa tients who did not themselves have a colostomy. The clinical significance of these differences was examined in a simplified clinical decision problem that compared surgery (with colostomy) and radiotherapy (without colostomy) as primary treatment. The expected clinical value of these treatment alternatives was substantially influenced by the differences observed in utilities for colostomy. These results emphasize the importance of patient utilities in clinical decision making and the need to gain greater understanding of the factors that influence the utilities that patients assign to health states. Key words: utilities; decision analysis; oncology. (Med Decis Making 1990;10:58-67)},
	pages = {58--67},
	number = {1},
	journaltitle = {Medical Decision Making},
	shortjournal = {Med Decis Making},
	author = {Boyd, Norman F. and Sutherland, Heather J. and Heasman, Karen Z. and Tritchler, David L. and Cummings, Bernard J.},
	urldate = {2015-05-26},
	date = {1990-02-01},
	langid = {english},
	pmid = {2182963},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8I6P5NIB\\Boyd et al. - 1990 - Whose Utilities for Decision Analysis.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\77ZKJUWI\\58.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MT9PVURF\\58.html:text/html}
}

@article{fearon_pancreatic_1999,
	title = {Pancreatic cancer as a model: inflammatory mediators, acute-phase response, and cancer cachexia.},
	volume = {23},
	abstract = {Patients with pancreatic cancer frequently develop the syndrome of cancer cachexia. Pro-inflammatory cytokines have been strongly implicated in the pathogenesis of this syndrome. In patients with pancreatic cancer an acute-phase  response (an index of pro-inflammatory cytokine activity) is associated with accelerated weight loss, hypermetabolism, anorexia, and a shortened duration of survival. However, little is known about the primary significance of the acute-phase response in terms of altered hepatic export protein synthesis rates and its potential impact on the body's nitrogen economy. In a recent series of studies on weight-losing pancreatic cancer patients with hypoalbuminemia we have  demonstrated albumin synthesis to be unaltered whereas fibrinogen synthesis is increased two- to threefold compared with healthy controls. Because of the mismatch in amino acid composition between the body's main labile amino acid reserve (skeletal muscle) and that of acute-phase proteins, these results lend support to the concept that in pancreatic cancer the reprioritization of body protein metabolism during an acute-phase response may well be a significant factor in the loss of lean tissue in these patients.},
	pages = {584--588},
	number = {6},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Fearon, K. C. and Barber, M. D. and Falconer, J. S. and {McMillan}, D. C. and Ross, J. A. and Preston, T.},
	date = {1999-06},
	pmid = {10227928},
	keywords = {Acute-Phase Proteins/metabolism, Acute-Phase Reaction/*metabolism, Amino Acids/metabolism, Anorexia/etiology, Cachexia/etiology/*metabolism, Cytokines/metabolism, Fibrinogen/biosynthesis, Humans, Inflammation Mediators/*metabolism, Liver/metabolism, Metabolic Diseases/etiology, Muscle, Skeletal/metabolism, Nitrogen/metabolism, Pancreatic Neoplasms/complications/*metabolism, Protein Biosynthesis, Serum Albumin/biosynthesis/metabolism, Survival Rate, Weight Loss}
}

@article{pain_perioperative_1985,
	title = {Perioperative complications in obstructive jaundice: therapeutic considerations},
	volume = {72},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3936565},
	pages = {942--5},
	number = {12},
	journaltitle = {Br J Surg},
	author = {Pain, J A and Cahill, C J and Bailey, M E},
	date = {1985-12}
}

@article{ali_tumour_2004,
	title = {Tumour T-lymphocyte subset infiltration and tumour recurrence following curative  resection for colorectal cancer.},
	volume = {30},
	doi = {10.1016/j.ejso.2003.11.018},
	abstract = {{AIM}: The relationship of tumour T-lymphocytic subset infiltration and recurrence  in patients undergoing potentially curative resection for colorectal cancer has not been clearly defined. {METHODS}: Tumour sections from patients who had undergone potentially curative resection for colorectal cancer were stained and counted for {CD}4+ and {CD}8+ T-lymphocytes. {RESULTS}: Twenty-three patients developed recurrence during the follow-up period. Patients were grouped according to whether or not they developed recurrence. The groups were similar in age, sex, site of tumour, Dukes stage and the numbers of patients receiving adjuvant therapy. The total percentage volume of labelled {CD}4+ T-lymphocytes in the tumour was significantly lower in the patients who recurred (p{\textless}0.05). {CONCLUSIONS}: The results of the present pilot study suggest that a reduction in tumour},
	pages = {292--295},
	number = {3},
	journaltitle = {European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology},
	shortjournal = {Eur J Surg Oncol},
	author = {Ali, A. A. and {McMillan}, D. C. and Matalka, I. I. and {McNicol}, A. M. and {McArdle}, C. S.},
	date = {2004-04},
	pmid = {15028311},
	keywords = {Aged, {CD}4-Positive T-Lymphocytes/*immunology, {CD}8-Positive T-Lymphocytes/*immunology, Chemotaxis, Leukocyte/*immunology, Colectomy, Colorectal Neoplasms/*immunology/pathology/surgery, Female, Humans, Male, Neoplasm Recurrence, Local/*immunology, Neoplasm Staging, Pilot Projects, T-Lymphocyte Subsets/*immunology}
}

@article{cole_clinical_2008,
	title = {Clinical Utility of Peri-Operative C-Reactive Protein Testing in General Surgery},
	volume = {90},
	issn = {0035-8843},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647195/},
	doi = {10.1308/003588408X285865},
	abstract = {{INTRODUCTION}
C-reactive protein ({CRP}) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. {CRP} measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients.

{PATIENTS} {AND} {METHODS}
General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. {CRP} results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted.

{RESULTS}
{CRP} was requested pre-operatively on 84\% of patients. A high {CRP} was more likely to be found in patients with co-morbidity. Postoperatively, {CRP} was requested during the first 3 days on 69\% of patients. {CRP} peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative {CRP}, the peak {CRP} was higher and occurred later, than those who had a normal pre-operative {CRP}.

{CONCLUSIONS}
{CRP} requesting pre-operatively is common, but is not recommended in {NICE} guidelines. Postoperatively, {CRP} levels rise; as a result, its use as a tool to screen for infection is limited. {CRP} has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of {CRP} measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative {CRP} should only be requested if there is a clear clinical indication.},
	pages = {317--321},
	number = {4},
	journaltitle = {Annals of The Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Cole, Duncan S and Watts, Andrew and Scott-Coombes, David and Avades, Tony},
	urldate = {2015-08-19},
	date = {2008-05},
	pmid = {18492397},
	pmcid = {PMC2647195},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D2VIS4ES\\Cole et al. - 2008 - Clinical Utility of Peri-Operative C-Reactive Prot.pdf:application/pdf}
}

@article{padillo_preoperative_1999,
	title = {Preoperative Assessment of Body Fluid Disturbances in Patients with Obstructive Jaundice},
	volume = {23},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/PL00012368},
	doi = {10.1007/PL00012368},
	abstract = {Postoperative renal dysfunction in obstructive jaundice ({OJ}) patients has been associated with hypovolemia and depletion of the extracellular water compartment ({ECW}). The aim of the study was to evaluate the preoperative status of body compartments in {OJ} patients measured by two methods. In a prospective study 39 {OJ} patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group ({CG}). Bioelectrical impedance analysis ({BIA}) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of {BIA} was below 4\% in both {OJ} and {CG} subjects. No differences were found in intracellular water. However total body water ({TBW}) and {ECW} were reduced in {OJ} patients (50.5 ± 4.6 vs. 56 ± 8\% body weight, p= 0.05; and 21 ± 4.5 vs. 23.8 ± 2.5\% body weight, p {\textless} 0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of {OJ} patients had an {ECW} volume below the mean ± 2 {SD} in the {CG} subjects. Anthropometric and {BIA} determinations correlated closely for {TBW} measurements in both {CG} (r= 0.92, p {\textless} 0.001) and {OJ} patients (r= 0.91, p {\textless} 0.001). Bland-Altman analysis also showed that for {TBW} the {BIA} was in agreement with anthropometry. In the present study, {BIA} offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.},
	pages = {681--687},
	number = {7},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J. Surg.},
	author = {Padillo, Francisco J. and Rodriguez, María and Gallardo, Jose M. and Andicoberry, Beatriz and Naranjo, Antonio and Martín-Malo, Alejandro and Miño, Gonzalo and Sitges-Serra, Antonio and Pera-Madrazo, Carlos},
	urldate = {2015-06-03},
	date = {1999-07-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\G344HFXM\\Padillo et al. - 1999 - Preoperative Assessment of Body Fluid Disturbances.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NTDNWQCM\\PL00012368.html:text/html}
}

@article{copeland_possum:_1991,
	title = {{POSSUM}: a scoring system for surgical audit},
	volume = {78},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2021856},
	abstract = {{POSSUM}, a Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and morbidity (P less than 0.001). When displayed graphically zones of increasing morbidity and mortality rates could be defined which could be of value in surgical audit. The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates.},
	pages = {355--60},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Copeland, G P and Jones, D and Walters, M},
	date = {1991-03}
}

@article{myatra_preoperative_2011,
	title = {Preoperative assessment and optimization in periampullary and pancreatic cancer},
	volume = {48},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21248439},
	abstract = {Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign), stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.},
	pages = {86--93},
	number = {1},
	journaltitle = {Indian J Cancer},
	author = {Myatra, S and Divatia, J V and Jibhkate, B and Barreto, G S and Shrikhande, S V},
	date = {2011-03},
	file = {Myatra et al. - 2011 - Preoperative assessment and optimization in periam.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Z99A498P\\Myatra et al. - 2011 - Preoperative assessment and optimization in periam.pdf:application/pdf}
}

@article{zhou_does_2011,
	title = {Does preoperative biliary drainage associated time delay harm? From trial design to conclusion},
	volume = {254},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21775881},
	pages = {542--3},
	number = {3},
	journaltitle = {Ann Surg},
	author = {Zhou, Haiyang and Zhang, Jian and Wang, Weijun and Hu, Zhiqian},
	date = {2011-09},
	file = {Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\97EJ36KD\\Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:application/pdf;Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SXAGIKBM\\Zhou et al. - 2011 - Does preoperative biliary drainage associated time.pdf:application/pdf}
}

@article{bakker_endoscopic_2012,
	title = {Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial},
	volume = {307},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22416101},
	abstract = {Most patients with infected necrotizing pancreatitis require necrosectomy. Surgical necrosectomy induces a proinflammatory response and is associated with a high complication rate. Endoscopic transgastric necrosectomy, a form of natural orifice transluminal endoscopic surgery, may reduce the proinflammatory response and reduce complications.},
	pages = {1053--61},
	number = {10},
	journaltitle = {{JAMA}},
	author = {Bakker, Olaf J and van Santvoort, Hjalmar C and van Brunschot, Sandra and Geskus, Ronald B and Besselink, Marc G and Bollen, Thomas L and van Eijck, Casper H and Fockens, Paul and Hazebroek, Eric J and Nijmeijer, Rian M and Poley, Jan-Werner and van Ramshorst, Bert and Vleggaar, Frank P and Boermeester, Marja A and Gooszen, Hein G and Weusten, Bas L and Timmer, Robin},
	date = {2012-03}
}

@article{yamaguchi_postoperative_2006,
	title = {Postoperative immunosuppression cascade and immunotherapy using lymphokine-activated killer cells for patients with esophageal cancer: possible application for compensatory anti-inflammatory response syndrome},
	volume = {15},
	issn = {1021-335X},
	shorttitle = {Postoperative immunosuppression cascade and immunotherapy using lymphokine-activated killer cells for patients with esophageal cancer},
	abstract = {Immunological parameters were measured in order to elucidate a postoperative immunosuppression mechanism in transthoracic esophagectomy for patients with esophageal cancer. Moreover, lymphokine-activated killer ({LAK}) cells were transferred just after the surgery to overcome the postoperative immunosuppression. Fifteen consecutive patients who underwent transthoracic esophagectomy were subjected to the postoperative measurement of immunological parameters. Ten patients who underwent open cholecystectomy served as controls. Heparinized venous blood was obtained pre- and postoperatively, and serum levels of cytokines {IL}-6 and {IL}-10 and immunosuppressive acidic protein ({IAP}) were measured. Peripheral blood lymphocytes were harvested and analyzed by flow cytometry for phenotype detection and by a mixed lymphocyte reaction for detecting concanavalin (Con)-A-induced or -non-induced suppressor activity. Another 29 consecutive patients who underwent transthoracic esophagectomy were randomly enrolled in a postoperative immunotherapy trial either with or without lymphokine-activated killer cells. It was found that, in the esophagectomy group, {IL}-6 and {IL}-10 increased postoperatively and peaked on day 1, followed by an increase in {IAP}, peaked again on day 4, with a profound decrease in helper and cytotoxic T-cell subsets, followed by increases in Con-A-induced (on day 7 or later) and spontaneous (on day 10) suppressor activities. These changes were minimal in the cholecystectomy group. {LAK} cell transfer restored the postoperative decrease in the helper and cytotoxic T-cell population, and there was a trend of reduction for postoperative remote infection such as pneumonia and surgical site infection in the {LAK} therapy group. Taken together, we would like to propose the existence of a postoperative immunosuppression cascade consisting of increases in cytokines and immunosuppressive proteins, decreases in helper and cytotoxic T-cell populations, and the development of suppressor T-cell activities in surgery for esophageal cancer. Postoperative adoptive transfer of {LAK} cells may be a novel clinical application in surgery for esophageal cancer as a means of treating this postoperative immunosuppressive condition that may be identical to the status of compensatory anti-inflammatory response syndrome ({CARS}).},
	pages = {895--901},
	number = {4},
	journaltitle = {Oncology Reports},
	shortjournal = {Oncol. Rep.},
	author = {Yamaguchi, Yoshiyuki and Hihara, Jun and Hironaka, Katsuji and Ohshita, Akiko and Okita, Riki and Okawaki, Makoto and Matsuura, Kazuo and Nagamine, Ichiro and Ikeda, Takuhiro and Ohara, Masahiro and Hamai, Yoichi},
	date = {2006-04},
	pmid = {16525677},
	keywords = {Aged, Cell Count, Concanavalin A, Esophageal Neoplasms, Esophagectomy, Female, Flow Cytometry, Humans, Immunosuppression, Immunotherapy, Adoptive, Interleukin-6, Interleukin-10, Killer Cells, Lymphokine-Activated, Lymphocyte Culture Test, Mixed, Lymphocytes, Male, Middle Aged, Neoplasm Proteins, Systemic Inflammatory Response Syndrome, Time Factors, T-Lymphocytes, Cytotoxic, T-Lymphocytes, Helper-Inducer}
}

@article{yang_prognostic_2015,
	title = {Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: A meta-analysis},
	volume = {21},
	issn = {1007-9327},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351235/},
	doi = {10.3748/wjg.v21.i9.2807},
	shorttitle = {Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer},
	abstract = {{AIM}: To conduct a meta-analysis evaluating the association between the peripheral blood neutrophil to lymphocyte ratio ({NLR}) and the outcome of patients with pancreatic cancer., {METHODS}: Studies evaluating the relationship between the peripheral blood {NLR} and outcome of patients with pancreatic cancer published up to May 2014 were searched using electronic databases, including {PubMed}, Web of Science, Embase and Ovid. A meta-analysis was performed to pool the hazard ratios ({HRs}) or odds ratios ({ORs}) and their 95\% confidence intervals ({CIs}) using either a fixed-effects model or a random-effects model to quantitatively assess the prognostic value of {NLR} and its association with clinicopathological parameters., {RESULTS}: Eleven studies containing a total of 1804 patients were eligible according to our selection criteria, and combined hazard ratios indicated that high {NLR} was a poor prognostic marker for pancreatic cancer patients because it had an unfavorable impact on the overall survival ({OS}) ({HR} = 2.61, 95\%{CI}: 1.68-4.06, P = 0.000) and cancer specific survival ({HR} = 1.66, 95\%{CI}: 1.08-2.57, P = 0.021). Subgroup analysis revealed that high {NLR} was associated with poor {OS} in patients with mixed treatment ({HR} = 4.36, 95\%{CI}: 2.50-7.61, P = 0.000), chemotherapy ({HR} = 2.08, 95\%{CI}: 1.49-2.9, P = 0.000), or surgical resection ({HR} = 1.2, 95\%{CI}: 1.00-1.44, P = 0.048). Additionally, high {NLR} was significantly correlated with tumor metastasis ({OR} = 1.69, 95\%{CI}: 1.10-2.59, P = 0.016), poor tumor differentiation ({OR} = 2.75, 95\%{CI}: 1.19-6.36, P = 0.016), poor performance status ({OR} = 2.56, 95\%{CI}: 1.63-4.03, P = 0.000), high cancer antigen 199 ({OR} = 2.62, 95\%{CI}: 1.49-4.60, P = 0.000), high C-reactive protein ({OR} = 4.32, 95\%{CI}: 2.71-6.87, P = 0.000), and low albumin ({OR} = 3.56, 95\%{CI}: 1.37-9.27, P = 0.009)., {CONCLUSION}: High peripheral blood {NLR} suggested a poor prognosis for patients with pancreatic cancer, and it could be a novel marker of survival evaluation and could help clinicians develop therapeutic strategies for pancreatic cancer patients.},
	pages = {2807--2815},
	number = {9},
	journaltitle = {World Journal of Gastroenterology : {WJG}},
	shortjournal = {World J Gastroenterol},
	author = {Yang, Jian-Jun and Hu, Zhi-Gao and Shi, Wu-Xiang and Deng, Te and He, Song-Qing and Yuan, Sheng-Guang},
	urldate = {2015-05-26},
	date = {2015-03-07},
	pmid = {25759553},
	pmcid = {PMC4351235},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PQEE7DK6\\Yang et al. - 2015 - Prognostic significance of neutrophil to lymphocyt.pdf:application/pdf}
}

@article{wilson_impaired_2010,
	title = {Impaired functional capacity is associated with all-cause mortality after major elective intra-abdominal surgery},
	volume = {105},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aeq128},
	doi = {10.1093/bja/aeq128},
	pages = {297--303},
	number = {3},
	journaltitle = {British Journal of Anaesthesia},
	author = {Wilson, R. J. T. and Davies, S. and Yates, D. and Redman, J. and Stone, M.},
	urldate = {2014-01-27},
	date = {2010-06-23},
	file = {Wilson et al. - 2010 - Impaired functional capacity is associated with al.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JT6AME3T\\Wilson et al. - 2010 - Impaired functional capacity is associated with al.pdf:application/pdf}
}

@article{sutton_estimation_1940,
	title = {Estimation of cardiopulmonary functional capacity by means of oxygen debt studies},
	volume = {20},
	issn = {0002-8703},
	url = {http://www.sciencedirect.com/science/article/pii/S0002870340908766},
	doi = {10.1016/S0002-8703(40)90876-6},
	abstract = {The response of forty-five persons with, or without, cardiac, pulmonary and combined cardiopulmonary disease to a modified stairclimbing exercise test has been studied, and the “oxygen debt” measured.

The results have been compared with those of other types of function tests, and the limitations of interpretation pointed out.

Although the series of cases is small, the results indicate that the test is important as an objective method of evaluating diminution in cardiopulmonary reserve.},
	pages = {423--442},
	number = {4},
	journaltitle = {American Heart Journal},
	shortjournal = {American Heart Journal},
	author = {Sutton, Frank C. and Britton, James A. and Carr, James G.},
	urldate = {2015-08-22},
	date = {1940-10},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KU23UBV6\\Sutton et al. - 1940 - Estimation of cardiopulmonary functional capacity .pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7J8SMMJ3\\S0002870340908766.html:text/html}
}

@article{bower_irreversible_2011,
	title = {Irreversible electroporation of the pancreas: definitive local therapy without systemic effects},
	volume = {104},
	issn = {1096-9098},
	doi = {10.1002/jso.21899},
	shorttitle = {Irreversible electroporation of the pancreas},
	abstract = {{BACKGROUND}: The use of thermal tumor ablative techniques in the pancreas is limited due to the risk of pancreatitis and damage to major vascular structures. Irreversible electroporation ({IRE}) is a non-thermal ablation technique that could allow ablation in the pancreas while preserving vital surrounding blood vessels. The aim of this study was to assess the safety and ablation volume of {IRE} in porcine pancreatic tissue.
{METHODS}: {IRE} of swine pancreases was performed using an open technique and ultrasound guidance and the animals were followed for 72 hr, 7 days, and 14 days post-{IRE}.
{RESULTS}: All pigs underwent {IRE}, with one pig was unsuccessful after three attempts using at 3,000 V due to inability to achieve a stable current. All animals recovered well and revealed only mild adhesions, no ascites, and no pancreatic necrosis. All animals had transient increases in amylase and lipase that normalized on post-{IRE} day 3. Pathologic analysis revealed that ablation defects (median size 3 cm × 2.8 cm) were seen in electroporated areas with significant destruction of the pancreatic tissue with patent vascular structures.
{CONCLUSIONS}: This animal model demonstrates that {IRE} of the pancreas performed at an optimal voltage is well tolerated, with rapid resolution of pancreatic inflammation and preservation of vascular structures.},
	pages = {22--28},
	number = {1},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J Surg Oncol},
	author = {Bower, Matthew and Sherwood, Leslie and Li, Yan and Martin, Robert},
	date = {2011-07-01},
	pmid = {21360714},
	keywords = {Amylases, Animals, Catheter Ablation, Electroporation, Female, Lipase, Minimally Invasive Surgical Procedures, Models, Animal, pancreas, Sus scrofa, Treatment Outcome}
}

@article{howard_contemporary_1998,
	title = {Contemporary treatment strategies for external pancreatic fistulas},
	volume = {124},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9780981},
	abstract = {Optimal treatment strategies for patients with external pancreatic fistulas have evolved with improved radiographic imaging and the development of transpapillary pancreatic duct stents. The aim of this study was to examine factors affecting fistula closure and develop a classification scheme to guide therapeutic interventions.},
	pages = {627--32; discussion 632--3},
	number = {4},
	journaltitle = {Surgery},
	author = {Howard, T J and Stonerock, C E and Sarkar, J and Lehman, G A and Sherman, S and Wiebke, E A and Madura, J A and Broadie, T A},
	date = {1998-10}
}

@article{guest_application_2012,
	title = {Application of Variable Life Adjusted Display ({VLAD}) to risk-adjusted mortality of esophagogastric cancer surgery},
	volume = {36},
	issn = {1432-2323},
	doi = {10.1007/s00268-011-1303-4},
	abstract = {{PURPOSE}: In the new era of revalidation, there is an increasing need to measure surgical outcome objectively. We apply a graphical method, the Variable Life Adjusted Display ({VLAD}), to esophagogastric resection for malignancy. This technique charts the cumulative difference between expected and actual risk-adjusted mortality over time, allowing observation of performance trends irrespective of case-mix.
{METHODS}: P-{POSSUM} was applied retrospectively to 182 consecutive patients who underwent resection for esophageal or gastric malignancy in a district general hospital. The primary outcome measured was 30-day mortality.
{RESULTS}: A total of 168 patients were eligible for inclusion, with a median age of 68 years. The overall 30-day mortality rate was 4.2\% compared with 7.1\% as predicted by P-{POSSUM}. The resulting {VLAD} plot demonstrates an upward trend of better than predicted surgical performance.
{CONCLUSIONS}: {VLAD} has been hereby applied to esophagogastric surgery and has graphically demonstrated risk-adjusted trends in a single general surgeon's performance. For qualitative comparative purposes, including recertification, {VLAD} is judged to be a simple, directly interpretable, and useful technique for monitoring surgical performance.},
	pages = {104--108},
	number = {1},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Guest, R V and Chandrabalan, V V and Murray, G D and Auld, C D},
	date = {2012-01},
	pmid = {21964818},
	keywords = {Adult, Aged, Aged, 80 and over, Clinical Competence, Esophageal Neoplasms, Esophagectomy, Female, Gastrectomy, Humans, Male, Middle Aged, Retrospective Studies, Risk Adjustment, Severity of Illness Index, Stomach Neoplasms, Treatment Outcome},
	file = {Guest et al. - 2012 - Application of Variable Life Adjusted Display (VLA.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FPAQPGJ2\\Guest et al. - 2012 - Application of Variable Life Adjusted Display (VLA.pdf:application/pdf}
}

@article{mcneer_early_2010,
	title = {Early elevation of C-reactive protein correlates with severe infection and nonrelapse mortality in children undergoing allogeneic stem cell transplantation},
	volume = {16},
	issn = {1523-6536},
	doi = {10.1016/j.bbmt.2009.10.036},
	abstract = {C-reactive protein ({CRP}) is an acute phase reactant that is a reliable marker of systemic inflammation and has been associated with increased morbidity and mortality following hematopoietic stem cell transplantation ({HSCT}) in adults. In this study, we evaluated whether early elevations of {CRP} were associated with various complications and nonrelapse mortality following {HSCT} in pediatric patients. Seventy pediatric patients had {CRP} levels drawn at regular time points during the first week following their transplants. Patients were followed for 100 days following transplant, and transplant-related complications were documented. Patients who subsequently developed severe infections had higher median {CRP} values than those without severe infections (median 8.03 mg/{dL} versus 1.64 mg/{dL}, P = .0008) as did those who suffered nonrelapse mortality compared with those who did not (12.6 mg/{dL} versus 2.44 mg/{dL}, P = .02). These findings suggest that elevated {CRP} values may be useful as a marker of individual pediatric patients with a higher risk for treatment-related morbidity and mortality.},
	pages = {350--357},
	number = {3},
	journaltitle = {Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation},
	shortjournal = {Biol. Blood Marrow Transplant.},
	author = {{McNeer}, Jennifer L. and Kletzel, Morris and Rademaker, Alfred and Alford, Kavita and O'Day, Kathleen and Schaefer, Colleen and Duerst, Reggie and Jacobsohn, David A.},
	date = {2010-03},
	pmid = {20005964},
	keywords = {Adolescent, Adult, Area Under Curve, Biological Markers, Child, Child, Preschool, Communicable Diseases, C-Reactive Protein, Female, Graft vs Host Disease, Hematologic Diseases, Hematologic Neoplasms, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, postoperative complications, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, {ROC} Curve, Sex Factors, Transplantation Conditioning, Transplantation, Homologous, Young Adult}
}

@article{rachet_socioeconomic_2010,
	title = {Socioeconomic inequalities in cancer survival in England after the {NHS} cancer plan},
	volume = {103},
	rights = {© 2010 Nature Publishing Group},
	issn = {0007-0920},
	url = {http://www.nature.com/bjc/journal/v103/n4/full/6605752a.html},
	doi = {10.1038/sj.bjc.6605752},
	abstract = {Background: Socioeconomic inequalities in survival were observed for many cancers in England during 1981–1999. The {NHS} Cancer Plan (2000) aimed to improve survival and reduce these inequalities. This study examines trends in the deprivation gap in cancer survival after implementation of the Plan.
Materials and method: We examined relative survival among adults diagnosed with 1 of 21 common cancers in England during 1996–2006, followed up to 31 December 2007. Three periods were defined: 1996–2000 (before the Cancer Plan), 2001–2003 (initialisation) and 2004–2006 (implementation). We estimated the difference in survival between the most deprived and most affluent groups (deprivation gap) at 1 and 3 years after diagnosis, and the change in the deprivation gap both within and between these periods.
Results: Survival improved for most cancers, but inequalities in survival were still wide for many cancers in 2006. Only the deprivation gap in 1-year survival narrowed slightly over time. A majority of the socioeconomic disparities in survival occurred soon after a cancer diagnosis, regardless of the cancer prognosis.
Conclusion: The recently observed reduction in the deprivation gap was minor and limited to 1-year survival, suggesting that, so far, the Cancer Plan has little effect on those inequalities. Our findings highlight that earlier diagnosis and rapid access to optimal treatment should be ensured for all socioeconomic groups.},
	pages = {446--453},
	number = {4},
	journaltitle = {British Journal of Cancer},
	shortjournal = {Br J Cancer},
	author = {Rachet, B. and Ellis, L. and Maringe, C. and Chu, T. and Nur, U. and Quaresma, M. and Shah, A. and Walters, S. and Woods, L. and Forman, D. and Coleman, M. P.},
	urldate = {2015-05-26},
	date = {2010-08-10},
	langid = {english},
	keywords = {deprivation, health policy, relative survival, socioeconomic inequalities},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\R3DQTAW8\\Rachet et al. - 2010 - Socioeconomic inequalities in cancer survival in E.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C3A4NPMP\\6605752a.html:text/html}
}

@article{omokawa_mitochondrial_1989,
	title = {Mitochondrial function of isolated rat hepatocytes from normal and cirrhotic liver},
	volume = {158},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2588258},
	abstract = {Mitochondrial fractions were obtained from purely isolated hepatocytes of the normal and cirrhotic livers. Mitochondrial function of isolated hepatocytes was evaluated to compare between those from the normal and those from the cirrhotic livers in addition to the evaluation of the mitochondrial function of the normal and cirrhotic liver tissues. Respiratory control, {ADP}/O ratio and {ATP} synthesis were significantly lower in the cirrhotic liver tissue than those in the normal liver tissue. However, the mitochondrial function of isolated hepatocytes showed no difference between normal and cirrhotic groups. By electron microscopic examination, debris was more observed in the mitochondrial fractions from the normal and cirrhotic tissues compared to those from hepatocytes. However, no difference of the shape and size of the mitochondria was seen between the fraction from hepatocytes and that from the tissue in each group. These results suggest that as far as hepatocyte itself is concerned, the cirrhotic liver preserves the sufficient function as well as the normal liver.},
	pages = {265--8},
	number = {4},
	journaltitle = {Tohoku J Exp Med},
	author = {Omokawa, S and Koyama, K and Suzuki, K and Asanuma, Y},
	date = {1989-08}
}

@article{nakano_perioperative_1999,
	title = {Perioperative hepatic functional risk assessed with technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin liver scintigraphy in patients undergoing pancreaticoduodenectomy complicated by obstructive jaundice},
	volume = {25},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10211415},
	abstract = {{CONCLUSION}: Liver scintigraphy with technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin (Tc-{GSA}) can be used to predict outcome of biliary drainage and hepatic function after pancreaticoduodenectomy in patients with pancreatic, biliary, and ampullary carcinomas complicated by obstructive jaundice. {BACKGROUND}: Preoperative obstructive jaundice has been reported as a crucial risk factor for serious postoperative complications in patients undergoing pancreaticoduodenectomy. The aim of the present study was to investigate whether Tc-{GSA} liver scintigraphy can assess hepatic functional risk in patients with pancreatic, biliary, and ampullary carcinomas complicated by obstructive jaundice. {METHODS}: Liver scintigraphy was performed before biliary drainage in 18 patients with obstructive jaundice. The maximum removal rate of Tc-{GSA} ({GSA}-Rmax; standard normal value {\textgreater} or = 0.60) was calculated. These patients underwent pancreaticoduodenectomy with wide lymphadenectomy. The efficacy of preoperative biliary drainage was assessed with the decrease in serum bilirubin concentration in the first week after biliary drainage. Postoperative liver function was assessed with the increase in serum bilirubin concentration, which was the difference between the immediate preoperative and maximal postoperative bilirubin concentrations. {RESULTS}: Serum bilirubin decreased more in the first week after biliary drainage in patients with {GSA}-Rmax {\textgreater} or = 0.60 (7.64 +/- 1.09 mg/Dl/wk) than in patients with {GSA}-Rmax {\textless} 0.60 (3.56 +/- 1.25 mg/{DL}/wk, p = 0.042). Postoperative bilirubin increased less in patients with {GSA}-Rmax {\textgreater} or = 0.60 (0.81 +/- 0.30 mg/{dL}) than in patients with {GSA}-Rmax {\textless} 0.60 (4.00 +/- 0.69 mg/{DL}, p = 0.0012). Multivariate analysis showed that {GSA}-Rmax significantly predicted the postoperative bilirubin increase (p = 0.020).},
	pages = {3--9},
	number = {1},
	journaltitle = {Int J Pancreatol},
	author = {Nakano, H and Kumada, K and Takekuma, Y and Hasebe, S and Yoshizawa, Y and Yamaguchi, M and Jaeck, D},
	date = {1999-02}
}

@article{mcmillan_web-based_2011,
	title = {Web-based course in neuroimmune pharmacology.},
	volume = {6},
	doi = {10.1007/s11481-010-9235-6},
	abstract = {Web-based instruction of biomedical sciences courses has increased dramatically during the last decade, and this increase has been driven by the need to increase student access to educational programs and by the increasing demand for courses that are compatible with distance learning. Here, a blended learning curriculum in neuroimmune pharmacology is described that combines web-based learning modules with traditional face-to-face lectures. The course content is appropriate for graduate-level students and can be adapted to an entirely web-based course that can be deployed for distance learning. In addition to providing a course syllabus, this article describes the process of creating the web-based modules for course construction.},
	pages = {76--79},
	number = {1},
	journaltitle = {Journal of neuroimmune pharmacology : the official journal of the Society on {NeuroImmune} Pharmacology},
	shortjournal = {J Neuroimmune Pharmacol},
	author = {{McMillan}, David C.},
	date = {2011-03},
	pmid = {20658201},
	keywords = {Allergy and Immunology/*education, Computer-Assisted Instruction/*methods, Curriculum, Education, Distance/*methods, Education, Graduate/methods, Humans, Internet, Neurosciences/*education, Pharmacology/*education}
}

@article{hooper_mitochondrial_1995,
	title = {Mitochondrial Enzyme Deficiency Causing Exercise Limitation in Normal-Appearing Adults},
	volume = {107},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.107.2.317},
	doi = {10.1378/chest.107.2.317},
	pages = {317},
	number = {2},
	journaltitle = {{CHEST} Journal},
	author = {Hooper, Robert G.},
	urldate = {2015-04-28},
	date = {1995-02-01},
	langid = {english},
	file = {Hooper - 1995 - Mitochondrial Enzyme Deficiency Causing Exercise L.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NTGX5SS3\\Hooper - 1995 - Mitochondrial Enzyme Deficiency Causing Exercise L.pdf:application/pdf}
}

@article{hilmy_relationship_2006,
	title = {The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration and {COX}-2 expression and survival in patients with transitional cell carcinoma of the urinary bladder.},
	volume = {95},
	doi = {10.1038/sj.bjc.6603415},
	abstract = {The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration, and {COX}-2 expression and survival was examined in patients with transitional cell carcinoma of the urinary bladder (n=103). Sixty-one patients had superficial disease and 42 patients had invasive  disease. Cancer-specific survival was shorter in those patients with invasive compared with superficial bladder cancer (P{\textless}0.001). On univariate analysis, stratified by stage, increased Ki-67 labelling index (P{\textless}0.05), increased {COX}-2 expression (P{\textless}0.05), C-reactive protein (P{\textless}0.05) and adjuvant therapy (P{\textless}0.01) were associated with poorer cancer-specific survival. On multivariate analysis of these significant factors, stratified by stage, only C-reactive protein ({HR} 2.89, 95\% {CI} 1.42-5.91, P=0.004) and adjuvant therapy ({HR} 0.29, 95\% {CI} 0.14-0.62, P=0.001) were independently associated with poorer cancer-specific survival. These results would suggest that tumour-based factors such as grade, {COX}-2 expression or T-lymphocytic infiltration are subordinate to systemic factors such as C-reactive protein in determining survival in patients with transitional cell  carcinoma of the urinary bladder.},
	pages = {1234--1238},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Hilmy, M. and Campbell, R. and Bartlett, J. M. S. and {McNicol}, A.-M. and Underwood, M. A. and {McMillan}, D. C.},
	date = {2006-11-06},
	pmid = {17024120},
	pmcid = {PMC2360556},
	keywords = {*Cell Proliferation, Aged, Carcinoma, Transitional Cell/blood/enzymology/*pathology, {CD}4-Positive T-Lymphocytes/metabolism/pathology, {CD}8-Positive T-Lymphocytes/metabolism/pathology, C-Reactive Protein/analysis, Cross-Sectional Studies, Cyclooxygenase 2/*biosynthesis, Female, Humans, Immunohistochemistry, Inflammation/*blood, Ki-67 Antigen/analysis, Lymphocytes, Tumor-Infiltrating/metabolism/*pathology, Male, Middle Aged, Multivariate Analysis, Prognosis, Retrospective Studies, Survival Analysis, Urinary Bladder Neoplasms/blood/enzymology/*pathology}
}

@article{bakkevold_morbidity_1993,
	title = {Morbidity and mortality after radical and palliative pancreatic cancer surgery. Risk factors influencing the short-term results},
	volume = {217},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7682052},
	abstract = {{OBJECTIVE}: To analyze the morbidity and mortality after radical and palliative pancreatic cancer surgery in Norway, especially the risk factors. {SUMMARY} {BACKGROUND} {DATA}: A prospective multicenter study between 1984-1987 including only histologically or cytologically verified adenocarcinoma of the pancreas (N = 442) or the papilla of Vater (N = 30); 84 patients (19\%) with pancreatic carcinoma and 24 patients (80\%) with papilla carcinoma underwent radical operations. A palliative procedure was performed in 252 patients (53\%). {METHODS}: Clinical data, surgical procedures and the following morbidity and mortality were recorded on standardized forms. The risk factors were analyzed by a logistic multiple regression model. {RESULTS}: The morbidity, reoperation, and mortality rates were 43, 18, and 11\% after radical surgery and 23, 4, and 14\% after palliative surgery. Karnofsky's index was the sole independent risk factor for death after radical surgery. Splenectomy, age, and {TNM} stage influenced morbidity. Diabetes, Karnofsky's index, and liver metastases were risk factors in palliative surgery. {CONCLUSIONS}: The morbidity and mortality risks were comparable between total pancreatectomy and a Whipple's procedure and between biliary and a double bypass. Preoperative biliary drainage had no impact on the risks and may be abandoned. High age is a relative and a low Karnofsky's index an absolute contraindication for radical surgery. Nonsurgical palliation of jaundice should be considered according to the presence of independent risk factors.},
	pages = {356--68},
	number = {4},
	journaltitle = {Ann Surg},
	author = {Bakkevold, K E and Kambestad, B},
	date = {1993-04}
}

@article{ammori_laparoscopic_2002,
	title = {Laparoscopic transgastric pancreatic necrosectomy for infected pancreatic necrosis},
	volume = {16},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12072994},
	abstract = {Secondary infection of pancreatic necrosis is an indication for surgical debridement, and has traditionally been treated by laparotomy, and more recently by laparoscopic transmesocolic or transgastrocolic and retroperitoneoscopic approaches. This report describes and evaluates the safety and feasibility of a laparoscopic transgastric approach to extensive necrosectomy for infected pancreatic necrosis.},
	pages = {1362},
	number = {9},
	journaltitle = {Surg Endosc},
	author = {Ammori, B J},
	date = {2002-09}
}

@article{gillis_prehabilitation_2014,
	title = {Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer},
	volume = {121},
	issn = {1528-1175},
	doi = {10.1097/ALN.0000000000000393},
	shorttitle = {Prehabilitation versus rehabilitation},
	abstract = {{BACKGROUND}: The preoperative period (prehabilitation) may represent a more appropriate time than the postoperative period to implement an intervention. The impact of prehabilitation on recovery of function al exercise capacity was thus studied in patients undergoing colorectal resection for cancer.
{METHODS}: A parallel-arm single-blind superiority randomized controlled trial was conducted. Seventy-seven patients were randomized to receive either prehabilitation (n = 38) or rehabilitation (n = 39). Both groups received a home-based intervention of moderate aerobic and resistance exercises, nutritional counseling with protein supplementation, and relaxation exercises initiated either 4 weeks before surgery (prehabilitation) or immediately after surgery (rehabilitation), and continued for 8 weeks after surgery. Patients were managed with an enhanced recovery pathway. Primary outcome was functional exercise capacity measured using the validated 6-min walk test.
{RESULTS}: Median duration of prehabilitation was 24.5 days. While awaiting surgery, functional walking capacity increased (≥ 20 m) in a higher proportion of the prehabilitation group compared with the rehabilitation group (53 vs. 15\%, adjusted P = 0.006). Complication rates and duration of hospital stay were similar. The difference between baseline and 8-week 6-min walking test was significantly higher in the prehabilitation compared with the rehabilitation group (+23.7 m [{SD}, 54.8] vs. -21.8 m [{SD}, 80.7]; mean difference 45.4 m [95\% {CI}, 13.9 to 77.0]). A higher proportion of the prehabilitation group were also recovered to or above baseline exercise capacity at 8 weeks compared with the rehabilitation group (84 vs. 62\%, adjusted P = 0.049).
{CONCLUSION}: Meaningful changes in postoperative functional exercise capacity can be achieved with a prehabilitation program.},
	pages = {937--947},
	number = {5},
	journaltitle = {Anesthesiology},
	shortjournal = {Anesthesiology},
	author = {Gillis, Chelsia and Li, Chao and Lee, Lawrence and Awasthi, Rashami and Augustin, Berson and Gamsa, Ann and Liberman, A. Sender and Stein, Barry and Charlebois, Patrick and Feldman, Liane S. and Carli, Francesco},
	date = {2014-11},
	pmid = {25076007},
	keywords = {Aged, Colorectal Neoplasms, Exercise, Exercise Therapy, Exercise Tolerance, Female, Humans, Male, Middle Aged, Nutrition Therapy, Postoperative Care, preoperative care, Resistance Training, Single-Blind Method, Treatment Outcome, Walking}
}

@article{forrest_comparison_2014,
	title = {Comparison of visual and automated assessment of tumour inflammatory infiltrates  in patients with colorectal cancer.},
	volume = {50},
	rights = {Copyright (c) 2013 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ejca.2013.11.003},
	abstract = {{BACKGROUND}: Cancer-associated inflammation is increasingly recognised to be an important determinant of oncological outcome. In colorectal cancer, the presence  of peri-tumoural inflammatory/lymphocytic infiltrates predicts improved survival. To date, these infiltrates, assessed visually on haematoxylin and eosin (H\&E) stained sections, have failed to enter routine clinical practice, partly due to their subjective assessment and considerable inter-observer variation. The present study aims to develop an automated scoring method to enable consistent and reproducible assessment of tumour inflammatory infiltrates in colorectal cancer. {METHODS}: 154 colorectal cancer patients who underwent curative resection  were included in the study. The local inflammatory infiltrate was assessed using  the method described by Klintrup-Makinen. H\&E tumour sections were uploaded to an image analysis programme (Slidepath, Leica Biosystems). An image analysis algorithm was developed to count the inflammatory cells at the invasive margin. The manual and automated assessments of the tumour inflammatory infiltrates were  then compared. {RESULTS}: The automated inflammatory cell counts assessed using the freehand annotation method (p{\textless}0.001) and the rectangular box method (p{\textless}0.001) were significantly associated with both K-M score (p{\textless}0.001) and K-M grade (p{\textless}0.001). The inflammatory cell counts were divided using quartiles to group tumours with similar inflammatory cell densities. There was good agreement between the manual and automated scoring methods (intraclass correlation coefficient ({ICC})=0.82). Similar to the visual K-M scoring system, the automated},
	pages = {544--552},
	number = {3},
	journaltitle = {European journal of cancer (Oxford, England : 1990)},
	shortjournal = {Eur J Cancer},
	author = {Forrest, R. and Guthrie, G. J. K. and Orange, C. and Horgan, P. G. and {McMillan}, D. C. and Roxburgh, C. S. D.},
	date = {2014-02},
	pmid = {24332571},
	keywords = {Aged, Cell Count, Cell Separation/methods, Colorectal Neoplasms/diagnosis/*pathology, Female, Humans, Inflammation/diagnosis/*pathology, Male, Middle Aged, Prognosis, Treatment Outcome}
}

@article{mansouri_screening_2013,
	title = {Screening for colorectal cancer: what is the impact on the determinants of outcome?},
	volume = {85},
	rights = {Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved.},
	doi = {10.1016/j.critrevonc.2012.08.006},
	abstract = {Colorectal cancer screening has been introduced across the {UK} following several large randomised control trials and a Cochrane review that have shown a reduction in cancer specific mortality with population based Faecal Occult Blood testing. This has been attributed to the detection of more early stage disease. It is well known that in addition to stage at presentation there are a variety of other key  factors that determine a patient's outcome following a diagnosis of colorectal cancer. For example there are tumour-related factors, such the presence of venous invasion and tumour necrosis, and also host-related factors, both in terms of demographic profile and an elevated circulating host inflammatory response that have been shown to be predictive of a poorer outcome. The present review summarises both the background behind the current screening programme and the observed and anticipated impact that colorectal cancer screening will have on the key determinants of outcome.},
	pages = {342--349},
	number = {3},
	journaltitle = {Critical reviews in oncology/hematology},
	shortjournal = {Crit Rev Oncol Hematol},
	author = {Mansouri, David and {McMillan}, Donald C. and Crighton, Emilia M. and Horgan, Paul G.},
	date = {2013-03},
	pmid = {22980405},
	keywords = {Colorectal Neoplasms/*diagnosis, Early Detection of Cancer, Great Britain, Humans, Prognosis}
}

@article{mcardle_systemic_2006,
	title = {Systemic inflammatory response, prostate-specific antigen and survival in patients with metastatic prostate cancer.},
	volume = {77},
	doi = {10.1159/000093905},
	abstract = {{BACKGROUND}: It is increasingly recognised that, in cancer patients, disease progression is dependent on a complex interaction of the tumour and the host inflammatory response and that the systemic inflammatory response, as evidenced by an elevated C-reactive protein ({CRP}) concentration, may be a useful prognostic factor. {MATERIALS} {AND} {METHODS}: The prognostic value of {CRP} compared with prostate-specific antigen ({PSA}) was examined in 62 patients with metastatic prostate cancer receiving androgen-deprivation therapy. {RESULTS}: In all, 41 (66\%) of patients died, 38 (61\%) of their disease. On univariate survival analysis, {PSA} (p {\textless} 0.05) and {CRP} (p {\textless} 0.05) were significant predictors of cancer-specific survival. On multivariate analysis, both {PSA} ({HR} 1.96, 95\% {CI} 1.00-3.83, p = 0.049) and {CR} ({HR} 1.97, 95\% {CI} 0.99-3.92, p = 0.052) were independent predictors  of cancer-specific survival. {PSA} concentrations were significantly correlated with those of {CRP} (r(s) = 0.46, p {\textless} 0.001). {CONCLUSION}: The results of the present study suggest that, in patients with metastatic prostate cancer, the presence of an elevated {CRP} concentration predicts poor outcome, independent of {PSA}.},
	pages = {127--129},
	number = {2},
	journaltitle = {Urologia internationalis},
	shortjournal = {Urol Int},
	author = {{McArdle}, Peter A. and Mir, Khurram and Almushatat, A. S. K. and Wallace, A. Michael and Underwood, Mark A. and {McMillan}, Donald C.},
	date = {2006},
	pmid = {16888416},
	keywords = {Aged, Humans, Inflammation/*etiology, Male, Neoplasm Metastasis, Prostate-Specific Antigen/*blood, Prostatic Neoplasms/*blood/complications/*mortality/pathology, Survival Rate}
}

@article{stevenson_quantitative_2009,
	title = {Quantitative {SERRS} immunoassay for the detection of human {PSA}.},
	volume = {134},
	doi = {10.1039/b902174d},
	abstract = {We report the first use of a commonly used {ELISA} colorimetric substrate as a {SERRS} marker and show how it can be used for the detection of pg ml(-1) levels of human prostate specific antigen ({PSA}) in clinical samples. The technique is amenable over a wide range of concentrations and lends itself to future multiplexing analysis.},
	pages = {842--844},
	number = {5},
	journaltitle = {The Analyst},
	shortjournal = {Analyst},
	author = {Stevenson, Ross and Ingram, Andrew and Leung, Hing and {McMillan}, Donald C. and Graham, Duncan},
	date = {2009-05},
	pmid = {19381373},
	keywords = {Benzothiazoles, Colorimetry, Enzyme-Linked Immunosorbent Assay/instrumentation/*methods, Humans, Male, Prostate-Specific Antigen/*blood, Spectrum Analysis, Raman/instrumentation/*methods, Sulfonic Acids, Thiazoles, Time Factors}
}

@article{tsai_impact_2010,
	title = {Impact of obesity on perioperative outcomes and survival following pancreaticoduodenectomy for pancreatic cancer: a large single-institution study},
	volume = {14},
	issn = {1873-4626},
	doi = {10.1007/s11605-010-1201-3},
	shorttitle = {Impact of obesity on perioperative outcomes and survival following pancreaticoduodenectomy for pancreatic cancer},
	abstract = {{BACKGROUND}: To examine the effect of body mass index ({BMI}) on clinicopathologic factors and long-term survival in patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma.
{METHODS}: Data on {BMI}, weight loss, operative details, surgical pathology, and long-term survival were collected on 795 patients who underwent pancreaticoduodenectomy. Patients were categorized as obese ({BMI} {\textgreater} 30 kg/m(2)), overweight ({BMI} 25 to {\textless}30 kg/m(2)), or normal weight ({BMI} {\textless} 25 kg/m(2)) and compared using univariate and multivariate analyses.
{RESULTS}: At the time of surgery, 14\% of patients were obese, 33\% overweight, and 53\% normal weight. Overall, 32\% of patients had preoperative weight loss of {\textgreater}10\%. There were no differences in operative times among the groups; however, higher {BMI} was associated with increased risk of blood loss (P {\textless} 0.001) and pancreatic fistula (P = 0.01). On pathologic analysis, {BMI} was not associated with tumor stage or number of lymph nodes harvested (both P {\textgreater} 0.05). Higher {BMI} patients had a lower incidence of a positive retroperitoneal/uncinate margin versus normal weight patients (P = 0.03). Perioperative morbidity and mortality were similar among the groups. Obese and overweight patients had better 5-year survival (22\% and 22\%, respectively) versus normal weight patients (15\%; P = 0.02). After adjusting for other prognostic factors, as well as preoperative weight loss, higher {BMI} remained independently associated with improved cancer-specific survival (overweight: hazard ratio, 0.68; obese: hazard ratio, 0.72; both P {\textless} 0.05).
{CONCLUSION}: Obese patients had similar tumor-specific characteristics, as well as perioperative outcomes, compared with normal weight patients. However, obese patients undergoing pancreaticoduodenectomy for pancreatic cancer had an improved long-term survival independent of known clinicopathologic factors.},
	pages = {1143--1150},
	number = {7},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Tsai, Susan and Choti, Michael A. and Assumpcao, Lia and Cameron, John L. and Gleisner, Ana L. and Herman, Joseph M. and Eckhauser, Frederic and Edil, Barish H. and Schulick, Richard D. and Wolfgang, Christopher L. and Pawlik, Timothy M.},
	date = {2010-07},
	pmid = {20431978},
	keywords = {Adenocarcinoma, Aged, Body Mass Index, Female, Humans, Male, Middle Aged, Obesity, Overweight, Pancreatic Neoplasms, Pancreaticoduodenectomy, Survival Rate, Treatment Outcome},
	file = {Tsai et al. - 2010 - Impact of Obesity on Perioperative Outcomes and Su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RGE9X74X\\Tsai et al. - 2010 - Impact of Obesity on Perioperative Outcomes and Su.pdf:application/pdf}
}

@article{mcardle_impact_2006,
	title = {The impact of blood loss, obstruction and perforation on survival in patients undergoing curative resection for colon cancer.},
	volume = {93},
	doi = {10.1002/bjs.5269},
	abstract = {{BACKGROUND}: Previous studies have drawn attention to the high postoperative mortality and poor survival of patients who present as an emergency with colon cancer. However, these patients are a heterogeneous group. The aim of the present study was to establish, having adjusted for case mix, the size of the differences in postoperative mortality and 5-year survival between patients presenting as an  emergency with evidence of blood loss, obstruction and perforation. {METHODS}: The  study included 2068 patients who presented with colon cancer between 1991 and 1994 in Scotland. Five-year survival rates and the adjusted hazard ratios were calculated. {RESULTS}: Thirty-day postoperative mortality following potentially curative resection was consistently higher in patients who presented with evidence of blood loss, obstruction or perforation (all P {\textless} 0.005) than in elective patients. Following potentially curative surgery, cancer-specific survival at 5 years was 74.6 per cent compared with 60.9, 51.6 and 46.5 per cent  in those who presented with blood loss, obstruction and perforation respectively  (all P {\textless} 0.001). The corresponding adjusted hazard ratios (95 per cent confidence interval) for cancer-specific survival, relative to elective patients, were 1.62  (1.22 to 2.15), 2.22 (1.78 to 2.75) and 2.93 (1.82 to 4.70) for patients presenting with evidence of blood loss, obstruction or perforation (all P {\textless} 0.001). {CONCLUSION}: Compared with patients who undergo elective surgery for colon cancer, those who present as an emergency with evidence of blood loss, obstruction or perforation have higher postoperative mortality rates and poorer cancer-specific survival.},
	pages = {483--488},
	number = {4},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {{McArdle}, C. S. and {McMillan}, D. C. and Hole, D. J.},
	date = {2006-04},
	pmid = {16555262},
	keywords = {Adult, Aged, Colonic Neoplasms/mortality/*surgery, Diagnosis-Related Groups, Emergencies, Emergency Treatment/mortality, Female, Gastrointestinal Hemorrhage/*complications/mortality, Humans, Intestinal Obstruction/*complications/mortality, Intestinal Perforation/*complications/mortality, Male, Middle Aged, Postoperative Complications/*etiology/mortality, Proportional Hazards Models, Survival Analysis}
}

@article{ogata_role_2000,
	title = {Role of interleukin-10 on hyporesponsiveness of endotoxin during surgery},
	volume = {28},
	issn = {0090-3493},
	abstract = {{OBJECTIVE}: To examine whether surgical stress causes blood cells to lose their responsiveness to endotoxin during surgery.
{DESIGN}: Prospective case series.
{SETTING}: A university hospital.
{PATIENTS}: Sixteen volunteers classified as American Society of Anesthesiologists physical status I-{II} who were scheduled for elective distal partial gastrectomy.
{INTERVENTIONS}: We studied nine patients who underwent elective distal partial gastrectomy. Blood samples for tumor necrosis factor ({TNF}) and interleukin ({IL})-10 assay were obtained before anesthesia, preincision, 2 hrs and 4 hrs postincision, postextubation, and 24 hrs postincision. The rest of each blood sample was diluted with 5 volumes of endotoxin-free saline, incubated for 4 hrs in the presence of lipopolysaccharide ({LPS}), centrifuged to remove cells, and assayed for {TNF}. In another seven patients, antihuman {IL}-10 antibody was added into the diluted whole blood sample before {LPS} stimulation.
{MEASUREMENTS} {AND} {MAIN} {RESULTS}: {TNF} activity was not detected in the blood of any patient throughout the study. In contrast, plasma cortisol and {IL}-10 levels increased rapidly during surgery (p {\textless} .01, p {\textless} .05, respectively). {LPS}-induced {TNF} activity in whole blood decreased significantly during surgery (p {\textless} .01) and recovered to control levels by 24 hrs postincision. The peak suppression of {LPS}-induced {TNF} and the peak value of plasma {IL}-10 levels occurred postextubation. Treatment with anti-{IL}-10 antibody partially restored the ability of {LPS} to induce {TNF} activity postextubation (p {\textless} .05).
{CONCLUSIONS}: Surgical trauma rapidly induces a transient hyporesponsiveness of blood cells to endotoxin. Plasma {IL}-10, which increases during surgery, participates in this hyporesponsiveness.},
	pages = {3166--3170},
	number = {9},
	journaltitle = {Critical Care Medicine},
	shortjournal = {Crit. Care Med.},
	author = {Ogata, M. and Okamoto, K. and Kohriyama, K. and Kawasaki, T. and Itoh, H. and Shigematsu, A.},
	date = {2000-09},
	pmid = {11008976},
	keywords = {Adult, Endotoxins, Escherichia coli, Gastrectomy, Humans, Hydrocortisone, Immune Tolerance, Interleukin-10, Lipopolysaccharides, postoperative complications, Tumor Necrosis Factor-alpha}
}

@article{crozier_presence_2006,
	title = {The presence of a systemic inflammatory response predicts poorer survival in patients receiving adjuvant 5-{FU} chemotherapy following potentially curative resection for colorectal cancer.},
	volume = {94},
	doi = {10.1038/sj.bjc.6603185},
	abstract = {There is increasing evidence that the presence of a systemic inflammatory response plays an important role in survival following curative resection for colorectal cancer. The present study evaluated the relationship between},
	pages = {1833--1836},
	number = {12},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Crozier, J. E. M. and {McKee}, R. F. and {McArdle}, C. S. and Angerson, W. J. and Anderson, J. H. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2006-06-19},
	pmid = {16721360},
	pmcid = {PMC2361334},
	keywords = {Adenocarcinoma/*drug therapy/mortality/surgery, Aged, Antimetabolites, Antineoplastic/*therapeutic use, Chemotherapy, Adjuvant, Colorectal Neoplasms/*drug therapy/mortality/surgery, C-Reactive Protein/analysis, Digestive System Surgical Procedures, Female, Fluorouracil/*therapeutic use, Humans, Inflammation/*physiopathology, Male, Middle Aged, Prognosis, Survival Analysis, Survival Rate}
}

@article{smith_social_2006,
	title = {Social deprivation and outcomes in colorectal cancer},
	volume = {93},
	doi = {10.1002/bjs.5357},
	abstract = {Background: The aim of this study was to examine the influence of social deprivation on postoperative mortality and length of stay in patients having surgery for colorectal cancer. Methods: Data were extracted from the Association of Coloproctology of Great Britain and Ireland database of patients presenting between April 2001 and March 2002. The effect of social deprivation, measured by the Townsend score, on 30-day postoperative mortality and length of stay was evaluated by two-level hierarchical regression analysis. Results: A total of 7290 (86.8 per cent) patients underwent surgery. Operative mortality was 6.7 per cent and median length of stay 11 days. Deprivation indices were significantly higher in patients with Dukes' 'D' cancers, undergoing emergency surgery and with higher American Society of Anesthesiologists ({ASA}) grades (P {\textless} 0.005). Worsening deprivation was associated with higher operative mortality and longer stay (P = 0.014). For each unit increase in deprivation, there was 2.9 (95 per cent confidence interval 0.5 to 5.2) per cent increase in 30-day mortality. On multifactorial analysis, social deprivation was an independent predictor of length of stay, but its effect on operative mortality was explained by differences in {ASA} grade, operative urgency and Dukes' classification. Conclusion: Social deprivation was an independent risk factor of postoperative length of stay and associated with higher postoperative mortality. These results have important implications for risk modelling of postoperative outcomes.},
	pages = {1123--1131},
	number = {9},
	journaltitle = {British Journal of Surgery},
	author = {Smith, J. J. and Tilney, H. S. and Heriot, A. G. and Darzi, A. W. and Forbes, H. and Thompson, M. R. and Stamatakis, J. D. and Tekkis, P. P.},
	date = {2006-09},
	note = {{WOS}:000240394200014}
}

@article{koukoutsis_haemorrhage_2006,
	title = {Haemorrhage following pancreaticoduodenectomy: risk factors and the importance of sentinel bleed},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16874003},
	abstract = {To document the prevalence and to evaluate the management strategies of haemorrhagic complications following pancreaticoduodenectomy ({PD}).},
	pages = {224--8},
	number = {4},
	journaltitle = {Dig Surg},
	author = {Koukoutsis, I and Bellagamba, R and Morris-Stiff, G and Wickremesekera, S and Coldham, C and Wigmore, S J and Mayer, A D and Mirza, D F and Buckels, J A C and Bramhall, S R},
	date = {2006}
}

@article{nakos_haemodynamics_1993,
	title = {Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bismesylate},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8497691},
	abstract = {The present study was conducted to analyse the effect on haemodynamics and to evaluate the role of hypoxic pulmonary vasoconstriction ({HPV}) in cirrhotic patients with hypoxaemia using almitrine bismesylate, an agent which increases the response of {HPV}. Six male patients, mean age of 51 years, with hepatic cirrhosis and associated hypoxaemia were studied. All patients had normal lung and cardiac function tests. When the patients were clinically stable, right heart and radial artery catheterization were performed. Data from the pulmonary artery catheter and blood gases were obtained before and after 4 days of oral almitrine bismesylate. The results indicated that these cirrhotics were in a mild hyperdynamic circulatory state. The cardiac output ({CO}), cardiac index ({CI}), oxygen delivery ({DO}2), and oxygen consumption ({VO}2) were elevated while the pulmonary vascular resistance ({PVR}) and systemic vascular resistance ({SVR}) were low. Almitrine significantly increased {PVR} (P {\textless} 0.05) and mean pulmonary artery pressure ({mPAP}) (P {\textless} 0.01). In addition, almitrine improved alveolar arterial oxygen content difference [D(A-a)O2] (P {\textless} 0.01) and shunt fraction (Qva/{QT}) (P {\textless} 0.01). The {PaCO}2 and {PaO}2 increased slightly but this was not statistically significant. In conclusion, in our group of patients with hepatic cirrhosis, four days of treatment with almitrine improved their gas exchange. The data suggest a weak {HPV} response in this group of cirrhotics; that response may be enhanced by almitrine.},
	pages = {93--8},
	number = {2},
	journaltitle = {Respir Med},
	author = {Nakos, G and Evrenoglou, D and Vassilakis, N and Lampropoulos, S},
	date = {1993-02},
	file = {Nakos et al. - 1993 - Haemodynamics and gas exchange in liver cirrhosis.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UNBQWVVG\\Nakos et al. - 1993 - Haemodynamics and gas exchange in liver cirrhosis.pdf:application/pdf}
}

@article{leung_clinical_2012,
	title = {Clinical utility of the pretreatment glasgow prognostic score in patients with advanced inoperable non-small cell lung cancer.},
	volume = {7},
	doi = {10.1097/JTO.0b013e318244ffe1},
	abstract = {{INTRODUCTION}: Traditional tumor-based staging systems provide limited information on the best treatment option for individual patients with advanced inoperable non-small cell lung cancer ({NSCLC}). The Glasgow prognostic score ({GPS}) reflects the host systemic inflammatory response and is a validated independent prognostic factor in these patients. The aim of this study was to examine the clinical application of the pretreatment {GPS} in a mature cohort of patients with inoperable {NSCLC}. {METHODS}: The data of 261 patients with inoperable {NSCLC} were collected prospectively and before treatment. Information on patient demographics, body mass index, performance status ({PS}), the modified Glasgow prognostic score ({mGPS}), the prognostic index, and treatment received were included. {RESULTS}: The majority of patients were aged 65 years or older (68\%), were men (59\%), had a body mass index more than 20 (89\%), and an Eastern Cooperative Oncology Group performance status ({ECOG}-{PS}) 0 or 1 (54\%). Most patients had a pretreatment {mGPS} = 1 (62\%) and pretreatment prognostic index = 1  (56\%). During the follow-up period, 248 (95\%) patients died, 246 from their disease. The median survival was 8 months. On multivariate analysis, age (p = 0.001), {ECOG}-{PS} (p {\textless} 0.05), {mGPS} (p {\textless} 0.0001), and tumor stage (p {\textless} 0.0001) were  independently associated with cancer-specific survival. Using 5-year cancer-specific mortality as an end point, the area under the receiver operator curve was 0.735 (95\% confidence interval [{CI}], 0.566-0.903; p = 0.024) for the {mGPS}, 0.669 (95\% {CI}, 0.489-0.848; p = 0.106) for {ECOG}-{PS}, and 0.622 (95\% {CI}, 0.437-0.807; p = 0.240) for tumor, node, metastasis stage. Patients with an increased {mGPS} were more likely to have a poorer {ECOG}-{PS} (p {\textless} 0.05), an increased white cell count (p {\textless} 0.05), and received palliative treatment (p {\textless} 0.05). {CONCLUSION}: The pretreatment {mGPS} is a useful and important predictor of cancer-specific survival in patients with inoperable {NSCLC}. Basing clinical assessment on the {mGPS} has implications for the routine monitoring and treatment  of the patients.},
	pages = {655--662},
	number = {4},
	journaltitle = {Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer},
	shortjournal = {J Thorac Oncol},
	author = {Leung, Elaine Y. L. and Scott, Hazel R. and {McMillan}, Donald C.},
	date = {2012-04},
	pmid = {22425914},
	keywords = {Aged, Carcinoma, Non-Small-Cell Lung/blood/*mortality/pathology, C-Reactive Protein/*analysis, Female, Humans, Lung Neoplasms/blood/*mortality/pathology, Male, Middle Aged, Neoplasm Staging, Prognosis, {ROC} Curve, Serum Albumin/*analysis}
}

@article{bilimoria_national_2007,
	title = {National failure to operate on early stage pancreatic cancer},
	volume = {246},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17667493},
	abstract = {Despite studies demonstrating improved outcomes, pessimism persists regarding the effectiveness of surgery for pancreatic cancer. Our objective was to evaluate utilization of surgery in early stage disease and identify factors predicting failure to undergo surgery.},
	pages = {173--80},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Bilimoria, Karl Y and Bentrem, David J and Ko, Clifford Y and Stewart, Andrew K and Winchester, David P and Talamonti, Mark S},
	date = {2007-08}
}

@article{ogorman_prognostic_2000,
	title = {Prognostic factors in advanced gastrointestinal cancer patients with weight loss.},
	volume = {37},
	doi = {10.1207/S15327914NC3701_4},
	abstract = {There are few reports on factors that determine survival in advanced gastrointestinal cancer with weight loss. In these patients (n = 91, median weight loss 16.6\%), we prospectively examined the importance of metastatic spread, anthropometry, blood parameters, Karnofsky performance status, appetite,  and the acute-phase response as predictors of survival. Survival was calculated from date of assessment to the most recent clinic attendance ({\textgreater} or = 30 mo) or until death. On multivariate analysis, metastatic spread (p {\textless} 0.05), Karnofsky performance status (p {\textless} 0.01), and C-reactive protein concentration (p {\textless} 0.001) had independent prognostic value. In locally advanced disease (n = 64), Karnofsky performance status and C-reactive protein concentration remained significant. There was a significantly lower survival in patients with an acute-phase response (median 136 days) than in patients with no response (median 466 days; p {\textless} 0.01).  Performance status and the acute-phase response are associated, independent of weight loss, with survival duration in advanced gastrointestinal cancer patients.},
	number = {1},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {O'Gorman, P. and {McMillan}, D. C. and {McArdle}, C. S.},
	date = {2000},
	pmid = {10965517},
	keywords = {*Weight Loss, Acute-Phase Reaction/*mortality, Adult, Aged, Aged, 80 and over, Analysis of Variance, Anthropometry, Appetite, C-Reactive Protein/metabolism, Female, Gastrointestinal Neoplasms/*mortality/physiopathology/secondary, Humans, Karnofsky Performance Status, Longitudinal Studies, Male, Middle Aged, Prognosis, Prospective Studies, Time Factors}
}

@article{kwon_preoperative_2002,
	title = {Preoperative laparoscopic examination using surgical manipulation and ultrasonography for pancreatic lesions},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12048629},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: Unnecessary laparotomies in patients with advanced pancreatic disease are unlikely to provide any benefits and may compromise both the quality and duration of survival. The purpose of this study was to determine the contribution of laparoscopy and laparoscopic ultrasound to the diagnosis or staging, or both, of pancreatic lesions. {PATIENTS} {AND} {METHODS}: Fifty-two patients were diagnosed preoperatively with pancreatic cancer. The diagnoses made by laparoscopic ultrasonography ({LUS}) were compared with those made prior to the operation. Laparoscopic visualization of the body of the pancreas was obtained via an infragastric approach. For the laparoscopic examination of the head of the pancreas, a retroduodenal approach was used. {RESULTS}: In 52 patients with cancer of the pancreatic head and body, unresectable findings were observed in 13 patients. Portal vein displacement without other unresectable findings was evident in six patients using {LUS}, and was confirmed at exploratory laparotomy in five patients. The surgical approaches were changed, with seven patients undergoing an open exploration for biliary drainage and the other six patients receiving endoscopic endoprostheses. In six of the 52 patients, {LUS}-guided needle biopsies and frozen-section examinations detected chronic pancreatitis (n = 4), a malignant lymphoma (n = 1), and an abdominal tuberculosis (n = 1), which were diagnosed preoperatively as pancreatic cancers and cysts. Only one patient undergoing the laparoscopic procedure had acute pancreatitis; this patient was treated conservatively. {CONCLUSIONS}: {LUS}, when combined with laparoscopic manipulations, may overcome many of the limitations of laparoscopy alone in the investigation of pancreatic lesions by providing an accurate diagnosis and assessment of the size and extent of the local dissemination.},
	pages = {464--8},
	number = {6},
	journaltitle = {Endoscopy},
	author = {Kwon, A H and Inui, H and Kamiyama, Y},
	date = {2002-06}
}

@article{sahora_effects_????,
	title = {Effects of Co-morbidities on Outcomes of Patients with Intraductal Papillary Mucinous Neoplasms},
	issn = {1542-3565},
	url = {http://www.sciencedirect.com/science/article/pii/S1542356515006369},
	doi = {10.1016/j.cgh.2015.04.177},
	abstract = {{AbstarctBackground} \& Aims
Intraductal papillary mucinous neoplasms ({IPMN}) of the pancreas occur mostly in older individuals. Individual life expectancy and risk of death from other factors must be carefully considered in analyzing the risks that {IPMNs} pose. We investigated whether there is a subset of patients with {IPMNs} and a high risk of dying from other causes who would not benefit from pancreatic surgery.
Methods
We collected data from 725 patients at the Massachusetts General Hospital who underwent resection or have been under observation for {IPMN} from 1992 through 2012. Comorbidities were classified according the age-adjusted Charlson Comorbidity Index ({CACI}). Causes of death were recorded and survival data were analyzed by the Kaplan-Meier method.
Results
The patients’ median {CACI} score was 3; 10\% of patients had a {CACI} of 7 or more. Of the entire cohort, 55\% underwent resection and the remaining 45\% have been under observation. After a median follow-up period of 5 y, 177 patients died (24\%; 55\% of deaths within 5 y of diagnosis); 78\% of deaths were not related to {IPMN}. The median survival time for all patients with a {CACI} score of 7 or more was 43 months. Multivariate regression analysis revealed that the chance of non-{IPMN}−related death within 3 y of diagnosis is 11-fold higher for patients with a {CACI} score of 7 or more than for patients with lower scores.
Conclusion
The {CACI} can be used to identify patients with a high risk of death from factors other than {IPMN} within a few years after diagnosis. These patients are therefore not likely to benefit from further {IPMN} observation or pancreatic resection.},
	journaltitle = {Clinical Gastroenterology and Hepatology},
	shortjournal = {Clinical Gastroenterology and Hepatology},
	author = {Sahora, Klaus and Ferrone, Cristina R. and Brugge, William R. and Morales-Oyarvide, Vicente and Warshaw, Andrew L. and Lillemoe, Keith D. and Fernández-del Castillo, Carlos},
	urldate = {2015-05-26},
	keywords = {cancer risk, management, pancreas, treatment},
	file = {ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VAKAZBHC\\S1542356515006369.html:text/html}
}

@article{mcmillan_changes_2000,
	title = {Changes in micronutrient concentrations following anti-inflammatory treatment in  patients with gastrointestinal cancer.},
	volume = {16},
	abstract = {Circulating concentrations of vitamin antioxidants (retinol, alpha-tocopherol, lutein, lycopene, alpha- and beta-carotene) and trace elements (zinc, copper, iron and selenium) plus carrier proteins (albumin, transferrin, caeruloplasmin) in gastrointestinal cancer patients (n = 12) with an inflammatory response (as demonstrated by an elevated C-reactive protein concentration) were compared with  a control group (n = 12). Further, the effect of moderating the inflammatory response, using the anti-inflammatory agent ibuprofen, on these measurements was  examined in the cancer group. The control and cancer groups were similar in terms of age, sex, and body mass index. However, the cancer group had significantly higher C-reactive protein concentrations (P {\textless} 0.001). Concentrations of vitamin antioxidants and trace elements (and carrier proteins) were significantly lower (P {\textless} 0.001), except copper (ceruloplasmin) which was significantly higher (P {\textless} 0.05). After anti-inflammatory treatment, there were small but significant increases in lutein, lycopene, and beta-carotene (P {\textless} 0.05) and in iron and selenium (P {\textless} 0.05), whereas ceruloplasmin decreased (P {\textless} 0. 05). The micronutrient concentrations in the cancer patients remained different from those in the control subjects. These results support the concept that the magnitude of  inflammation plays an important role in the regulation of circulating concentrations of vitamin antioxidants and trace elements in patients with gastrointestinal cancer.},
	pages = {425--428},
	number = {6},
	journaltitle = {Nutrition (Burbank, Los Angeles County, Calif.)},
	shortjournal = {Nutrition},
	author = {{McMillan}, D. C. and Sattar, N. and Talwar, D. and O'Reilly, D. S. and {McArdle}, C. S.},
	date = {2000-06},
	pmid = {10869897},
	keywords = {Adrenal Cortex Hormones/therapeutic use, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Anti-Inflammatory Agents/*therapeutic use, Antioxidants/*analysis, Carotenoids/blood, Carrier Proteins/*blood, Ceruloplasmin/metabolism, C-Reactive Protein/analysis, Gastrointestinal Neoplasms/blood/*drug therapy, Humans, Iron/blood, Selenium/blood, Serum Albumin/metabolism, Trace Elements/*blood, Transferrin/metabolism, Vitamin A/blood, Vitamin E/blood, Vitamins/*blood}
}

@article{fischer_quantitation_1976,
	title = {Quantitation of "acute-phase proteins" postoperatively. Value in detection and monitoring of complications},
	volume = {66},
	issn = {0002-9173},
	abstract = {Serial determinations of serum C-reactive protein are helpful in the detection and monitoring of postoperative complications associated with inflammation and/or tissue necrosis. The serum C-reactive protein level begins to increase within sex hours after operation, peaks on the second day, and by the third postoperative day begins to decrease toward the preoperative level. In cases with surgical complications involving inflammation, serum C-reactive protein levels remain elevated and do not show a decline on the third postoperative day. Serum levels of other "acute-phase proteins," such as alpha-1 acid glycoprotein, ceruloplasmin, alpha-1 antitrypsin, and haptoglobin, were found to increase in response to surgical procedures, but subsequent to the increase in C-reactive protein. These other proteins offer no additional information in monitoring the postoperative acutephase response,},
	pages = {840--846},
	number = {5},
	journaltitle = {American Journal of Clinical Pathology},
	shortjournal = {Am. J. Clin. Pathol.},
	author = {Fischer, C. L. and Gill, C. and Forrester, M. G. and Nakamura, R.},
	date = {1976-11},
	pmid = {1086592},
	keywords = {Abscess, Adult, Aged, alpha 1-Antitrypsin, Ceruloplasmin, C-Reactive Protein, Female, Haptoglobins, Humans, Inflammation, Male, Middle Aged, Monitoring, Physiologic, Orosomucoid, Pneumonia, postoperative complications, Pulmonary Embolism, Surgical Wound Infection}
}

@article{philips_irreversible_2013,
	title = {Irreversible electroporation ablation ({IRE}) of unresectable soft tissue tumors: learning curve evaluation in the first 150 patients treated},
	volume = {8},
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0076260},
	shorttitle = {Irreversible electroporation ablation ({IRE}) of unresectable soft tissue tumors},
	abstract = {{BACKGROUND}: Irreversible electroporation ({IRE}) is a novel technology that uses peri-target discrete probes to deliver high-voltage localized electric current to induce cell death without thermal-induced coagulative necrosis. "Learnability" and consistently effective results by novice practitioners is essential for determining acceptance of novel techniques. This multi-center prospectively-collected database study evaluates the learning curve of {IRE}.
{METHODS}: Analysis of 150 consecutive patients over 7 institutions from 9/2010-7/2012 was performed with patients treated divided into 3 groups A (1(st) 50 patients treated), B (2(nd) 50) and C (3(rd) 50 patients treated) chronologically and analyzed for outcomes.
{RESULTS}: A total of 167 {IRE} procedures were performed, with a majority being liver(39.5\%) and pancreatic(35.5\%) lesions. The three groups were similar with respect to co-morbidities and demographics. Group C had larger lesions (3.9 vs 3 cm,p=0.001), more numerous lesions (3.2 vs 2.2,p=0.07), more vascular invasion(p=0.001), underwent more associated procedures(p=0.001) and had longer operative times(p{\textless}0.001). Despite this, they had similar complication and high-grade complication rates(p=0.24). Attributable morbidity rate was 13.3\%(total 29.3\%) and high-grade complications were seen in 4.19\%(total 12.6\%). Pancreatic lesions(p=0.001) and laparotomy(p=0.001) were associated with complications.
{CONCLUSION}: The review represents that single largest review of {IRE} soft tissue ablation demonstrating initial patient selection and safety. Over time, complex treatments of larger lesions and lesions with greater vascular involvement were performed without a significant increase in adverse effects or impact on local relapse free survival. This evolution demonstrates the safety profile of {IRE} and speed of graduation to more complex lesions, which was greater than 5 cases by institution. {IRE} is a safe and effective alternative to conventional ablation with a demonstrable learning curve of at least 5 cases to become proficient.},
	pages = {e76260},
	number = {11},
	journaltitle = {{PloS} One},
	shortjournal = {{PLoS} {ONE}},
	author = {Philips, Prejesh and Hays, David and Martin, Robert C. G.},
	date = {2013},
	pmid = {24223700},
	pmcid = {PMC3815199},
	keywords = {Ablation Techniques, Adenocarcinoma, Electroporation, Humans, Learning Curve, Liver Neoplasms, Middle Aged, Pancreatic Neoplasms, Prospective Studies, Soft Tissue Neoplasms, Treatment Outcome}
}

@article{amundson_obesity_2010,
	title = {The obesity paradox},
	volume = {26},
	issn = {1557-8232},
	doi = {10.1016/j.ccc.2010.06.004},
	abstract = {The term "obesity paradox" refers to the observation that, although obesity is a major risk factor in the development of cardiovascular and peripheral vascular disease, when acute cardiovascular decompensation occurs, for example, in myocardial infarction or congestive heart failure, obese patients may have a survival benefit. In addition, it has been suggested that obese patients tend to fare better after certain surgical procedures, such as coronary artery bypass surgery. Moreover, it appears that obese men with chronic hypertensive heart disease live longer than men of normal weight. Mounting evidence shows that obesity alone may confer a survival benefit independent of age, medical care, or therapy. Perhaps the definition of obesity needs to be revisited, and it is also possible that all fat is not equal.},
	pages = {583--596},
	number = {4},
	journaltitle = {Critical Care Clinics},
	shortjournal = {Crit Care Clin},
	author = {Amundson, Dennis E. and Djurkovic, Svetolik and Matwiyoff, Gregory N.},
	date = {2010-10},
	pmid = {20970043},
	keywords = {Heart Failure, Humans, Hypertension, Obesity, postoperative complications, Renal Insufficiency, Chronic, Sepsis, Survival Rate}
}

@article{klaiber_meta-analysis_2015,
	title = {Meta-analysis of complication rates for single-loop versus dual-loop (Roux-en-Y) with isolated pancreaticojejunostomy reconstruction after pancreaticoduodenectomy},
	volume = {102},
	rights = {© 2015 {BJS} Society Ltd Published by John Wiley \& Sons Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.9703/abstract},
	doi = {10.1002/bjs.9703},
	abstract = {Background

Postoperative pancreatic fistula is one of the most important and potentially severe complications after partial pancreaticoduodenectomy. In this context, the reduction of postoperative pancreatic fistula by means of a dual-loop (Roux-en-Y) reconstruction with isolation of the pancreaticojejunostomy from biliary drainage has been evaluated in several studies. This systematic review and meta-analysis summarizes evidence of effectiveness and safety of the isolation of the pancreaticojejunostomy compared with conventional single-loop reconstruction.


Methods

Randomized clinical trials ({RCTs}) and controlled clinical trials ({CCTs}) comparing outcomes of dual-loop reconstruction with isolated pancreaticojejunostomy and single-loop reconstruction were searched according to {PRISMA} guidelines. Random-effects meta-analyses were performed and the results presented as weighted risk ratios or mean differences with their corresponding 95 per cent c.i.


Results

Of 83 trials screened for eligibility, three {RCTs} and four {CCTs} including a total of 802 patients were finally included. Quantitative synthesis showed no significant statistical difference between the two procedures regarding postoperative pancreatic fistula, delayed gastric emptying, haemorrhage, intra-abdominal fluid collection or abscess, bile leakage, wound infection, pneumonia, overall morbidity, mortality, reinterventions, reoperations, perioperative blood loss and length of hospital stay. Duration of surgery was significantly longer in patients undergoing dual-loop reconstruction.


Conclusion

Dual-loop (Roux-en-Y) reconstruction with isolated pancreaticojejunostomy after partial pancreaticoduodenectomy is not superior to single-loop reconstruction regarding pancreatic fistula rate or other relevant outcomes. Additional superiority trials are therefore not warranted, although a high-quality trial may be justified to prove equivalence or non-inferiority.},
	pages = {331--340},
	number = {4},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Klaiber, U. and Probst, P. and Knebel, P. and Contin, P. and Diener, M. K. and Büchler, M. W. and Hackert, T.},
	urldate = {2015-05-17},
	date = {2015-03-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5TXGZE78\\Klaiber et al. - 2015 - Meta-analysis of complication rates for single-loo.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CGHEASB2\\abstract.html:text/html}
}

@article{kothmann_effect_2009,
	title = {Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study},
	volume = {103},
	issn = {1471-6771},
	doi = {10.1093/bja/aep205},
	shorttitle = {Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms},
	abstract = {{BACKGROUND}: Patients with abdominal aortic aneurysms ({AAA}) represent a high-risk surgical group. Despite medical optimization and radiological stenting interventions, mortality remains high and it is difficult to improve fitness. The aim of this pilot study was to evaluate the effect of a 6 week, supervised exercise programme (30 min continuous moderate intensity cycle ergometry, twice weekly) on anaerobic threshold ({AT}) in subjects with {AAA}.
{METHODS}: Thirty participants with an {AAA} under surveillance were randomized to either the supervised exercise intervention (n=20) or a usual care control group (n=10). {AT} was measured using cardiopulmonary exercise testing, at baseline ({AT}1), week 5 ({AT}2), and week 7 ({AT}3). The change in {AT} ({AT}3-{AT}1) between the groups was compared using a mixed model ancova, providing the mean effect together with the standard deviation (sd) for individual patient responses to the intervention. The minimum clinically important difference ({MCID}) was defined as an improvement in {AT} of 2 ml O(2) kg(-1) min(-1).
{RESULTS}: Of the 30 participants recruited, 17 of 20 (exercise) and eight of 10 (control) completed the study. The {AT} in the intervention group increased by 10\% (equivalent to 1.1 ml O(2) kg(-1) min(-1)) compared with the control (90\% confidence interval 4-16\%; P=0.007). The sd for the individual patient responses to the intervention was 8\%. The estimated number needed to treat ({NNT}) for benefit was 5 patients.
{CONCLUSIONS}: The small mean benefit was lower than the {MCID}. However, the marked variability in the individual patient responses revealed that a proportion of patients did benefit clinically, with an estimated {NNT} of 5.},
	pages = {505--510},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br J Anaesth},
	author = {Kothmann, E. and Batterham, A. M. and Owen, S. J. and Turley, A. J. and Cheesman, M. and Parry, A. and Danjoux, G.},
	date = {2009-10},
	pmid = {19628486},
	keywords = {Aged, Aortic Aneurysm, Abdominal, assessment, preanaesthetic, Exercise Test, Exercise Therapy, Female, Humans, Male, Middle Aged, Physical fitness, Pilot Projects, Prospective Studies, surgery, vascular, Treatment Outcome},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VCT9CPUD\\Kothmann et al. - 2009 - Effect of short-term exercise training on aerobic .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M68QQ98J\\505.html:text/html}
}

@article{mcmillan_prospective_1997,
	title = {Prospective study of circulating T-lymphocyte subpopulations and disease progression in colorectal cancer.},
	volume = {40},
	abstract = {{PURPOSE}: It has recently been reported that {CD}4+ T-lymphocytes are reduced in advanced colorectal cancer patients. However, it is not clear whether such changes in T-lymphocyte subsets are an early or late event in such patients. The  aim of this study was to examine the relationship between these subsets and disease progression in colorectal cancer. {METHODS}: Flow cytometric analysis of},
	pages = {1068--1071},
	number = {9},
	journaltitle = {Diseases of the colon and rectum},
	shortjournal = {Dis Colon Rectum},
	author = {{McMillan}, D. C. and Fyffe, G. D. and Wotherspoon, H. A. and Cooke, T. G. and {McArdle}, C. S.},
	date = {1997-09},
	pmid = {9293937},
	keywords = {*{CD}4-Positive T-Lymphocytes, *{CD}8-Positive T-Lymphocytes, *T-Lymphocyte Subsets, Adult, Aged, Antigens, {CD}3, Colorectal Neoplasms/*immunology, Disease Progression, Female, Flow Cytometry, Humans, Male, Middle Aged, Neoplasm Recurrence, Local/*immunology, Prospective Studies}
}

@article{martin_patterns_1997,
	title = {Patterns of cytokine evolution (tumor necrosis factor-alpha and interleukin-6) after septic shock, hemorrhagic shock, and severe trauma},
	volume = {25},
	issn = {0090-3493},
	abstract = {{OBJECTIVE}: To compare the patterns of evolution of two proinflammatory cytokines (tumor necrosis factor [{TNF}]-alpha and interleukin-6 [{IL}-6]) in two major clinical entities associated with systemic inflammatory response: septic shock and multiple trauma (with and without hemorrhagic shock).
{DESIGN}: Prospective study of two cohorts of patients.
{SETTING}: Critical care unit and Emergency Center of a university hospital.
{PATIENTS}: Twenty-five nontrauma patients with septic shock and 60 multiple trauma patients (of whom eight patients were resuscitated from hemorrhagic shock).
{INTERVENTIONS}: Serial blood samples were collected in each patient for determination of serum cytokine concentrations. Samples were obtained over 7 days in septic shock patients and 11 days in trauma patients. Standard resuscitation techniques were used in each patient. Clinical and laboratory data were prospectively collected.
{MEASUREMENTS} {AND} {MAIN} {RESULTS}: High concentrations of circulating {TNF}-alpha and {IL}-6 were found in patients with septic shock. High {IL}-6 concentrations, but normal {TNF}-alpha concentrations were detected in trauma patients. At study entry, {TNF}-alpha concentrations were higher in nonsurvivor septic shock than in nonsurvivor trauma patients (42 +/- 7 vs 13 +/- 2 pg/{mL}; p {\textless} .001). During the whole study period, nonsurvivor septic shock patients maintained higher {TNF}-alpha concentrations than nonsurvivor trauma patients (p {\textless} .001). In survivors in both groups, normal values for {TNF}-alpha were detected during the whole study period. At study entry, {IL}-6 concentrations were significantly higher in nonsurvivor septic shock patients than in nonsurvivor trauma patients (15,627 +/- 4336 vs. 317 +/- 124 pg/{mL}; p {\textless} .0001). During the whole study period, much higher concentrations of {IL}-6 were detected in septic shock patients than in trauma patients (p {\textless} .0001). In survivors, at study entry, {IL}-6 concentrations were much higher in septic shock patients than in trauma patients (3947 +/- 1410 vs. 247 +/- 41 pg/{mL}; p {\textless} .001). Higher {IL}-6 concentrations were maintained throughout the study period in septic shock patients than in trauma patients (p {\textless} .001). In septic shock patients, changes in both {TNF}-alpha and {IL}-6 were correlated with outcome, higher values being found in patients likely to die. Neither {TNF}-alpha nor {IL}-6 values were of any significant value in predicting outcome of trauma patients. When septic shock patients were compared with traumatized patients resuscitated from hemorrhagic shock, the former had much higher concentrations of both {TNF}-alpha and {IL}-6 throughout the study period (p {\textless} .01 to p {\textless} .00001). Increased {IL}-6 values were an indicator of the development of a nosocomial infection in trauma patients. In five trauma patients who developed a nosocomial pneumonia during the study period, the {IL}-6 concentration was 433 +/- 385 pg/{mL} before the onset of pneumonia, then peaked at 3970 +/- 1478 pg/{mL} on day 7, and returned to baseline (219 +/- 58 pg/{mL}) on day 11.
{CONCLUSIONS}: In septic shock patients, high amounts of circulating {TNF}-alpha and {IL}-6 are found and then correlate with fatal outcome. In trauma patients (even those patients resuscitated from hemorrhagic shock), much less increased concentrations of {IL}-6 are detected while normal {TNF}-alpha circulating concentrations are measured. In these patients, cytokine concentrations do not correlate with outcome. This finding suggests a much higher degree of activation of the immunoinflammatory cascade in septic shock than in multiple trauma patients. Increased {IL}-6 values are an indicator of the development of a nosocomial infection in trauma patients.},
	pages = {1813--1819},
	number = {11},
	journaltitle = {Critical Care Medicine},
	shortjournal = {Crit. Care Med.},
	author = {Martin, C. and Boisson, C. and Haccoun, M. and Thomachot, L. and Mege, J. L.},
	date = {1997-11},
	pmid = {9366763},
	keywords = {Adult, Aged, Female, Humans, Interleukin-6, Male, Middle Aged, Multiple Trauma, Prospective Studies, Shock, Hemorrhagic, Shock, Septic, Tumor Necrosis Factor-alpha}
}

@article{sanjay_preoperative_2012,
	title = {Preoperative Serum C-Reactive Protein Levels and Post-Operative Lymph Node Ratio Are Important Predictors of Survival After Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma},
	volume = {13},
	rights = {Copyright (c) 2014 Pandanaboyana Sanjay, Heather Leaver, Rodrigo S de Figueiredo, Simon Ogston, Christoph Kulli, Francesco M Polignano, Is Tait},
	issn = {1590-8577},
	url = {http://www.serena.unina.it/index.php/jop/article/view/urn%3Anbn%3Ait%3Aunina-3365},
	pages = {199--204},
	number = {2},
	journaltitle = {{JOP}. Journal of the Pancreas},
	author = {Sanjay, Pandanaboyana and Leaver, Heather and Figueiredo, Rodrigo S. de and Ogston, Simon and Kulli, Christoph and Polignano, Francesco M. and Tait, Is},
	urldate = {2015-05-18},
	date = {2012-03-10},
	langid = {english},
	keywords = {C-Reactive Protein, Lymph Nodes, Pancreatic Neoplasms},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C3TU9AV4\\Sanjay et al. - 2012 - Preoperative Serum C-Reactive Protein Levels and P.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WANTHNM6\\840.html:text/html}
}

@article{mavros_impact_2013,
	title = {Impact of complications on long-term survival after resection of colorectal liver metastases},
	volume = {100},
	issn = {1365-2168},
	doi = {10.1002/bjs.9060},
	abstract = {{BACKGROUND}: Postoperative complications may have an adverse effect not only on short-term but also long-term outcome among patients having surgery for cancer. A retrospective series of patients who had surgery for colorectal liver metastases ({CLM}) was used to assess this association.
{METHODS}: Patients who had surgery with curative intent for {CLM} from 2000 to 2009 were included. The impact of postoperative complications, patient characteristics, disease stage and treatment on long-term survival was analysed using multivariable Cox regression models.
{RESULTS}: A total of 251 patients were included. The median age was 58 (interquartile range 51-68) years and there were 87 women (34.7 per cent). A minor or major postoperative complication developed in 41 and 14 patients respectively, and five patients (2.0 per cent) died after surgery. The 5-year recurrence-free ({RFS}) and overall survival rates were 19.5 and 41.9 per cent respectively. Multivariable analysis revealed that postoperative complications independently predicted shorter {RFS} (hazard ratio ({HR}) 2.36, 95 per cent confidence interval 1.56 to 3.58) and overall survival ({HR} 2.34, 1.46 to 3.74). Other independent predictors of shorter {RFS} and overall survival included lymph node metastasis, concomitant extrahepatic disease, a serum carcinoembryonic antigen level of at least 100 ng/dl, and the use of radiofrequency ablation ({RFS} only). The severity of complications also correlated with {RFS} (P = 0.006) and overall survival (P = 0.001).
{CONCLUSION}: Postoperative complications were independently associated with decreased long-term survival after surgery for {CLM} with curative intent. The prevention and management of postoperative adverse events may be important oncologically.},
	pages = {711--718},
	number = {5},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Mavros, M. N. and de Jong, M. and Dogeas, E. and Hyder, O. and Pawlik, T. M.},
	date = {2013-04},
	pmid = {23364914},
	keywords = {Aged, Colonic Neoplasms, Disease-Free Survival, Female, Humans, Liver Neoplasms, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, postoperative complications, Rectal Neoplasms, Retrospective Studies, Treatment Outcome}
}

@article{richards_relationship_2010,
	title = {The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer.},
	volume = {103},
	doi = {10.1038/sj.bjc.6605919},
	abstract = {{BACKGROUND}: It is increasingly recognised that host-related factors may be important in determining cancer outcome. The aim was to examine the relationship  between patient physiology, the systemic inflammatory response and survival after colorectal cancer resection. {METHODS}: Patients undergoing potentially curative resection of colorectal cancer were identified from a prospectively maintained database. Patient physiology was assessed using the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}) criteria.  The systemic inflammatory response was assessed using the modified Glasgow Prognostic Score ({mGPS}). Multivariate 5-year survival analysis was carried out with calculation of hazard ratios ({HR}). {RESULTS}: A total of 320 patients were included. During follow-up (median 74 months), there were 136 deaths: 83 colorectal cancer related and 53 non-cancer related. Independent predictors of cancer-specific survival were age ({HR}: 1.46, P{\textless}0.01), Dukes stage ({HR}: 2.39, P{\textless}0.001), {mGPS} ({HR}: 1.78, P{\textless}0.001) and {POSSUM} physiology score ({HR}: 1.38, P=0.02). Predictors of overall survival were age ({HR}: 1.64, P{\textless}0.001), smoking ({HR}: 1.52, P=0.02), Dukes stage ({HR}: 1.64, P{\textless}0.001), {mGPS} ({HR}: 1.60, P{\textless}0.001) and {POSSUM} physiology score ({HR}: 1.27, P=0.03). A relationship between {mGPS} and {POSSUM} physiology score was also established (P{\textless}0.006). {CONCLUSION}: The {POSSUM} physiology score and the systemic inflammatory response are strongly associated and both are independent predictors of cancer specific and overall survival in patients undergoing potentially curative resection of colorectal cancer.},
	pages = {1356--1361},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Richards, C. H. and Leitch, E. F. and Horgan, P. G. and Anderson, J. H. and {McKee}, R. F. and {McMillan}, D. C.},
	date = {2010-10-26},
	pmid = {20877354},
	pmcid = {PMC2990607},
	keywords = {Aged, Colorectal Neoplasms/*immunology/mortality/*physiopathology/*surgery, Female, Humans, Inflammation/*mortality, Male, Middle Aged, Prognosis, Survival Analysis}
}

@article{dronkers_preoperative_2010,
	title = {Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: a randomized controlled pilot study},
	volume = {24},
	issn = {0269-2155, 1477-0873},
	url = {http://cre.sagepub.com/content/24/7/614},
	doi = {10.1177/0269215509358941},
	shorttitle = {Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery},
	abstract = {Objective: Investigation of the feasibility and preliminary effect of a short-term intensive preoperative exercise programme for elderly patients scheduled for elective abdominal oncological surgery.
Design: Single-blind randomized controlled pilot study.
Setting: Ordinary hospital in the Netherlands.
Subjects: Forty-two elderly patients ({\textgreater}60 years).
Interventions: Patients were randomly assigned to receive a short-term intensive therapeutic exercise programme to improve muscle strength, aerobic capacity, and functional activities, given in the outpatient department (intervention group; n =22), or home-based exercise advice (control group; n=20).
Main measures: Parameters of feasibility, preoperative functional capacity and postoperative course.
Results: The intensive training programme was feasible, with a high compliance and no adverse events. Respiratory muscle endurance increased in the preoperative period from 259 ± 273 to 404 ± 349 J in the intervention group and differed significantly from that in the control group (350 ± 299 to 305 ± 323 J; P{\textless}0.01). Timed-Up-and-Go, chair rise time, {LASA} Physical Activity Questionnaire, Physical Work Capacity and Quality of Life ({EORTC}-C30) did not reveal significant differences between the two groups. There was no significant difference in postoperative complications and length of hospital stay between the two groups.
Conclusion: The intensive therapeutic exercise programme was feasible and improved the respiratory function of patients due to undergo elective abdominal surgery compared with home-based exercise advice.},
	pages = {614--622},
	number = {7},
	journaltitle = {Clinical Rehabilitation},
	shortjournal = {Clin Rehabil},
	author = {Dronkers, J. J. and Lamberts, H. and Reutelingsperger, Immd and Naber, R. H. and Dronkers-Landman, C. M. and Veldman, A. and Meeteren, {NLU} van},
	urldate = {2015-05-10},
	date = {2010-07-01},
	langid = {english},
	pmid = {20530651},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CCAAKM24\\Dronkers et al. - 2010 - Preoperative therapeutic programme for elderly pat.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\334XUF9X\\614.html:text/html}
}

@article{balthazar_acute_2002,
	title = {Acute pancreatitis: assessment of severity with clinical and {CT} evaluation},
	volume = {223},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12034923},
	abstract = {Treatment of patients with acute pancreatitis is based on the initial assessment of disease severity. Severe pancreatitis occurs in 20\%-30\% of all patients with acute pancreatitis and is characterized by a protracted clinical course, multiorgan failure, and pancreatic necrosis. Early staging is based on the presence and degree of systemic failure (cardiovascular, pulmonary, renal) and on the presence and extent of pancreatic necrosis. Individual laboratory indexes (markers of pancreatic injury, markers of inflammatory response), while promising, have not yet gained clinical acceptance. Numeric grading systems with sensitivities of about 70\% are commonly used today as indicators of organ failure and disease severity. Contrast material-enhanced computed tomography is used in addition to help evaluate local pancreatic morphology and the presence and extent of pancreatic necrosis. Advantages and limitations of the clinical, laboratory, and imaging prognostic indexes are analyzed and discussed.},
	pages = {603--13},
	number = {3},
	journaltitle = {Radiology},
	author = {Balthazar, Emil J},
	date = {2002-06}
}

@article{gu_[endoscopic_1993,
	title = {[Endoscopic retrograde biliary drainage for malignant obstructive jaundice]},
	volume = {31},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7518376},
	abstract = {This paper reports 19 cases of malignant obstructive jaundice treated by endoscopic retrograde biliary drainage ({ERBD}). Since 1989, {ERBD} is a palliative treatment of inserted into the obstructed bile duct by endoscopy. This method can efficiently relieve biliary obstruction. Elimination jaundice reduces some discomforts such as irritating pruritus. It also increases the appetite and improve patient's general physical condition. Temporary preoperative decompression of the bile ducts in seriously jaundiced patients should result in a significant reduction postoperative morbidity and mortality. There were 9 patients of this group who underwent operation after a short period of drainage, These patients weren't found any postoperative complication. {ERBD} also be used for palliative decompression of the bile duct in cases of inoperable cancer. The method was carried out in 7 inoperable patients of this group. Results were satisfactory.},
	pages = {739--42},
	number = {12},
	journaltitle = {Zhonghua Wai Ke Za Zhi},
	author = {Gu, W Q},
	date = {1993-12}
}

@article{gotohda_can_1998,
	title = {Can {POSSUM}, a scoring system for perioperative surgical risk, predict postoperative clinical course?},
	volume = {52},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9876770},
	abstract = {{POSSUM}, a Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity, is a scoring system which assesses perioperative surgical risks (Copeland {GP} et al.: Br J Surg, 1991, Vol 78, 356-360). The {POSSUM} scoring system consists of two categories of assessment to assess the risk of surgery. A 12-factor (age, cardiac status, pulse rate, systolic blood pressure, respiratory status, Glasgow Coma Score, serum concentration of urea, potassium and sodium, hemoglobin concentration, white cell count and findings on electrocardiography) and 4-grade physiological score ({PS}) were developed. This was combined with a 6-factor (type of surgical procedure, number of procedures, blood loss, peritoneal soiling, presence of malignancy and mode of surgery) and 4-grade operative severity score ({OSS}). The present paper attempts to validate it retrospectively. Postoperative hospitalization period and duration of antibiotics administration were both significantly correlated with {OSS}, but not with {PS}. These results suggest that the {POSSUM} scoring system is useful for predicting the postoperative clinical course.},
	pages = {325--9},
	number = {6},
	journaltitle = {Acta Med Okayama},
	author = {Gotohda, N and Iwagaki, H and Itano, S and Horiki, S and Fujiwara, T and Saito, S and Hizuta, A and Isozaki, H and Takakura, N and Terada, N and Tanaka, N},
	date = {1998-12}
}

@article{de_castro_evaluation_2009,
	title = {Evaluation of {POSSUM} for patients undergoing pancreatoduodenectomy},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19384458},
	abstract = {{BACKGROUND}: Comparison of operative morbidity rates after pancreatoduodenectomy between units may be misleading because it does not take into account the physiological variable of the condition of the patients. The aim of the present study was to evaluate the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) for pancreatoduodenectomy patients and to look for risk factors associated with morbidity in a high-volume center. {METHODS}: Between January 1993 and April 2006, 652 patients underwent a pancreatoduodenectomy, 502 of them for malignant disease. {POSSUM} performance was evaluated by assessing the "goodness-of-fit" with the linear analysis method. {RESULTS}: Overall, 332 of the 652 patients (50.9\%) had one or more complication after pancreatoduodenectomy, and 9 patients (1.4\%) died. {POSSUM} had a significant lack of fit using goodness-of-fit analysis. In multivariate analysis, one statistically significant factor associated with morbidity and not incorporated in {POSSUM} (P {\textless} 0.05) was identified: ampulla of Vater adenocarcinoma ({OR} = 1.73, 95\% {CI}: 1.07-2.80). {CONCLUSIONS}: Overall, there is a lack of calibration of {POSSUM} among patients who undergo pancreatoduodenectomy.},
	pages = {1481--7},
	number = {7},
	journaltitle = {World J Surg},
	author = {de Castro, S M M and Houwert, J T and Lagarde, S M and Reitsma, J B and Busch, O R C and van Gulik, T M and Obertop, H and Gouma, D J},
	date = {2009-07}
}

@article{proctor_systemic_2015,
	title = {Systemic inflammation predicts all-cause mortality: a glasgow inflammation outcome study.},
	volume = {10},
	doi = {10.1371/journal.pone.0116206},
	abstract = {{INTRODUCTION}: Markers of the systemic inflammatory response, including C-reactive protein and albumin (combined to form the modified Glasgow Prognostic Score), as  well as neutrophil, lymphocyte and platelet counts have been shown to be prognostic of survival in patients with cancer. The aim of the present study was  to examine the prognostic relationship between these markers of the systemic inflammatory response and all-cause, cancer, cardiovascular and cerebrovascular mortality in a large incidentally sampled cohort. {METHODS}: Patients (n = 160 481) who had an incidental blood sample taken between 2000 and 2008 were studied for the prognostic value of C-reactive protein ({\textgreater}10mg/l, albumin ({\textgreater}35mg/l), neutrophil ({\textgreater}7.5x109/l) lymphocyte and platelet counts. Also, patients (n = 52 091) sampled following the introduction of high sensitivity C-reactive protein ({\textgreater}3mg/l) measurements were studied. A combination of these markers, to make cumulative inflammation-based scores, were investigated. {RESULTS}: In all patients (n = 160 481) C-reactive protein ({\textgreater}10mg/l) ({HR} 2.71, p{\textless}0.001), albumin ({\textgreater}35mg/l)  ({HR} 3.68, p{\textless}0.001) and neutrophil counts ({HR} 2.18, p{\textless}0.001) were independently predictive of all-cause mortality. These associations were also observed in cancer, cardiovascular and cerebrovascular mortality before and after the introduction of high sensitivity C-reactive protein measurements ({\textgreater}3mg/l) (n = 52 091). A combination of high sensitivity C-reactive protein ({\textgreater}3mg/l), albumin and  neutrophil count predicted all-cause ({HR} 7.37, p{\textless}0.001, {AUC} 0.723), cancer ({HR} 9.32, p{\textless}0.001, {AUC} 0.731), cardiovascular ({HR} 4.03, p{\textless}0.001, {AUC} 0.650) and cerebrovascular ({HR} 3.10, p{\textless}0.001, {AUC} 0.623) mortality. {CONCLUSION}: The results  of the present study showed that an inflammation-based prognostic score, combining high sensitivity C-reactive protein, albumin and neutrophil count is prognostic of all-cause mortality.},
	number = {3},
	journaltitle = {{PloS} one},
	shortjournal = {{PLoS} One},
	author = {Proctor, Michael J. and {McMillan}, Donald C. and Horgan, Paul G. and Fletcher, Colin D. and Talwar, Dinesh and Morrison, David S.},
	date = {2015},
	pmid = {25730322},
	pmcid = {PMC4346265}
}

@article{khan_evaluation_2003,
	title = {Evaluation of the {POSSUM} scoring system for comparative audit in pancreatic surgery},
	volume = {20},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14534377},
	abstract = {{BACKGROUND}: Wide variations exist in the reported morbidity and mortality rates for major pancreatic resections. The Physiological and Operative Scoring System for {enUmeration} of Morbidity and mortality ({POSSUM}) was developed for comparative audit in general surgical patients. It has also been found to be reliable for audit in colorectal, thoracic and vascular surgery with minor modifications. {AIMS}: To evaluate {POSSUM} and its modification for mortality, P-{POSSUM}, in pancreatic surgery. {METHODS}: Retrospective analysis of 50 patients undergoing partial pancreaticoduodenectomy ({PD}) (46 tumours, 4 chronic pancreatitis) using the {POSSUM} and P-{POSSUM} as predictors of morbidity and mortality. These were then compared with the observed values. {RESULTS}: The {POSSUM}-predicted mortality was 26\%. The P-{POSSUM} predicted a mortality risk of 6\%. The observed mortality was 4\%. Using {POSSUM} for morbidity, the predicted value was 76\%. The observed morbidity was 46\%. The risk scores for patients with and without morbidity were similar (66.4 +/- 11.0 vs. 68.8 +/- 12.9, p = 0.49). {CONCLUSIONS}: While P-{POSSUM} appeared satisfactory for predicting mortality risk, {POSSUM} overestimated morbidity and mortality for {PD} in a specialist centre. Modifications are needed prior to its application for comparative audit in pancreatic surgery.},
	pages = {539--45},
	number = {6},
	journaltitle = {Dig Surg},
	author = {Khan, Abdaal W and Shah, Sudeep R and Agarwal, Anil K and Davidson, Brian R},
	date = {2003}
}

@article{scott_systemic_2002,
	title = {The systemic inflammatory response, weight loss, performance status and survival  in patients with inoperable non-small cell lung cancer.},
	volume = {87},
	rights = {Copyright 2002 Cancer Research {UK}},
	doi = {10.1038/sj.bjc.6600466},
	abstract = {The relationship between the magnitude of systemic inflammatory response and the  nutritional/functional parameters in patients with inoperable non-small cell lung cancer were studied. The extent of weight loss, albumin, C-reactive protein, performance status and quality of life was measured in 106 patients with inoperable non-small cell lung cancer (stages {III} and {IV}). Survival analysis was  performed using the Cox proportional hazard model. The majority of patients were  male and almost 80\% had elevated circulating C-reactive protein concentrations ({\textgreater}10 mg x l(-1)). On multivariate analysis, age (P=0.012), tumour type (0.002), weight loss (P=0.056), C-reactive protein (P=0.047), Karnofsky performance status (P=0.002) and fatigue (P=0.046) were independent predictors of survival. The patients were grouped according to the magnitude of the C-reactive protein concentrations ({\textless} or =10, 11-100 and {\textgreater}100 mg x l(-1)). An increase in the magnitude of the systemic inflammatory response was associated with increased weight loss (P=0.004), reduced albumin concentrations (P=0.001), reduced performance status (P=0.060), increased fatigue (P=0.011) and reduced survival ({HR} 1.936 95\%{CI} 1.414-2.650, P{\textless}0.001). These results indicate that the majority of patients with inoperable non-small cell lung cancer have evidence of a systemic inflammatory response. Furthermore, an increase in the magnitude of the  systemic inflammatory response resulted in greater weight loss, poorer performance status, more fatigue and poorer survival.},
	pages = {264--267},
	number = {3},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Scott, H. R. and {McMillan}, D. C. and Forrest, L. M. and Brown, D. J. F. and {McArdle}, C. S. and Milroy, R.},
	date = {2002-07-29},
	pmid = {12177792},
	pmcid = {PMC2364225},
	keywords = {*Weight Loss, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung/complications/*mortality/psychology, C-Reactive Protein/analysis, Fatigue/etiology, Female, Humans, Lung Neoplasms/complications/*mortality/psychology, Male, Middle Aged, Quality of Life, Systemic Inflammatory Response Syndrome/*complications}
}

@article{preston_rapid_1988,
	title = {Rapid sample throughput for biomedical stable isotope tracer studies.},
	volume = {16},
	abstract = {Typical 13C or 15N tracer studies generate large numbers of samples. Instrumentation capable of rapid automated analysis is therefore of importance as a practical alternative to conventional isotope methodology. Although biomedical  sample nature is diverse, experimenters often require analysis of substrates and  products of particular biochemical pathways. Clearly, reaction products can contain considerably less isotope tracer than precursors. Analytical techniques thus need to accommodate samples of widely varying nature, size and isotope enrichment. In the clinical field, where stable isotopes are increasingly used to study protein, carbohydrate and fat metabolism, analysis of the isotope ratio of  a substrate infused into the plasma and a product of its metabolism is often required. Conventional analytical approaches demand access to two mass spectrometers: isotope ratio mass spectrometry ({IRMS}) for isotope analysis of the relatively large concentrations of low-enrichment metabolic product, and gas chromatography/mass spectrometry ({GC}/{MS}) for analysis of the infused substrate often present at high enrichment but low concentration offers a practical alternative to the conventional approaches that is rapid and automatic. In addition to providing a considerably less complex and costly alternative to conventional instrumentation, a single {CF}-{IRMS} instrument can also analyse small  quantities of low-enrichment metabolites with superior performance than either of the alternative approaches. {CF}-{IRMS} is illustrated using results from constant-infusion studies in human protein and fat metabolism which require measurement of the isotope enrichment in submicromolar quantities of plasma substrates together with analysis of larger quantities of their oxidation products, urinary nitrogen and breath {CO}2.},
	pages = {229--235},
	number = {1},
	journaltitle = {Biomedical \& environmental mass spectrometry},
	shortjournal = {Biomed Environ Mass Spectrom},
	author = {Preston, T. and {McMillan}, D. C.},
	date = {1988-10},
	pmid = {3149535},
	keywords = {*Isotopes, Ammonia/urine, Breath Tests, Carbon Dioxide/analysis, Carbon Isotopes, Glycine/blood, Humans, Mass Spectrometry/instrumentation/*methods, Nitrogen Isotopes, Nitrogen/urine, Urea/urine}
}

@article{balady_clinicians_2010,
	title = {Clinician's Guide to Cardiopulmonary Exercise Testing in Adults: A Scientific Statement From the American Heart Association},
	volume = {122},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/cgi/doi/10.1161/CIR.0b013e3181e52e69},
	doi = {10.1161/CIR.0b013e3181e52e69},
	shorttitle = {Clinician's Guide to Cardiopulmonary Exercise Testing in Adults},
	pages = {191--225},
	number = {2},
	journaltitle = {Circulation},
	author = {Balady, G. J. and Arena, R. and Sietsema, K. and Myers, J. and Coke, L. and Fletcher, G. F. and Forman, D. and Franklin, B. and Guazzi, M. and Gulati, M. and Keteyian, S. J. and Lavie, C. J. and Macko, R. and Mancini, D. and Milani, R. V. and {on behalf of the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology} and {Council on Epidemiology and Prevention} and {Council on Peripheral Vascular Disease} and {Interdisciplinary Council on Quality of Care and Outcomes Research}},
	urldate = {2014-01-27},
	date = {2010-06-28},
	file = {Balady et al. - 2010 - Clinician's Guide to Cardiopulmonary Exercise Test.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\B4Z56GX6\\Balady et al. - 2010 - Clinician's Guide to Cardiopulmonary Exercise Test.pdf:application/pdf}
}

@article{hayashi_impact_2015,
	title = {Impact of infectious complications on gastric cancer recurrence},
	volume = {18},
	issn = {1436-3291},
	doi = {10.1007/s10120-014-0361-3},
	abstract = {{BACKGROUND}: Postoperative infectious complications increase disease recurrence in colorectal cancer patients. We herein investigated the impact of infectious complications on gastric cancer recurrence after curative surgery.
{METHODS}: In total, 502 patients who underwent R0 resection for gastric cancer were reviewed. Patients were classified into those with infectious complications ({IC} group) and those without infectious complications ({NO} group). The risk factors for recurrence-free survival ({RFS}) were identified.
{RESULTS}: Infectious complications, which occurred in 52 patients (10.4 \%), included pneumonia, ileus with a systemic inflammatory reaction, anastomotic leakage, and intraperitoneal abscess. The overall 5-year {RFS} rate was 83 \% in the {NO} group and 58 \% in the {IC} group (p = 0.000). Multivariate analysis demonstrated that age, {ASA} score, stage, and infectious complications were significant predictors of {RFS}.
{CONCLUSIONS}: Infectious complications were a risk factor for gastric cancer recurrence. To avoid causing infectious complications, the surgical procedure, surgical strategy, and perioperative care should be carefully planned.},
	pages = {368--374},
	number = {2},
	journaltitle = {Gastric Cancer: Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association},
	shortjournal = {Gastric Cancer},
	author = {Hayashi, Tsutomu and Yoshikawa, Takaki and Aoyama, Toru and Hasegawa, Shinichi and Yamada, Takanobu and Tsuchida, Kazuhito and Fujikawa, Hirohito and Sato, Tsutomu and Ogata, Takashi and Cho, Haruhiko and Oshima, Takashi and Rino, Yasushi and Masuda, Munetaka},
	date = {2015-04},
	pmid = {24634097}
}

@article{ward_cancer_2004,
	title = {Cancer disparities by race/ethnicity and socioeconomic status},
	volume = {54},
	abstract = {This article highlights disparities in cancer incidence, mortality, and relation to race/ethnicity, and census data on poverty in the county or census tract of The incidence and survival data derive from the National Cancer Institute's ({NCI}) Epidemiology, and End Results ({SEER}) Program; mortality data are from the National Health Statistics ({NCHS}); data on the prevalence of major cancer risk factors and screening are from the National Health Interview Survey ({NHIS}) conducted by {NCHS}. cancer sites combined, residents of poorer counties (those with greater than or equal to the population below the poverty line) have 13\% higher death rates from cancer in men higher rates in women compared with more affluent counties (less than 10\% below the line). Differences in cancer survival account for part of this disparity. Among both men women, five-year survival for all cancers combined is 10 percentage points lower persons who live in poorer than in more affluent census tracts. Even when census tract rate is accounted for, however, African American, American Indian/Alaskan Native, and Pacific Islander men and African American and American Indian/Alaskan Native women lower five-year survival than non-Hispanic Whites. More detailed analyses of selected show large variations in cancer survival by race and ethnicity. Opportunities to reduce disparities exist in prevention (reductions in tobacco use, physical inactivity, and obesity), detection (mammography, colorectal screening, Pap tests), treatment, and palliative care.},
	pages = {78--93},
	number = {2},
	journaltitle = {Ca-a Cancer Journal for Clinicians},
	author = {Ward, E. and Jemal, A. and Cokkinides, V. and Singh, G. K. and Cardinez, C. and Ghafoor, A. and Thun, M.},
	date = {2004-04},
	note = {{WOS}:000231482800005}
}

@article{desai_hypertrophic_2010,
	title = {Hypertrophic cardiomyopathy and dysregulation of cardiac energetics in a mouse model of biliary fibrosis},
	volume = {51},
	issn = {02709139},
	url = {http://doi.wiley.com/10.1002/hep.23585},
	doi = {10.1002/hep.23585},
	pages = {2097--2107},
	number = {6},
	journaltitle = {Hepatology},
	author = {Desai, Moreshwar S. and Shabier, Zainuer and Taylor, Michael and Lam, Fong and Thevananther, Sundararajah and Kosters, Astrid and Karpen, Saul J.},
	urldate = {2014-01-27},
	date = {2010-06},
	file = {Desai et al. - 2010 - Hypertrophic cardiomyopathy and dysregulation of c.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BRU3JGXF\\Desai et al. - 2010 - Hypertrophic cardiomyopathy and dysregulation of c.pdf:application/pdf}
}

@article{lygidakis_preoperative_1990,
	title = {Preoperative biliary drainage},
	volume = {156},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2349861},
	pages = {417},
	number = {5},
	journaltitle = {Acta Chir Scand},
	author = {Lygidakis, N J},
	date = {1990-05}
}

@article{takamori_pancreatic_2004,
	title = {Pancreatic liver metastases after curative resection combined with intraoperative radiation for pancreatic cancer},
	volume = {51},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15362786},
	abstract = {{BACKGROUND}/{AIMS}: A high proportion of patients even after curative resection for pancreatic cancer suffer from hepatic metastases. The aim of this study was to identify clinicopathological predictors of liver metastases after surgery, retrospectively. {METHODOLOGY}: Forty-one patients underwent extended radical pancreatectomy combined with intraoperative radiotherapy, which is one of the best local control methods for ductal cell carcinoma of the pancreas. Of the 41 patients, twenty-one patients regarded as being in a cancer free state after this combined therapy were studied to analyze clinicopathological predictors of hepatic metastases. Odds ratios and their 95\% confidence intervals were calculated from data using logistic regression analysis. Statistical difference was considered significant at p{\textless}0.05. {RESULTS}: Liver metastases after curative resection occurred in 11 patients. Preoperative biliary drainage, jaundice, elevated preoperative serum tumor-associated carbohydrate antigens levels, microscopic distal bile duct invasion, duodenal wall invasion, extrapancreatic nerve plexuses invasion were factors influencing postoperative liver metastases. {CONCLUSIONS}: We found clinicopathological predictors of postoperative liver metastases. Patients with these factors require consideration in careful follow-up and perioperative adjuvant therapy for prevention of postoperative liver metastases.},
	pages = {1500--3},
	number = {59},
	journaltitle = {Hepatogastroenterology},
	author = {Takamori, Hiroshi and Hiraoka, Takehisa and Kanemitsu, Keiichiro and Tsuji, Tatsuya},
	date = {2004-10}
}

@article{fernandez_[what_2006,
	title = {[What are the main errors made by surgeons in the management of pancreatic cancer?]},
	volume = {79},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16753101},
	abstract = {The present review identifies two major conceptual errors. Therapeutic nihilism, which should be discounted in view of the results currently achieved by surgery, and noncentralization, since better results have been demonstrated, both in terms of morbidity and mortality and in survival, in high-volume centers than in low volume centers. The present review also identifies errors in management, the most important of which are: undervaluing the medical record, which is of great utility and continues to be the pillar on which the entire diagnostic process is based; the systematic use of preoperative biliary drainage, which used to be considered mandatory but should be used highly selectively in patients with severe jaundice or biliary tract infections, and viewing preoperative imaging tests as unreliable, when current radiological techniques, particularly helical computed tomography ({CT}), are highly reliable in establishing tumor resectability and consequently they should be used in all treatment planning. Moreover, because radiological tests are highly reliable, laparoscopic staging has lost diagnostic value; obtaining a preoperative histological diagnosis, which is not mandatory except when neoadjuvant therapy is planned or when tumors requiring nonsurgical treatment are suspected; undervaluing the use of surgical palliation, since this technique provides better long-term results than nonsurgical palliation, and consequently still plays a role in patients with good general health status and prolonged life expectancy; systematically performing gastrojejunostomy with bilio-enteric bypass, as this procedure should only be performed in tumors of the uncus or when there is imminent biliary or gastroduodenal obstruction; the use of supraradical surgical techniques such as regional, total or extensive pancreatectomy, since these techniques do not prolong survival after resection. Furthermore, the use of vascular resections would only be justified if resection with disease-free margins could be performed; undervaluing close postoperative monitoring within specialized units since this is the key to reducing morbidity and mortality rates in this type of surgery; and lastly when an intraoperative pancreatic incidentaloma is present, performing diagnostic maneuvers such as biopsy or pancreatic mobilization, since these procedures hamper subsequent radiological interpretation and possible surgical intervention.},
	pages = {215--23},
	number = {4},
	journaltitle = {Cir Esp},
	author = {Fernández, Juan Angel and Parrilla, Pascual},
	date = {2006-04}
}

@article{campillo_submaximal_1990,
	title = {Submaximal oxygen consumption in liver cirrhosis. Evidence of severe functional aerobic impairment},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2332586},
	abstract = {We studied maximal aerobic work capacity in 24 cirrhotic patients whose clinical condition was well compensated. Nineteen of our patients had no heart or lung disease, and five had mild mechanical ventilatory impairment. The patients performed incremental exercise on a treadmill until subjective exhaustion. The maximal exercise levels reached by all were relatively low and led to a lower observed maximal oxygen uptake ({VO}2 max), than predicted uptake (19.6 +/- 0.5 vs. 37.9 +/- 0.6 ml/kg; p less than 0.001). Observed {VO}2 max values correlated strongly with the Pugh score, which reflects the degree of liver failure (r = -0.571; p less than 0.01). Since there were no clear cardiac or pulmonary causes to explain the decrease in work capacity, these observations suggest that liver cirrhosis might induce or be accompanied by muscular impairment. {VO}2 max, which seems to decline with the functional severity of the disease, may be a useful index for evaluating the capacity of patients for physical rehabilitation.},
	pages = {163--7},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Campillo, B and Fouet, P and Bonnet, J C and Atlan, G},
	date = {1990-03},
	file = {Campillo et al. - 1990 - Submaximal oxygen consumption in liver cirrhosis. .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\59RESE4P\\Campillo et al. - 1990 - Submaximal oxygen consumption in liver cirrhosis. .pdf:application/pdf}
}

@article{crozier_relationship_2009,
	title = {Relationship between emergency presentation, systemic inflammatory response, and  cancer-specific survival in patients undergoing potentially curative surgery for  colon cancer.},
	volume = {197},
	doi = {10.1016/j.amjsurg.2007.12.052},
	abstract = {{BACKGROUND}: Emergency presentation is recognized to be associated with poorer cancer-specific survival following curative resection for colorectal cancer. The  present study examined the hypothesis that an enhanced systemic inflammatory response, prior to surgery, might explain the impact of emergency presentation on survival. {METHODS}: In all, 188 patients undergoing potentially curative resection for colorectal cancer were studied. Of these, 55 (29\%) presented as emergencies.  The systemic inflammatory response was assessed using the Glasgow Prognostic Score ({mGPS}), which is the combination of an elevated C-reactive protein ({\textgreater}10 mg/L) and hypoalbuminemia ({\textless}35 g/L). {RESULTS}: In the emergency group, tumor stage was greater (P {\textless} 0.01), more patients received adjuvant therapy (P {\textless} 0.01) more patients had an elevated {mGPS} (P {\textless} 0.01), and more patients died of their disease (P {\textless} 0.05). The minimum follow-up was 12 months; the median follow-up of the survivors was 48 months. Emergency presentation was associated with poorer 3-year cancer-specific survival in those patients aged 65 to 74 years (P {\textless} 0.01), in both males and females (P {\textless} 0.05), in the deprived (P {\textless} 0.01), in patients with tumor-node-metastasis ({TNM}) stage {II} disease (P {\textless} 0.01), in those who received no adjuvant therapy (P {\textless} 0.01), and in the {mGPS} 0 and 1 groups (P {\textless} 0.05) groups. On multivariate survival analysis of patients undergoing potentially curative surgery for {TNM} stage {II} colon cancer, emergency presentation (P {\textless} 0.05) and {mGPS} (P {\textless} 0.05) were independently associated with cancer-specific survival. {CONCLUSIONS}: These results suggest that emergency presentation and the presence of systemic inflammatory response prior to surgery are linked and account for poorer cancer-specific survival in patients undergoing potentially curative surgery for colon cancer. Both emergency presentation and an elevated {mGPS} should be taken into account when assessing the likely outcome of these patients.},
	pages = {544--549},
	number = {4},
	journaltitle = {American journal of surgery},
	shortjournal = {Am J Surg},
	author = {Crozier, Joseph E. M. and Leitch, E. Fiona and {McKee}, Ruth F. and Anderson, John H. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2009-04},
	pmid = {18614139},
	keywords = {Aged, Colectomy, Colonic Neoplasms/blood/mortality/*surgery, C-Reactive Protein/analysis, Emergencies, Female, Humans, Hypoalbuminemia/diagnosis, Male, Middle Aged, Serum Albumin/analysis, Survival Analysis, Systemic Inflammatory Response Syndrome/blood}
}

@article{padillo_effect_2002,
	title = {Effect of internal biliary drainage on plasma levels of endotoxin, cytokines, and C-reactive protein in patients with obstructive jaundice},
	volume = {26},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/s00268-002-6232-9},
	doi = {10.1007/s00268-002-6232-9},
	abstract = {Preoperative biliary drainage may improve the cytokine and acute-phase response derangements observed in patients with obstructive jaundice. We conducted a prospective longitudinal, before-after trial in our 600-bed teaching hospital. Twenty-four patients with obstructive jaundice were investigated, 11 with benign obstruction and 13 with malignant disease. Endoscopic internal biliary drainage was performed in all patients (7 by papillotomy and 17 by endoprostheses). Endotoxin, tumor necrosis factor alpha ({TNF}-α), {interIeukin}-6 ({IL}-6), nitric oxide production, and C-reactive protein ({CRP}) were determined at admission and on days 2 and 7 after internal biliary drainage was accomplished. Bile cultures were obtained before and at the time of drainage. Endotoxin, {IL}-6, {TNF}-α, and {CRP} were significantly higher in patients with cancer. After internal drainage, endotoxin (11.4 vs. 2 {EU}/L; p{\textless}0.05), {TNF}-α (87.5 vs. 48 pg/ml; p=0.03), and {IL}-6 (324 vs. 232 pg/ml;/ p{\textless}0.05) plasma levels decreased significantly in the early postdrainage period in patients with cancer. Endotoxin, cytokines, as well as the {CRP} plasma values, however, increased again on day 7 after drainage. This trend was less marked in patients with benign obstruction. Patients with positive bile cultures after drainage displayed higher levels of {CRP} (115 vs. 62 mg/L; p=0.03), {IL}-6 (598 vs. 330 pg/ml; p=0.04), and endotoxin (10.6 vs. 4.8 {EU}/L; p=0.02) than those with negative bile cultures. Biliary tract obstruction is associated with an increase in endotoxin levels, a positive acute-phase response, and plasma cytokine elevation. After biliary drainage a transitory improvement of these alterations was observed, although values remained high 1 week postdrainage. These findings were associated with positive bile cultures.},
	pages = {1328--1332},
	number = {11},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J. Surg.},
	author = {Padillo, Francisco J. and Muntane, Jordi and Montero, Jose L. and Briceño, Javier and Miño, Gonzalo and Solorzano, Guillermo and Sitges-Serra, Antonio and Pera-Madrazo, Carlos},
	urldate = {2015-08-21},
	date = {2002-11},
	langid = {english},
	keywords = {Abdominal Surgery, Cardiac Surgery, general surgery, surgery, Thoracic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6I2V8T9K\\Padillo et al. - 2002 - Effect of internal biliary drainage on plasma leve.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\T8KBT48A\\10.html:text/html}
}

@article{roxburgh_comparison_2010,
	title = {Comparison of the prognostic value of tumour- and patient-related factors in patients undergoing potentially curative surgery for colon cancer.},
	volume = {12},
	rights = {(c) 2010 The Authors. Colorectal Disease (c) 2010 The Association of Coloproctology of Great Britain and Ireland.},
	doi = {10.1111/j.1463-1318.2009.01961.x},
	abstract = {{AIM}: To comprehensively compare the prognostic value of tumour- and patient-related factors in patients undergoing curative surgery for colon cancer. {METHOD}: From a database of 287 patients who underwent elective resection between  1997 and 2005, tumour factors including stage and host factors including systemic inflammatory response [modified Glasgow Prognostic Score ({mGPS})] were identified. {RESULTS}: Median follow-up was 65 months. Over this period, 125 patients died, 80  from cancer. On multivariate analysis of all significant patient and tumour related factors, Dukes stage (P {\textless} 0.01), vascular invasion (P {\textless} 0.01) and the {mGPS} (P {\textless} 0.01) were independently associated with cancer-survival. Of the patient-related factors, age (P {\textless} 0.01), haemoglobin (P {\textless} 0.01), white-cell (P {\textless}  0.01), neutrophil (P {\textless} 0.01) and platelet (P {\textless} 0.01) counts, and alkaline phosphatase (P {\textless} 0.01) were most significantly associated with the {mGPS}. {CONCLUSION}: In addition to tumour-related factors such as Dukes stage and vascular invasion, the preoperative {mGPS} should be included to guide prognosis in patients undergoing curative resection for colon cancer.},
	pages = {987--994},
	number = {10},
	journaltitle = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
	shortjournal = {Colorectal Dis},
	author = {Roxburgh, C. S. D. and Wallace, A. M. and Guthrie, G. K. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2010-10},
	pmid = {19555389},
	keywords = {Aged, Age Factors, Alkaline Phosphatase/analysis, Biological Markers/analysis, Blood Cell Count, Cause of Death, Chi-Square Distribution, Colonic Neoplasms/mortality/pathology/*surgery, Female, Follow-Up Studies, Hemoglobins/analysis, Humans, Male, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Risk Factors}
}

@article{kim_predictive_2009,
	title = {Predictive Value of C-Reactive Protein for Major Postoperative Complications Following Off-Pump Coronary Artery Bypass Surgery},
	volume = {73},
	doi = {10.1253/circj.CJ-08-1010},
	abstract = {Background: To prospectively investigate the predictive value of the preoperative C-reactive protein ({CRP}) concentration for major postoperative complications following off-pump coronary artery bypass ({OPCAB}) surgery. Methods and Results: From January 2007 to December 2007, 185 consecutive patients scheduled for elective {OPCAB} surgery were allocated to a low-{CRP} group (n=137, {CRP} {\textless}0.3 mg/dl) and a high-{CRP} group (n=48, {CRP} ≥0.3 mg/dl). The incidence of major postoperative complications, defined as postoperative myocardial infarction, and 5 major morbidity endpoints including permanent stroke, renal dysfunction, any cardiac surgery reoperation, ventilation for more than 48 h, and deep sternal wound infection were assessed and compared. Multivariate logistic regression was used to determine the predictors of major postoperative complications. Patients in the high-{CRP} group had a significantly higher overall incidence of major postoperative complications, particularly renal dysfunction. In the multivariate logistic regression model, adjusting all the significant univariate predictors, baseline {CRP} {\textgreater}0.3 mg/dl and preoperative chronic renal failure ({CRF}) remained as significant independent predictors of major postoperative complications. Conclusions: Elevated preoperative {CRP} level and/or preoperative {CRF} indicate increased risk of developing major postoperative complications, particularly acute postoperative renal dysfunction in patients undergoing {OPCAB} surgery. (Circ J 2009; 73: 872 - 877)},
	pages = {872--877},
	number = {5},
	journaltitle = {Circulation Journal},
	author = {Kim, Dae Hee and Shim, Jae Kwang and Hong, Seong Wook and Cho, Kwang Rae and Kang, Seung Youn and Kwak, Young Lan},
	date = {2009},
	keywords = {C-Reactive Protein, Off-pump coronary artery bypass surgery, Postoperative morbidity},
	file = {Jstage - Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WEA4B3VC\\Kim et al. - 2009 - Predictive Value of C-Reactive Protein for Major P.pdf:application/pdf}
}

@article{woolsey_vasoactive_2006,
	title = {Vasoactive drugs and the gut: is there anything new?},
	volume = {12},
	url = {http://journals.lww.com/co-criticalcare/Abstract/2006/04000/Vasoactive_drugs_and_the_gut__is_there_anything.16.aspx},
	shorttitle = {Vasoactive drugs and the gut},
	pages = {155--159},
	number = {2},
	journaltitle = {Current opinion in critical care},
	author = {Woolsey, Cheryl A. and Coopersmith, Craig M.},
	urldate = {2014-01-27},
	date = {2006},
	file = {Woolsey and Coopersmith - 2006 - Vasoactive drugs and the gut is there anything ne.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9HF9RWPE\\Woolsey and Coopersmith - 2006 - Vasoactive drugs and the gut is there anything ne.pdf:application/pdf}
}

@article{khurana_bile_2011,
	title = {Bile acids regulate cardiovascular function},
	volume = {4},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21707953},
	abstract = {Research over the last decade has uncovered roles for bile acids ({BAs}) that extend beyond their traditional functions in regulating lipid digestion and cholesterol metabolism. {BAs} are now recognized as signaling molecules that interact with both plasma membrane and nuclear receptors. Emerging evidence indicates that by interacting with these receptors, {BAs} regulate their own synthesis, glucose and energy homeostasis, and other important physiological events. Herein, we provide a comprehensive review of the actions of {BAs} on cardiovascular function. In the heart and the systemic circulation, {BAs} interact with plasma membrane G-protein-coupled receptors, for example, {TGR}5 and muscarinic receptors, and nuclear receptors, for example, the farnesoid ({FXR}) and pregnane ({PXR}) xenobiotic receptors. {BA} receptors are expressed in cardiovascular tissue, however, the mechanisms underlying {BA}-mediated regulation of cardiovascular function remain poorly understood. {BAs} reduce heart rate by regulating channel conductance and calcium dynamics in sino-atrial and ventricular cardiomyocytes and regulate vascular tone via both endothelium-dependent and -independent mechanisms. End-stage liver disease, obstructive jaundice, and intrahepatic cholestasis of pregnancy are prominent conditions in which elevated serum {BAs} alter vascular dynamics. This review focuses on {BAs} as newly recognized signaling molecules that modulate cardiovascular function.},
	pages = {210--8},
	number = {3},
	journaltitle = {Clin Transl Sci},
	author = {Khurana, Sandeep and Raufman, Jean-Pierre and Pallone, Thomas L},
	date = {2011-06},
	file = {Khurana et al. - 2011 - Bile acids regulate cardiovascular function.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HTIDSD4H\\Khurana et al. - 2011 - Bile acids regulate cardiovascular function.pdf:application/pdf}
}

@article{barauskas_[influence_2003,
	title = {[Influence of preoperative biliary drainage and obstructive jaundice on the early outcome of pancreaticoduodenectomy]},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12738904},
	abstract = {{OBJECTIVE}: To assess the influence of jaundice and preoperative biliary drainage ({PBD}) on postoperative outcome following pancreaticoduodenectomy ({PD}). {MATERIAL} {AND} {METHODS}: Data of 122 patients who underwent {PD} for periampular tumors and pancreatic adenocarcinoma in Kaunas University of Medicine Hospital was analyzed. Patients were divided into groups: those who have not underwent {PBD}, but had preoperative bilirubin level {\textless}50 micromol/l (n=42), patients without {PBD}, but preoperative bilirubin exceeding 50 micromol/l (n=61) and patients who have undergone preoperative {PBD} (n=19). {RESULTS}: Overall morbidity following {PD} was 55.6\%. There were 10.7\% pancreatic fistulas, 13.1\% septic complications (either intraabdominal sepsis or wound infection) and 9\% of postoperative intraabdominal bleeding. Postoperative mortality was 9.8\%. There was no statistically significant difference in either overall morbidity, pancreatic fistula rates, septic complications, bleeding or postoperative mortality between jaundiced and nonjaundiced patients. Preoperative bilirubinemia in patients without {PBD} and without postoperative complications did not significantly differ from those without {PBD} who developed complications. Overall morbidity, pancreatic fistula rate, septic complications, bleeding, postoperative mortality were similar in {PBD} and {nonPBD} groups as well as in stented and nonstented patients. {CONCLUSIONS}: As obstructive jaundice has no impact on postoperative results of {PD}. {PBD} or stenting of bile ducts should not be used routinely and is justified in cases when surgery with intent for cure has to be postponed.},
	pages = {359--64},
	number = {4},
	journaltitle = {Medicina (Kaunas)},
	author = {Barauskas, Giedrius and Gulbinas, Antanas and Pundzius, Juozas},
	date = {2003}
}

@article{yuan_prediagnostic_2013,
	title = {Prediagnostic Body Mass Index and Pancreatic Cancer Survival},
	issn = {0732-183X, 1527-7755},
	url = {http://jco.ascopubs.org/content/early/2013/10/21/JCO.2013.51.7532},
	doi = {10.1200/JCO.2013.51.7532},
	abstract = {Purpose Although obesity is associated with increased incidence of pancreatic cancer, studies have not prospectively evaluated prediagnostic body mass index ({BMI}) and survival.
Patients and Methods We analyzed survival by prediagnostic {BMI} assessed in 1986 among 902 patients from two large prospective cohorts diagnosed from 1988 to 2010. We estimated hazard ratios ({HRs}) for death using Cox proportional hazards models, with adjustment for age, sex, race/ethnicity, smoking, diagnosis year, and stage. We evaluated the temporal association of {BMI} with survival by grouping reported {BMI} by 2-year lag-time intervals before diagnosis.
Results The multivariable-adjusted {HR} for death was 1.53 (95\% {CI}, 1.11 to 2.09) comparing patients with {BMI} ≥ 35 kg/m2 with those with {BMI} {\textless} 25 kg/m2 (P trend = .001), which was similar after adjustment for stage. The association of {BMI} with survival was stronger with longer lag times between reported {BMI} and cancer diagnosis. Among patients with {BMI} collected 18 to 20 years before diagnosis, {HR} for death was 2.31 (95\% {CI}, 1.48 to 3.61; P trend {\textless} .001), comparing obese with healthy-weight patients. No statistically significant differences were seen by cohort, smoking status, or stage, although the association was stronger among never-smokers ({HR}, 1.61; 95\% {CI}, 1.01 to 2.57; P trend = .002) than ever-smokers ({HR}, 1.36; 95\% {CI}, 0.86 to 2.15; P trend = .63), comparing {BMI} ≥ 35 kg/m2 with {BMI} {\textless} 25 kg/m2. Higher prediagnostic {BMI} was associated with more advanced stage at diagnosis, with 72.5\% of obese patients presenting with metastatic disease versus 59.4\% of healthy-weight patients (P = .02).
Conclusion Higher prediagnostic {BMI} was associated with statistically significantly decreased survival among patients with pancreatic cancer from two large prospective cohorts.},
	pages = {JCO.2013.51.7532},
	journaltitle = {Journal of Clinical Oncology},
	shortjournal = {{JCO}},
	author = {Yuan, Chen and Bao, Ying and Wu, Chen and Kraft, Peter and Ogino, Shuji and Ng, Kimmie and Qian, Zhi Rong and Rubinson, Douglas A. and Stampfer, Meir J. and Giovannucci, Edward L. and Wolpin, Brian M.},
	urldate = {2015-08-08},
	date = {2013-10-21},
	langid = {english},
	pmid = {24145341},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\REU7FNKX\\Yuan et al. - 2013 - Prediagnostic Body Mass Index and Pancreatic Cance.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\F6VV8JW3\\JCO.2013.51.7532.html:text/html}
}

@article{hennis_cardiopulmonary_2012,
	title = {Cardiopulmonary exercise testing predicts postoperative outcome in patients undergoing gastric bypass surgery},
	volume = {109},
	issn = {1471-6771},
	doi = {10.1093/bja/aes225},
	abstract = {{BACKGROUND}: For several types of non-cardiac surgery, the cardiopulmonary exercise testing ({CPET})-derived variables anaerobic threshold ({AT}), peak oxygen consumption ({VO}2 peak), and ventilatory equivalent for {CO}(2) ({VE}/{VCO}2 ) are predictive of increased postoperative risk: less physically fit patients having a greater risk of adverse outcome. We investigated this relationship in patients undergoing gastric bypass surgery.
{METHODS}: All patients ({\textless}190 kg) who were referred for {CPET} and underwent elective gastric bypass surgery at the Whittington Hospital {NHS} Trust between September 1, 2009, and February 25, 2011, were included in the study (n=121). Fifteen patients did not complete {CPET}. {CPET} variables ({VO}2 peak, {AT}, and {VE}/{VCO}2 ) were derived for 106 patients. The primary outcome variables were day 5 morbidity and hospital length of stay ({LOS}). The independent t-test and Fisher's exact test were used to test for differences between surgical outcome groups. The predictive capacity of {CPET} markers was determined using receiver operating characteristic ({ROC}) curves.
{RESULTS}: The {AT} was lower in patients with postoperative complications than in those without [9.9 (1.5) vs 11.1 (1.7) ml kg(-1) min(-1), P=0.049] and in patients with a {LOS}{\textgreater}3 days compared with {LOS} ≤ 3 days [10.4 (1.4) vs 11.3 (1.8) ml kg(-1) min(-1), P=0.023]. {ROC} curve analysis identified {AT} as a significant predictor of {LOS}{\textgreater}3 days ({AUC} 0.640, P=0.030). The {VO}2 peak and {VE}/{VCO}2 were not associated with postoperative outcome.
{CONCLUSIONS}: {AT}, determined using {CPET}, predicts {LOS} after gastric bypass surgery.},
	pages = {566--571},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br J Anaesth},
	author = {Hennis, P. J. and Meale, P. M. and Hurst, R. A. and O'Doherty, A. F. and Otto, J. and Kuper, M. and Harper, N. and Sufi, P. A. and Heath, D. and Montgomery, H. E. and Grocott, M. P. W.},
	date = {2012-10},
	pmid = {22810563},
	keywords = {Adult, anaerobic threshold, Area Under Curve, Body Weight, Exercise Test, Female, Gastric Bypass, Humans, length of stay, Male, Patient Readmission, Physical fitness, postoperative complications, Predictive Value of Tests, Prospective Studies, {ROC} Curve, Treatment Outcome}
}

@article{pancreatic_section_of_the_british_society_of_gastroenterology_pancreatic_society_of_great_britain_and_ireland_association_of_upper_gastrointestinal_surgeons_of_great_britain_and_ireland_royal_college_of_pathologists_special_interest_group_for_gastro-i_guidelines_2005,
	title = {Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas},
	volume = {54},
	issn = {0017-5749},
	url = {http://gut.bmj.com/cgi/doi/10.1136/gut.2004.057059},
	doi = {10.1136/gut.2004.057059},
	pages = {v1--v16},
	issue = {suppl\_5},
	journaltitle = {Gut},
	author = {{Pancreatic Section of the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Pathologists, Special Interest Group for Gastro-I}},
	urldate = {2014-01-27},
	date = {2005-06-01},
	file = {Pancreatic Section of the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Royal College of Pathologists, Special Interest Group for Gastro-I - 2005 - Guidelines for the management of patients with pan.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KW5BADZ3\\15888770.GutGuidelines2005.Gut Guidelines on the management of pancreatic cancers.pdf:application/pdf}
}

@article{sinclair_validity_2011,
	title = {Validity of the 6 min walk test in prediction of the anaerobic threshold before major non-cardiac surgery},
	volume = {108},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aer322},
	doi = {10.1093/bja/aer322},
	pages = {30--35},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Sinclair, R. C. F. and Batterham, A. M. and Davies, S. and Cawthorn, L. and Danjoux, G. R.},
	urldate = {2014-01-27},
	date = {2011-10-05},
	file = {Sinclair et al. - 2011 - Validity of the 6 min walk test in prediction of t.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SUJNIFKF\\Sinclair et al. - 2011 - Validity of the 6 min walk test in prediction of t.pdf:application/pdf}
}

@article{benzo_preoperative_2011,
	title = {Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies},
	volume = {74},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21663994},
	abstract = {Complete surgical resection is the most effective curative treatment for lung cancer. However, many patients with lung cancer also have severe {COPD} which increases their risk of postoperative complications and their likelihood of being considered "inoperable." Preoperative pulmonary rehabilitation ({PR}) has been proposed as an intervention to decrease surgical morbidity but there is no established protocol and no randomized study has been published to date. We tested two preoperative {PR} interventions in patients undergoing lung cancer resection and with moderate-severe {COPD} in a randomized single blinded design. Outcomes were length of hospital stay and postoperative complications. The first study tested 4 weeks of guideline-based {PR} vs. usual care: that study proved to be very difficult to recruit as patients and providers were reluctant to delay surgery. Nine patients were randomized and no differences were found between arms. The second study tested ten preoperative {PR} sessions using a customized protocol with nonstandard components (exercise prescription based on self efficacy, inspiratory muscle training, and the practice of slow breathing) (n=10) vs. usual care (n=9). The {PR} arm had shorter length of hospital stay by 3 days (p=0.058), fewer prolonged chest tubes (11\% vs. 63\%, p=0.03) and fewer days needing a chest tube (8.8 vs. 4.3 days p=0.04) compared to the controlled arm. A ten-session preoperative {PR} intervention may improve post operative lung reexpansion evidenced by shorter chest tube times and decrease the length of hospital stay, a crude estimator of post operative morbidity and costs. Our results suggest the potential for short term preoperative pulmonary rehabilitation interventions in patients with moderate-severe {COPD} undergoing curative lung resection. 4 weeks of conventional preoperative {PR} seems non feasible.},
	pages = {441--5},
	number = {3},
	journaltitle = {Lung Cancer},
	author = {Benzo, Roberto and Wigle, Dennis and Novotny, Paul and Wetzstein, Marnie and Nichols, Francis and Shen, Robert K and Cassivi, Steve and Deschamps, Claude},
	date = {2011-12}
}

@article{gibbs_preoperative_1999,
	title = {Preoperative serum albumin level as a predictor of operative mortality and morbidity - Results from the national {VA} surgical risk study},
	volume = {134},
	issn = {0004-0010},
	doi = {10.1001/archsurg.134.1.36},
	abstract = {Objective: To improve the precision and reliability of estimates of the association between preoperative serum albumin concentration and surgical outcomes. Design: Prospective observational study. Patients were followed up for 30 days postoperatively. Multiple logistic regression models were developed to evaluate serum albumin level as a predictor of operative mortality and morbidity in relation to 61 other preoperative patient risk variables. Setting: Forty-four tertiary care Veterans Affairs ({VA}) medical centers. Patients: A total of 54 215 major noncardiac surgery cases from the National {VA} Surgical Risk Study. Main Outcome Measures: Thirty-day operative mortality and morbidity. Results: A decrease in serum albumin from concentrations greater than 46 g/L to less than 21 g/L was associated with an exponential increase in mortality rates from less than 1\% to 29\% and in morbidity rates from 10\% to 65\%. In the regression models, albumin level was the strongest predictor of mortality and morbidity for surgery as a whole and within several subspecialties selected for further analysis. Albumin Level was a better predictor of some types of morbidity, particularly sepsis and major infections, than other types. Conclusions: Serum albumin concentration is a better predictor of surgical outcomes than many other preoperative patient characteristics, It is a relatively low-cost test that should be used more frequently as a prognostic tool to detect malnutrition and risk of adverse surgical outcomes, particularly in populations in whom comorbid conditions are relatively frequent.},
	pages = {36--42},
	number = {1},
	journaltitle = {Archives of Surgery},
	shortjournal = {Arch. Surg.},
	author = {Gibbs, J. and Cull, W. and Henderson, W. and Daley, J. and Hur, K. and Khuri, S. F.},
	date = {1999-01},
	note = {{WOS}:000078053500009},
	keywords = {adjustment, care, Complications, gastrointestinal surgery, nutritional   assessment, outcomes, protein-calorie malnutrition, quality, stay}
}

@article{sear_kidney_2005,
	title = {Kidney dysfunction in the postoperative period},
	volume = {95},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aei018},
	doi = {10.1093/bja/aei018},
	pages = {20--32},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Sear, J. W.},
	urldate = {2014-01-27},
	date = {2005-07-01},
	file = {Sear - 2005 - Kidney dysfunction in the postoperative period.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QKFPF6G5\\Sear - 2005 - Kidney dysfunction in the postoperative period.pdf:application/pdf}
}

@article{hatfield_preoperative_1982,
	title = {Preoperative external biliary drainage in obstructive jaundice. A prospective controlled clinical trial},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6126752},
	abstract = {57 patients with obstructive jaundice were randomly allocated to surgery with preoperative external biliary drainage (29 patients) and without preoperative external biliary drainage (28 patients). 22 patients ultimately underwent laparotomy after a mean of 11.7 days of drainage and 25 had surgery without preoperative drainage. The postoperative complication rate was low and similar in both groups but complications associated with the drainage procedure were substantial. Perioperative mortality was 4/28 (14\%) in the drainage group and 4/27 (15\%) in the non-drainage group. There seems to be no advantage associated with routine preoperative external biliary drainage before surgery for obstructive jaundice.},
	pages = {896--9},
	number = {8304},
	journaltitle = {Lancet},
	author = {Hatfield, A R and Tobias, R and Terblanche, J and Girdwood, A H and Fataar, S and Harries-Jones, R and Kernoff, L and Marks, I N},
	date = {1982-10},
	note = {Cochrane review paper}
}

@article{willett_guidelines_1999,
	title = {Guidelines for healthy weight},
	volume = {341},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10432328},
	pages = {427--34},
	number = {6},
	journaltitle = {N Engl J Med},
	author = {Willett, W C and Dietz, W H and Colditz, G A},
	date = {1999-08}
}

@article{nugent_cardiopulmonary_1998,
	title = {Cardiopulmonary exercise testing in the pre-operative assessment of patients for repair of abdominal aortic aneurysm},
	volume = {167},
	issn = {0021-1265},
	abstract = {We have investigated the value of cardiopulmonary exercise testing in the pre-operative assessment to patients for abdominal aortic aneurysm repair. Thirty-six patients were entered into the study. All had a pre-operative clinical assessment and investigations including chest radiograph, electrocardiograph, spirometry and echocardiogram with measurement of left ventricular ejection fraction. Each patient performed a symptom limited treadmill exercise test using a {STEEP} protocol with on-line measurement of respiratory gas exchange. Patients were followed up for 12 months post-operatively by review of casenotes. Thirty out of 36 patients had surgical repair of abdominal aortic aneurysm. There was 1 death in the perioperative period and 2 deaths in the following 12 months. Seven other patients suffered post-operative complications. There were no significant differences in left ventricular ejection fraction, spirometry and peak achieved oxygen consumption ({PVO}2) between those patients who died or who had post-operative complications and those who had not. However, {PVO}2 {\textless} 20 ml/min/kg was found in 70 per cent of patients who had complications compared with 50 per cent of those who had not. Also 4 patients considered medically unfit for surgery all had {PVO}2 {\textless} 20 ml/min/kg. Cardiopulmonary exercise testing with measurement of {PVO}2 may be helpful in identifying patients more at risk of post-operative complications but should not be used in isolation without through clinical assessment.},
	pages = {238--241},
	number = {4},
	journaltitle = {Irish Journal of Medical Science},
	shortjournal = {Ir J Med Sci},
	author = {Nugent, A. M. and Riley, M. and Megarry, J. and O'Reilly, M. J. and {MacMahon}, J. and Lowry, R.},
	date = {1998-12},
	pmid = {9868863},
	keywords = {Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, Exercise Test, Female, General Practice / Family Medicine, Heart, Humans, Male, Medicine/Public Health, general, Middle Aged, Oxygen Consumption, preoperative care, Pulmonary Gas Exchange, Respiration},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C6M26ZPE\\Nugent et al. - 1998 - Cardiopulmonary exercise testing in the pre-operat.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2R6ZNQK2\\10.html:text/html}
}

@article{kahaleh_covered_2007,
	title = {Covered self-expandable metal stents in pancreatic malignancy regardless of resectability: a new concept validated by a decision analysis},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17357951},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: The current treatment model for the management of malignant biliary obstruction is to place a plastic stent for unstaged pancreatic cancer. In patients with unresectable disease but a life expectancy of more than 6 months, self-expandable metal stents ({SEMS}) are favored because of their more prolonged patency. We analyzed the efficacy and cost-effectiveness of covered {SEMS} ({CSEMS}) in patients with pancreatic cancer and distal biliary obstruction without regard to surgical resectability. {PATIENTS} {AND} {METHODS}: Between March 2001 and March 2005, 101 consecutive patients with obstructive jaundice secondary to pancreatic cancer underwent placement of a {CSEMS}. Patients with resectable tumor were offered pancreaticoduodenectomy. A model was developed to compare the costs of {CSEMS} and polyethylene and {DoubleLayer} stents. {RESULTS}: A total of 21 patients underwent staging laparoscopy, of whom 16 had a resection (76\%). The 85 patients who did not have a resection had a mean survival of 5.9 months (range 1-25 months) and a mean {CSEMS} patency duration of 5.5 months (range 1-16 months). Life-table analysis demonstrated {CSEMS} patency rates of 97\% at 3 months, 85\% at 6 months, and 68\% at 12 months. In a cost model that accounted for polyethylene and {DoubleLayer} stent malfunction and surgical resections, initial {CSEMS} placement (3177 euros per patient) was a less costly intervention than either {DoubleLayer} stent placement (3224 euros per patient) or polyethylene stent placement with revision (3570 euros per patient). {CONCLUSIONS}: Covered {SEMS} are an effective treatment for distal biliary obstructions caused by pancreatic carcinoma. Their prolonged patency and removability makes them an attractive option for biliary decompression, regardless of resectability. The strategy of initial covered {SEMS} placement might be the most cost-effective strategy in these patients.},
	pages = {319--24},
	number = {4},
	journaltitle = {Endoscopy},
	author = {Kahaleh, M and Brock, A and Conaway, M R and Shami, V M and Dumonceau, J M and Northup, P G and Tokar, J and Rich, T A and Adams, R B and Yeaton, P},
	date = {2007-04}
}

@article{kim_responsive_2009,
	title = {Responsive Measures to Prehabilitation in Patients Undergoing Bowel Resection Surgery},
	volume = {217},
	doi = {10.1620/tjem.217.109},
	abstract = {Surgical patients often show physiological and metabolic distress, muscle weakness, and long hospital stays.  Physical conditioning might help recovery.  We attempted to identify the most responsive measure of aerobic fitness from a four-week pre-surgical aerobic exercise program (prehabilitation) in patients undergoing major bowel resection.  Twenty-one subjects randomized two to one (exercise: control) scheduled for colorectal surgery.  Fourteen subjects [Body Mass Index ({BMI}) = 27 ± 6 kg/m2; maximal oxygen uptake ({VO}2max) = 22 ± 10 ml/kg/min] underwent 3.8 ± 1.2 weeks (27 ± 8 sessions) of progressive, structured pre-surgical aerobic exercise training at 40 to 65\% of heart rate reserve (\%{HRR}).  Peak power output was the only maximal measure that was responsive to training [26 ± 27\%, Effects Size ({ES}) = 0.24; Standardized Response Mean ({SRM}) = 1.05; p {\textless} 0.05].  For the submaximal measures, heart rate and oxygen uptake during submaximal exercise was most responsive to training (decrease by 13\% ± 15\%, {ES} = −0.24; {SRM} = −0.57; and 7\% ± 6\%, {ES} = −0.40; {SRM} −0.97; p {\textless} 0.05) at an exercise intensity of 76 ± 47 W.  There was no change to maximal or submaximal measures in the control group.  The distance walked over six minutes improved in both groups (by ∼30 m), but the effect size and t-statistic were higher in the exercise group.  Heart rate and oxygen uptake during submaximal exercise, and peak power output are the most responsive measures to four weeks of prehabilitation in subjects with low initial fitness.},
	pages = {109--115},
	number = {2},
	journaltitle = {The Tohoku Journal of Experimental Medicine},
	author = {Kim, Do Jun and Mayo, Nancy E. and Carli, Franco and Montgomery, David L. and Zavorsky, Gerald S.},
	date = {2009},
	keywords = {Exercise, prehabilitation, responsiveness, submaximal},
	file = {Jstage - Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VMDN43AJ\\Kim et al. - 2009 - Responsive Measures to Prehabilitation in Patients.pdf:application/pdf}
}

@article{chu_differences_2010,
	title = {Differences in presentation and perioperative outcome after pancreaticoduodenectomy for cancer and benign pancreatitis},
	volume = {76},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20583516},
	abstract = {The aim of this study was to examine differences in presentation and outcome in pancreaticoduodenectomy for benign and malignant processes. Pancreaticoduodenectomies performed for pancreatic adenocarcinoma or chronic pancreatitis from 2000 to 2008 were identified from a prospectively maintained database and compared. Pancreaticoduodenectomy revealed adenocarcinoma in 220 patients and benign chronic pancreatitis in 40 patients. Patients with adenocarcinoma were older (64 +/- 10.6 years and 47.6 +/- 10.8 years, respectively, P {\textless} 0.001) and more likely to demonstrate jaundice (92 and 13\%, respectively, P {\textless} 0.001), weight loss (76 and 58\%, respectively, P = 0.01), and discrete masses (72 and 55\%, respectively, P = 0.03). By contrast, chronic pancreatitis presented with increased pain (98 and 49\%, respectively, P {\textless} 0.001) and nausea (68 and 32\%, respectively, P {\textless} 0.001). Patients with pancreatitis experienced reduced blood loss (227 +/- 156 and 571 +/- 626 {mL}, respectively, P = 0.05) and transfusion (10 and 42\%, respectively, P {\textless} 0.001). Postoperatively, the groups were similar in risk of fistula, gastroparesis, overall morbidity, and mortality. Infection rates were higher in adenocarcinoma (42 and 20\%, respectively, P = 0.01). Forty-nine patients underwent pancreaticoduodenectomy for presumptive chronic pancreatitis, of which nine had adenocarcinoma; logistic regression identified increasing age and jaundice as predictors of malignancy. Compared with patients with adenocarcinoma, those who undergo pancreaticoduodenectomy for chronic pancreatitis are less likely to require preoperative biliary drainage and perioperative transfusion. Infectious complication risk is higher in patients with adenocarcinoma. Increased age and jaundice should raise suspicion of cancer in patients with chronic pancreatitis undergoing evaluation for surgical treatment.},
	pages = {606--13},
	number = {6},
	journaltitle = {Am Surg},
	author = {Chu, Carrie K and Sarmiento, Juan M and Park, Jaemin and Staley, Charles A and Galloway, John R and Adsay, N Volkan and Kooby, David A},
	date = {2010-06}
}

@article{nakamura_influence_1999,
	title = {Influence of preoperative nutritional state on inflammatory response after surgery},
	volume = {15},
	issn = {0899-9007},
	url = {http://www.sciencedirect.com/science/article/pii/S0899900799001768},
	doi = {10.1016/S0899-9007(99)00176-8},
	abstract = {To investigate whether the preoperative nutritional state influences the postoperative inflammatory reaction and immunity, we grouped patients whose postoperative nutritional support was performed by total parenteral nutrition into the good nutritional state group (group I) and the latent protein-calorie malnutrition suggested group (group {II}) based on the preoperative rapid turnover protein ({RTP}). Nutritional markers markedly decreased after surgery and recovered almost to preoperative levels on postoperative day ({POD}-) 7 in groups I and {II}. Nutritional markers on {POD}-7 in group {II} were significantly lower than those in group I ({RTP}, P \< 0.001; albumin, P \< 0.05). After surgery, levels of interleukin-6 ({IL}-6), C-reactive protein ({CRP}), and polymorphonuclear ({PMN}-) elastase were higher in group {II} than in group I (P \< 0.01). In groups I and {II}, {IL}-6 and interleukin- 8 ({IL}-8) rose before the remarkable elevation of {CRP} and {PMN}-elastase. In group I, all the nutritional markers showed a negative correlation with {CRP} and {PMN}-elastase. Further, a positive correlation was observed between {IL}-6 and {CRP} and between {IL}-8 and {PMN}-elastase. In conclusion, evaluation of the preoperative nutritional state appears to be very important for the prediction of postoperative complication.},
	pages = {834--841},
	number = {11},
	journaltitle = {Nutrition},
	shortjournal = {Nutrition},
	author = {Nakamura, Kazuo and Moriyama, Yukinori and Kariyazono, Hiroko and Hamada, Nobuo and Toyohira, Hitoshi and Taira, Akira and Yamada, Katsushi},
	urldate = {2015-08-21},
	date = {1999-11-01},
	keywords = {C-Reactive Protein, Interleukin-6, interleukin-8, polymorphonuclear elastase, rapid turnover protein},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AP7NWG6R\\Nakamura et al. - 1999 - Influence of preoperative nutritional state on inf.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MV2GNSEH\\S0899900799001768.html:text/html}
}

@article{katz_ln_metabolic_1934,
	title = {A "metabolic exercise tolerance test" for patients with cardiac disease: A feasible method for using the excess oxygen consumption and the recovery time of exercise as criteria of the cardiac status},
	volume = {53},
	issn = {0730-188X},
	url = {http://dx.doi.org/10.1001/archinte.1934.00160110079008},
	doi = {10.1001/archinte.1934.00160110079008},
	shorttitle = {A "metabolic exercise tolerance test" for patients with cardiac disease},
	abstract = {In accordance with the present trend of clinical medicine, there have been many attempts to devise methods for obtaining objective evidence concerning the functional condition of the heart in patients with cardiovascular disease. Such methods may be divided into two categories: (1) those which attempt to estimate the functional state of the heart at any given time, i. e., its ability to meet the routine demands of life, and (2) those designed to measure the cardiac reserve, i. e., the ability of the heart to meet emergency demands.Most of the phenomena which have been observed under those methods have been the coincidental changes in the cardiovascular and respiratory systems, such as deviations from the normal in vital capacity, minute volume of respiration, venous pressure, minute volume of blood flow, circulation time, blood pressure and pulse rate. While these measurements within their limits of accuracy are of undoubted value in},
	pages = {710--723},
	number = {5},
	journaltitle = {Archives of Internal Medicine},
	shortjournal = {Arch Intern Med (Chic)},
	author = {{KATZ LN} and {SOSKIN S} and {SCHUTZ WJ} and {ACKERMAN W} and {PLAUT JL}},
	urldate = {2015-08-22},
	date = {1934-05-01},
	file = {archinte_53_5_008.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WU5ZR9NH\\archinte_53_5_008.pdf:application/pdf}
}

@article{rodrigues_bilirubin_2002,
	title = {Bilirubin directly disrupts membrane lipid polarity and fluidity, protein order, and redox status in rat mitochondria},
	volume = {36},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11867176},
	abstract = {Unconjugated bilirubin ({UCB}) impairs crucial aspects of cell function and induces apoptosis in primary cultured neurones. While mechanisms of cytotoxicity begin to unfold, mitochondria appear as potential primary targets.},
	pages = {335--41},
	number = {3},
	journaltitle = {J Hepatol},
	author = {Rodrigues, Cecília M P and Solá, Susana and Brito, Maria A and Brites, Dora and Moura, José J G},
	date = {2002-03}
}

@article{matthiessen_increase_2008,
	title = {Increase of serum C-reactive protein is an early indicator of subsequent symptomatic anastomotic leakage after anterior resection},
	volume = {10},
	issn = {1463-1318},
	doi = {10.1111/j.1463-1318.2007.01300.x},
	abstract = {{OBJECTIVE}: This prospective study investigated the factors which might indicate anastomotic leakage after low anterior resection.
{METHOD}: Thirty-three patients who underwent anterior resection for rectal carcinoma (n = 32) and severe dysplasia (n = 1), were monitored daily by serum C-reactive protein ({CRP}) and white blood cell count ({WBC}) estimations until discharge from hospital. Computed tomography ({CT}) scans were performed on postoperative days 2 and 7 and the amount of presacral fluid collection was assessed. All patients had a pelvic drain and the volume of drainage was measured daily.
{RESULTS}: The level of the anastomosis was at a median 5 cm (3-12 cm) above the anal verge. There was no 30-day mortality. Nine (27.2\%) of the 33 patients developed a symptomatic anastomotic leakage which was diagnosed at a median of 8 days (range 4-14) postoperatively. The serum {CRP} was increased in patients who leaked from postoperative day 2 onwards (P = 0.004 on day 2; P {\textless} 0.001 on day 3-8). The {WBC} was decreased in preoperatively irradiated patients on days 1-5 (P {\textless}/= 0.021), with no difference seen between patients with or without leakage. Patients with leakage had a larger presacral fluid collection on {CT} on day 7 (median 76 ml vs 52 ml; P = 0.016) and a larger increase in the fluid collection between the first and the second {CT} examinations (28 ml vs 3 ml; P = 0.046). {CONCLUSION}; An early rise in serum {CRP} was a strong indicator of leakage. Monitoring of {CRP} for possible early detection of symptomatic anastomotic leakage is recommended.},
	pages = {75--80},
	number = {1},
	journaltitle = {Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland},
	shortjournal = {Colorectal Dis},
	author = {Matthiessen, P. and Henriksson, M. and Hallböök, O. and Grunditz, E. and Norén, B. and Arbman, G.},
	date = {2008-01},
	pmid = {17666099},
	keywords = {Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Biopsy, Needle, Chi-Square Distribution, Colectomy, C-Reactive Protein, Female, Humans, Immunohistochemistry, Male, Middle Aged, Neoplasm Staging, postoperative complications, Probability, prognosis, Prospective Studies, Rectal Fistula, Rectal Neoplasms, Risk assessment, Sensitivity and Specificity, Statistics, Nonparametric, Survival Analysis, Tumor Markers, Biological},
	file = {Matthiessen_et_al-2008-Colorectal_Disease.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SAQA74WB\\Matthiessen_et_al-2008-Colorectal_Disease.pdf:application/pdf}
}

@article{bronley-delancey_application_2006,
	title = {Application of cryopreserved human hepatocytes in trichloroethylene risk assessment: relative disposition of chloral hydrate to trichloroacetate and trichloroethanol.},
	volume = {114},
	abstract = {{BACKGROUND}: Trichloroethylene ({TCE}) is a suspected human carcinogen and a common  groundwater contaminant. Chloral hydrate ({CH}) is the major metabolite of {TCE} formed in the liver by cytochrome P450 2E1. {CH} is metabolized to the hepatocarcinogen trichloroacetate ({TCA}) by aldehyde dehydrogenase ({ALDH}) and to the noncarcinogenic metabolite trichloroethanol ({TCOH}) by alcohol dehydrogenase ({ADH}). {ALDH} and {ADH} are polymorphic in humans, and these polymorphisms are known  to affect the elimination of ethanol. It is therefore possible that polymorphisms in {CH} metabolism will yield subpopulations with greater than expected {TCA} formation with associated enhanced risk of liver tumors after {TCE} exposure. {METHODS}: The present studies were undertaken to determine the feasibility of using commercially available, cryogenically preserved human hepatocytes to determine simultaneously the kinetics of {CH} metabolism and {ALDH}/{ADH} genotype. Thirteen human hepatocyte samples were examined. Linear reciprocal plots were obtained for 11 {ADH} and 12 {ALDH} determinations. {RESULTS}: There was large interindividual variation in the Vmax values for both {TCOH} and {TCA} formation. Within this limited sample size, no correlation with {ADH}/{ALDH} genotype was apparent. Despite the large variation in Vmax values among individuals, disposition of {CH} into the two competing pathways was relatively constant. {CONCLUSIONS}: These data support the use of cryopreserved human hepatocytes as an  experimental system to generate metabolic and genomic information for incorporation into {TCE} cancer risk assessment models. The data are discussed with regard to cellular factors, other than genotype, that may contribute to the observed variability in metabolism of {CH} in human liver.},
	pages = {1237--1242},
	number = {8},
	journaltitle = {Environmental health perspectives},
	shortjournal = {Environ Health Perspect},
	author = {Bronley-{DeLancey}, Apryl and {McMillan}, David C. and {McMillan}, {JoEllyn} M. and Jollow, David J. and Mohr, Lawrence C. and Hoel, David G.},
	date = {2006-08},
	pmid = {16882532},
	pmcid = {PMC1551986},
	keywords = {Adult, Aged, Alcohol Dehydrogenase/genetics/metabolism, Aldehyde Dehydrogenase/genetics/metabolism, Animals, Chloral Hydrate/*metabolism, Cryopreservation, Ethylene Chlorohydrin/*analogs \& derivatives/metabolism/toxicity, Female, Genotype, Hepatocytes/*drug effects, Humans, In Vitro Techniques, Kinetics, Male, Middle Aged, Rats, Rats, Sprague-Dawley, Reproducibility of Results, Risk Assessment, Solvents/toxicity, Trichloroacetic Acid/*metabolism/*toxicity, Trichloroethylene/*metabolism/*toxicity}
}

@article{timbrell_comment_2012,
	title = {Comment on 'A systematic review of the role of cardiopulmonary exercise testing in vascular surgery'},
	volume = {44},
	issn = {1532-2165},
	doi = {10.1016/j.ejvs.2012.05.023},
	pages = {350; author reply 350--351},
	number = {3},
	journaltitle = {European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery},
	shortjournal = {Eur J Vasc Endovasc Surg},
	author = {Timbrell, D. and Gudgeon, J. and Chong, P. and Tote, S.},
	date = {2012-09},
	pmid = {22727061},
	keywords = {Aortic Aneurysm, Abdominal, Exercise Test, Exercise Tolerance, Humans, preoperative care, Vascular Surgical Procedures}
}

@article{young_is_2014,
	title = {Is the aerobic capacity at the time of cardiopulmonary exercise testing useful in predicting survival following liver transplantation?},
	volume = {20},
	rights = {© 2014 American Association for the Study of Liver Diseases},
	issn = {1527-6473},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/lt.23840/abstract},
	doi = {10.1002/lt.23840},
	pages = {502--502},
	number = {4},
	journaltitle = {Liver Transplantation},
	shortjournal = {Liver Transpl},
	author = {Young, Rebecca and Murphy, Nick and Elsharkawy, Ahmed M.},
	urldate = {2015-05-05},
	date = {2014-04-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PR8QEBN2\\Young et al. - 2014 - Is the aerobic capacity at the time of cardiopulmo.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DT365R3D\\abstract.html:text/html}
}

@article{ward_compensatory_2008,
	title = {The Compensatory Anti-inflammatory Response syndrome ({CARS}) in Critically ill patients},
	volume = {29},
	issn = {0272-5231},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786900/},
	doi = {10.1016/j.ccm.2008.06.010},
	pages = {617--viii},
	number = {4},
	journaltitle = {Clinics in chest medicine},
	shortjournal = {Clin Chest Med},
	author = {Ward, Nicholas S. and Casserly, Brian and Ayala, Alfred},
	urldate = {2015-05-25},
	date = {2008-12},
	pmid = {18954697},
	pmcid = {PMC2786900},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NSNTFMJV\\Ward et al. - 2008 - The Compensatory Anti-inflammatory Response syndro.pdf:application/pdf;PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZTMWKXNU\\Ward et al. - 2008 - The Compensatory Anti-inflammatory Response syndro.pdf:application/pdf}
}

@article{noun_impact_2008,
	title = {The impact of obesity on surgical outcome after pancreaticoduodenectomy},
	volume = {9},
	issn = {1590-8577},
	abstract = {{CONTEXT}: The effect of obesity on surgical outcome is becoming an increasingly relevant issue given the growing rate of obesity worldwide.
{OBJECTIVE}: To investigate the specific impact of obesity on pancreaticoduodenectomy.
{DESIGN}: A retrospective comparative study of a prospectively maintained database was carried out to investigate the specific impact of obesity on the technical aspects and postoperative outcome of pancreaticoduodenectomy.
{PATIENTS}: Between 1999 and 2006, 92 consecutive patients underwent pancreaticoduodenectomy using a standardized technique. The study population was subdivided according to the presence or absence of obesity.
{RESULTS}: Nineteen (20.7\%) patients were obese and 73 (79.3\%) patients were non-obese. The two groups were comparable in terms of demographics, American Society of Anesthesiology ({ASA}) score as well as nature and type of pancreatico-digestive anastomosis. The rate of clinically relevant pancreatic fistula (36.8\% vs. 15.1\%; P=0.050) and hospital stay (23.1+/-13.9 vs. 17.0+/-8.0 days; P=0.015) were significantly increased in obese vs. non-obese patients, respectively. Pancreatic fistula was responsible for one-half of the deaths (2/4) and two ruptured pseudoaneurysms. The incidence of the other procedure-related and general postoperative complications were not significantly different between the two groups. Intrapancreatic fat was increased in 10 obese patients (52.6\%) and correlated positively both with {BMI} (P=0.001) and with the occurrence of pancreatic fistula (P=0.003).
{CONCLUSION}: Obese patients are at increased risk for developing pancreatic fistula after pancreaticoduodenectomy. Special surgical caution as well as vigilant postoperative monitoring are therefore recommended in obese patients.},
	pages = {468--476},
	number = {4},
	journaltitle = {{JOP}: Journal of the pancreas},
	shortjournal = {{JOP}},
	author = {Noun, Roger and Riachy, Edward and Ghorra, Claude and Yazbeck, Thierry and Tohme, Cyril and Abboud, Bassam and Naderi, Samah and Chalhoub, Viviane and Ayoub, Eliane and Yazbeck, Patricia},
	date = {2008},
	pmid = {18648138},
	keywords = {Adenocarcinoma, Adipose Tissue, Adult, Aged, Aged, 80 and over, Body Mass Index, Female, Hospital Mortality, Humans, Lebanon, length of stay, Male, Middle Aged, Obesity, Outcome Assessment (Health Care), pancreas, Pancreatic Fistula, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, Treatment Outcome}
}

@article{lee_impact_2004,
	title = {Impact of body mass index on radical cystectomy},
	volume = {172},
	issn = {0022-5347},
	abstract = {{PURPOSE}: Radical cystectomy has a significant rate of morbidity and it is important to elucidate the factors that contribute to this risk. Obesity is a major problem in the United States and is associated with increased health hazard. Morbid obesity may even preclude definitive surgical treatment. This study examines the impact of body mass index ({BMI}) on radical cystectomy.
{MATERIALS} {AND} {METHODS}: Retrospective analysis was performed on 498 patients who underwent radical cystectomy primarily for bladder cancer from July 1, 1990 to May 10, 2002. Patient {BMI} was defined as normal (less than 25 in 151), overweight (25 to 29.9 in 198), obese (30 to 34.9 in 98) and morbidly obese (35 or greater in 51). The bivariate relationships among {BMI} categories and clinical parameters were assessed using the chi-square test, the analysis of variance and the log rank test. Multivariate analyses were performed using Cox regression models.
{RESULTS}: Median followup for the cohort was 3.3 years. Mean {BMI} was 28 and 70 of the study group was above normal weight. Compared to normal {BMI}, upper weight {BMI} groups were younger (p {\textless}0.0001), and had increased estimated blood loss (p = 0.01) and operative time (p = 0.001). Complication number (p = 0.0004) was increased in these groups but complication severity was similar (p = 0.54). Morbidly obese patients underwent incontinent diversion more often (p = 0.03). In multivariate models increased {BMI} was independently associated with increased estimated blood loss (p = 0.004), prolonged operative time (p = 0.006) and increased complication rate (p = 0.01).
{CONCLUSIONS}: Increased {BMI} independently poses a greater perioperative risk to the patient and contributes to the technical challenge of the cystectomy. This is most appreciated in the morbidly obese population and likely contributes to a greater use of incontinent diversion in this group. The increased perioperative risk associated with elevated {BMI} is significant but not prohibitive and should not preclude cystectomy as definitive treatment.},
	pages = {1281--1285},
	number = {4},
	journaltitle = {The Journal of Urology},
	shortjournal = {J. Urol.},
	author = {Lee, Cheryl T. and Dunn, Rodney L. and Chen, Bert T. and Joshi, Daya P. and Sheffield, Jaqueline and Montie, James E.},
	date = {2004-10},
	pmid = {15371824},
	keywords = {Aged, Analysis of Variance, Blood Loss, Surgical, Body Mass Index, Chi-Square Distribution, Cohort Studies, Cystectomy, Female, Follow-Up Studies, Hospitals, University, Humans, Male, Michigan, Middle Aged, Obesity, Obesity, Morbid, Outcome and Process Assessment (Health Care), postoperative complications, prognosis, Retrospective Studies, Risk, Urinary Bladder Diseases, Urinary Bladder Neoplasms, Urinary Diversion, Urinary Reservoirs, Continent}
}

@article{canna_relationship_2005,
	title = {The relationship between tumour T-lymphocyte infiltration, the systemic inflammatory response and survival in patients undergoing curative resection for  colorectal cancer.},
	volume = {92},
	doi = {10.1038/sj.bjc.6602419},
	abstract = {There is increasing evidence that both local and systemic inflammatory responses  play an important role in the progression of a variety of common solid tumours. The aim of the present study was to examine the relationship between tumour},
	pages = {651--654},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Canna, K. and {McArdle}, P. A. and {McMillan}, D. C. and {McNicol}, A.-M. and Smith, G. W. and {McKee}, R. F. and {McArdle}, C. S.},
	date = {2005-02-28},
	pmid = {15700032},
	pmcid = {PMC2361875},
	keywords = {*T-Lymphocytes, Aged, {CD}4-Positive T-Lymphocytes, {CD}8-Positive T-Lymphocytes, Colorectal Neoplasms/blood/immunology/*mortality/pathology/*surgery, C-Reactive Protein/metabolism, Female, Humans, Immunohistochemistry, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Predictive Value of Tests, Survival Analysis, Systemic Inflammatory Response Syndrome/blood/*immunology/mortality}
}

@article{crozier_tumor_2007,
	title = {Tumor size is associated with the systemic inflammatory response but not survival in patients with primary operable colorectal cancer.},
	volume = {22},
	doi = {10.1111/j.1440-1746.2006.04792.x},
	abstract = {{AIM}: To examine the relationship between tumor diameter, C-reactive protein concentrations and survival in patients undergoing surgery for colorectal cancer. {METHOD}: Tumor diameter and pathological characteristics of the resected specimen  were assessed in 227 patients. Circulating concentrations of C-reactive protein were measured prior to surgery. {RESULTS}: Ninety-six patients had an elevated},
	pages = {2288--2291},
	number = {12},
	journaltitle = {Journal of gastroenterology and hepatology},
	shortjournal = {J Gastroenterol Hepatol},
	author = {Crozier, Joseph Em and {McMillan}, Donald C. and {McArdle}, Colin S. and Angerson, Wilson J. and Anderson, John H. and Horgan, Paul G. and {McKee}, Ruth F.},
	date = {2007-12},
	pmid = {18031394},
	keywords = {*Tumor Burden, Aged, Aged, 80 and over, Colorectal Neoplasms/*pathology/*surgery, C-Reactive Protein/metabolism, Female, Humans, Male, Middle Aged, Preoperative Care, Survival Analysis, Systemic Inflammatory Response Syndrome/*pathology}
}

@article{almeida_elevated_2012,
	title = {Elevated serum C-reactive protein as a predictive factor for anastomotic leakage in colorectal surgery},
	volume = {10},
	issn = {1743-9191},
	url = {http://www.sciencedirect.com/science/article/pii/S1743919111005991},
	doi = {10.1016/j.ijsu.2011.12.006},
	abstract = {Background
C-reactive protein ({CRP}) has been used as an indicator of postoperative complications in abdominal surgery. Its short half-life makes it a reliable marker of the systemic inflammatory response secondary to a surgical procedure or to the appearance of complications, rapidly returning to normal values with the recovery of the patient.
Aim
To demonstrate the value of sequential serum determinations of postoperative C-reactive protein ({CRP}) and white blood cell counts ({WBC}) in the identification of increased risk of anastomotic leakage after colorectal surgery.
Methods
We reviewed the daily postoperative serum {CRP} and white blood cell counts in 173 patients who underwent surgery for colorectal disease with anastomosis, between January 2008 and October 2009. Patients with anastomotic leakage (Group A, n = 24) were compared to patients without leakage (Group B, n = 149). Patients with ongoing infections before surgery or with acquired postoperative infections other than leakage were excluded. Mean pre- and postoperative values of {CRP} and {WBC} were compared.
Results
The diagnosis of anastomotic leakage was made between the 4th and 11th postoperative day ({POD}; mean 7th {POD}). The daily average values of serum {CRP} were significantly higher in group A starting at the 2nd {POD} and remained significantly elevated until the diagnosis of leakage (p = 0.003). The cut-off value of 140 mg/L on the 3rd {POD} maximized the sensitivity (78\%) and specificity (86\%) of serum {CRP} in assessing the risk of leakage. Comparison of postoperative serum {WBC} values did not show any significant differences between the two groups until the 6th {POD}.
Conclusion
According to these results, an early and persistent elevation of {CRP} after colorectal surgery with anastomosis, is a marker of anastomotic leakage. A cut-off value \> 140 mg/L on {POD}3 maximizes sensitivity and specificity.},
	pages = {87--91},
	number = {2},
	journaltitle = {International Journal of Surgery},
	shortjournal = {International Journal of Surgery},
	author = {Almeida, A. B. and Faria, G. and Moreira, H. and Pinto-de-Sousa, J. and Correia-da-Silva, P. and Maia, J. Costa},
	urldate = {2015-08-20},
	date = {2012},
	keywords = {Anastomotic leakage, colorectal surgery, C-Reactive Protein},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3BEPSPJ7\\Almeida et al. - 2012 - Elevated serum C-reactive protein as a predictive .pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JG7EFHVX\\S1743919111005991.html:text/html}
}

@article{richards_revised_2011,
	title = {The revised {ACPGBI} model is a simple and accurate predictor of operative mortality after potentially curative resection of colorectal cancer.},
	volume = {18},
	doi = {10.1245/s10434-011-1805-1},
	abstract = {{BACKGROUND}: The Association of Coloproctology of Great Britain and Ireland ({ACPGBI}) risk-adjustment model for colorectal cancer surgery has been recently revised. The aim of the present study was to compare the performance of the revised {ACPGBI} model, the original {ACPGBI} model, P-{POSSUM}, and {CR}-{POSSUM}, in the  prediction of operative mortality after resection of colorectal cancer. {METHODS}:  A total of 423 patients who underwent potentially curative resection of colorectal cancer at a single institution (1997-2007) were included. Data used in the construction of the {ACPGBI} model was collected prospectively. The models were compared by examining observed to expected (O:E) ratios, the Hosmer-Lemeshow (H-L) goodness-of-fit test, and area under the receiver operator characteristic curve ({AUC}) analysis. {RESULTS}: The 30-day mortality rate was 4\%. The performance  of the models was as follows: revised {ACPGBI} model (O:E ratio = 1.05, {AUC} = 0.73,},
	pages = {3680--3685},
	number = {13},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Richards, Colin H. and Leitch, E. Fiona and Anderson, John H. and {McKee}, Ruth F. and {McMillan}, Donald C. and Horgan, Paul G.},
	date = {2011-12},
	pmid = {21674271},
	keywords = {*Logistic Models, *Postoperative Complications, *Risk Adjustment, Aged, Colorectal Neoplasms/*mortality/*surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Survival Rate}
}

@article{valentijn_obesity_2013,
	title = {The obesity paradox in the surgical population},
	volume = {11},
	issn = {1479-666X},
	url = {http://www.sciencedirect.com/science/article/pii/S1479666X13000140},
	doi = {10.1016/j.surge.2013.02.003},
	abstract = {Background
Despite the medical hazards of obesity, recent reports examining body mass index ({BMI}) show an inverse relationship with morbidity and mortality in the surgical patient. This phenomenon is known as the ‘obesity paradox’. The aim of this review is to summarize both the literature concerned with the obesity paradox in the surgical setting, as well as the theories explaining its causation.
Methods
{PubMed} was searched to identify available literature. Search criteria included obesity paradox and {BMI} paradox, and studies in which {BMI} was used as a measure of body fat were potentially eligible for inclusion in this review.
Results
The obesity paradox has been demonstrated in cardiac and in non-cardiac surgery patients. Underweight and morbidly obese patients displayed the worse outcomes, both postoperatively as well as at long-term follow-up. Hypotheses to explain the obesity paradox include increased lean body mass, (protective) peripheral body fat, reduced inflammatory response, genetics and a decline in cardiovascular disease risk factors, but probably unknown factors contribute too.
Conclusions
Patients at the extremes of {BMI}, both the underweight and the morbid obese, seem to have the highest postoperative morbidity and mortality hazard, which even persists at long-term. The cause of the obesity paradox is probably multi-factorial. This offers potential for future research in order to improve outcomes for persons on both sides of the ‘optimum {BMI}’.},
	pages = {169--176},
	number = {3},
	journaltitle = {The Surgeon},
	shortjournal = {The Surgeon},
	author = {Valentijn, Tabita M. and Galal, Wael and Tjeertes, Elke K. M. and Hoeks, Sanne E. and Verhagen, Hence J. and Stolker, Robert Jan},
	urldate = {2015-08-21},
	date = {2013-06},
	keywords = {Body Mass Index, mortality, Obesity paradox, surgery},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\58N2W27I\\Valentijn et al. - 2013 - The obesity paradox in the surgical population.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TZQ6B5AM\\S1479666X13000140.html:text/html}
}

@article{levett_cardiopulmonary_2015-1,
	title = {Cardiopulmonary Exercise Testing for Risk Prediction in Major Abdominal Surgery},
	volume = {33},
	issn = {1932-2275},
	url = {http://www.sciencedirect.com/science/article/pii/S193222751400127X},
	doi = {10.1016/j.anclin.2014.11.001},
	series = {Anesthetic Care for Abdominal Surgery},
	pages = {1--16},
	number = {1},
	journaltitle = {Anesthesiology Clinics},
	shortjournal = {Anesthesiology Clinics},
	author = {Levett, Denny Z. H. and Grocott, Michael P. W.},
	urldate = {2015-05-05},
	date = {2015-03},
	keywords = {Anaerobic threshold ({AT}), Cardiopulmonary exercise testing, Collaborative decision making, Functional capacity, Incremental exercise test, Peak oxygen consumption (    V  ˙    o2 peak), Preoperative, Risk assessment},
	file = {ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2JACCM5W\\S193222751400127X.html:text/html}
}

@article{kalser_pancreatic_1985-1,
	title = {Pancreatic cancer. Assessment of prognosis by clinical presentation},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4005804},
	abstract = {Three hundred ninety-three patients who were entered into pancreatic carcinoma treatment protocols of the Gastrointestinal Tumor Study Group ({GITSG}) were analyzed as to significant differences in clinical presentation and factors influencing survival. Patients were grouped according to the stage of the disease. Group I (21 cases) included those patients who had a potentially curative resection. Group {II} (182 cases) patients had a locally unresectable tumor less then 400 cm2 (surgically proven) and no distant metastases, and Group {III} (190 cases) had advanced disease. Group I patients had the smallest lesions (median area, 9 cm2), located in head of the gland in 90\% and painless jaundice was the most frequent clinical presentation (52\%). In Group {II}, 83\% were located in the head of the gland but the median area was much larger (36 cm2). Pain was present in 80\% of cases, and jaundice in 62\% with 48\% having jaundice and pain. In Group {III} patients, lesions of body and tail were over four-fold as frequent as in Group I and almost three-fold greater than in Group {II}. The median area of the lesion was large (30 cm2). Pain was present in 85\% and jaundice in only 31\%. Median survival in Group I patients was longer than Group {III} (73 versus 10 weeks; P less than 0.001). Ambulatory status, sex, race, abdominal pain, and histologic type influenced survival in one or more groups whereas age, jaundice, location of the tumor, degree of cellular differentiation, back pain, and nutritional status did not influence survival in any group. In all groups, those with a good performance status (Eastern Cooperative Oncology Group [{ECOG}] 0 and 1) survived longer than those with poor status ({ECOG} 2 and 3; P less than 0.05). The best potential prognosis is in those who are fully productive and present with painless jaundice, and who have resection of the tumor.},
	pages = {397--402},
	number = {2},
	journaltitle = {Cancer},
	author = {Kalser, M H and Barkin, J and {MacIntyre}, J M},
	date = {1985-07}
}

@article{bharathan_impact_2011,
	title = {Impact of deprivation on short- and long-term outcomes after colorectal cancer surgery},
	volume = {98},
	rights = {Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons, Ltd.},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.7427/abstract},
	doi = {10.1002/bjs.7427},
	abstract = {Background:
The aim of the study was to determine the association between short- and long-term outcomes and deprivation for patients undergoing operative treatment for colorectal cancer in the Northern Region of England.
Methods:
This was a retrospective analytical study based on the Northern Region Colorectal Cancer Audit Group database for the period 1998–2002. The Index of Multiple Deprivation 2004, an area-based measure, was recalibrated and used to quantify deprivation. Patients were ranked based on their postcode of residence and grouped into five categories.
Results:
Of 8159 patients in total, 7352 (90·1 per cent) had surgery; 6953 (94·6 per cent) of the 7352 patients underwent tumour resection and 4935 (67·7 per cent) of 7294 had a margin-negative (R0) resection. Deprivation was not associated with age, sex, tumour site, stage or other tumour-related factors. Compared with the most affluent group, the most deprived patients had fewer elective operations (72·9 versus 76·4 per cent; P = 0·014), more adverse co-morbidity (P {\textless} 0·001) and fewer curative resections (65·5 versus 71·2 per cent; P {\textless} 0·001). In multivariable analysis, deprivation was not an independent predictor of postoperative death (odds ratio ({OR}) 0·72, 95 per cent confidence interval 0·48 to 1·06; P = 0·101) but it was a predictor of curative resection ({OR} 1·24, 1·01 to 1·52; P = 0·042), overall survival ({HR} 0·83, 0·73 to 0·95; P = 0·006) and relative survival ({HR} 0·74, 0·58 to 0·95; P = 0·023).
Conclusion:
Deprivation, both independently and by influencing other surgical predictors, impacts on short- and long-term outcomes of patients with colorectal cancer. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons, Ltd.},
	pages = {854--865},
	number = {6},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Bharathan, B. and Welfare, M. and Borowski, D. W. and Mills, S. J. and Steen, I. N. and Kelly, S. B. and {on behalf of the members of the Northern Region Colorectal Cancer Audit Group (NORCCAG)}},
	urldate = {2015-05-26},
	date = {2011-06-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\74I53MRX\\Bharathan et al. - 2011 - Impact of deprivation on short- and long-term outc.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3NAX5448\\abstract.html:text/html}
}

@article{richards_impact_2011,
	title = {The impact of perioperative risk, tumor pathology and surgical complications on disease recurrence following potentially curative resection of colorectal cancer.},
	volume = {254},
	doi = {10.1097/SLA.0b013e31821fd469},
	abstract = {{OBJECTIVE}: The objective of the study was to identify determinants of disease recurrence after potentially curative resection of colorectal cancer. {SUMMARY} {BACKGROUND} {DATA}: The identification of patients at increased risk of disease recurrence is currently based on pathological factors. Recently, there has been considerable interest in the potential impact of perioperative factors on long-term colorectal cancer outcome. Few studies have examined pre-, intra-, and  postoperative variables in a single cohort. {METHODS}: Four hundred and twenty-three patients with histologically confirmed colorectal cancer who underwent surgery with curative intent between 1997 and 2007 were included. Pre-, intra-, and postoperative variables were recorded. Logistic and Cox regression analyses were performed to identify predictors of surgical complications and disease recurrence, respectively. {RESULTS}: The postoperative mortality rate was 4\% and the morbidity rate 34\%. The most important predictors of complications were smoking (odd ratio [{OR}] 1.32), {ASA} grade ({OR} 1.90) and {POSSUM} operative score ({OR} 1.32). During follow up (median 80 months), 35\% of patients developed disease recurrence. Predictors of recurrence, independent of tumor stage, were {POSSUM} physiology score (hazard ratio [{HR}] 1.31) and systemic inflammatory response ({HR} 1.31). {CONCLUSIONS}: Preoperative risk factors, but not postoperative complications, are associated with early disease recurrence after potentially curative resection of colorectal cancer.},
	pages = {83--89},
	number = {1},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Richards, Colin H. and Platt, Jonathan J. and Anderson, John H. and {McKee}, Ruth F. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-07},
	pmid = {21572320},
	keywords = {Aged, Colorectal Neoplasms/pathology/*surgery, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local/epidemiology, Perioperative Period, Postoperative Complications/epidemiology, Prospective Studies, Risk Factors}
}

@article{shimada_safety_2005,
	title = {Safety and effectiveness of left hepatic trisegmentectomy for hilar cholangiocarcinoma},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15880281},
	abstract = {Left hepatic trisegmentectomy has been performed for huge malignant tumors, but it is rarely applied in patients with hilar cholangiocarcinoma. Twelve consecutive patients (7 men and 5 women; mean age, 64 years) underwent left hepatic trisegmentectomy in our institution between January 2000 and December 2003. The preoperative management and postoperative outcomes of this surgical procedure were presented and retrospectively analyzed. Preoperative biliary drainage and portal vein embolization were performed in 6 patients (50\%) and 9 patients (75\%), respectively. The preoperative estimated volume ratio of the posterior segment /the whole liver was 44.8 +/- 7.0\% (34.3-54.3), the plasma retention rate of indocyanine green at 15 minutes was 8.6 +/- 2.2\% (4.7-13.7), and the serum total bilirubin level before surgery was 1.0 +/- 0.4 mg/dl (0.4-1.7). The serum total bilirubin level on the first postoperative day was 3.3 +/- 0.4 mg/dl (1.4-6.2). There was no hospital death or postoperative hepatic failure. The incidence of positive resectional margin was 25\%. With biliary decompression and preoperative portal embolization techniques, left hepatic trisegmentectomy was a safe and curative resectional option for hilar cholangiocarcinoma.},
	pages = {723--7},
	number = {6},
	journaltitle = {World J Surg},
	author = {Shimada, Kazuaki and Sano, Tsuyoshi and Sakamoto, Yoshihiro and Kosuge, Tomoo},
	date = {2005-06}
}

@article{mcwilliams_obesity_2010,
	title = {Obesity adversely affects survival in pancreatic cancer patients},
	volume = {116},
	issn = {0008-543X},
	doi = {10.1002/cncr.25465},
	abstract = {{BACKGROUND}: Higher body-mass index ({BMI}) has been implicated as a risk factor for developing pancreatic cancer, but its effect on survival has not been thoroughly investigated. The authors assessed the association of {BMI} with survival in a sample of pancreatic cancer patients and used epidemiologic and clinical information to understand the contribution of diabetes and hyperglycemia.
{METHODS}: A survival analysis using Cox proportional hazards by usual adult {BMI} was performed on 1861 unselected patients with pancreatic adenocarcinoma; analyses were adjusted for covariates that included clinical stage, age, and sex. Secondary analyses incorporated self-reported diabetes and fasting blood glucose in the survival model.
{RESULTS}: {BMI} as a continuous variable was inversely associated with survival from pancreatic adenocarcinoma (hazard ratio [{HR}], 1.019 for each increased unit of {BMI} [kg/m2], P{\textless}.001) after adjustment for age, stage, and sex. In analysis by National Institutes of Health {BMI} category, {BMIs} of 30 to 34.99 kg/m2 ({HR}, 1.14; 95\% confidence interval [{CI}], 0.98-1.33), 35 to 39.99 kg/m2 ({HR} 1.32, 95\% {CI} 1.08-1.62), and ≥40 ({HR} 1.60, 95\% {CI} 1.26-2.04) were associated with decreased survival compared with normal {BMI} of 18.5 to 24.99 kg/m2 (overall trend test P{\textless}.001). Fasting blood glucose and diabetes did not affect the results.
{CONCLUSIONS}: Higher {BMI} is associated with decreased survival in pancreatic cancer. Although the mechanism of this association remains undetermined, diabetes and hyperglycemia do not appear to account for the observed association.},
	pages = {5054--5062},
	number = {21},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {{McWilliams}, Robert R. and Matsumoto, Martha E. and Burch, Patrick A. and Kim, George P. and Halfdanarson, Thorvardur R. and de Andrade, Mariza and Reid-Lombardo, Kaye and Bamlet, William R.},
	date = {2010-11-01},
	pmid = {20665496},
	pmcid = {PMC2963722},
	keywords = {Adenocarcinoma, Adult, Aged, Body Mass Index, diabetes mellitus, Female, Humans, Male, Middle Aged, Obesity, Pancreatic Neoplasms, Risk Factors}
}

@article{oliphant_emergency_2014,
	title = {Emergency presentation of node-negative colorectal cancer treated with curative surgery is associated with poorer short and longer-term survival.},
	volume = {29},
	doi = {10.1007/s00384-014-1847-5},
	abstract = {{PURPOSE}: The majority of patients with node-negative colorectal cancer have excellent 5-year survival prospects, but up to a third relapse. Strategies to identify patients at higher risk of adverse outcomes are desirable to enable optimal treatment and follow-up. The aim of this study was to examine postoperative mortality and longer-term survival by mode of presentation for patients with node-negative colorectal cancer undergoing surgery with curative intent. {METHODS}: Patients from 16 hospitals in the west of Scotland between 2001  and 2004 were identified from a prospectively maintained regional clinical audit  database. Postoperative mortality and 5-year relative survival by mode of presentation were recorded. {RESULTS}: Of 1,877 patients with node-negative disease, 251 (13.4\%) presented as an emergency. Those presenting as an emergency  were more likely to be older (P = 0.023), have colon rather than rectal cancer (P {\textless} 0.001), have {pT}4 stage disease (P {\textless} 0.001), have extramural vascular invasion (P = 0.001), and receive surgery under the care of a nonspecialist surgeon (P {\textless} 0.001) compared to those presenting electively. The postoperative mortality rate  was 3.3\% after elective and 12.8\% after emergency presentation (P {\textless} 0.001). Five-year relative survival was 91.8\% after elective and 66.8\% after emergency presentation (P {\textless} 0.001). The adjusted relative excess risk ratio for 5-year relative survival after emergency relative to elective presentation was 2.59 (95\% {CI} 1.67-4.01; P {\textless} 0.001) and 1.90 (95\% {CI} 1.00-3.62; P = 0.049) after exclusion of postoperative deaths. {CONCLUSIONS}: Emergency presentation of node-negative colorectal cancer treated with curative intent was independently associated with  higher postoperative mortality and poorer 5-year relative survival compared to elective presentation.},
	pages = {591--598},
	number = {5},
	journaltitle = {International journal of colorectal disease},
	shortjournal = {Int J Colorectal Dis},
	author = {Oliphant, Raymond and Mansouri, David and Nicholson, Gary A. and {McMillan}, Donald C. and Horgan, Paul G. and Morrison, David S.},
	date = {2014-05},
	pmid = {24651957},
	keywords = {Adult, Aged, Aged, 80 and over, Colonic Neoplasms/*mortality/pathology/*surgery, Emergencies, Female, Humans, Lymph Nodes/pathology, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Rectal Neoplasms/*mortality/pathology/*surgery, Socioeconomic Factors, Survival Analysis, Young Adult}
}

@article{li_body_2009,
	title = {Body mass index and risk, age of onset, and survival in patients with pancreatic cancer},
	volume = {301},
	issn = {1538-3598},
	doi = {10.1001/jama.2009.886},
	abstract = {{CONTEXT}: Obesity has been implicated as a risk factor for pancreatic cancer.
{OBJECTIVE}: To demonstrate the association of excess body weight across an age cohort and the risk, age of onset, and overall survival of patients with pancreatic cancer.
{DESIGN}, {SETTING}, {AND} {PARTICIPANTS}: A case-control study of 841 patients with pancreatic adenocarcinoma and 754 healthy individuals frequency matched by age, race, and sex. The study was conducted at a university cancer center in the United States from 2004 to 2008. Height and body weight histories were collected by personal interview starting at ages 14 to 19 years and over 10-year intervals progressing to the year prior to recruitment in the study.
{MAIN} {OUTCOME} {MEASURES}: The associations between patients' body mass index ({BMI}) and risk of pancreatic cancer, age at onset, and overall survival were examined by unconditional logistic regression, linear regression, and Cox proportional hazard regression models, respectively.
{RESULTS}: Individuals who were overweight (a {BMI} of 25-29.9) from the ages of 14 to 39 years (highest odds ratio [{OR}], 1.67; 95\% confidence interval [{CI}], 1.20-2.34) or obese (a {BMI} {\textgreater} or = 30) from the ages of 20 to 49 years (highest {OR}, 2.58; 95\% {CI}, 1.70-3.90) had an associated increased risk of pancreatic cancer, independent of diabetes status. The association was stronger in men (adjusted {OR}, 1.80; 95\% {CI}, 1.45-2.23) by mean {BMI} from the ages of 14 to 59 years than in women (adjusted {OR}, 1.32; 95\% {CI}, 1.02-1.70) and in ever smokers (adjusted {OR}, 1.75; 95\% {CI}, 1.37-2.22) than in never smokers (adjusted {OR}, 1.46; 95\% {CI}, 1.16-1.84). The population-attributable risk percentage of pancreatic cancer based on the mean {BMI} from the ages of 14 to 59 years was 10.3\% for never smokers and 21.3\% for ever smokers. Individuals who were overweight or obese from the ages of 20 to 49 years had an earlier onset of pancreatic cancer by 2 to 6 years (median age of onset was 64 years for patients with normal weight, 61 years for overweight patients [P = .02], and 59 years for obese patients [P {\textless} .001]). Compared with those with normal body weight and after adjusting for all clinical factors, individuals who were overweight or obese from the ages of 30 to 79 years or in the year prior to recruitment had reduced overall survival of pancreatic cancer regardless of disease stage and tumor resection status (overweight patients: hazard ratio, 1.26 [95\% {CI}, 0.94-1.69], P = .04; obese patients: hazard ratio, 1.86 [95\% {CI}, 1.35-2.56], P {\textless} .001).
{CONCLUSIONS}: Overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset. Obesity at an older age was associated with a lower overall survival in patients with pancreatic cancer.},
	pages = {2553--2562},
	number = {24},
	journaltitle = {{JAMA}},
	shortjournal = {{JAMA}},
	author = {Li, Donghui and Morris, Jeffrey S. and Liu, Jun and Hassan, Manal M. and Day, R. Sue and Bondy, Melissa L. and Abbruzzese, James L.},
	date = {2009-06-24},
	pmid = {19549972},
	pmcid = {PMC2760963},
	keywords = {Adenocarcinoma, Adolescent, Adult, Aged, Age of Onset, Body Mass Index, Case-Control Studies, Female, Humans, Male, Middle Aged, Obesity, Overweight, Pancreatic Neoplasms, Regression Analysis, Risk Factors, Young Adult},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\G5M827UK\\Li et al. - 2009 - Body Mass Index and Risk, Age of Onset, and Surviv.pdf:application/pdf}
}

@article{seltzer_body_1940,
	title = {{BODY} {BUILD} {AND} {OXYGEN} {METABOLISM} {AT} {REST} {AND} {DURING} {EXERCISE}},
	volume = {129},
	rights = {Copyright © 1940 by American Physiological Society},
	issn = {0002-9513},
	url = {http://ajplegacy.physiology.org/content/129/1/1},
	pages = {1--13},
	number = {1},
	journaltitle = {American Journal of Physiology -- Legacy Content},
	author = {Seltzer, Carl C.},
	urldate = {2015-05-03},
	date = {1940-03-31},
	langid = {english},
	file = {Seltzer - 1940 - BODY BUILD AND OXYGEN METABOLISM AT REST AND DURIN.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3A7JWXPZ\\Seltzer - 1940 - BODY BUILD AND OXYGEN METABOLISM AT REST AND DURIN.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U7WT7DQN\\ajplegacy.physiology.org.html:text/html}
}

@article{fuhrman_rationale_1996,
	title = {Rationale for en bloc vein resection in the treatment of pancreatic adenocarcinoma adherent to the superior mesenteric-portal vein confluence. Pancreatic Tumor Study Group},
	volume = {223},
	issn = {0003-4932},
	abstract = {{OBJECTIVE}: Tumor invasion of the superior mesenteric-portal vein ({SMPV}) confluence is often considered a contraindication to pancreaticoduodenectomy for patients with malignant tumors of the pancreas or periampullary region. The authors sought to determine whether pancreaticoduodenectomy with en bloc resection of the {SMPV} confluence could be safely performed and whether tumors involving the {SMPV} confluence were associated with pathologic parameters suggesting poor prognosis.
{SUMMARY} {BACKGROUND} {DATA}: Several centers have reported high rates of retroperitoneal margin positivity after pancreaticoduodenectomy for tumors of the pancreatic head and periampullary region. Positive-margin or incomplete resection is associated with early tumor recurrence and no survival benefit compared with palliative therapy. Tumor adherence to the lateral of posterior wall of the {SMPV} confluence often represents the only barrier to complete tumor resection at the time of pancreaticoduodenectomy.
{METHODS}: Data on all patients undergoing pancreaticoduodenectomy for adenocarcinoma of the pancreas or periampullary region over a 3.5-year period were entered prospectively in a pancreatic tumor database. To be considered for surgery, patients were required to fulfill the following computed tomography criteria for resectability: 1) the absence of extrapancreatic disease, 2) no tumor encasement of the superior mesenteric artery or celiac axis, and 3) a patent {SMPV} confluence. Tumor adherence to the superior mesenteric vein or {SMPV} confluence was assessed intraoperatively, and en bloc venous resection was performed when necessary to achieve complete tumor extirpation. Data on operative characteristics, morbidity, mortality, tumor size, nodal metastases, margin positivity, perineural invasion, and tumor {DNA} content were compared for patients who did and did not receive venous resection.
{RESULTS}: Fifty-nine patients underwent pancreaticoduodenectomy, 36 without venous resection and 23 with en bloc resection of the {SMPV} confluence. No differences in median hospital stay, morbidity, mortality, tumor size, margin positivity, nodal positivity, or tumor {DNA} content were observed between groups.
{CONCLUSIONS}: When necessary, segmental resection of the {SMPV} confluence may be performed safely during pancreaticoduodenectomy for periampullary malignant tumors. Tumors invading the {SMPV} confluence are not associated with histologic parameters suggesting a poor prognosis. Our data suggest that venous involvement is a function of tumor location rather than an indicator of aggressive tumor biology.},
	pages = {154--162},
	number = {2},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {Fuhrman, G. M. and Leach, S. D. and Staley, C. A. and Cusack, J. C. and Charnsangavej, C. and Cleary, K. R. and El-Naggar, A. K. and Fenoglio, C. J. and Lee, J. E. and Evans, D. B.},
	date = {1996-02},
	pmid = {8597509},
	pmcid = {PMC1235091},
	keywords = {Adenocarcinoma, Chi-Square Distribution, {DNA}, Neoplasm, Female, Humans, Male, Mesenteric Veins, Middle Aged, Neoplasm Invasiveness, pancreas, Pancreatic Neoplasms, Portal Vein, postoperative complications, Prospective Studies}
}

@article{lin_risk_2004,
	title = {Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula},
	volume = {8},
	issn = {1091-255X},
	doi = {10.1016/j.gassur.2004.09.044},
	abstract = {A significant fraction of patients undergoing pancreaticoduodenectomy develop a postoperative pancreaticocutaneous fistula. To identify risk factors for this complication and to delineate its impact on patient outcomes, we conducted a retrospective review of 1891 patients undergoing pancreaticoduodenectomy between 1981 and 2002. Overall, 216 patients (11.4\%) developed a postoperative pancreaticocutaneous fistula. In univariate analysis, gender, coronary disease, diabetes mellitus, operative times, blood loss, radical lymphadenectomy, gland texture, and specimen pathology correlated with fistula rates. In a multivariate model, however, only gland texture and coronary disease were statistically predictive. A soft gland was associated with a 22.6\% fistula rate, a 20.4-fold increase in fistula risk over those patients with a medium or firm gland (95\% confidence interval, 4.7-90.9). No patient with a firm gland developed a fistula. Although 30-day postoperative mortality was not different between those patients with and those without fistula (1.4\% versus 1.5\%), the mean length of stay was longer (26.0 days versus 13.2 days) and the rates of certain complications were increased in those patients with fistula. In this single-institution experience, pancreaticocutaneous fistula was most strongly predicted by pancreatic texture. Choice of anastomotic technique did not correlate with fistula rates. Pancreaticocutaneous fistula increases postoperative length of stay and morbidity but was not directly associated with increased postoperative mortality.},
	pages = {951--959},
	number = {8},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Lin, John W. and Cameron, John L. and Yeo, Charles J. and Riall, Taylor S. and Lillemoe, Keith D.},
	date = {2004-12},
	pmid = {15585382},
	keywords = {Cutaneous Fistula, Female, Humans, length of stay, Male, Middle Aged, Morbidity, Multivariate Analysis, pancreas, Pancreatic Fistula, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, Retrospective Studies, Risk Factors}
}

@article{thompson_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients},
	volume = {93},
	issn = {1478-7083},
	doi = {10.1308/003588411X587235},
	abstract = {{INTRODUCTION}: The aim of this study was to determine if cardiopulmonary exercise testing ({CPET}) predicts 30-day and mid-term outcomes when assessing suitability for abdominal aortic aneurysm ({AAA}) repair.
{METHODS}: Since July 2006 consecutive patients from a single centre identified with a large (≥5.5 cm) {AAA} were sent for {CPET}. Follow-up was completed on 1 August 2009. Univariate logistical regression was used to compare {CPET} parameters with the Detsky score, the Acute Physiology and Chronic Health Evaluation ({APACHE}) {II} score and the Vascular Physiological and Operative Severity Score for the {enUmeration} of Mortality and morbidity ({VPOSSUM}) in predicting predefined early and late outcome measures.
{RESULTS}: Full data were available for 102 patients (93\% male, median age: 75 years, interquartile range ({IQR}): 70-80 years, median follow up: 28 months, {IQR}: 18-33 months). Ventilatory equivalents for oxygen and {APACHE} {II} predicted postoperative inotrope requirement (p=0.018 and p=0.019 respectively). The Detsky score predicted the length of stay in the intensive care unit (p=0.008). Mid-term (30-month) survival was predicted by the anaerobic threshold (p=0.02).
{CONCLUSIONS}: {CPET} provided the only means in this study of predicting both 30-day outcome and 30-month mortality. {CPET} could therefore become an increasingly important tool in determining the optimum management for {AAA} patients.},
	pages = {474--481},
	number = {6},
	journaltitle = {Annals of the Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Thompson, A. R. and Peters, N. and Lovegrove, R. E. and Ledwidge, S. and Kitching, A. and Magee, T. R. and Galland, R. B.},
	date = {2011-09},
	pmid = {21929919},
	pmcid = {PMC3369334},
	keywords = {Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, {APACHE}, Cardiotonic Agents, endovascular procedures, Exercise Test, Female, Humans, Kaplan-Meier Estimate, length of stay, Male, Middle Aged, postoperative complications, Predictive Value of Tests, preoperative care, Risk assessment, Treatment Outcome}
}

@article{sagar_comparison_1996,
	title = {Comparison of individual surgeon's performance. Risk-adjusted analysis with {POSSUM} scoring system},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8646952},
	abstract = {Comparison of outcome after colorectal resection among different surgeons is difficult. Crude rates of morbidity and mortality can be misleading because such rates make no allowance for differences in case mix and fitness of patients. {AIM}: The aim of this study was to compare outcome among five surgeons by means of the simple, well-validated scoring system {POSSUM} for risk-adjusted analysis. {METHODS}: A total of 438 patients were studied prospectively. Each patient underwent colorectal resection by one of the five surgeons. Demographic details, operative procedure, and postoperative course were recorded, and physiologic and operative severity scores were determined. Risk of morbidity and mortality was calculated for each patient. {RESULTS}: Incidence of morbidity varied sharply among the five surgeons, from 13.6 to 30.6 percent, and the 30-day mortality varied from 4.5 to 6.9 percent. However, application of {POSSUM} to allow risk-adjusted analysis of the data demonstrated that the incidence of morbidity and mortality predicted by {POSSUM} based on patients physiologic and operative risks factors was very similar to the observed outcome for each surgeon. {CONCLUSION}: Direct comparison of individual surgeon's performance based on crude rates of morbidity and mortality can be misleading. Risk-adjusted analysis allows more meaningful comparison.},
	pages = {654--8},
	number = {6},
	journaltitle = {Dis Colon Rectum},
	author = {Sagar, P M and Hartley, M N and {MacFie}, J and Taylor, B A and Copeland, G P},
	date = {1996-06}
}

@article{crumley_comparison_2010,
	title = {Comparison of pre-treatment clinical prognostic factors in patients with gastro-oesophageal cancer and proposal of a new staging system.},
	volume = {14},
	doi = {10.1007/s11605-010-1162-6},
	abstract = {{BACKGROUND}: Clinical staging in patients with gastro-oesophageal cancer, is of crucial importance in determining the likely benefit of treatment. Despite recent advances in clinical staging, overall survival remains poor. The aim of the present study was to examine the relationship between pre-treatment clinical prognostic factors and cancer-specific survival. {METHODS}: Two hundred and seventeen patients, undergoing staging investigations including host factors (Edinburgh Clinical Risk Score ({ECRS})) and the systemic inflammatory response (Glasgow Prognostic score ({mGPS})), in the upper {GI} surgical unit at Glasgow Royal Infirmary, were studied. {RESULTS}: During the follow-up period, 188 (87\%) patients died; 178 of these patients died from the disease. The minimum follow-up was 46 months, and the median follow-up of the survivors was 65 months. On multivariate  survival analysis of the significant factors, only {cTNM} stage ({HR} 1.84, 95\% {CI} 1.56-2.17, p {\textless} 0.001), {mGPS} ({HR} 1.67, 95\% {CI} 1.35-2.07, p {\textless} 0.001) and treatment  ({HR} 2.12, 95\% {CI} 1.73-2.60, p {\textless} 0.001) were independently associated with survival. An elevated {mGPS} was associated with advanced {cTNM} stage, poor performance status, an elevated {ECRS} and more conservative treatment. {CONCLUSIONS}: Pre-treatment {mGPS} improves clinical staging in patients with gastro-oesophageal cancer. Therefore, it is likely to aid clinical decision making for these difficult to treat patients.},
	pages = {781--787},
	number = {5},
	journaltitle = {Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J Gastrointest Surg},
	author = {Crumley, Andrew B. C. and Stuart, Robert C. and {McKernan}, Margaret and Going, James J. and Shearer, Christopher J. and {McMillan}, Donald C.},
	date = {2010-05},
	pmid = {20148314},
	keywords = {Aged, Aged, 80 and over, Biopsy, Needle, Chemotherapy, Adjuvant, Cohort Studies, Combined Modality Therapy, Confidence Intervals, C-Reactive Protein/*metabolism, Esophageal Neoplasms/*mortality/*pathology/therapy, Esophagogastric Junction/pathology, Female, Follow-Up Studies, Humans, Immunohistochemistry, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging/*methods, Preoperative Care/methods, Probability, Radiotherapy, Adjuvant, Stomach Neoplasms/*mortality/*pathology/therapy, Survival Analysis, Time Factors, Treatment Outcome, Tumor Markers, Biological/analysis},
	file = {Crumley et al. - 2010 - Comparison of Pre-treatment Clinical Prognostic Fa.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\C5PEUPPE\\Crumley et al. - 2010 - Comparison of Pre-treatment Clinical Prognostic Fa.pdf:application/pdf}
}

@article{mohamed_assessment_2002,
	title = {An assessment of the {POSSUM} system in orthopaedic surgery},
	volume = {84},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12188495},
	abstract = {We describe the development and validation of a scoring system for auditing orthopaedic surgery. It is a minor modification of the {POSSUM} scoring system widely used in general surgery. The orthopaedic {POSSUM} system which we have developed gives predictions for mortality and morbidity which correlate well with the observed rates in a sample of 2326 orthopaedic operations over a period of 12 months.},
	pages = {735--9},
	number = {5},
	journaltitle = {J Bone Joint Surg Br},
	author = {Mohamed, K and Copeland, G P and Boot, D A and Casserley, H C and Shackleford, I M and Sherry, P G and Stewart, G J},
	date = {2002-07}
}

@article{milani_cardiopulmonary_2004,
	title = {Cardiopulmonary Exercise Testing: How Do We Differentiate the Cause of Dyspnea?},
	volume = {110},
	issn = {0009-7322, 1524-4539},
	url = {http://circ.ahajournals.org/cgi/doi/10.1161/01.CIR.0000136811.45524.2F},
	doi = {10.1161/01.CIR.0000136811.45524.2F},
	shorttitle = {Cardiopulmonary Exercise Testing},
	pages = {e27--e31},
	number = {4},
	journaltitle = {Circulation},
	author = {Milani, R. V.},
	urldate = {2014-01-27},
	date = {2004-07-06},
	file = {Milani - 2004 - Cardiopulmonary Exercise Testing How Do We Differ.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CH5K5RX4\\Milani - 2004 - Cardiopulmonary Exercise Testing How Do We Differ.pdf:application/pdf}
}

@article{pausch_cachexia_2012,
	title = {Cachexia but not obesity worsens the postoperative outcome after pancreatoduodenectomy in pancreatic cancer},
	volume = {152},
	issn = {0039-6060},
	url = {http://www.sciencedirect.com/science/article/pii/S003960601200236X},
	doi = {10.1016/j.surg.2012.05.028},
	series = {Topics in Pancreatic Surgery: A Festschrift Honoring Andrew L. Warshaw},
	abstract = {Background
Prognosis after pancreatoduodenectomy for pancreatic cancer is determined by tumor characteristics, completeness of resection, and patient's comorbidity. Our aim was to assess the effects of body mass and fat distribution on the postoperative course after pancreatoduodenectomy.
Methods
Of 2,968 pancreatic resections, 408 patients with primary pancreatic adenocarcinoma who underwent pancreatoduodenectomy and of whom cross sectional images were available were identified and followed-up in a prospective database. Preoperative computed tomographic or magnetic resonance imaging scans were analyzed for abdominal wall fat, hip girdle fat, visceral fat, and abdominal depth. Peri- and postoperative parameters, including preoperative unintentional weight loss, cachexia-associated serum parameters, nonoperative and operative complications, and mortality and long-term survival were evaluated and correlated with body mass index and fat distribution.
Results
Patients with low body mass index had a greater 90-day mortality (P = .048) and a trend toward greater complication rates and in-hospital mortality, despite a greater comorbidity in obese patients with a higher body mass index. Accordingly, patients with large amounts of abdominal wall fat had fewer intra-abdominal abscesses (P = .047), lower in-hospital (P = .019) and 90-day mortality rates (P = .007), and better long-term survival (P = .016).
Conclusion
In pancreatic cancer, underweight but not obese patients have a poor outcome after pancreatoduodenectomy. This observation emphasizes the need for pre- and perioperative therapeutic improvements in the setting of pancreatic cancer–associated cachexia.},
	pages = {S81--S88},
	number = {3},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Pausch, Thomas and Hartwig, Werner and Hinz, Ulf and Swolana, Thomas and Bundy, Bogota D. and Hackert, Thilo and Grenacher, Lars and Büchler, Markus W. and Werner, Jens},
	urldate = {2015-05-26},
	date = {2012-09},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IRSA37MB\\Pausch et al. - 2012 - Cachexia but not obesity worsens the postoperative.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KJBB5VS7\\S003960601200236X.html:text/html}
}

@article{van_der_gaag_[study_2006,
	title = {[A study of the value of preoperative biliary-tract drainage in the treatment of periampullary tumours: the {DROP}-trial]},
	volume = {150},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16553052},
	abstract = {Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumour is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. More recently, the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. This has raised doubts as to whether biliary drainage should always be performed in these patients. The project referred to above involves a randomised multicentre trial to compare the outcome of a 'preoperative biliary-drainage strategy' (standard strategy) with that of an 'early-surgery' strategy with respect to the incidence of severe complications (primary-outcome measure), hospital stay, number of invasive diagnostic tests, costs, and quality of life.},
	pages = {509--11},
	number = {9},
	journaltitle = {Ned Tijdschr Geneeskd},
	author = {van der Gaag, N A and Gouma, D J},
	date = {2006-03}
}

@article{tew_endurance_2012,
	title = {Endurance exercise training in patients with small abdominal aortic aneurysm: a randomized controlled pilot study},
	volume = {93},
	issn = {1532-821X},
	doi = {10.1016/j.apmr.2012.07.012},
	shorttitle = {Endurance exercise training in patients with small abdominal aortic aneurysm},
	abstract = {{OBJECTIVE}: To investigate the feasibility of endurance exercise training in patients with small abdominal aortic aneurysm ({AAA}), and to obtain preliminary data of its impact on important health outcomes.
{DESIGN}: Randomized controlled pilot study.
{SETTING}: University rehabilitation facility.
{PARTICIPANTS}: Patients with small {AAA} (N=28; mean age ± {SD}, 72±7 y).
{INTERVENTION}: Participants were randomized to a 12-week program of moderate-intensity endurance exercise or standard care control (encouragement to exercise only).
{MAIN} {OUTCOME} {MEASURES}: Safety was assessed in terms of the frequency of adverse events and changes in maximum {AAA} diameter. Outcomes were assessed at baseline and 12 weeks including cardiopulmonary fitness (ventilatory threshold), health-related quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey [version 2]), and markers of vascular risk (eg, blood pressure and high-sensitivity C-reactive protein).
{RESULTS}: Of 545 patients contacted, 28 (5\%) entered the trial. There were 3 (11\%) dropouts. Adherence to the exercise program was 94\%. There were no paradoxical increases in {AAA} size or adverse clinical events. Ventilatory threshold increased in the exercise group, but not the control group (adjusted mean difference, 2.5 {mL}·kg(-1)·min(-1); 95\% confidence interval, 0.5-4.5; d=.82). Systolic blood pressure and high-sensitivity C-reactive protein decreased in the exercise group compared with the control group (d=.34 and d=.58, respectively). There were no substantial changes in anthropometric variables or quality of life.
{CONCLUSIONS}: Despite a low recruitment rate, the findings suggest that moderate-intensity endurance exercise training is feasible in patients with small {AAA}, and can evoke improvements in important health outcomes.},
	pages = {2148--2153},
	number = {12},
	journaltitle = {Archives of Physical Medicine and Rehabilitation},
	shortjournal = {Arch Phys Med Rehabil},
	author = {Tew, Garry A. and Moss, James and Crank, Helen and Mitchell, Pauline A. and Nawaz, Shah},
	date = {2012-12},
	pmid = {22846453},
	keywords = {Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, Blood Pressure, C-Reactive Protein, Exercise Therapy, Female, Humans, Male, Physical Endurance, Pilot Projects}
}

@article{green_jaundiced_1986,
	title = {The "jaundiced heart": a possible explanation for postoperative shock in obstructive jaundice},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3726756},
	abstract = {Patients with obstructive jaundice are susceptible to postoperative shock and kidney failure. The cause of these potentially fatal complications has not been fully clarified. The present study was designed to assess the role of myocardial dysfunction in the hemodynamic disturbance of obstructive jaundice. We studied the effect of isolated cholemia on left ventricular performance in five conscious dogs before and 2 weeks after choledochocaval anastomosis by using measurements of systolic time intervals ({STIs}) and maximal dp/dt. Mean left ventricular ejection tiem ({LVET}) decreased after cholemia from 159 +/- 2.8 msec to 139 +/- 2.6 msec (p less than 0.005), while mean preejection period ({PEP}) and mean {PEP}/{LVET} were increased from 41 +/- 8.5 msec to 87 +/- 14 msec (p less than 0.05) and from 0.39 +/- 0.06 to 0.62 +/- 0.1 (p less than 0.01), respectively. During cholemia, {STIs} were unchanged after intravenous administration of ouabain, whereas in the control period, there was shortening of mean {PEP} from 71 +/- 8.8 msec to 58 +/- 7.6 msec (p less than 0.05) and of Q-S2 from 257 +/- 12 msec to 235 +/- 14 msec (p less than 0.005) in response to ouabain. Maximal dp/dt decreased after choledochocaval anastomosis from 4543 +/- 593 mm Hg/sec to 3666 +/- 648 mm Hg/sec (p less than 0.025). We conclude that cholemia in the dog is clearly associated with impaired left ventricular performance. The present data also support a previously published in vitro study from our laboratory showing that cholemia blunts the myocardial contractile response to sympathomimetic agents. The cardiodepressor effect of cholemia may explain the increased tendency of patients with obstructive jaundice to postoperative shock and renal failure.},
	pages = {14--20},
	number = {1},
	journaltitle = {Surgery},
	author = {Green, J and Beyar, R and Sideman, S and Mordechovitz, D and Better, O S},
	date = {1986-07},
	note = {cited 54},
	file = {Green et al. - 1986 - The jaundiced heart a possible explanation for .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EMZZDM8A\\Green et al. - 1986 - The jaundiced heart a possible explanation for .pdf:application/pdf}
}

@article{scott_relationship_1996,
	title = {The relationship between weight loss and interleukin 6 in non-small-cell lung cancer.},
	volume = {73},
	abstract = {Markers of the inflammatory response, interleukin 6, C-reactive protein, albumin  and full blood count, were measured in non-small-cell lung cancer ({NSCLC}) patients (n = 21) with and without weight loss ( {\textgreater} 5\%). There were significant increases in circulating C-reactive protein (P {\textless} 0.001), interleukin 6 (P {\textless} 0.01) and platelets (P {\textless} 0.01) in the weight-losing group. Moreover, there was a statistically significant correlation (r = 0.785, P {\textless} 0.001) between interleukin  6 and C-reactive protein concentrations. These results are consistent with interleukin 6 and the acute phase response promoting weight loss in {NSCLC}.},
	pages = {1560--1562},
	number = {12},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Scott, H. R. and {McMillan}, D. C. and Crilly, A. and {McArdle}, C. S. and Milroy, R.},
	date = {1996-06},
	pmid = {8664130},
	pmcid = {PMC2074552},
	keywords = {Acute-Phase Reaction/blood, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung/*blood, Female, Humans, Interleukin-6/*blood, Lung Neoplasms/*blood, Male, Middle Aged, Weight Loss/*physiology}
}

@article{van_der_gaag_preoperative_2007,
	title = {Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; {DRainage} vs. (direct) {OPeration} ({DROP}-trial)},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17352805},
	abstract = {{BACKGROUND}: Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. Early studies showed a reduction in morbidity. However, more recently the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. Whether biliary drainage should always be performed in jaundiced patients remains controversial. The randomized controlled multicenter {DROP}-trial ({DRainage} vs. Operation) was conceived to compare the outcome of a 'preoperative biliary drainage strategy' (standard strategy) with that of an 'early-surgery' strategy, with respect to the incidence of severe complications (primary-outcome measure), hospital stay, number of invasive diagnostic tests, costs, and quality of life. {METHODS}/{DESIGN}: Patients with obstructive jaundice due to a periampullary tumor, eligible for exploration after staging with {CT} scan, and scheduled to undergo a "curative" resection, will be randomized to either "early surgical treatment" (within one week) or "preoperative biliary drainage" (for 4 weeks) and subsequent surgical treatment (standard treatment). Primary outcome measure is the percentage of severe complications up to 90 days after surgery. The sample size calculation is based on the equivalence design for the primary outcome measure. If equivalence is found, the comparison of the secondary outcomes will be essential in selecting the preferred strategy. Based on a 40\% complication rate for early surgical treatment and 48\% for preoperative drainage, equivalence is taken to be demonstrated if the percentage of severe complications with early surgical treatment is not more than 10\% higher compared to standard treatment: preoperative biliary drainage. Accounting for a 10\% dropout, 105 patients are needed in each arm resulting in a study population of 210 (alpha = 0.95, beta = 0.8). {DISCUSSION}: The {DROP}-trial is a randomized controlled multicenter trial that will provide evidence whether or not preoperative biliary drainage is to be performed in patients with obstructive jaundice due to a periampullary tumor.},
	pages = {3},
	journaltitle = {{BMC} Surg},
	author = {van der Gaag, Niels A and de Castro, Steve M M and Rauws, Erik A J and Bruno, Marco J and van Eijck, Casper H J and Kuipers, Ernst J and Gerritsen, Josephus J G M and Rutten, Jan-Paul and Greve, Jan Willem and Hesselink, Erik J and Klinkenbijl, Jean H G and Rinkes, Inne H M Borel and Boerma, Djamila and Bonsing, Bert A and van Laarhoven, Cees J and Kubben, Frank J G M and van der Harst, Erwin and Sosef, Meindert N and Bosscha, Koop and de Hingh, Ignace H J T and Th de Wit, Laurens and van Delden, Otto M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2007}
}

@article{kalantar-zadeh_risk_2007,
	title = {Risk factor paradox in wasting diseases},
	volume = {10},
	issn = {1363-1950},
	doi = {10.1097/MCO.0b013e3281a30594},
	abstract = {{PURPOSE} {OF} {REVIEW}: Emerging data indicate that conventional cardiovascular risk factors (e.g. hypercholesterolemia and obesity) are paradoxically associated with better survival in distinct populations with wasting. We identify these populations and review survival paradoxes and common pathophysiologic mechanisms.
{RECENT} {FINDINGS}: A 'reverse epidemiology' of cardiovascular risk is observed in chronic kidney disease, chronic heart failure, chronic obstructive lung disease, cancer, {AIDS} and rheumatoid arthritis, and in the elderly. These populations apparently have slowly progressive to full-blown wasting and significantly greater short-term mortality than the general population. The survival paradoxes may result from the time differential between the two competing risk factors [i.e. over-nutrition (long-term killer but short-term protective) versus undernutrition (short-term killer)]. Hemodynamic stability of obesity, protective adipokine profile, endotoxin-lipoprotein interaction, toxin sequestration of fat, antioxidation of muscle, reverse causation, and survival selection may also contribute.
{SUMMARY}: The seemingly counterintuitive risk factor paradox is the hallmark of chronic disease states or conditions associated with wasting disease at the population level. Studying similarities among these populations may help reveal common pathophysiologic mechanisms of wasting disease, leading to a major shift in clinical medicine and public health beyond the conventional Framingham paradigm and to novel therapeutic approaches related to wasting and short-term mortality.},
	pages = {433--442},
	number = {4},
	journaltitle = {Current Opinion in Clinical Nutrition and Metabolic Care},
	shortjournal = {Curr Opin Clin Nutr Metab Care},
	author = {Kalantar-Zadeh, Kamyar and Horwich, Tamara B. and Oreopoulos, Antigone and Kovesdy, Csaba P. and Younessi, Houman and Anker, Stefan D. and Morley, John E.},
	date = {2007-07},
	pmid = {17563461},
	keywords = {cachexia, Cardiovascular Diseases, Chronic Disease, Humans, Neoplasms, Obesity, Risk Factors, Survival Analysis, Wasting Syndrome}
}

@article{mcglynn_sirt2:_2014,
	title = {{SIRT}2: tumour suppressor or tumour promoter in operable breast cancer?},
	volume = {50},
	rights = {Copyright (c) 2013 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ejca.2013.10.005},
	abstract = {{PURPOSE}: Sirtuins comprise a family of genes involved in cellular stress, survival and damage responses. They have been implicated in a range of diseases including cancer, with most information pertaining to their function in tumourigenesis being derived from in vitro studies, or model organisms. Their putative roles as tumour suppressors or tumour promoters remain to be validated in vivo. Little is known about their role in breast tumourigenesis. We sought to  evaluate the seven sirtuin family members ({SIRT}1-7) in a human breast cancer cohort, in relation to clinico-pathological features and outcome of the disease.  {MATERIALS} {AND} {METHODS}: Immunohistochemical analysis of {SIRT}1-7 protein levels was undertaken in 392 oestrogen receptor ({ER}+ve) and 153 {ER}-ve breast tumour samples.},
	number = {2},
	journaltitle = {European journal of cancer (Oxford, England : 1990)},
	shortjournal = {Eur J Cancer},
	author = {{McGlynn}, Liane M. and Zino, Samer and {MacDonald}, Alasdair I. and Curle, Jennifer and Reilly, Justice E. and Mohammed, Zahra M. A. and {McMillan}, Donald C. and Mallon, Elizabeth and Payne, Anthony P. and Edwards, Joanne and Shiels, Paul G.},
	date = {2014-01},
	pmid = {24183459},
	keywords = {Antineoplastic Agents, Hormonal/therapeutic use, Breast/drug effects/*metabolism/pathology, Breast Neoplasms/drug therapy/genetics/*metabolism, Cell Transformation, Neoplastic/genetics/metabolism, Female, Gene Expression Regulation, Neoplastic, Humans, Immunohistochemistry, Isoenzymes/genetics/metabolism, Kaplan-Meier Estimate, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local, Prognosis, Receptors, Estrogen/metabolism, Reverse Transcriptase Polymerase Chain Reaction, Sirtuin 2/genetics/*metabolism, Tamoxifen/therapeutic use, Treatment Outcome, Tumor Markers, Biological/genetics/*metabolism, Tumor Suppressor Proteins/genetics/metabolism}
}

@article{wright_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise testing before and after blood transfusion: a prospective clinical study},
	volume = {113},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/113/1/91},
	doi = {10.1093/bja/aeu050},
	shorttitle = {Cardiopulmonary exercise testing before and after blood transfusion},
	abstract = {Background Cardiopulmonary exercise testing ({CPET}) is used to risk-stratify patients undergoing major elective surgery, with a poor exercise capacity being associated with an increased risk of complications and death. Patients with anaemia have a decreased exercise capacity and an increased risk of morbidity and mortality after major surgery. Blood transfusion is often used to correct anaemia in the perioperative period but the effect of this intervention on exercise capacity is not well described. We sought to measure the effect of blood transfusion on exercise capacity measured objectively with {CPET}.
Methods Patients with stable haematological conditions requiring blood transfusion underwent {CPET} before and 2–6 days after transfusion.
Results Twenty patients were enrolled and completed both pre- and post-transfusion tests. The mean (sd) haemoglobin (Hb) concentration increased from 8.3 (1.2) to 11.2 (1.4) g dl−1 after transfusion of a median (range) of 3 (1–4) units of packed red cells. The anaerobic threshold increased from a mean (sd) of 10.4 (2.4) to 11.6 (2.5) ml kg−1 min−1 (P=0.018), a mean difference of 1.2 ml kg−1 min−1 (95\% confidence interval ({CI})=0.2–2.2). When corrected for the change in Hb concentration, the anaerobic threshold increased by a mean (sd) of 0.39 (0.74) ml kg−1 min−1 per g dl−1 Hb.
Conclusions Transfusion of allogeneic packed red cells in anaemic adults led to a significant increase in their capacity to exercise. This increase was seen in the anaerobic threshold, and other {CPET} variables.},
	pages = {91--96},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Wright, S. E. and Pearce, B. and Snowden, C. P. and Anderson, H. and Wallis, J. P.},
	urldate = {2015-05-05},
	date = {2014-07-01},
	langid = {english},
	pmid = {24681715},
	keywords = {Adult, anaemia, anaerobic threshold, erythrocyte transfusion, Exercise Test, Humans, Oxygen Consumption, physical exertion, Pulmonary Gas Exchange},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\T9X9786F\\Wright et al. - 2014 - Cardiopulmonary exercise testing before and after .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U9EUU89C\\91.html:text/html}
}

@article{abraham_pancreaticoduodenectomy_2003,
	title = {Pancreaticoduodenectomy (Whipple resections) in patients without malignancy - Are they all 'chronic pancreatitis'?},
	volume = {27},
	issn = {0147-5185},
	doi = {10.1097/00000478-200301000-00012},
	abstract = {Pancreaticoduodenectomy (Whipple resection) has evolved into a safe procedure in major high-volume medical centers for the treatment of pancreatic adenocarcinoma and refractory chronic pancreatitis. However, some Whipple resections performed for a clinical suspicion of malignancy reveal only benign disease on pathologic examination. We evaluated the frequency of such Whipple resections without tumor in a large series of pancreaticoduodenectomies and classified the diverse pancreatic and biliary tract diseases present in these specimens. Of 442 Whipple resections performed during 1999-2001, 47 (10.6\%) were negative for neoplastic disease and, in 40 cases, had been performed for a clinical suspicion of malignancy. Most Whipple resections revealed benign pancreatic disease, including 8 (17\%) alcohol-associated chronic pancreatitis, 4 (8.5\%) gallstone-associated pancreatitis, 1 (2.1\%) pancreas divisum, 6 (12.8\%) "ordinary" chronic pancreatitis of unknown etiology, and 11 (23.4\%) lymphoplasmacytic sclerosing pancreatitis. In particular, patients with lymphoplasmacytic sclerosing pancreatitis were all thought to harbor malignancy, whereas only 13 of 19 (68.4\%) of Whipple resections showing histologically "ordinary" forms of chronic pancreatitis were performed for a clinical suspicion of malignancy. Benign biliary tract disease, including three cases of primary sclerosing cholangitis, two cases of choledocholithiasis-associated chronic biliary tract disease, and four fibroinflammatory strictures isolated to the intrapancreatic common bile duct, was a common etiology for clinically suspicious Whipple resections (22.5\% of cases). Pancreatic intraepithelial neoplasia ({PanIN}) was a common finding among all pancreata, whether involved by pancreatitis or histologically normal. Overall, {PanIN} 1A/1B was present in 68.1\%, {PanIN} 2 in 40.4\%, and {PanIN} 3 in just 2.1\%. These findings indicate that "benign but clinically suspicious" Whipple resections are relatively common in high-volume centers (9.2\%) and reveal a diverse group of clinico-pathologically distinctive pancreatic and biliary tract disease.},
	pages = {110--120},
	number = {1},
	journaltitle = {American Journal of Surgical Pathology},
	shortjournal = {Am. J. Surg. Pathol.},
	author = {Abraham, S. C. and Wilentz, R. E. and Yeo, C. J. and Sohn, T. A. and Cameron, J. L. and Boitnott, J. K. and Hruban, R. H.},
	date = {2003-01},
	note = {{WOS}:000180144000012},
	keywords = {autoimmune-related pancreatitis, cancer, chronic pancreatitis, destructive chronic-pancreatitis, differential-diagnosis, disease, duct, eosinophilic pancreatitis, head, pancreas, Pancreaticoduodenectomy, primary sclerosing cholangitis, sclerosing cholangitis, sclerosing pancreatitis, steroid-therapy, Whipple}
}

@article{kingsnorth_acute_2006,
	title = {Acute pancreatitis},
	volume = {332},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16675814},
	pages = {1072--6},
	number = {7549},
	journaltitle = {{BMJ}},
	author = {Kingsnorth, Andrew and O'Reilly, Derek},
	date = {2006-05}
}

@article{mcmillan_analysis_1989,
	title = {Analysis of 18O enrichment in biological fluids by continuous flow-isotope ratio  mass spectrometry.},
	volume = {18},
	doi = {10.1002/bms.1200180805},
	abstract = {A novel method is described for the analysis of 18O in urine by continuous flow-isotope ratio mass spectrometry ({CF}-{IRMS}), after sample equilibration with {CO}2. The method is shown to be fast, precise and accurate and therefore facilitates studies of total body water and water turnover in the clinical field. The method uses existing {CF}-{IRMS} instrumentation with minor hardware modification which does not compromise routine analysis of 13C and 15N. This method emphasizes the versatility of {CF}-{IRMS} and thus its economy for the biomedical research group using stable isotope tracers.},
	pages = {543--546},
	number = {8},
	journaltitle = {Biomedical \& environmental mass spectrometry},
	shortjournal = {Biomed Environ Mass Spectrom},
	author = {{McMillan}, D. C. and Preston, T. and Taggart, D. P.},
	date = {1989-08},
	pmid = {2804440},
	keywords = {Humans, Isotope Labeling, Oxygen/*analysis/blood/urine, Oxygen Radioisotopes/analysis, Pressure, Spectrum Analysis}
}

@article{laird_prognostic_2013,
	title = {Prognostic factors in patients with advanced cancer: a comparison of clinicopathological factors and the development of an inflammation-based prognostic system.},
	volume = {19},
	rights = {(c)2013 {AACR}.},
	doi = {10.1158/1078-0432.CCR-13-1066},
	abstract = {{PURPOSE}: In advanced cancer, oncological treatment is influenced by performance status ({PS}); however, this has limitations. Biomarkers of systemic inflammation may have prognostic value in advanced cancer. The study compares key factors in prognosis (performance status, patient-reported outcomes; {PRO}) with an inflammation-based score (Glasgow Prognostic Score, {mGPS}). A new method of prognosis in advanced cancer (combining performance status and {mGPS}) is tested and then validated. {EXPERIMENTAL} {DESIGN}: Two international biobanks of patients with advanced cancer were analyzed. Key prognostic factors [performance status, {PROs} (European Organisation for Research and Treatment of Cancer Quality of Life  Questionnaire C-30), and {mGPS} (using C-reactive protein and albumin concentrations)] were examined. The relationship between these and survival was examined using Kaplan-Meier and Cox regression methods, in a test sample before independent validation. {RESULTS}: Data were available on 1,825 patients (test) and 631 patients (validation). Median survival ranged from 3.2 months (test) to 7.03  months (validation). On multivariate analysis, performance status ({HR} 1.62-2.77)  and {mGPS} ({HR} 1.51-2.27) were independently associated with, and were the strongest predictors of survival (P {\textless} 0.01). Survival at 3 months varied from 82\% ({mGPS} 0) to 39\% ({mGPS} 2) and from 75\% (performance status 0-1) to 14\% (performance status 4). When used together, survival ranged from 88\% ({mGPS} 0, {PS}},
	pages = {5456--5464},
	number = {19},
	journaltitle = {Clinical cancer research : an official journal of the American Association for Cancer Research},
	shortjournal = {Clin Cancer Res},
	author = {Laird, Barry J. and Kaasa, Stein and {McMillan}, Donald C. and Fallon, Marie T. and Hjermstad, Marianne J. and Fayers, Peter and Klepstad, Pal},
	date = {2013-10-01},
	pmid = {23938289},
	keywords = {Aged, Aged, 80 and over, Female, Humans, Inflammation/*metabolism, Male, Middle Aged, Neoplasms/*diagnosis/*metabolism/mortality, Neoplasm Staging, Prognosis, Reproducibility of Results, Tumor Markers, Biological/*metabolism}
}

@article{lai_preoperative_1994,
	title = {Preoperative endoscopic drainage for malignant obstructive jaundice},
	volume = {81},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7741850},
	abstract = {The role of preoperative endoscopic drainage for patients with malignant obstructive jaundice was evaluated in a randomized controlled trial. A total of 87 patients were assigned to either early elective surgery (44 patients) or endoscopic biliary drainage followed by exploration (43). Thirty-seven patients underwent successful stent insertion and 25 had effective biliary drainage. Complications related to endoscopy occurred in 12 patients. After endoscopic drainage significant reductions of hyperbilirubinaemia, indocyanine green retention and serum albumin concentration were observed. Patients with hilar lesions had a significantly higher incidence of cholangitis and failed endoscopic drainage after stent placement. The overall morbidity rate (18 patients versus 16) and mortality rate (six patients in each group) were similar in the two treatment arms irrespective of the level of biliary obstruction. Despite the improvement of liver function, routine application of endoscopic drainage had no demonstrable benefit. Endoscopic drainage is indicated only when early surgery is not feasible, especially for patients with distal obstruction.},
	pages = {1195--8},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Lai, E C and Mok, F P and Fan, S T and Lo, C M and Chu, K M and Liu, C L and Wong, J},
	date = {1994-08},
	note = {Cochrane review paper}
}

@article{rodrigues_bilirubin_2000,
	title = {Bilirubin and amyloid-beta peptide induce cytochrome c release through mitochondrial membrane permeabilization},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11147571},
	abstract = {The pathogenesis of bilirubin encephalopathy and Alzheimer's disease appears to result from accumulation of unconjugated bilirubin ({UCB}) and amyloid-beta (Abeta) peptide, respectively, which may cause apoptosis. Permeabilization of the mitochondrial membrane, with release of intermembrane proteins, has been strongly implicated in cell death. Inhibition of the mitochondrial permeability is one pathway by which ursodeoxycholate ({UDC}) and tauroursodeoxycholate ({TUDC}) protect against apoptosis in hepatic and nonhepatic cells. In this study, we further characterize {UCB}- and Abeta-induced cytotoxicty in isolated neural cells, and investigate membrane perturbation during incubation of isolated mitochondria with both agents. In addition, we evaluate whether the anti-apoptotic drugs {UDC} and {TUDC} prevent any changes from occurring.},
	pages = {936--46},
	number = {11},
	journaltitle = {Mol Med},
	author = {Rodrigues, C M and Solá, S and Silva, R and Brites, D},
	date = {2000-11}
}

@article{leendertse_acute-phase_2009,
	title = {The acute-phase response impairs host defence against Enterococcus faecium peritonitis},
	volume = {128},
	issn = {0019-2805},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753956/},
	doi = {10.1111/j.1365-2567.2008.02967.x},
	abstract = {Enterococcus faecium is an emerging pathogen that causes infections in hospitalized patients with various co-morbid diseases. These underlying diseases are often associated with an acute-phase response that renders patients vulnerable to nosocomial infections. To study the influence of the acute-phase response induced by sterile tissue injury on host defence against E. faecium, mice were injected subcutaneously with either turpentine or casein 1 day before intraperitoneal infection with E. faecium. Control mice were subcutaneously injected with saline or sodium bicarbonate, respectively. Turpentine and casein induced an acute-phase response as reflected by increases in the plasma concentrations of interleukin-6, serum amyloid P and C3. A pre-existent acute-phase response in mice was associated with a strongly reduced capacity to clear E. faecium, resulting in prolonged bacteraemia for several days. The inflammatory response to E. faecium was impaired in mice with an acute-phase response, as shown by reduced capacity to mount a neutrophilic leucocytosis in peripheral blood and by decreased local cytokine concentrations. These data indicate that the acute-phase response impairs host defence against E. faecium, suggesting that this condition may contribute to the increased vulnerability of critically ill patients to enterococcal infections.},
	pages = {e335--e342},
	number = {1},
	journaltitle = {Immunology},
	shortjournal = {Immunology},
	author = {Leendertse, Masja and Willems, Rob J L and Giebelen, Ida A J and van den Pangaart, Petra S and Bonten, Marc J M and van der Poll, Tom},
	urldate = {2015-08-20},
	date = {2009-09},
	pmid = {19175794},
	pmcid = {PMC2753956},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9UX67CD7\\Leendertse et al. - 2009 - The acute-phase response impairs host defence agai.pdf:application/pdf}
}

@article{mcmillan_evaluation_2007,
	title = {Evaluation of an inflammation-based prognostic score ({GPS}) in patients undergoing resection for colon and rectal cancer.},
	volume = {22},
	doi = {10.1007/s00384-006-0259-6},
	abstract = {{BACKGROUND}/{AIMS}: The aim of the study was to examine the value of the combination of an elevated C-reactive protein and hypoalbuminaemia ({GPS}) in predicting cancer-specific survival after resection for colon and rectal cancer. {MATERIALS} {AND} {METHODS}: The {GPS} was constructed as follows: Patients with both an elevated},
	pages = {881--886},
	number = {8},
	journaltitle = {International journal of colorectal disease},
	shortjournal = {Int J Colorectal Dis},
	author = {{McMillan}, Donald C. and Crozier, Joseph E. M. and Canna, Khalid and Angerson, Wilson J. and {McArdle}, Colin S.},
	date = {2007-08},
	pmid = {17245566},
	keywords = {*Digestive System Surgical Procedures, Aged, Biological Markers/blood, Colonic Neoplasms/blood/mortality/surgery, C-Reactive Protein/*analysis, Disease-Free Survival, Female, Health Status Indicators, Humans, Hypoalbuminemia/*blood, Inflammation/*blood, Male, Middle Aged, Predictive Value of Tests, Rectal Neoplasms/blood/mortality/surgery, Reproducibility of Results, Serum Albumin/*analysis, Treatment Outcome}
}

@article{rowell_human_1974,
	title = {Human cardiovascular adjustments to exercise and thermal stress.},
	volume = {54},
	rights = {Copyright © 1974 by American Physiological Society},
	url = {http://physrev.physiology.org/content/54/1/75},
	pages = {75--159},
	number = {1},
	journaltitle = {Physiological Reviews},
	author = {Rowell, L. B.},
	urldate = {2015-05-03},
	date = {1974-01-01},
	langid = {english},
	pmid = {4587247},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VNSBDD7D\\75.full.html:text/html}
}

@article{faintuch_pulmonary_2004,
	title = {Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity},
	volume = {59},
	issn = {0041-8781},
	doi = {/S0041-87812004000400005},
	abstract = {{PURPOSE}: Aerobic capacity and respiratory function may be compromised in obesity, but few studies have been done in highly obese bariatric candidates. In a prospective study, these variables were documented in the preoperative period, aiming to define possible physiologic limitations in a apparently healthy and asymptomatic population.
{METHOD}: Forty-six consecutively enrolled adults (age 39.6 +/- 8.4 years, 87.0\% females, body mass index /{BMI} 49.6 +/- 6.3 kg/m2) were analyzed. Ventilatory variables were investigated by automated spirometry, aerobic capacity was estimated by a modified Bruce test in an ergometric treadmill, and body composition was determined by bioimpedance analysis.
{RESULTS}: Total fat was greatly increased (46.4 +/- 4.6\% of body weight) and body water reduced (47.3 +/- 4.6 \% body weight), as expected for such obese group. Spirometric findings including forced vital capacity of 3.3 +/- 0.8 L and forced expiratory volume-1 second of 2.6 +/- 0.6 L were usually acceptable for age and gender, but mild restrictive pulmonary insufficiency was diagnosed in 20.9\%. Aerobic capacity was more markedly diminished, as reflected by very modest maximal time (4.5 +/- 1.1 min) and distance (322 +/-142 m) along with proportionally elevated maximal oxygen consumption (23.4 +/- 9.5 {mL}/kg/min) achieved by these subjects during test exercise.
{CONCLUSIONS}: 1) Cardiopulmonary evaluation was feasible and well-tolerated in this severely obese population; 2) Mean spirometric variables were not diminished in this study, but part of the population displayed mild restrictive changes; 3) Exercise tolerance was very negatively influenced by obesity, resulting in reduced endurance and excessive metabolic cost for the treadmill run; 4) More attention to fitness and aerobic capacity is recommended for seriously obese bariatric candidates;},
	pages = {181--186},
	number = {4},
	journaltitle = {Revista Do Hospital Das Clínicas},
	shortjournal = {Rev Hosp Clin Fac Med Sao Paulo},
	author = {Faintuch, Joel and Souza, Shirley A. F. and Valezi, Antonio C. and Sant'Anna, Antonio F. and Gama-Rodrigues, Joaquim José},
	date = {2004-08},
	pmid = {15361982},
	keywords = {Adolescent, Adult, Body Mass Index, Exercise Test, Female, Humans, Lung, Male, Middle Aged, Obesity, Morbid, preoperative care, Prospective Studies, Respiration, Spirometry}
}

@article{iacono_systematic_2013,
	title = {Systematic review of central pancreatectomy and meta-analysis of central \textit{versus} distal pancreatectomy: Central versus distal pancreatectomy},
	volume = {100},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.9136},
	doi = {10.1002/bjs.9136},
	shorttitle = {Systematic review of central pancreatectomy and meta-analysis of central \textit{versus} distal pancreatectomy},
	pages = {873--885},
	number = {7},
	journaltitle = {British Journal of Surgery},
	author = {Iacono, C. and Verlato, G. and Ruzzenente, A. and Campagnaro, T. and Bacchelli, C. and Valdegamberi, A. and Bortolasi, L. and Guglielmi, A.},
	urldate = {2014-03-16},
	date = {2013-06},
	langid = {english},
	file = {Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7JEU78VE\\Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:application/pdf;Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QV2PATV4\\Iacono et al. - 2013 - Systematic review of central pancreatectomy and me.pdf:application/pdf}
}

@article{fransen_enhanced_1999,
	title = {Enhanced preoperative C-reactive protein plasma levels as a risk factor for postoperative infections after cardiac surgery},
	volume = {67},
	issn = {0003-4975},
	doi = {10.1016/S0003-4975(98)00973-4},
	abstract = {Background. We examined the possible predictive role of preoperative C-reactive protein ({CRP}) levels for postoperative infections in patients who have cardiac operations. Methods. {CRP} levels were determined on the day before the operation and on postoperative days 1 to 4 and 6 in 593 consecutive patients. Furthermore, we documented infectious disease-related data. Results. Patients in whom an infection developed during the postoperative course (n = 87) had significantly higher {CRP} levels on the day before operation (17.8 +/- 3.9 mg/L compared with 7.7 +/- 0.7 mg/L; p {\textless} 0.001) and on postoperative days 4 and 6. The incidence of postoperative infections was significantly higher in patients with increased preoperative {CRP} levels than in those with normal preoperative {CRP} levels (25.3\% versus 11.2\%, respectively; p {\textless} 0.001). Furthermore, patients with higher preoperative {CRP} levels had a significantly longer postoperative hospital stay than those with normal preoperative {CRP} levels (10.8 +/- 1.2 days versus 7.8 +/- 0.3 days; p {\textless} 0.001). Multivariate analysis, including classic risk factors and increased preoperative {CRP} levels, demonstrated that higher preoperative {CRP} was the most important variable predicting postoperative infection (odds ratio = 2.7; 95\% confidence interval = 1.7 to 4.3; p {\textless} 0.001). Conclusions. Patients with higher preoperative {CRP} levels are at increased risk for postoperative infections. Therefore, preoperative measurement of {CRP} might be a useful, predictive marker in risk stratification for postoperative infections in patients scheduled for cardiac operations. (C) 1999 by The Society of Thoracic Surgeons.},
	pages = {134--138},
	number = {1},
	journaltitle = {Annals of Thoracic Surgery},
	shortjournal = {Ann. Thorac. Surg.},
	author = {Fransen, E. J. and Maessen, J. G. and Elenbaas, T. W. O. and van Aarnhem, Eehl and van Dieijen-Visser, M. P.},
	date = {1999-01},
	note = {{WOS}:000078970500027},
	keywords = {amyloid-a protein, Cardiopulmonary Bypass, Interleukin-6, nosocomial infections, operations, serum, trauma, unstable angina}
}

@article{van_der_gaag_preoperative_2010,
	title = {Preoperative biliary drainage for cancer of the head of the pancreas},
	volume = {362},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20071702},
	abstract = {{BACKGROUND}: The benefits of preoperative biliary drainage, which was introduced to improve the postoperative outcome in patients with obstructive jaundice caused by a tumor of the pancreatic head, are unclear. {METHODS}: In this multicenter, randomized trial, we compared preoperative biliary drainage with surgery alone for patients with cancer of the pancreatic head. Patients with obstructive jaundice and a bilirubin level of 40 to 250 micromol per liter (2.3 to 14.6 mg per deciliter) were randomly assigned to undergo either preoperative biliary drainage for 4 to 6 weeks, followed by surgery, or surgery alone within 1 week after diagnosis. Preoperative biliary drainage was attempted primarily with the placement of an endoprosthesis by means of endoscopic retrograde cholangiopancreatography. The primary outcome was the rate of serious complications within 120 days after randomization. {RESULTS}: We enrolled 202 patients; 96 were assigned to undergo early surgery and 106 to undergo preoperative biliary drainage; 6 patients were excluded from the analysis. The rates of serious complications were 39\% (37 patients) in the early-surgery group and 74\% (75 patients) in the biliary-drainage group (relative risk in the early-surgery group, 0.54; 95\% confidence interval [{CI}], 0.41 to 0.71; P{\textless}0.001). Preoperative biliary drainage was successful in 96 patients (94\%) after one or more attempts, with complications in 47 patients (46\%). Surgery-related complications occurred in 35 patients (37\%) in the early-surgery group and in 48 patients (47\%) in the biliary-drainage group (relative risk, 0.79; 95\% {CI}, 0.57 to 1.11; P=0.14). Mortality and the length of hospital stay did not differ significantly between the two groups. {CONCLUSIONS}: Routine preoperative biliary drainage in patients undergoing surgery for cancer of the pancreatic head increases the rate of complications. (Current Controlled Trials number, {ISRCTN}31939699.)},
	pages = {129--37},
	number = {2},
	journaltitle = {N Engl J Med},
	author = {van der Gaag, Niels A and Rauws, Erik A J and van Eijck, Casper H J and Bruno, Marco J and van der Harst, Erwin and Kubben, Frank J G M and Gerritsen, Josephus J G M and Greve, Jan Willem and Gerhards, Michael F and de Hingh, Ignace H J T and Klinkenbijl, Jean H and Nio, Chung Y and de Castro, Steve M M and Busch, Olivier R C and van Gulik, Thomas M and Bossuyt, Patrick M M and Gouma, Dirk J},
	date = {2010-01},
	note = {{BD} increases complications},
	file = {van der Gaag et al. - 2010 - Preoperative biliary drainage for cancer of the he.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KH397E7S\\van der Gaag et al. - 2010 - Preoperative biliary drainage for cancer of the he.pdf:application/pdf}
}

@article{mohammed_relationship_2012,
	title = {The relationship between components of tumour inflammatory cell infiltrate and clinicopathological factors and survival in patients with primary operable invasive ductal breast cancer.},
	volume = {107},
	doi = {10.1038/bjc.2012.347},
	abstract = {{BACKGROUND}: The importance of the components of host local inflammatory response  in determining outcome in primary operable ductal invasive breast cancer is not clear. The aim of this study was to examine the relationship between components of the tumour inflammatory cell infiltrate and standard clinicopathological factors including hormone status (oestrogen receptor ({ER}), progesterone receptor  ({PR}) and human epidermal growth factor receptor ({HER})-2), Ki-67 and survival in patients with primary operable invasive ductal breast cancer. {METHODS}: Tumour inflammatory cell infiltrate, hormone status ({ER}, {PR} and {HER}-2), Ki-67 and standard clinicopathological factors were determined using routine pathological and immuno-histochemical techniques in 468 patients. {RESULTS}: The large majority  (94\%) of ductal tumours had evidence of inflammatory cell infiltrate. The general inflammatory cell infiltrate was positively associated with high grade (P{\textless}0.001), the absence of {ER} (P{\textless}0.001), the absence of {PR} (P{\textless}0.01), the presence of vascular invasion (P{\textless}0.05) and high lymphocytic infiltrate, plasma cell infiltrate, other  inflammatory cell infiltrate and macrophage infiltrate (all P{\textless}0.001). The median  follow-up of the survivors was 165 months. During this period, 93 patients died of their cancer. On univariate analysis, stratified for {ER} status, tumour size (P{\textless}0.01), lymph node involvement (P{\textless}0.001), tumour plasma cell infiltrate (P{\textless}0.001), other inflammatory cell infiltrate (P{\textless}0.05) and treatment (P{\textless}0.05) were associated with poorer cancer-specific survival whereas lymphocyte infiltrate (P{\textless}0.001) was associated with improved cancer-specific survival. On multivariate analysis, stratified for {ER} status, lymph node involvement (P{\textless}0.05)  was independently associated with poorer cancer-specific survival whereas increased tumour lymphocyte infiltrate (P{\textless}0.001) was independently associated with improved cancer-specific survival. {CONCLUSION}: The results of this study show that, using routine histology, the general inflammatory cell infiltrate was  a common feature and was positively associated with high grade, the absence of {ER}, the absence of {PR}, the presence of vascular invasion and high-grade infiltration of lymphocytes, plasma cells, other inflammatory cells and macrophages. Also, that within a mature cohort of patients, a high lymphocytic infiltrate was associated with improved survival, independent of clinicopathological characteristics including {ER} status, in primary operable ductal invasive breast cancer. These results rationalise previous work and provide a sound basis for future studies in this important area of breast cancer  research.},
	pages = {864--873},
	number = {5},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Mohammed, Z. M. A. and Going, J. J. and Edwards, J. and Elsberger, B. and Doughty, J. C. and {McMillan}, D. C.},
	date = {2012-08-21},
	pmid = {22878371},
	pmcid = {PMC3426752},
	keywords = {Breast Neoplasms/metabolism/*pathology/surgery, Carcinoma, Ductal, Breast/metabolism/*pathology/surgery, Female, Humans, Immunohistochemistry, Inflammation/metabolism/*pathology, Ki-67 Antigen/metabolism, Lymphocytes, Tumor-Infiltrating/pathology, Middle Aged, Neoplasm Invasiveness, Plasma Cells/pathology, Receptor, {ErbB}-2/metabolism, Receptors, Estrogen/metabolism, Receptors, Progesterone/metabolism, Survival Rate}
}

@article{jagannath_effect_2005,
	title = {Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy},
	volume = {92},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15672425},
	abstract = {{BACKGROUND}: Preoperative biliary stenting is associated with bacterial contamination of bile and an increased rate of infectious complications after pancreaticoduodenectomy. Preoperative drainage has been found to have conflicting effects on morbidity and mortality, and no studies have been published on the effect of stent complications and duration of stenting on postoperative outcome. This study examined the effects of preoperative biliary stenting on early outcome after pancreaticoduodenectomy. {METHODS}: Details of 144 patients undergoing pancreaticoduodenectomy from 1992 to 2001 were entered into a database. Variables included biliary stenting, duration of stenting, stent complications and bile culture results. Details of surgery and postoperative complications were noted. Patients were grouped as stented and non-stented. Factors likely to affect postoperative mortality and morbidity were analysed. {RESULTS}: Preoperative biliary stenting was performed in 74 of the 144 patients; post-stenting complications developed in 18 patients (24 per cent) before surgery. After surgery there were nine deaths (6.3 per cent) and 60 (41.7 per cent) of the 144 patients developed complications, with no significant difference in morbidity rate between stented and non-stented patients. Logistic regression showed that a positive intraoperative bile culture was the only factor significantly associated with operative morbidity (P {\textless} 0.001) and mortality (P = 0.019). Biliary stenting was not significantly associated with a positive culture (P = 0.073), but stenting that resulted in complications (P = 0.006) and drainage for less than 6 weeks (P = 0.011) was associated with significantly greater culture positivity. Stenting followed by complications was shown by logistic regression to be the only factor significantly associated with a positive culture (P = 0.012). {CONCLUSION}: A positive intraoperative bile culture was associated with higher morbidity and mortality rates following pancreaticoduodenectomy. A positive culture in the stented group was related to stent complications and duration of stenting. Uncomplicated stenting was not associated with increased morbidity or mortality.},
	pages = {356--61},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Jagannath, P and Dhir, V and Shrikhande, S and Shah, R C and Mullerpatan, P and Mohandas, K M},
	date = {2005-03}
}

@article{bandyopadhyay_negative_2007,
	title = {Negative signaling contributes to T-cell anergy in trauma patients},
	volume = {35},
	issn = {0090-3493},
	doi = {10.1097/01.CCM.0000256847.61085.A5},
	abstract = {{OBJECTIVE}: Maintenance of postinjury T-lymphocyte immune paralysis or anergy could result from failure to activate costimulatory receptors during T-cell receptor activation and/or from chronic stimulation of a competing set of elevated corepressor receptors. Our objective was to assess whether elevated posttrauma T-lymphocyte surface expression of corepressor receptors was associated with immunodepressed lymphocyte responses and corresponded to increased inhibitory and decreased activating signal transduction molecules.
{DESIGN}: Prospective observational study.
{SETTING}: University trauma intensive care unit and research laboratory.
{PATIENTS}: Sixty-one severe thermal and mechanical trauma patients.
{INTERVENTIONS}: None.
{MEASUREMENTS} {AND} {MAIN} {RESULTS}: Isolated trauma patients' and controls' peripheral blood T cells were assayed for negative and positive costimulation receptor expression. These receptor expression levels were compared (flow cytometry) between the two groups and correlated to T-cell levels of inhibitory and activating signal transduction molecules and proliferation capacity. Patients' proliferation hyporesponsive (anergic) T cells had increased expression of novel inhibitory receptors (corepressors) {PD}-1 (p {\textless} .05) and {CD}47 (p {\textless} .05) vs. patients' T-cell proliferation competent or controls' T cells. Patients' T-cell {CD}152 ({CTLA}-4) expression was also elevated vs. controls. Only patients' anergic T cells had simultaneously increased levels of the inhibitory signal transduction proteins, c-Cbl, a ubiquitin-ligase (p {\textless} .01) and {SHP}-1, a phosphatase (p {\textless} .01), concomitant to depressed phosphorylation of the activating signal kinases Erk, Zap70, and {CD}3Euro. T-cell receptor complex phosphorylation and activation of the interleukin-2 pivotal transcriptional complex protein {CREB} were also simultaneously depressed as c-Cbl and {SHP}-1 were elevated.
{CONCLUSIONS}: Up-regulated corepressor receptor expression is novelly shown to characterize trauma patients' anergic T cells and correlate with predominance of inhibitory overactivating signal transduction molecules during T-cell stimulation. This could contribute to postinjury immunosuppression.},
	pages = {794--801},
	number = {3},
	journaltitle = {Critical Care Medicine},
	shortjournal = {Crit. Care Med.},
	author = {Bandyopadhyay, Gautam and De, Asit and Laudanski, Krzysztof and Li, Fang and Lentz, Christopher and Bankey, Paul and Miller-Graziano, Carol},
	date = {2007-03},
	pmid = {17255857},
	keywords = {Adult, Antigens, {CD}, Antigens, {CD}47, Antigens, Differentiation, Apoptosis Regulatory Proteins, Burns, Clonal Anergy, {CREB}-Binding Protein, {CTLA}-4 Antigen, Extracellular Signal-Regulated {MAP} Kinases, Female, Flow Cytometry, Humans, Immune Tolerance, Intensive Care Units, Intracellular Signaling Peptides and Proteins, Lymphocyte Activation, Male, Middle Aged, Phosphorylation, Programmed Cell Death 1 Receptor, Prospective Studies, Protein-Tyrosine Kinases, Protein Tyrosine Phosphatase, Non-Receptor Type 6, Proto-Oncogene Proteins c-cbl, Signal Transduction, T-Lymphocytes, Wounds and Injuries, {ZAP}-70 Protein-Tyrosine Kinase}
}

@article{benns_impact_2009,
	title = {The impact of obesity on outcomes following pancreatectomy for malignancy},
	volume = {16},
	issn = {1534-4681},
	doi = {10.1245/s10434-009-0573-7},
	abstract = {{BACKGROUND}: Obesity has previously been shown to correlate with higher stage and decreased survival in pancreatic cancer. The aim of this study was to determine the impact of obesity on operative outcomes, recurrence, and overall survival.
{METHODS}: A review of our 1345 patient prospective hepatopancreaticobiliary database was performed to identify patients undergoing pancreatic resection from January 1991 to August 2008 for adenocarcinoma. Obesity was defined as a body mass index ({BMI}) {\textgreater} 30 kg/m(2). Data was analyzed using Wilcoxon, t test, and chi-square methods. Survival was analyzed using log-rank analysis. Postoperative complications were assessed using a 5-point scale. P {\textless} .05 was considered significant.
{RESULTS}: Of 306 patients undergoing pancreatic resection for pancreatic adenocarcinoma examined, 68 were defined as obese. There was no significant difference seen in length of stay, operative time, tumor size, or node status. Obese patients had a higher operative blood loss (median 650 vs. 400 {mL}, P = .0008). Obese patients were more likely to suffer postoperative complications (67.6\% vs. 50.4\%, P = .01). There was no significant difference seen in disease-free survival or overall survival (22.1 months for obese vs. 25.6 months for nonobese, P = .5; 19.8 months for obese vs. 23.5 months for nonobese, P = .46).
{CONCLUSION}: Obese patients had a higher rate and greater severity of postoperative complications, with increased operative blood loss. However, obese patients did not demonstrate any significant difference in specific oncologic factors or survival. These data suggest an equivalent biologic effect of obesity on pancreatic cancer survival.},
	pages = {2565--2569},
	number = {9},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Benns, Matthew and Woodall, Charles and Scoggins, Charles and {McMasters}, Kelly and Martin, Robert},
	date = {2009-09},
	pmid = {19557479},
	keywords = {Adenocarcinoma, Adult, Aged, Aged, 80 and over, Body Mass Index, Female, Humans, Immunoenzyme Techniques, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Obesity, Pancreatectomy, Pancreatic Neoplasms, prognosis, Prospective Studies, Risk Factors, Survival Rate, Treatment Outcome},
	file = {Benns et al. - 2009 - The impact of obesity on outcomes following pancre.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VER7PW5V\\Benns et al. - 2009 - The impact of obesity on outcomes following pancre.pdf:application/pdf;Benns et al. - 2009 - The Impact of Obesity on Outcomes Following Pancre.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\39ADFMZJ\\Benns et al. - 2009 - The Impact of Obesity on Outcomes Following Pancre.pdf:application/pdf}
}

@article{otto_haemoglobin_2013,
	title = {Haemoglobin concentration and mass as determinants of exercise performance and of surgical outcome},
	volume = {2},
	issn = {2046-7648},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874847/},
	doi = {10.1186/2046-7648-2-33},
	abstract = {The ability of the cardiorespiratory system (heart, lungs, blood) to deliver oxygen to exercising skeletal muscle constrains maximum oxygen consumption V˙O2max, with cardiac output and the concentration of oxygen-carrying haemoglobin ([Hb]) being key limiting parameters. Total blood volume ({BV}) is the sum of the plasma volume ({PV}) and the total red cell volume. The measured [Hb] is dependent upon the total circulating mass of haemoglobin ({tHb}-mass) and plasma volume ({PV}). While the proportion of oxygen carried in plasma is trivial (0.3 {mL} of oxygen per 100 {mL} of plasma), each gram of Hb, contained in red blood cells, binds 1.39 {mL} of oxygen. As a result, the relationship between V˙O2max and {tHb}-mass is stronger than that observed between V˙O2max and [Hb] or {BV}. The glycoprotein hormone erythropoietin drives red cell synthesis and, like simple transfusion of packed red blood cells, can increase {tHb}-mass. An iron-containing haem group lies at the centre of the Hb molecule and, in situations of actual or functional iron deficiency, {tHb}-mass will also rise following iron administration. However achieved, an increase in {tHb}-mass also increases circulating oxygen-carrying capacity, and thus the capacity for aerobic phosphorylation. It is for such reasons that alterations in V˙O2max and exercise performance are proportional to those in arterial oxygen content and systemic oxygen transport, a change in {tHb}-mass of 1 g being associated with a 4 {mL} · min−1 change in V˙O2max. Similarly, V˙O2max increases by approximately 1\% for each 3 g · L−1 increase in [Hb] over the [Hb] range (120 to 170 g · L−1). Surgery, like exercise, places substantial metabolic demands on the patient. Whilst subject to debate, oxygen supply at a rate inadequate to prevent muscle anaerobiosis may underpin the occurrence of the anaerobic threshold ({AT}), an important submaximal marker of cardiorespiratory fitness. Preoperatively, cardiopulmonary exercise testing ({CPET}) can be used to determine {AT} and peak exertional oxygen uptake (V˙O2 peak) as measures of ability to meet increasing oxygen demands. The degree of surgical insult and the ability to meet the resulting additional postoperative oxygen demand appear to be fundamental determinants of surgical outcome: individuals in whom such ability is impaired (and thus those with reduced V˙O2 peak and {AT}) are at greater risk of adverse surgical outcome. This review provides an overview of the relationships between [Hb], {tHb}-mass, exercise capacity, and surgical outcome and discusses the potential value of assessing {tHb}-mass over [Hb].},
	pages = {33},
	journaltitle = {Extreme Physiology \& Medicine},
	shortjournal = {Extrem Physiol Med},
	author = {Otto, James M and Montgomery, Hugh E and Richards, Toby},
	urldate = {2015-05-05},
	date = {2013-11-26},
	pmid = {24280034},
	pmcid = {PMC3874847},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AJ9KDCCT\\Otto et al. - 2013 - Haemoglobin concentration and mass as determinants.pdf:application/pdf}
}

@article{brosens_possum_2006,
	title = {{POSSUM} predicts decreased overall survival in curative resection for colorectal cancer},
	volume = {49},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16550320},
	abstract = {{PURPOSE}: Poor condition at operation determined by the physiologic {POSSUM} score is related to postoperative mortality and morbidity of colorectal cancer surgery. This study was designed to analyze the relationship between condition of patients with colorectal cancer at operation and long-term overall survival. {METHODS}: A total of 542 patients survived a radical resection for Stages I, {II}, or {III} colorectal cancer. Physiologic {POSSUM} score at surgery, exclusive of age, was calculated for all patients. Mean physiologic {POSSUM} score was used as cutoff point to determine low-risk and high-risk group patients. A Cox proportional hazard analysis was performed to study the effect of low-risk and high-risk group on overall survival and to identify independent risk factors. {RESULTS}: Five-year overall survival was significantly higher in low-risk group patients than in high-risk group patients (low-risk group 66.6 percent vs. high-risk group 48.5 percent; P {\textless} 0.001). Differences in overall survival also were found when patients in Stages I, {II}, and {III} were analyzed separately. Risk factors for overall survival were advanced stage of disease, poor tumor differentiation, mucinous adenocarcinoma, older than age 70 years, and poor condition of the patient at time of operation. {CONCLUSIONS}: Poor condition at operation, as determined by physiologic {POSSUM} score, is a risk indicator for long-term overall survival in colorectal cancer patients.},
	pages = {825--32},
	number = {6},
	journaltitle = {Dis Colon Rectum},
	author = {Brosens, Rebecca P and Oomen, Joannes L and Glas, Afina S and van Bochove, Aart and Cuesta, Miguel A and Engel, Alexander F},
	date = {2006-06}
}

@article{yadav_epidemiology_2013,
	title = {The epidemiology of pancreatitis and pancreatic cancer},
	volume = {144},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23622135},
	abstract = {Acute pancreatitis is one of the most frequent gastrointestinal causes of hospital admission in the United States. Chronic pancreatitis, although lower in incidence, significantly reduces patients' quality of life. Pancreatic cancer is associated with a high mortality rate and is one of the top 5 causes of death from cancer. The burden of pancreatic disorders is expected to increase over time. The risk and etiology of pancreatitis differ with age and sex, and all pancreatic disorders affect the black population more than any other race. Gallstones are the most common cause of acute pancreatitis, and early cholecystectomy eliminates the risk of future attacks. Alcohol continues to be the single most important risk factor for chronic pancreatitis. Smoking is an independent risk factor for acute and chronic pancreatitis, and its effects could synergize with those of alcohol. Significant risk factors for pancreatic cancer include smoking and non-O blood groups. Alcohol abstinence and smoking cessation can alter the progression of pancreatitis and reduce recurrence; smoking cessation is the most effective strategy to reduce the risk of pancreatic cancer.},
	pages = {1252--61},
	number = {6},
	journaltitle = {Gastroenterology},
	author = {Yadav, Dhiraj and Lowenfels, Albert B},
	date = {2013-06}
}

@article{limongelli_correlation_2007,
	title = {Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17723881},
	abstract = {{BACKGROUND}: Although previously examined, the potential relationship between preoperative biliary drainage ({PBD}), intraoperative bile culture ({IBC}), and postoperative morbidity and mortality rate for pancreatic surgery remains unclear. {METHODS}: Two hundred twenty patients underwent operation for either benign pancreatic disease or malignant periampullary and pancreatic neoplasms, consisting of pylorus-preserving proximal pancreatoduodenectomy (n = 180), biliary bypass (n = 31), and total pancreatectomy (n = 9). An intraoperative bile specimen was prospectively collected immediately after division of the bile duct and sent for bacteriologic evaluation for both aerobic and anaerobic microorganisms. Morbidity and mortality rates were evaluated. {RESULTS}: Of 220 patients evaluated, 113 patients (51.4\%) had a positive {IBC}. Factors associated with a positive {IBC} were age {\textgreater}70 years (odds ratio [{OR}], 5.9;95\% confidence interval, [{CI}]: 1.6-22.1; P = .007), history of coronary artery disease ({OR}, 0.08; 95\% {CI}, 0.01-0.5; P = .007), diagnosis of neoplasia ({OR}, 0.3; 95\% {CI}, 0.1-0.9; P =. 03), and {PBD} ({OR}, 0.1; 95\% {CI}, 0.06-0.2; P = .0001). Infectious complications ({OR}, 1.8; 95\% {CI}, 1-3; P = .03), and wound infection ({OR}, 2.8; 95\% {CI},1.4-5.3; P = .002) were greater in patients with positive {IBC}. {CONCLUSIONS}: {PBD} predisposes to a positive {IBC}. Patients with a positive {IBC} have a clinically important increased risk of developing both infectious complications and wound infection after pancreatic surgery.},
	pages = {313--8},
	number = {3},
	journaltitle = {Surgery},
	author = {Limongelli, Paolo and Pai, Madhava and Bansi, Dev and Thiallinagram, Andrew and Tait, Paul and Jackson, James and Habib, Nagy A and Williamson, Robin C N and Jiao, Long R},
	date = {2007-09}
}

@article{kaluz_at_2011,
	title = {At the crossroads of cancer and inflammation: Ras rewires an {HIF}-driven {IL}-1 autocrine loop},
	volume = {89},
	issn = {0946-2716, 1432-1440},
	url = {http://link.springer.com/10.1007/s00109-010-0706-2},
	doi = {10.1007/s00109-010-0706-2},
	shorttitle = {At the crossroads of cancer and inflammation},
	pages = {91--94},
	number = {2},
	journaltitle = {Journal of Molecular Medicine},
	author = {Kaluz, Stefan and Van Meir, Erwin G.},
	urldate = {2015-04-28},
	date = {2011-02},
	langid = {english},
	file = {Kaluz and Van Meir - 2011 - At the crossroads of cancer and inflammation Ras .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EMGI644F\\Kaluz and Van Meir - 2011 - At the crossroads of cancer and inflammation Ras .pdf:application/pdf}
}

@article{lavie_obesity_2003,
	title = {Obesity and cardiovascular disease: the hippocrates paradox?*},
	volume = {42},
	issn = {0735-1097},
	url = {http://www.sciencedirect.com/science/article/pii/S0735109703007848},
	doi = {10.1016/S0735-1097(03)00784-8},
	shorttitle = {Obesity and cardiovascular disease},
	pages = {677--679},
	number = {4},
	journaltitle = {Journal of the American College of Cardiology},
	shortjournal = {Journal of the American College of Cardiology},
	author = {Lavie, Carl J and Milani, Richard V},
	urldate = {2015-08-04},
	date = {2003-08-20},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\V7NM5XX2\\Lavie and Milani - 2003 - Obesity and cardiovascular disease the hippocrate.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\624IK3BH\\S0735109703007848.html:text/html}
}

@article{flaherty_unexplained_2001,
	title = {Unexplained exertional limitation: characterization of patients with a mitochondrial myopathy},
	volume = {164},
	url = {http://www.atsjournals.org/doi/abs/10.1164/ajrccm.164.3.2005110},
	shorttitle = {Unexplained exertional limitation},
	pages = {425--432},
	number = {3},
	journaltitle = {American journal of respiratory and critical care medicine},
	author = {Flaherty, Kevin R. and {WALD}, {JOHN} and Weisman, Idelle M. and Zeballos, R. Jorge and Schork, M. Anthony and Blaivas, Mila and Rubenfire, Melvyn and Martinez, Fernando J.},
	urldate = {2014-01-27},
	date = {2001},
	file = {Flaherty et al. - 2001 - Unexplained exertional limitation characterizatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4XRSMSBE\\Flaherty et al. - 2001 - Unexplained exertional limitation characterizatio.pdf:application/pdf}
}

@article{mayo_management_2012,
	title = {Management of Patients with Pancreatic Adenocarcinoma: National Trends in Patient Selection, Operative Management, and Use of Adjuvant Therapy},
	volume = {214},
	issn = {10727515},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1072751511011422},
	doi = {10.1016/j.jamcollsurg.2011.09.022},
	shorttitle = {Management of Patients with Pancreatic Adenocarcinoma},
	pages = {33--45},
	number = {1},
	journaltitle = {Journal of the American College of Surgeons},
	author = {Mayo, Skye C. and Gilson, Marta M. and Herman, Joseph M. and Cameron, John L. and Nathan, Hari and Edil, Barish H. and Choti, Michael A. and Schulick, Richard D. and Wolfgang, Christopher L. and Pawlik, Timothy M.},
	urldate = {2014-01-27},
	date = {2012-01},
	file = {Mayo et al. - 2012 - Management of Patients with Pancreatic Adenocarcin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CITZTDGE\\Mayo et al. - 2012 - Management of Patients with Pancreatic Adenocarcin.pdf:application/pdf}
}

@article{mezzomo_preoperative_2011,
	title = {Preoperative C-reactive protein predicts respiratory infection after coronary artery bypass graft surgery},
	volume = {97},
	issn = {0066-782X},
	url = {http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0066-782X2011001400002&lng=en&nrm=iso&tlng=en},
	doi = {10.1590/S0066-782X2011005000092},
	pages = {365--371},
	number = {5},
	journaltitle = {Arquivos Brasileiros de Cardiologia},
	author = {Mezzomo, Agda and Jr, Bodin and L, Odemir and Lucia, Vera},
	urldate = {2015-08-20},
	date = {2011-11},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GZSJ7V68\\Mezzomo et al. - 2011 - Preoperative C-reactive protein predicts respirato.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8WZBX5A9\\scielo.html:text/html}
}

@article{bone_sepsis:_1997,
	title = {Sepsis: a new hypothesis for pathogenesis of the disease process},
	volume = {112},
	url = {http://journal.publications.chestnet.org/data/Journals/CHEST/21748/235.pdf},
	shorttitle = {Sepsis},
	pages = {235--243},
	number = {1},
	journaltitle = {{CHEST} Journal},
	author = {Bone, Roger C. and Grodzin, Charles J. and Balk, Robert A.},
	urldate = {2015-05-25},
	date = {1997},
	file = {235.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UU6KQ8ME\\235.pdf:application/pdf}
}

@article{ramsey_body_2011,
	title = {Body mass index and outcomes from pancreatic resection: a review and meta-analysis},
	volume = {15},
	issn = {1873-4626},
	doi = {10.1007/s11605-011-1502-1},
	shorttitle = {Body mass index and outcomes from pancreatic resection},
	abstract = {{INTRODUCTION}: There are 1.6 billion adults worldwide who are overweight, with body mass indices ({BMI}) between 25 and 30, while more than 400 million are obese ({BMI} {\textgreater}30). Obesity predicts the incidence of and poor outcomes from pancreatic cancer. Obesity has also been linked to surgical complications in pancreatectomy, including increased length of hospital stay, surgical infections, blood loss, and decreased survival. However, {BMI}'s impact on many complications following pancreatectomy remains controversial.
{METHODS}: We performed a {MEDLINE} search of all combinations of "{BMI}" with "pancreatectomy," "pancreatoduodenectomy," or "pancreaticoduodenectomy." From included studies, we created pooled and weighted estimates for quantitative and qualitative outcomes. We used the {PRISMA} criteria to ensure this project's validity.
{RESULTS}: Our primary cohort included 2,736 patients with {BMI} {\textless}30, 1,682 with {BMI} {\textgreater}25, and 546 with {BMI} between 25 and 30. Most outcomes showed no definitive differences across {BMIs}. Pancreatic fistula ({PF}) rates ranged from 4.7\% to 31.0\%, and four studies found multivariate association between {BMI} and {PF} (range odds ratio 1.6-4.2). Pooled analyses of {PF} by {BMI} showed significant association (p {\textless} 0.05).
{CONCLUSION}: {BMI} increases the operative complexity of pancreatectomy. However, with aggressive peri- and post-operative care, increases in {BMI}-associated morbidity and mortality may be mitigated.},
	pages = {1633--1642},
	number = {9},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Ramsey, Andrew M. and Martin, Robert C.},
	date = {2011-09},
	pmid = {21484490},
	keywords = {Body Mass Index, Humans, Obesity, Pancreatectomy, Pancreatic Fistula},
	file = {Ramsey and Martin - 2011 - Body mass index and outcomes from pancreatic resec.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UK5DPZBH\\Ramsey and Martin - 2011 - Body mass index and outcomes from pancreatic resec.pdf:application/pdf}
}

@article{powell_relationship_2013,
	title = {The relationship between genetic profiling, clinicopathological factors and survival in patients undergoing surgery for node-negative colorectal cancer:},
	volume = {139},
	doi = {10.1007/s00432-013-1521-2},
	abstract = {{PURPOSE}: The introduction of the bowel cancer screening programme has resulted in increasing numbers of patients being diagnosed with node-negative disease. Unfortunately, approximately 30 \% will develop recurrence following surgery. Given the toxicity associated with adjuvant chemotherapy, it is important to identify high-risk patients who may benefit from adjuvant therapy. This study aims to identify which clinicopathological factors and genetic profiling markers  predict outcome in node-negative disease. {METHODS}: Forty-nine microsatellite stable ({MSS}) patients undergoing curative resection between 1991 and 1993 were included. Local immune response was assessed by Klintrup criteria and vascular invasion status assessed through Miller's elastin staining. Comparative genomic hybridisation ({CGH}) on a range of loci provided data on allelic imbalance. Analysis of survival included clinicopathological and {CGH} data in a multivariate  (Cox) model. {RESULTS}: On binary logistical regression analysis, 4p deletion was independently associated with low Klintrup score ({HR} 0.16; 95 \% {CI} (0.03-0.96); P = 0.045), venous invasion ({HR} 4.19; 95 \% {CI} (1.08-16.29); P = 0.039) and higher Dukes' stage ({HR} 6.43; 95 \% {CI} (1.22-33.97); P = 0.028). Minimum follow-up was 109 months and there were 24 cancer deaths. On multivariate analysis, high Klintrup score ({HR} 0.33; 95 \% {CI} (0.12-0.93); P = 0.036), 4p- ({HR} 4.01; 95 \% {CI} (1.58-10.21); P = 0.004) and 5q- ({HR} 3.81; 95 \% {CI} (1.54-9.47); P = 0.004) were significantly associated with survival. {CONCLUSION}: 4p-, 5q- and low Klintrup score were independently associated with poor cancer-specific survival in node-negative {MSS} colorectal cancer. Confirmatory work in a larger cohort is needed to determine whether these markers may be used to identify patients who may benefit from adjuvant chemotherapy.},
	pages = {2013--2020},
	number = {12},
	journaltitle = {Journal of cancer research and clinical oncology},
	shortjournal = {J Cancer Res Clin Oncol},
	author = {Powell, Arfon G. M. T. and Ferguson, Jenny and Al-Mulla, Fahd and Orange, Clare and {McMillan}, Donald C. and Horgan, Paul G. and Edwards, Joanne and Going, James J.},
	date = {2013-12},
	pmid = {24072233},
	keywords = {Adult, Aged, Colorectal Neoplasms/genetics/*mortality/pathology/*surgery, Female, Follow-Up Studies, Genomic Instability/physiology, Humans, Lymph Nodes, Male, Microsatellite Repeats/genetics, Middle Aged, Prognosis, Risk Factors, Survival Analysis, Transcriptome}
}

@article{mcmillan_chemical_1993,
	title = {Chemical analysis and hemolytic activity of the fava bean aglycon divicine.},
	volume = {6},
	abstract = {Divicine is an unstable aglycon metabolite of the fava bean pyrimidine beta-glucoside vicine. Divicine has long been thought to be a mediator of an acute hemolytic crisis, known as favism, in susceptible individuals who ingest fava beans (Vicia faba). However, a recent report has questioned the chemical identity of the divicine that was used in most of the studies on divicine hemotoxicity. The present study was undertaken to examine the hemolytic potential of synthetic divicine. Divicine was synthesized and its identity and purity were  confirmed by {HPLC}, mass spectrometry, and {NMR} spectroscopy. The stability and redox behavior of divicine, under physiological conditions, were examined by {HPLC} and cyclic voltammetry. The data indicate that divicine is readily oxidized under aerobic conditions; however, it was sufficiently stable at {pH} 7.4 to permit its experimental manipulation. When 51Cr-labeled rat erythrocytes were exposed in vitro to the parent glucoside, vicine (5 {mM}), and then readministered to rats, no decrease in erythrocyte survival was observed. In contrast, erythrocyte survival  was dramatically reduced by in vitro exposure to divicine (1.5 {mM}). These data demonstrate that divicine is a direct-acting hemolytic agent and thus may be a mediator of the hemolytic crisis induced by fava bean ingestion.},
	pages = {439--444},
	number = {4},
	journaltitle = {Chemical research in toxicology},
	shortjournal = {Chem Res Toxicol},
	author = {{McMillan}, D. C. and Schey, K. L. and Meier, G. P. and Jollow, D. J.},
	date = {1993-08},
	pmid = {8374040},
	keywords = {*Plants, Medicinal, Animals, Chromatography, High Pressure Liquid, Drug Stability, Electrochemistry, Erythrocyte Aging/drug effects, Fabaceae/*chemistry, Glucosides/chemistry, Hemolysis/*drug effects, Hydrogen-Ion Concentration, Hydrolysis, In Vitro Techniques, Magnetic Resonance Spectroscopy, Male, Mass Spectrometry, Oxidation-Reduction, Pyrimidinones/*analysis/chemical synthesis/chemistry/pharmacology, Rats, Rats, Sprague-Dawley, Toxins, Biological/chemistry}
}

@article{shimizu_influence_2011,
	title = {Influence of Visceral Obesity for Postoperative Pulmonary Complications After Pancreaticoduodenectomy},
	volume = {15},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/article/10.1007/s11605-011-1436-7},
	doi = {10.1007/s11605-011-1436-7},
	abstract = {Background We conduct this study to determine whether postoperative complications, including postoperative pulmonary complications ({PPCs}), are associated with {BMI} and visceral fat area ({VFA}) after pancreaticoduodenectomy. Methods A total of 317 patients undergoing pancreaticoduodenectomy were enrolled. {VFA} was measured using a cross-sectional computed tomography ({CT}) scan at the level of the umbilicus by {FatScan} software version 3.0 (N2 systems Inc., Osaka, Japan). Clinicopathological variables, intraoperative outcomes, and postoperative courses were analyzed. Results Of all patients, 130 (41.0\%) had postoperative complications and {PPCs} occurred in 14 patients (4.4\%). {VFA} were significantly higher in patients who developed postoperative pancreatic fistula ({POPF}), {PPCs}, and mortality than in those patients who did not (P = .0282, P = .0058, and P = .0173, respectively). Multivariate analysis demonstrated that high {BMI} and high {VFA} were not independent predictive risk factors for {POPF} grade B/C and mortality; only high {VFA} was an independent risk factor influencing {PPCs} (P = .0390, odds ratio 4.246, 95\% confidence interval 1.076–16.759). Conclusions Visceral obesity was the independent risk factor for the incidence of {PPCs} after pancreaticoduodenectomy. Preoperative {VFA} measurement using {CT} scan is a useful tool for the prediction of the development of {PPCs} compared to {BMI} calculation.},
	pages = {1401--1410},
	number = {8},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Shimizu, Atsushi and Tani, Masaji and Kawai, Manabu and Hirono, Seiko and Miyazawa, Motoki and Uchiyama, Kazuhisa and Yamaue, Hiroki},
	urldate = {2015-08-20},
	date = {2011-05-13},
	langid = {english},
	keywords = {Body mass index ({BMI}), Gastroenterology, Pancreaticoduodenectomy, postoperative complications, Postoperative pulmonary complications ({PPCs}), surgery, Visceral fat area ({VFA})},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X6IVXHET\\Shimizu et al. - 2011 - Influence of Visceral Obesity for Postoperative Pu.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RA7JX4GF\\10.html:text/html}
}

@article{clarke_current_2006,
	title = {The current standard of care in the periprocedural management of the patient with obstructive jaundice},
	volume = {88},
	issn = {00358843, 14787083},
	url = {http://openurl.ingenta.com/content/xref?genre=article&issn=0035-8843&volume=88&issue=7&spage=610},
	doi = {10.1308/003588406X149327},
	pages = {610--616},
	number = {7},
	journaltitle = {Annals of The Royal College of Surgeons of England},
	author = {Clarke, Dl and Pillay, Y and Anderson, F and Thomson, Sr},
	urldate = {2014-01-27},
	date = {2006-11-01},
	file = {Clarke et al. - 2006 - The current standard of care in the periprocedural.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FS8U9HCZ\\Clarke et al. - 2006 - The current standard of care in the periprocedural.pdf:application/pdf}
}

@article{mcmillan_simultaneous_1996,
	title = {Simultaneous measurement of albumin and fibrinogen synthetic rates in normal fasted subjects.},
	volume = {12},
	abstract = {Albumin and fibrinogen synthesis appear to account for the majority of protein exported by the liver and therefore make a substantial contribution to that of whole-body protein synthesis. However, data on the protein synthetic rates of albumin and fibrinogen in normal subjects are limited. Albumin and fibrinogen synthetic rates were measured simultaneously over a 120-min period in normal subjects (n = 6) by using a flooding dose of 2H5-phenylalanine. Tracer incorporation into proteins was measured by gas chromatography/mass spectrometry. Body mass index, circulating concentrations of insulin, albumin, fibrinogen,},
	pages = {602--607},
	number = {9},
	journaltitle = {Nutrition (Burbank, Los Angeles County, Calif.)},
	shortjournal = {Nutrition},
	author = {{McMillan}, D. C. and Slater, C. and Preston, T. and Falconer, J. S. and Fearon, K. C.},
	date = {1996-09},
	pmid = {8878169},
	keywords = {*Fasting, Aged, Body Mass Index, C-Reactive Protein, Deuterium, Female, Fibrinogen/*biosynthesis, Gas Chromatography-Mass Spectrometry, Humans, Insulin/blood, Kinetics, Liver/*metabolism, Male, Middle Aged, Phenylalanine/administration \& dosage/diagnostic use, Plasma Volume, Serum Albumin/*biosynthesis}
}

@article{gotzinger_surgical_2002,
	title = {Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11910483},
	abstract = {In patients operated on for severe acute pancreatitis ({SAP}), the factors determining outcome remain unclear. From 1986 to 1998 a total of 340 patients with a diagnosis of {SAP} and in need of operative treatment were admitted to the intensive care unit ({ICU}) of a university hospital and a secondary care hospital. The mean {APACHE} {II} score on the day of admission was 16.1 (range 8-35). All patients required operative therapy. Among the 340 patients, 270 (79.4\%) had to be reoperated: 196 patients (72.6\%) underwent operative revisions on demand, and 74 (27.4\%) patients had preplanned reoperation. The overall mortality was 39.1\% (133 patients). Septic organ failure in 126 patients (37.1\%) and myocardial infarction or pulmonary embolism in 7 patients (2\%) were the causes of death. The patient's age (p {\textless} 0.0002), {APACHE} {II} scores at admission (p {\textless} 0.0001), presence or development of (single or multiple) organ failure (p {\textless} 0.002), infection (p {\textless} 0.02) and extent (p {\textless} 0.04) of pancreatic necrosis, and surgical control of local necrosis (p {\textless} 0.0001) significantly determined survival. {SAP} that requires surgical treatment is associated with high in-hospital mortality. Surgical control of local necrosis is the precondition for survival. Advanced age of the patient, high {APACHE} {II} score at admission, development of organ failure, and the extent and infection of pancreatic necrosis influence the outcome.},
	pages = {474--8},
	number = {4},
	journaltitle = {World J Surg},
	author = {Götzinger, Peter and Sautner, Thomas and Kriwanek, Stephan and Beckerhinn, Philipp and Barlan, Murat and Armbruster, Christian and Wamser, Peter and Függer, Reinhold},
	date = {2002-04}
}

@article{popovici_[periampullary_2000,
	title = {[The periampullary carcinoma. Clinical and therapeutic alternatives]},
	volume = {95},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14870550},
	abstract = {{BACKGROUND} {AND} {STUDY} {AIMS}: An analysis of the diagnosis difficulties in periampullary carcinoma ({PAC}) is done, the consequences being the possible therapeutically insufficiencies. {PATIENTS} {AND} {METHODS}: During 10 years (1990-1998) 54 patients have been operated on for a {PAC}. Sex ratio: 34 males (63\%)/20 females (37\%). The pick of frequency was in the decade 61-70 years (20 patients) with extremes ages between 20 and 80 years. The main symptom was the cholestatic progressive jaundice with or without neoplasic pain (39 patients–72\%). The intermittent jaundice was present only to 7 patients (13\%) and the clinical forms without jaundice were manifested to other 8 (15\%); superaded colangitic syndrome was present to 17 patients (31\%). Other concomitances manifestations of the neoplasic disease were record to 23 cases (43\%). Historical evolution of the illness until the cholestatic jaundice appearance was under 2 month to 23 cases, between 2 and 4 months to 24 patients and not sure determined to other 8. The biological preoperative investigations confirmed the clinically evident biliary retention syndrome in 85\% of the cases and not yet clinically visible to other 15\% of the cases. The ultrasonography was the most conclusive method from the imaging examinations because it have suggested the diagnostic of {PAC} to 43.5\% from the patients submitted to this exploration. Computed tomography was diagnosis relevant only for the in site-regional invasion of the tumors or for the nodes or systemic metastases. Endoscopy and the endobiopsy proved to be valuable especially associated with {ERCP} (our experience regarding {ERCP} is not conclusive yet). Therefore the real preoperative diagnostic was established to 11 patients (20\%), and for the rest of the cases there have been another presumptive preoperative diagnosis: cancer of the pancreatic head (11 patients), retentive jaundice without determined origin (24 patients), others (8 patients). Intraoperative exploration detected the periampullary tumor through palpation in 30 (55\%) cases, through palpation and exploratory duodenectomy in 8 (15\%) cases and/or by accessory signs (hydropic gallbladder, dilatation of the main biliary duct etc.). Organic metastases or duodenal stenosis was present in nine cases (6 with nodes metastases). The practiced surgery was: Whipple operations (in one–the majority–or two steps)–35 cases (65\%); palliative surgery for biliary drainage 16 (30\%) cases; others 3 (6\%) cases. The postoperative staging of {pT} parameter (in situ or ex situ dimensional determined) reveled: {pT}1-12 patients; {pT}2–9 patients; {pT}3–14 patients; {pT}4–19 patients. Histopathological examinations confirmed the diagnostic of periampullary adenocarcinoma (32 patients) or carcinoma (3 patients) for the 35 patients with resectional operations. The determination of the tissular origin of the periampullary tumor was initially possible only in 11 (31\%) operative specimens. A secondary study with many repeated sections in the wax included blocks specified the histogenesis of the tumors to other 10 patients, therefore for a total of 21 cases. We think that this histogenetically diagnosis aspect is important only for some predictive appreciations regarding the outcome of the operated patients and not for the elected therapeutically surgical method. {RESULTS}: The globally perioperative mortality was 8 (15\%) patients. Three from this deceased were a consequence of palliative surgery applied to patients with advanced stages of neoplasic disease. The medium outcome for patients submitted to Whipple operation–in course of evaluation–is between 32 and 41 months to the patients which we can followed. For the patients with palliative operations the same distant survival is between 12 and 24 months.},
	pages = {407--24},
	number = {5},
	journaltitle = {Chirurgia (Bucur)},
	author = {Popovici, A and Popescu, I and Ionescu, M I and Vasilescu, C and Ciurea, S and Tonea, A and David, L},
	date = {2000-10}
}

@article{society_ats/accp_2003,
	title = {{ATS}/{ACCP} Statement on cardiopulmonary exercise testing},
	volume = {167},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12524257},
	pages = {211--77},
	number = {2},
	journaltitle = {Am J Respir Crit Care Med},
	author = {Society, American Thoracic and Physicians, American College of Chest},
	date = {2003-01},
	file = {Society and Physicians - 2003 - ATSACCP Statement on cardiopulmonary exercise tes.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FH2AXMCR\\Society and Physicians - 2003 - ATSACCP Statement on cardiopulmonary exercise tes.pdf:application/pdf}
}

@article{mckay_chronic_2008,
	title = {Chronic inflammation and pancreatic cancer.},
	volume = {22},
	doi = {10.1016/j.bpg.2007.11.007},
	abstract = {There is a proven association between carcinoma of the pancreas and both the sporadic and hereditary forms of chronic pancreatitis. In chronic pancreatitis the standardised incidence ratio for development of pancreatic cancer is 14-18 and is further increased by cigarette smoking. Underlying mechanisms are unclear  but current theories point to the progressive accumulation of genetic mutations as a consequence of repeated {DNA} damage and cell regeneration in an environment favouring proliferation and neovascularisation. In patients who develop pancreatic cancer, there is interest in the role of the inflammatory response in  the development of cancer cachexia and in determining prognosis. Furthermore, markers of a systemic inflammatory response have prognostic significance in both  advanced, inoperable pancreatic cancer and in patients undergoing resection. Further understanding of the details of the relationship between inflammation, carcinogenesis and cancer prognosis may lead to new therapeutic possibilities as  part of multi-modality management of this difficult disease.},
	number = {1},
	journaltitle = {Best practice \& research. Clinical gastroenterology},
	shortjournal = {Best Pract Res Clin Gastroenterol},
	author = {{McKay}, Colin J. and Glen, Paul and {McMillan}, Donald C.},
	date = {2008},
	pmid = {18206813},
	keywords = {Biological Markers, Cachexia, C-Reactive Protein, Humans, Pancreatic Neoplasms/*etiology/mortality/*pathology, Pancreatitis, Chronic/genetics/*physiopathology, Prognosis, Risk Factors}
}

@article{ansorge_diagnostic_2014,
	title = {Diagnostic value of abdominal drainage in individual risk assessment of pancreatic fistula following pancreaticoduodenectomy},
	volume = {101},
	issn = {1365-2168},
	doi = {10.1002/bjs.9362},
	abstract = {{BACKGROUND}: The use of prophylactic abdominal drainage following pancreaticoduodenectomy ({PD}) is controversial as its therapeutic value is uncertain. However, the diagnosis of postoperative pancreatic fistula ({POPF}), the main cause of {PD}-associated morbidity, is often based on drain pancreatic amylase ({DPA}) levels. The aim of this study was to assess the predictive value of {DPA}, plasma pancreatic amylase ({PPA}) and serum C-reactive protein ({CRP}) for diagnosing {POPF} after {PD}.
{METHODS}: Patients undergoing {PD} with prophylactic drainage between 2008 and 2012 were studied prospectively. {DPA}, {PPA} and {CRP} levels were obtained daily. Differences between groups with clinically relevant {POPF} (International Study Group on Pancreatic Fistula ({ISGPF}) grade B/C) and without clinically relevant {POPF} (no {POPF} or {ISGPF} grade A) were evaluated. Receiver operating characteristic ({ROC}) analyses were performed to determine the value of {DPA}, {PPA} and {CRP} in prediction of {POPF}. Risk profiles for clinically relevant {POPF} were constructed and related to the intraoperative pancreatic risk assessment.
{RESULTS}: Fifty-nine (18.7 per cent) of 315 patients developed clinically relevant {POPF}. {DPA}, {PPA} and {CRP} levels on postoperative day ({POD}) 1-3 differed significantly between the study groups. In predicting {POPF}, the {DPA} level on {POD} 1 (cut-off at 1322 units/l; odds ratio ({OR}) 24.61, 95 per cent confidence interval 11.55 to 52.42) and {POD} 2 (cut-off at 314 units/l; {OR} 35.45, 14.07 to 89.33) was superior to that of {PPA} on {POD} 1 (cut-off at 177 units/l; {OR} 13.67, 6.46 to 28.94) and {POD} 2 (cut-off at 98 units/l; {OR} 16.97, 8.33 to 34.59). When {DPA} was combined with {CRP} (cut-off on {POD} 3 at 202 mg/l; {OR} 16.98, 8.43 to 34.21), 90.3 per cent of postoperative courses could be predicted correctly ({OR} 44.14, 16.89 to 115.38).
{CONCLUSION}: The combination of serum {CRP} and {DPA} adequately predicted the development of clinically relevant pancreatic fistula following {PD}.},
	pages = {100--108},
	number = {2},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Ansorge, C. and Nordin, J. Z. and Lundell, L. and Strömmer, L. and Rangelova, E. and Blomberg, J. and Del Chiaro, M. and Segersvärd, R.},
	date = {2014-01},
	pmid = {24306817},
	keywords = {Adult, Aged, Aged, 80 and over, Amylases, Carcinoma, Pancreatic Ductal, C-Reactive Protein, Drainage, Female, Humans, Male, Middle Aged, pancreas, Pancreatic Fistula, Pancreatic Neoplasms, Pancreaticoduodenectomy, Pancreatitis, Postoperative Care, Prospective Studies, Risk assessment, {ROC} Curve, Young Adult}
}

@article{crumley_is_2010,
	title = {Is hypoalbuminemia an independent prognostic factor in patients with gastric cancer?},
	volume = {34},
	doi = {10.1007/s00268-010-0641-y},
	abstract = {{BACKGROUND}: Studies have indicated that hypoalbuminemia is associated with decreased survival of patients with gastric cancer. However, the prognostic value of albumin may be secondary to an ongoing systemic inflammatory response. The aim of the study was to assess the relation between hypoalbuminemia, the systemic inflammatory response, and survival in patients with gastric cancer. {METHODS}: Patients diagnosed with gastric carcinoma attending the upper gastrointestinal surgical unit in the Royal Infirmary, Glasgow between April 1997 and December 2005 and who had a pretreatment measurement of albumin and C-reactive protein ({CRP}) were studied. {RESULTS}: Most of the patients had stage {III}/{IV} disease and received palliative treatment. The minimum follow-up was 15 months. During follow-up, 157 (72\%) patients died of their cancer. On univariate analysis, stage (p {\textless} 0.001), treatment (p {\textless} 0.001), albumin level (p {\textless} 0.001), and {CRP} level (p {\textless} 0.001) were significant predictors of survival. On multivariate analysis, stage (p {\textless} 0.001), treatment (p {\textless} 0.001), and {CRP} level (p {\textless} 0.001) remained significant predictors of survival. Albumin was no longer an independent predictor of survival. {CONCLUSIONS}: Low albumin concentrations are associated with poorer survival in patients with gastric cancer. However, the strength of this relation with survival is dependent on the presence of a systemic inflammatory response, as evidenced by an elevated {CRP} level. Therefore, it appears that the relation between hypoalbuminemia and poor survival is secondary  to that of the systemic inflammatory response.},
	pages = {2393--2398},
	number = {10},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Crumley, Andrew B. C. and Stuart, Robert C. and {McKernan}, Margaret and {McMillan}, Donald C.},
	date = {2010-10},
	pmid = {20602101},
	keywords = {Aged, Albumins/analysis, C-Reactive Protein/analysis, Female, Humans, Hypoalbuminemia/blood/*mortality, Male, Middle Aged, Predictive Value of Tests, Prognosis, Stomach Neoplasms/*blood/*mortality, Survival Analysis, Systemic Inflammatory Response Syndrome/blood/*mortality}
}

@article{clavien_clavien-dindo_2009,
	title = {The Clavien-Dindo Classification of Surgical Complications: Five-Year Experience},
	volume = {250},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-200908000-00002},
	doi = {10.1097/SLA.0b013e3181b13ca2},
	shorttitle = {The Clavien-Dindo Classification of Surgical Complications},
	pages = {187--196},
	number = {2},
	journaltitle = {Annals of Surgery},
	author = {Clavien, Pierre A. and Barkun, Jeffrey and de Oliveira, Michelle L. and Vauthey, Jean Nicolas and Dindo, Daniel and Schulick, Richard D. and de Santibañes, Eduardo and Pekolj, Juan and Slankamenac, Ksenija and Bassi, Claudio and Graf, Rolf and Vonlanthen, René and Padbury, Robert and Cameron, John L. and Makuuchi, Masatoshi},
	urldate = {2015-04-28},
	date = {2009-08},
	langid = {english},
	file = {Clavien et al. - 2009 - The Clavien-Dindo Classification of Surgical Compl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U9RN7PQV\\Clavien et al. - 2009 - The Clavien-Dindo Classification of Surgical Compl.pdf:application/pdf}
}

@article{freeman_interventions_2012,
	title = {Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23086243},
	abstract = {Pancreatic and peripancreatic necrosis may result in significant morbidity and mortality in patients with acute pancreatitis. Many recommendations have been made for management of necrotizing pancreatitis, but no published guidelines have incorporated the many recent developments in minimally invasive techniques for necrosectomy. Hence, a multidisciplinary conference was convened to develop a consensus on interventions for necrotizing pancreatitis. Participants included most international experts from multiple disciplines. The evidence for efficacy of interventions was reviewed, presentations were given by experts, and a consensus was reached on each topic. In summary, intervention is primarily indicated for infected necrosis, less often for symptomatic sterile necrosis, and should ideally be delayed as long as possible, preferably 4 weeks or longer after the onset of disease, for better demarcation and liquefaction of the necrosis. Both the step-up approach using percutaneous drainage followed by minimally invasive video-assisted retroperitoneal debridement and per-oral endoscopic necrosectomy have been shown to have superior outcomes to traditional open necrosectomy with respect to short-term and long-term morbidity and are emerging as treatments of choice. Applicability of these techniques depends on the availability of specialized expertise and a multidisciplinary team dedicated to the management of severe acute pancreatitis and its complications.},
	author = {Freeman, Martin L and Werner, Jens and van Santvoort, Hjalmar C and Baron, Todd H and Besselink, Marc G and Windsor, John A and Horvath, Karen D and {vanSonnenberg}, Eric and Bollen, Thomas L and Vege, Santhi Swaroop},
	date = {2012-11}
}

@article{liano_epidemiology_1996,
	title = {Epidemiology of acute renal failure: A prospective, multicenter, community-based study},
	volume = {50},
	issn = {0085-2538},
	doi = {10.1038/ki.1996.380},
	shorttitle = {Epidemiology of acute renal failure},
	abstract = {There are very limited data on overall epidemiology of {ARF}. It is crucial to know the incidence, etiology and clinical features of {ARF} to promote prevention strategies and to implement adequate resources for the management of this entity. During a nine month period, a collaborative prospective protocol with 98 variables was developed to assess all {ARF} episodes encountered in the 13 tertiary-care hospitals in Madrid, Spain (covering 4.2 million people of over 14 years of age). {ARF} was considered when a sudden rise in serum creatinine concentration (S-Cr) to more than 177 mu mol/liter was found in patients with normal renal function, or when the sudden rise (50\% or more) was observed in patients with previous mild-to-moderate chronic renal failure (S-Cr {\textless} 264 mu mol/liter). Of the 748 cases of {ARF} studied, 665 episodes presented in inhabitans from the Madrid area. This gives an overall incidence of {ARF} of 209 cases per million population (p.m.p.; 95\% Ci 195 to 223). The incidence of acute tubular necrosis ({ATN}) was 88 cases p.m.p. (95\% {CI} 79 to 97), prerenal {ARF} 36 p.m.p (95\% {CI} 40 to 52), acute-onset chronic {ARF} 29 p.m.p. (95\% {CI} 24 to 34), and obstructive {ARF} 13 p.m.p. (95\% {CI} 19 to 27). The mean age was 63 +/- 17 years. The most frequent causes of {ARF} were {ATN} (45\%), prerenal (21\%), acute-onset chronic renal failure (12.7\%) and obstructive {ARF} (10\%). Renal function was normal at admission in 48\% of patients who later developed {ARF}. Mortality (35\%) was much higher than that of the other patients admitted (5.4\%, P {\textless} 0.001). This real outcome correlated extremely well with the expected outcome calculated through out the severity index of {ARF} ({SI}) 0.433 +/- 0.246 (mean +/- {SD}). In 187 cases, mortality was attributed to underlying disease, thus corrected mortality due to {ARF} was 26.7\%. Dialysis was required in 36\% of patients. and was associated with a significantly higher {SI} of {ARF} (0.57 +/- 0.23 vs. 0.35 +/- 0.19, P {\textless} 0.001) and mortality (65.9 vs. 33.2\%, P {\textless} 0.001). Mortality in patients hemodialyzed with biocompatible synthetic membranes (N = 50) was similar to that observed with cellulosic ones (N = 84; 66\% vs. 59.5\%, {NS}). Mortality was higher in patients with coma, assisted respiration, hypotension, jaundice (all P {\textless} 0.001) and oliguria (P {\textless} 0.02). This study gives, for the first time, the incidence of all forms of {ARF} in a developed country. {ARF} is iatrogenically induced at a high rate by modern medicine. Prevention strategies, particularly in the perioperative period, are needed to decrease its impact.},
	pages = {811--818},
	number = {3},
	journaltitle = {Kidney International},
	shortjournal = {Kidney Int.},
	author = {Liano, F. and Pascual, J. and Gamez, C. and Gallego, A. and Bajo, M. A. and Sicilia, L. S. and Junco, E. and Verde, E. and Bernis, C. and Traver, J. A. and Alcazar, J. M. and Sanchez, R. and Oliet, A. and Hernando, C. and Portoles, J. and Barrientos, A. and Sanz, C. and Hernandez, J. and {deSequera}, P. and Caramelo, C. and Barrio, V. and Moreno, F. and Munoz, M. C. and Giner, V. and Junquera, E. and Parra, E. G. and Rodeles, M.},
	date = {1996-09},
	note = {{WOS}:A1996VD76600011},
	keywords = {hemodialysis, index, medical intensive-care, prediction, prognosis, requiring dialysis, risk-factors, surgery, Survival}
}

@article{williams_surgical_2014,
	title = {Surgical resection of primary tumour improves aerobic performance in colorectal cancer},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798313009177},
	doi = {10.1016/j.ejso.2013.11.009},
	abstract = {{AbstractBackground}
Colorectal cancer is the third most common cancer in the {UK}, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance.
Methods
We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51–77) y, body mass index 27.67 (4.83) kg m−2) and matched controls (n = 30, 64.6 (42–77) y, {BMI} 27.14 (3.51) kg m−2). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry.
Results
Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg−1 min−1, p \< 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg−1 min−1 p \< 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5–5 {IQR}), post-resection 3.75 (4–3 {IQR}), p \< 0.0001).
Conclusion
In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities.},
	pages = {220--226},
	number = {2},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {Williams, J. P. and Nyasavajjala, S. M. and Phillips, B. E. and Chakrabarty, M. and Lund, J. N.},
	urldate = {2015-05-05},
	date = {2014-02},
	keywords = {Aerobic performance, Colorectal cancer, surgery},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NBEKQNXH\\Williams et al. - 2014 - Surgical resection of primary tumour improves aero.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2IIXJDEG\\S0748798313009177.html:text/html}
}

@article{mok_use_2008,
	title = {Use of C-reactive protein after spinal surgery: comparison with erythrocyte sedimentation rate as predictor of early postoperative infectious complications},
	volume = {33},
	issn = {1528-1159},
	doi = {10.1097/BRS.0b013e318163f9ee},
	shorttitle = {Use of C-reactive protein after spinal surgery},
	abstract = {{STUDY} {DESIGN}: This is a prospective observational study of erythrocyte sedimentation rate ({ESR}) and C-reactive protein ({CRP}) in a cohort of patients undergoing spinal surgery.
{OBJECTIVE}: We sought to characterize the normal kinetics of {ESR} and {CRP} after spinal surgery and compare their usefulness as predictors of infectious complications in the early postoperative period.
{SUMMARY} {OF} {BACKGROUND} {DATA}: {ESR} and {CRP} are nonspecific markers of inflammation used to evaluate postoperative infection. {CRP} is a quantitative test that exhibits predictable kinetics consisting of a postoperative rise and a peak followed by a decrease toward the normal value. Deviation from normal kinetics may be an indicator of infection.
{METHODS}: {ESR} and {CRP} were collected before surgery and daily after surgery in consecutive patients. All infectious complications were recorded.
{RESULTS}: One hundred forty-nine patients met inclusion criteria. Infectious complications occurred in 20 patients. A postoperative peak, which is necessary to apply the test, was observed in 78\% of patients for {CRP} and 48\% for {ESR}. Multiple linear regression analysis revealed preoperative {CRP}, number of levels, and lumbar region as significant predictors of greater {CRP} peak value (r = 0.435, P = 0.001). After the peak, {CRP} showed an exponential decrease with a half-life of 2.6 days (r = 0.701, P {\textless} 0.001). No trend could be determined for {ESR}. A second rise or failure to decrease as expected had a sensitivity, specificity, positive predictive value, and negative predictive value of 82\%, 48\%, 41\%, and 86\% for infectious complications, respectively. Of 8 cases of deep wound infection, 7 exhibited substantial deviations from expected {CRP} values.
{CONCLUSION}: {CRP} is more applicable, predictable, and responsive in the early postoperative period compared with {ESR}. The postoperative kinetics of {CRP} derived in this study seems to be conserved regardless of operation, magnitude, or region. Knowledge of the kinetics allows assessment of the degree of difference between actual and expected values. Using a second rise or failure to decrease as expected for {CRP} is sensitive for infection. A negative test is reassuring that infection is unlikely.},
	pages = {415--421},
	number = {4},
	journaltitle = {Spine},
	shortjournal = {Spine},
	author = {Mok, James M. and Pekmezci, Murat and Piper, Samantha L. and Boyd, Erin and Berven, Sigurd H. and Burch, Shane and Deviren, Vedat and Tay, Bobby and Hu, Serena S.},
	date = {2008-02-15},
	pmid = {18277874},
	keywords = {Biological Markers, Blood Sedimentation, Chi-Square Distribution, C-Reactive Protein, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Regression Analysis, Reproducibility of Results, Sensitivity and Specificity, Statistics, Nonparametric, Surgical Wound Infection}
}

@article{scheele_resection_1995,
	title = {Resection of colorectal liver metastases},
	volume = {19},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/BF00316981},
	doi = {10.1007/BF00316981},
	abstract = {From 1960 to 1992 a total of 1718 patients with liver metastases from colorectal carcinoma were recorded. Of these patients, 469 (27.3\%) underwent hepatic resection, which was performed with curative intent in 434 patients (25.3\%). Operative mortality in this group was 4.4\%, being 1.8\% (2 of 114) during the last 3 years. Significant morbidity was observed in 16\% of patients with a decrease to 5\% (6 of 112) for the last 3 years. A 99.8\% follow-up until November 1, 1993 was achieved. Excluding operative mortality, there are 350 patients with “potentially curative” resection and 65 corresponding patients with minimal macroscopic (n=19) or microscopic (n=46) residual disease. The latter group demonstrated a poor prognosis, with median and maximum survival times of 14.4 and 56.0 months, respectively. Among the 350 patients having potentially curative resection, the actuarial 5-, 10-, and 20-year survivals were 39.3\%, 23.6\%, and 17.7\%, respectively. Tumor-free survival was 33.6\% at 5 years. In the univariate analysis, the following factors were associated with decreased crude survival: presence and extent of mesenteric lymph node involvement (p=0.0001); grade {III}/{IV} primary tumor (p=0.013); synchronous diagnosis of metastases (p=0.014); satellite metastases (p=0.00001); metastasis diameter of{\textgreater}5 cm (p=0.003); preoperative carcinoembryonic antigen ({CEA}) elevation (p=0.03); limited resection margins (p=0.009); extrahepatic disease (p=0.009); and nonanatomic procedures (p=0.008). With respect to disease-free survival, extrahepatic disease (p=0.09) failed to achieve statistical significance, whereas patients with primary tumors in the colon did significantly better than those with rectal cancer (p=0.04). The presence of five or more independent metastases adversely affected resectability (p{\textless}0.05). However, once a radical excision of all detectable disease was achieved, no significant predictive value of an increasing number of metastases (1–3 versus≥4) on either overall (p=0.40) or disease-free (p=0.64) survival was found. Using Cox's multivariate regression analysis, the presence of satellite metastases, primary tumor grade, the time of metastasis diagnosis diameter of the largest metastasis, anatomic versus nnanatomic approach, year of resection, and mesenteric lymph node involvement each independently affected both crude and tumor-free survival.},
	pages = {59--71},
	number = {1},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J. Surg.},
	author = {Scheele, Johannes and Stang, Richard and Altendorf-Hofmann, Annelore and Paul, Martin},
	urldate = {2015-05-27},
	date = {1995-01-01},
	langid = {english},
	keywords = {Abdominal Surgery, Cardiac Surgery, general surgery, Thoracic Surgery, Traumatic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M7MWU7CN\\Scheele et al. - 1995 - Resection of colorectal liver metastases.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BU82JS49\\10.html:text/html}
}

@article{holley_obesity_1990,
	title = {Obesity as a risk factor following cadaveric renal transplantation},
	volume = {49},
	issn = {0041-1337},
	abstract = {Obesity has generally been thought to increase the risk of operative mortality and postoperative complications in surgical patients. No data examining obesity as a factor in cadaveric renal transplantation were available. We therefore matched obese patients undergoing cadaveric renal transplantation with nonobese control patients and retrospectively analyzed mortality, morbidity, and graft survival in each group. Patients were matched for age, sex, diabetes mellitus, {PRA}, graft number, cardiovascular disease, date of transplantation, and posttransplant immunosuppression. There were significant differences found in mortality (11\% in obese vs. 2\% in nonobese patients, P less than or equal to 0.01), immediate graft function (38\% in obese vs. 64\% in nonobese patients, P less than or equal to 0.01), 1-year graft survival (66\% in obese vs. 84\% in nonobese patients, P less than or equal to 0.05), and postoperative complications. Wound complications (20\% vs. 2\%, P less than or equal to 0.01), intensive-care-unit admissions (10\% vs. 2\%, P less than or equal to 0.01), reintubations (16\% vs. 2\%, P less than or equal to 0.03), and new-onset diabetes (12\% vs. 0\%, P less than or equal to 0.02) were all significantly more common in the obese group. These results suggest that an attempt at significant weight reduction is indicated in obese patients prior to renal transplantation.},
	pages = {387--389},
	number = {2},
	journaltitle = {Transplantation},
	shortjournal = {Transplantation},
	author = {Holley, J. L. and Shapiro, R. and Lopatin, W. B. and Tzakis, A. G. and Hakala, T. R. and Starzl, T. E.},
	date = {1990-02},
	pmid = {2305469},
	pmcid = {PMC2965531},
	keywords = {Adult, Cadaver, Creatinine, Female, Graft Survival, Humans, Kidney Transplantation, Male, Middle Aged, Obesity, Retrospective Studies, Risk Factors, Survival Analysis}
}

@article{kajiwara_analysis_2010,
	title = {An analysis of risk factors for pancreatic fistula after pancreaticoduodenectomy: clinical impact of bile juice infection on day 1},
	volume = {395},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19655161},
	abstract = {{BACKGROUND}: Postoperative pancreatic fistula ({POPF}) is a most striking complication after pancreatic resection. The objective of this study is to reveal the risk factors for {POPF} defined by the international study group after pancreaticoduodenectomy in a Japanese high-volume center. {METHODS}: During the recent 4 years, 220 patients underwent pancreaticoduodenectomies. In patients of obstructive jaundice, preoperative biliary drainage was performed by percutaneous (n = 71) and/or retrograde (n = 38) approach. Pancreaticojejunostomy was performed using either duct-to-mucosa anastomosis (n = 180) or dunking method (n = 40). Risk factors for {POPF} (grade B or grade C {POPF} by international definition) were evaluated using univariate and multivariate analyses. {RESULTS}: {POPF} was found in 109 (50\%) patients; grade A in 45 (21\%), grade B in 54 (25\%), and grade C in 10 patients (5\%). One patient died of intra-abdominal hemorrhage caused by {POPF}. Univariate and multivariate analyses revealed that independent risk factors for grade B or grade C {POPF} were the size of the main pancreatic duct ({\textless}3 mm; relative risk ({RR}), 3.3; p = 0.002), body mass index ({\textgreater} or =20, {RR} 2.5, p = 0.03), and bile juice infection on day 1 ({RR}, 2.2; p = 0.04). The performance of biliary drainage or method of pancreaticojejunostomy was not a significant risk factor for {POPF}. Bile juice infection on day 1 was significantly associated with retrograde biliary drainage (p {\textless} 0.001). {CONCLUSIONS}: Bile juice infection on day 1 was a significant risk factor for grade B or grade C {POPF} after pancreaticoduodenectomy. Although the performance or the status of biliary drainage itself was not a risk factor for {POPF}, percutaneous biliary drainage might be advantageous against retrograde drainage to reduce the risk of biliary infection.},
	pages = {707--12},
	number = {6},
	journaltitle = {Langenbecks Arch Surg},
	author = {Kajiwara, Takahiro and Sakamoto, Yoshihiro and Morofuji, Noriaki and Nara, Satoshi and Esaki, Minoru and Shimada, Kazuaki and Kosuge, Tomoo},
	date = {2010-08},
	note = {Not assoc with fistula;Increases bile infection}
}

@article{gallardo_increased_1998,
	title = {Increased plasma levels of atrial natriuretic peptide and endocrine markers of volume depletion in patients with obstructive jaundice},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9462378},
	abstract = {{BACKGROUND}: Hypovolaemia may cause renal dysfunction in obstructive jaundice. This study investigated whether, in patients with obstructive jaundice: (1) atrial natriuretic peptide ({ANP}) is increased; (2) fluid-regulating hormones are altered; and (3) biliary drainage improves fluid homoeostasis. {METHODS}: Forty-three patients with obstructive jaundice were investigated. A renal profile was obtained and levels of {ANP}, renin, aldosterone and vasopressin were determined. In a subset of 18 patients, studies were repeated 3 days after endoscopic biliary drainage and changes in extracellular volume were measured. {RESULTS}: Creatinine clearance was impaired in ten of 30 patients. Patients with obstructive jaundice had higher mean levels of {ANP} (118 versus 40 pg/ml, P = 0.0001) and aldosterone (156 versus 43 pg/ml, P = 0.0001) than matched controls. Increased renin levels were observed in ten of the 43 patients and were associated with impaired creatinine clearance. After biliary drainage {ANP} concentration decreased (110 versus 67 pg/ml, P = 0.004) as well as aldosterone level (182 versus 85 pg/ml, P = 0.0002) and the mean extracellular volume increased (20.5 versus 23.1 per cent of body-weight, P = 0.001). {CONCLUSION}: Plasma {ANP} concentration is increased in obstructive jaundice. Endocrine markers of hypovolaemia are activated in obstructive jaundice. After biliary drainage there is an improvement of endocrine and fluid derangements.},
	pages = {28--31},
	number = {1},
	journaltitle = {Br J Surg},
	author = {Gallardo, J M and Padillo, J and Martín-Malo, A and Miño, G and Pera, C and Sitges-Serra, A},
	date = {1998-01},
	file = {Gallardo et al. - 1998 - Increased plasma levels of atrial natriuretic pept.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HP5EFZMV\\Gallardo et al. - 1998 - Increased plasma levels of atrial natriuretic pept.pdf:application/pdf}
}

@article{katoh_anastomotic_2011,
	title = {Anastomotic leakage contributes to the risk for systemic recurrence in stage {II} colorectal cancer},
	volume = {15},
	issn = {1873-4626},
	doi = {10.1007/s11605-010-1379-4},
	abstract = {{PURPOSE}: In stage {II} colorectal cancer ({CRC}), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage {II}.
{METHODS}: Two hundred seven patients with stage {II} {CRC} who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.
{RESULTS}: The 5-year disease-free survival rate ({DFS}) was 87.0\%. The univariable prognostic analyses indicated that Lk (P = 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio ({HR}), 4.21, P = 0.021), and the {DFS} was 58.3\% in cases with Lk, while 88.7\% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (P = 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (P = 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential ({HR}, 3.70, P = 0.075).
{CONCLUSIONS}: The findings concluded that Lk may be a high risk for systemic recurrence in stage {II} {CRC}.},
	pages = {120--129},
	number = {1},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Katoh, Hiroshi and Yamashita, Keishi and Wang, Guoqin and Sato, Takeo and Nakamura, Takatoshi and Watanabe, Masahiko},
	date = {2011-01},
	pmid = {21086058},
	keywords = {Anastomotic leak, Colorectal Neoplasms, Disease-Free Survival, Female, Follow-Up Studies, Humans, Incidence, Japan, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, prognosis, Retrospective Studies, Risk Factors, Survival Rate, Time Factors}
}

@article{prentis_submaximal_2012-1,
	title = {Submaximal cardiopulmonary exercise testing predicts 90-day survival after liver transplantation},
	volume = {18},
	rights = {Copyright © 2011 American Association for the Study of Liver Diseases},
	issn = {1527-6473},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/lt.22426/abstract},
	doi = {10.1002/lt.22426},
	abstract = {Liver transplantation has a significant early postoperative mortality rate. An accurate preoperative assessment is essential for minimizing mortality and optimizing limited donor organ resources. This study assessed the feasibility of preoperative submaximal cardiopulmonary exercise testing ({CPET}) for determining the cardiopulmonary reserve in patients being assessed for liver transplantation and its potential for predicting 90-day posttransplant survival. One hundred eighty-two patients underwent {CPET} as part of their preoperative assessment for elective liver transplantation. The 90-day mortality rate, critical care length of stay, and hospital length of stay were determined during the prospective posttransplant follow-up. One hundred sixty-five of the 182 patients (91\%) successfully completed {CPET}; this was defined as the ability to determine a submaximal exercise parameter: the anaerobic threshold ({AT}). Sixty of the 182 patients (33\%) underwent liver transplantation, and the mortality rate was 10.0\% (6/60). The mean {AT} value was significantly higher for survivors versus nonsurvivors (12.0 ± 2.4 versus 8.4 ± 1.3 {mL}/minute/kg, P {\textless} 0.001). Logistic regression revealed that {AT}, donor age, blood transfusions, and fresh frozen plasma transfusions were significant univariate predictors of outcomes. In a multivariate analysis, only {AT} was retained as a significant predictor of mortality. A receiver operating characteristic curve analysis demonstrated sensitivity and specificity of 90.7\% and 83.3\%, respectively, with good model accuracy (area under the receiver operating characteristic curve = 0.92, 95\% confidence interval = 0.82-0.97, P = 0.001). The optimal {AT} level for survival was defined to be {\textgreater}9.0 {mL}/minute/kg. The predictive value was improved when the ideal weight was substituted for the actual body weight of a patient with refractory ascites, even after a correction for the donor's age. In conclusion, the preoperative cardiorespiratory reserve (as defined by {CPET}) is a sensitive and specific predictor of early survival after liver transplantation. The predictive value of {CPET} requires further evaluation. Liver Transpl 18:152–159, 2012. © 2011 {AASLD}.},
	pages = {152--159},
	number = {2},
	journaltitle = {Liver Transplantation},
	shortjournal = {Liver Transpl},
	author = {Prentis, James M. and Manas, Derek M. D. and Trenell, Michael I. and Hudson, Mark and Jones, David J. and Snowden, Chris P.},
	urldate = {2015-05-27},
	date = {2012-02-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H978AHS7\\Prentis et al. - 2012 - Submaximal cardiopulmonary exercise testing predic.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\468E32XW\\abstract.html:text/html}
}

@article{roxburgh_situ_2013,
	title = {The in situ local immune response, tumour senescence and proliferation in colorectal cancer.},
	volume = {109},
	doi = {10.1038/bjc.2013.556},
	abstract = {{BACKGROUND}: Immune cell infiltrates are important determinants of colorectal cancer ({CRC}) outcome. Their presence may be driven by tumour or host-specific factors. From previous studies in mice, senescence, a state of cell cycle arrest, may moderate tumour progression through upregulation of antitumour immune responses. The relationships between senescence and immune infiltrates have not previously been studied in humans. We explore whether a marker of senescence (p16(ink4a)) in combination with low level expression of a proliferation marker (ki-67) relate to T cell infiltrates in {CRC}, and whether p16(ink4a), Ki-67 and immune infiltrates have similar prognostic value. {METHODS}: Immunostaining of p16(inka) and Ki-67 was performed within a {CRC} tissue microarray. Nuclear p16(inka) and Ki-67 were categorised as high/low. T-cell markers, {CD}3, {CD}45RO, {CD}8 and {FOXP}3 were scored separately as high/low grade in three areas of the tumour: the invasive margin ({IM}), tumour stroma and cancer cell nests ({CCNs}). results: Two hundred and thirty stage I-{III} cancers were studied. High nuclear p16(ink4a) was expressed in 63\% and high proliferation (Ki-67 {\textgreater}15\%) in 61\%. p16(ink4a) expression was associated with reduced {CD}45RO+ cells at the {IM} (P{\textless}0.05) and within the stroma (P{\textless}0.05) and reduced {CD}8+ cells at the {IM} (P{\textless}0.01). A low Ki-67 proliferative index was associated with reduced density of  {CD}3+ cells in {CCNs} (P{\textless}0.01), reduced {CD}45RO+ cells at the {IM} (P{\textless}0.05) and within  the {CCNs} (P{\textless}0.001), reduced {FOXP}3+ cells at the {IM} (P{\textless}0.001), within the stroma (P=0.001) and within {CCNs} (P{\textless}0.001) and reduced {CD}8+ cells at the {IM} (P{\textless}0.05) and within the {CCNs} (P{\textless}0.05). Tumours with both a low proliferative index and expression of p16(ink4a) demonstrated similar consistent relationships with reduced densities of T-cell infiltrates. On multivariate analysis, {TNM} stage (P{\textless}0.001), low {CD}3 cells at the {IM} (P=0.014), low {CD}8 cells at the {IM} (P=0.037),  low proliferation (Ki-67; P=0.013) and low senescence (p16(ink4a); P=0.002) were  independently associated with poorer cancer survival. {CONCLUSION}: Senescence, proliferation and immune cell infiltrates are independent prognostic factors in {CRC}. Although related to survival, p16(ink4a)-associated senescence is not associated with an upregulation of antitumour T-cell responses.},
	pages = {2207--2216},
	number = {8},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Roxburgh, C. S. and Richards, C. H. and Macdonald, A. I. and Powell, A. G. and {McGlynn}, L. M. and {McMillan}, D. C. and Horgan, P. G. and Edwards, J. and Shiels, P. G.},
	date = {2013-10-15},
	pmid = {24022192},
	pmcid = {PMC3798960},
	keywords = {Aged, Cell Aging/immunology, Cell Growth Processes/immunology, Colorectal Neoplasms/*immunology/*pathology, Female, Humans, Immunohistochemistry, Ki-67 Antigen/biosynthesis/immunology, Lymphocytes, Tumor-Infiltrating/immunology, Male, Middle Aged, Neoplasm Proteins/biosynthesis/immunology, Neoplasm Staging, Paraffin Embedding, Tissue Array Analysis, T-Lymphocytes/immunology}
}

@article{pieri_c-reactive_2014,
	title = {C-reactive protein and bacterial infection in cirrhosis},
	volume = {27},
	issn = {1108-7471},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982625/},
	abstract = {In the general population, C-reactive protein ({CRP}) level increases in the presence of acute or chronic inflammation and infections. In patients with cirrhosis, the basal level is higher than in patients without cirrhosis, due to chronic hepatic and other inflammation, but when infection occurs the more severe the underlying liver dysfunction, the lower the increase in {CRP}. Therefore, the predictive power of {CRP} for infection and prognosis is weak in patients with decompensated/advanced cirrhosis and in the intensive care setting. However, higher {CRP} and also persistently elevated {CRP} levels can help identify patients with a higher short-term risk of mortality.},
	pages = {113--120},
	number = {2},
	journaltitle = {Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology},
	shortjournal = {Ann Gastroenterol},
	author = {Pieri, Giulia and Agarwal, Banwari and Burroughs, Andrew K.},
	urldate = {2015-08-21},
	date = {2014},
	pmid = {24733601},
	pmcid = {PMC3982625},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TAWI2692\\Pieri et al. - 2014 - C-reactive protein and bacterial infection in cirr.pdf:application/pdf}
}

@article{baron_endoscopic_1996,
	title = {Endoscopic therapy for organized pancreatic necrosis},
	volume = {111},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8780582},
	abstract = {The treatment of patients with extensive pancreatic necrosis remains controversial; a subpopulation of patients with extensive acute pancreatic necrosis develop complex, organized collections. This study examined the feasibility of endoscopic drainage in patients with extensive organized pancreatic necrosis.},
	pages = {755--64},
	number = {3},
	journaltitle = {Gastroenterology},
	author = {Baron, T H and Thaggard, W G and Morgan, D E and Stanley, R J},
	date = {1996-09}
}

@article{harris_socioeconomic_2009,
	title = {Socioeconomic deprivation adversely affects survival of patients with rectal cancer},
	volume = {96},
	doi = {10.1002/bjs.6621},
	abstract = {Background: The aim was to examine the influence of socioeconomic deprivation on stage at presentation, perioperative mortality, permanent stoma rates and overall survival in patients with rectal cancer. Methods: Data on patient demographics, mode and stage of presentation, and short- and longer-term outcomes were extracted from a database of patients with rectal cancer. Comparisons were made after stratification into quintiles of socioeconomic deprivation. Results: In total 486 patients were identified. Fewer patients from the most deprived group than from the least deprived group underwent resectional surgery (79.2 versus 93 per cent; P = 0.005). Permanent stoma rates among patients who had surgery were 40.8 and 30 per cent respectively (P = 0.110). The overall 5-year survival rate was 32.8 per cent fur the most deprived compared with 64.0 per cent for the least deprived patients (P {\textless} 0.001). Respective rates for those who underwent resectional surgery were 49.9 and 72 per cent (P = 0.030). Conclusion: In rectal cancer, socioeconomic deprivation appears to be associated with poorer outcomes and survival. This has important implications for healthcare planning.},
	pages = {763--768},
	number = {7},
	journaltitle = {British Journal of Surgery},
	author = {Harris, A. R. and Bowley, D. M. and Stannard, A. and Kurrimboccus, S. and Geh, J. I. and Karandikar, S.},
	date = {2009-07},
	note = {{WOS}:000267578300011},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\I6RIID5H\\Harris et al. - 2009 - Socioeconomic deprivation adversely affects surviv.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MJ788KTZ\\abstract.html:text/html}
}

@article{kvist_total_1988,
	title = {Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations},
	volume = {48},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3202084},
	abstract = {Total and visceral adipose-tissue ({AT}) volumes were determined by computed tomography ({CT}) by a multiscan technique in 17 men and 10 women with a wide range of body weights. In these primary materials, weight, height, and various diameters, circumferences, and subcutaneous {AT} thicknesses of the trunk were examined for their relationships to {CT}-determined total and visceral {AT} volumes. Predictive {AT} equations from the primary materials were then tested on two cross-validation groups consisting of another 7 men and 9 women. For the prediction of the total {AT} volume, weight/height was the superior single predictor, with errors less than 11\% in primary and cross-validation materials. For the prediction of visceral {AT} volume, simple equations based entirely on the sagittal diameter of the trunk at the L3-L5 level resulted in errors less than 21\% in both sexes.},
	pages = {1351--61},
	number = {6},
	journaltitle = {Am J Clin Nutr},
	author = {Kvist, H and Chowdhury, B and Grangård, U and Tylén, U and Sjöström, L},
	date = {1988-12},
	file = {Kvist et al. - 1988 - Total and visceral adipose-tissue volumes derived .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SQJMIBBB\\Kvist et al. - 1988 - Total and visceral adipose-tissue volumes derived .pdf:application/pdf}
}

@article{halmes_detection_1997,
	title = {Detection of trichloroethylene-protein adducts in rat liver and plasma.},
	volume = {92},
	abstract = {Trichloroethylene is an industrial chemical with widespread occupational exposure and is a major environmental contaminant. In a Western blot using antiserum that  recognizes trichloroethylene covalently bound to protein, a single 50 {kDa} microsomal adduct was detected in the livers of trichloroethylene-treated Sprague-Dawley rats. To determine if trichloroethylene-protein adducts could be detected in blood, plasma proteins were immunoaffinity purified using an antidichloroacetyl column. A single 50 {kDa} protein was detected in the affinity-purified fraction in a Western blot using dichloroacetyl antiserum. This protein was also immunochemically reactive with anti-cytochrome P450 2E1 antibodies. The 50 {kDa} trichloroethylene-protein adduct may be formed in the liver and released into the blood following exposure to trichloroethylene. The significance of adduct formation with respect to trichloroethylene toxicity remains to be established; however, the data suggest that this approach may be useful in the investigation of trichloroethylene-protein adducts and adverse effects following exposure.},
	pages = {187--194},
	number = {3},
	journaltitle = {Toxicology letters},
	shortjournal = {Toxicol Lett},
	author = {Halmes, N. C. and Perkins, E. J. and {McMillan}, D. C. and Pumford, N. R.},
	date = {1997-08-22},
	pmid = {9334829},
	keywords = {Animals, Autoimmunity/drug effects, Blotting, Western, Cytochrome P-450 {CYP}2E1/metabolism, Environmental Pollutants/*metabolism, Liver/*metabolism, Male, Protein Binding, Rats, Rats, Sprague-Dawley, Trichloroethylene/*metabolism/toxicity}
}

@article{toth_examination_1993,
	title = {Examination of Data Normalization Procedures for Expressing Peak V-Center-Dot-O2 Data},
	volume = {75},
	issn = {8750-7587},
	abstract = {Peak O2 uptake ({VO}2) has traditionally been compared among individuals differing in body composition by dividing measured values (l/min) by fat-free mass ({FFM}) (i.e., ratio method). However, the ability of the ratio method to mathematically remove the confounding influence of {FFM} from peak {VO}2 has recently been questioned. Therefore, we compared the effectiveness of the ratio method vs. regression modeling to normalize peak {VO}2 in a large cohort of males and females for differences in {FFM}. Regression modeling adjusts peak {VO}2 according to the relationship derived from the regression of peak {VO}2 on {FFM}. Results showed that peak {VO}2 was 60\% higher in males (3.53 +/- 1.0 l/min) than in females (2.22 +/- 0.6 l/min; P {\textless} 0.01). With the ratio method (i.e., peak {VO}2/{FFM}), peak {VO}2 was 15\% higher in males (54.6 +/- 12 ml . kg {FFM} 1 . min-1) than in females (47.4 +/- 11 ml . kg {FFM}-1 . min-1; P {\textless} 0.01). In contrast, when a regression-based approach was employed to normalize values, no significant difference in adjusted peak {VO}2 was observed between males and females (3.04 +/- 0.9 vs. 3.01 +/- 1.0 l/min). In conclusion, dividing peak {VO}2 by {FFM} can produce spurious results, because this approach does not take into account the nonzero intercept. Therefore, a regression-based approach should be used to normalize peak {VO}2.},
	pages = {2288--2292},
	number = {5},
	journaltitle = {Journal of Applied Physiology},
	shortjournal = {J. Appl. Physiol.},
	author = {Toth, Mj and Goran, Mi and Ades, Pa and Howard, Db and Poehlman, Et},
	date = {1993-11},
	note = {{WOS}:A1993MG96000051},
	keywords = {age, endurance, fat-free mass, gender, healthy-men, hormones, maximal oxygen-uptake, metabolic-rate, normalization, peak oxygen uptake, sex difference, women}
}

@article{dutta_comparison_2012,
	title = {Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer.},
	volume = {204},
	rights = {Copyright (c) 2012 Elsevier Inc. All rights reserved.},
	doi = {10.1016/j.amjsurg.2011.10.015},
	abstract = {{BACKGROUND}: There is increasing evidence that the patient-related systemic inflammatory response is a powerful prognostic factor. The aim of the present study was to compare the prognostic value of selected markers of the systemic inflammatory response in patients undergoing resection of gastric cancer. {METHODS}: One hundred twenty patients undergoing resection of gastric cancer, had  measurements of various systemic inflammatory markers in addition to tumor-related factors. From these, the modified Glasgow Prognostic Score ({mGPS}),  neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and metastatic lymph node ratio were calculated. {RESULTS}: On multivariate analysis, only the ratio of positive to total lymph nodes (hazard ratio, 2.29\%; 95\% confidence interval, 1.57\%-3.33\%; P {\textless} .001) and the {mGPS} (hazard ratio, 2.23\%; 95\% confidence interval, 1.40\%-3.54\%; P = .001) were independently associated with cancer-specific survival in patients with gastric cancer. An increase in the {mGPS} was associated with a higher neutrophil/lymphocyte ratio (P {\textless} .05) and poorer survival (P {\textless} .001). {CONCLUSIONS}: The present study indicates that the {mGPS}, an acute-phase, protein-based prognostic score, is a superior predictor of cancer survival compared with the cellular components of the systemic inflammatory response in patients undergoing resection of gastric cancer.},
	pages = {294--299},
	number = {3},
	journaltitle = {American journal of surgery},
	shortjournal = {Am J Surg},
	author = {Dutta, Sumanta and Crumley, Andrew B. C. and Fullarton, Grant M. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2012-09},
	pmid = {22444831},
	keywords = {Aged, Blood Platelets/pathology, C-Reactive Protein/*metabolism, Female, Humans, Kaplan-Meier Estimate, Leukocyte Count, Lymphatic Metastasis, Lymph Nodes/*pathology, Lymphocytes/pathology, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Neutrophils/pathology, Odds Ratio, Predictive Value of Tests, Prognosis, Serum Albumin/*metabolism, Stomach Neoplasms/*blood/mortality/pathology/*surgery, Tumor Markers, Biological/*blood}
}

@article{buchler_acute_2000,
	title = {Acute necrotizing pancreatitis: treatment strategy according to the status of infection},
	volume = {232},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11066131},
	abstract = {To determine benefits of conservative versus surgical treatment in patients with necrotizing pancreatitis.},
	pages = {619--26},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Büchler, M W and Gloor, B and Müller, C A and Friess, H and Seiler, C A and Uhl, W},
	date = {2000-11}
}

@article{younes_ictericia_2007,
	title = {A icterícia obstrutiva induz depressão precoce da respiração mitocondrial em hepatócitos de ratos},
	volume = {22},
	url = {http://www.scientificcircle.com/pt/132192/ictericia-obstrutiva-induz-depressao-precoce-respiracao/},
	pages = {251--254},
	number = {4},
	journaltitle = {Acta Cirurgica Brasileira},
	author = {Younes, Riad Naim and Poggetti, Renato Sérgio and Fontes, Belchor and Itinoshe, Mario Matsuo and Yoshida, Vanda Mitie and Carvalho, Maria Elisa A. and Birolini, Dario},
	urldate = {2015-05-18},
	date = {2007},
	file = {obstructive_jaundice_induces_early_depression_of_mitochondrial_respiration_in_rat_hepatocytes.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4C27AHQ9\\obstructive_jaundice_induces_early_depression_of_mitochondrial_respiration_in_rat_hepatocytes.pdf:application/pdf}
}

@article{park_colorectal_2015,
	title = {Colorectal Cancer, Systemic Inflammation, and Outcome: Staging the Tumor and Staging the Host.},
	doi = {10.1097/SLA.0000000000001122},
	abstract = {{OBJECTIVE}:: This study aims to examine the clinical utility of the combination of {TNM} stage and modified Glasgow Prognostic Score ({mGPS}) in patients undergoing potentially curative resection of colorectal cancer ({CRC}). {BACKGROUND}:: Of measures of the systemic inflammatory response, the {mGPS} has been most extensively validated in patients with cancer. {METHODS}:: Data from 1000 consecutive patients undergoing potentially curative {CRC} resection from a single  institution (January 1997-May 2013) were included. The relationship between {mGPS}  [0-C-reactive protein ({CRP}) {\textless}/= 10 mg/L, 1-{CRP} {\textgreater} 10 mg/L and albumin {\textgreater}/=35 g/L,},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Park, James H. and Watt, David G. and Roxburgh, Campbell S. D. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2015-01-08},
	pmid = {25575264}
}

@article{wasan_use_2005,
	title = {Use of expandable metallic biliary stents in resectable pancreatic cancer},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16128952},
	abstract = {{AIM}: To compare the efficacy of metal versus plastic stents for biliary strictures in patients with surgically resectable pancreatic cancer. {METHODS}: The medical records at {MD} Anderson Caner Center from September 2001 to May 2004 were reviewed. Fifty-five patients were identified to have either a metal biliary stent (13 patients, group A) or a plastic biliary stent (42 patients, group B) and subsequently went to surgery. These two groups were compared with regards to number of stents placed prior to surgery, time period between the last stent and surgery, and operative and postoperative complications. {RESULTS}: Of the 13 patients in group A, 12 had pancreaticoduodenectomy performed and one had exploration only due to the peritoneal metastatses discovered at the time of surgery. Of the 12 patients with pancreaticoduodenectomy, 10 had pancreatic adenocarcinoma, 1 intraductal papillary mucinous tumor, and 1 ampullary cancer. Only 2 patients required an additional endoscopic retrograde cholangiopancreatography ({ERCP}) after initial metal stent placement until surgery. The average time between last stent placement and surgery was 106.5 days. Of the 42 patients in group B, 35 had pancreaticoduodenectomy and 7 had either palliative surgery or exploration due to metastatic diseases discovered at the time of surgery. Of the 35 patients, 27 had pancreatic adenocarcinoma, 5 ampullary cancer, 1 neuroendocrine tumor, 1 microcystic adenoma, and 1 autoimmune pancreatitis. Sixteen patients (38\%) in group B required 3 or more {ERCPs} with plastic stents prior to surgery. The average time between last stent placement and surgery was 56.4 days. Preoperative chemoradiation was given to all 13 patients in group A and 31 of 42 patients in group B. There were no stent-related intra- or postoperative complications in both groups. Two of 13 patients (15\%) with metal stents versus 39 of 42 patients (93\%) with plastic stents, however, developed either cholangitis or cholestasis due to stent occlusion while waiting for surgery. {CONCLUSIONS}: Contrary to the belief that metal stents are contraindicated for patients with surgically resectable pancreatic cancer, our study demonstrated that metal stents provided a longer patency rate, fewer {ERCP} sessions, and fewer episodes of cholangitis without adding any intra- or postoperative complications. Therefore, metal stents should be considered for patients with resectable pancreatic cancer, especially if surgery is not immediately planned as more patients are now receiving preoperative chemoradiation.},
	pages = {2056--61},
	number = {9},
	journaltitle = {Am J Gastroenterol},
	author = {Wasan, Sanjeev M and Ross, William A and Staerkel, Gregg A and Lee, Jeffrey H},
	date = {2005-09}
}

@article{raut_impact_2007,
	title = {Impact of Resection Status on Pattern of Failure and Survival After Pancreaticoduodenectomy for Pancreatic Adenocarcinoma},
	volume = {246},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1899216/},
	doi = {10.1097/01.sla.0000259391.84304.2b},
	abstract = {Pancreaticoduodenectomy for pancreatic adenocarcinoma was performed in 360 consecutive patients. A standardized system for the pathologic analysis of all surgical specimens was used. The presence of a microscopically positive margin of resection did not affect the pattern of first recurrence and, on multivariate analysis, did not impact survival duration.},
	pages = {52--60},
	number = {1},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Raut, Chandrajit P. and Tseng, Jennifer F. and Sun, Charlotte C. and Wang, Huamin and Wolff, Robert A. and Crane, Christopher H. and Hwang, Rosa and Vauthey, Jean-Nicolas and Abdalla, Eddie K. and Lee, Jeffrey E. and Pisters, Peter W. T. and Evans, Douglas B.},
	urldate = {2015-05-25},
	date = {2007-07},
	pmid = {17592291},
	pmcid = {PMC1899216},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZXW725SC\\Raut et al. - 2007 - Impact of Resection Status on Pattern of Failure a.pdf:application/pdf}
}

@article{sener_pancreatic_1999,
	title = {Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database},
	volume = {189},
	url = {http://www.sciencedirect.com/science/article/pii/S1072751599000757},
	shorttitle = {Pancreatic cancer},
	pages = {1--7},
	number = {1},
	journaltitle = {Journal of the American College of Surgeons},
	author = {Sener, Stephen F. and Fremgen, Amy and Menck, Herman R. and Winchester, David P.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Sener et al. - 1999 - Pancreatic cancer a report of treatment and survi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TE4VUVUM\\Sener et al. - 1999 - Pancreatic cancer a report of treatment and survi.pdf:application/pdf}
}

@article{tanner_fallacy_1949,
	title = {Fallacy of Per-Weight and Per-Surface Area Standards, and Their Relation to Spurious Correlation},
	volume = {2},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/2/1/1},
	pages = {1--15},
	number = {1},
	journaltitle = {Journal of Applied Physiology},
	author = {Tanner, J. M.},
	urldate = {2015-04-30},
	date = {1949-07-01},
	langid = {english},
	pmid = {18133122},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M58FG2XR\\1.html:text/html;Tanner - 1949 - Fallacy of Per-Weight and Per-Surface Area Standar.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7EH72UB3\\Tanner - 1949 - Fallacy of Per-Weight and Per-Surface Area Standar.pdf:application/pdf}
}

@article{mckeown_relationship_2004,
	title = {The relationship between circulating concentrations of C-reactive protein, inflammatory cytokines and cytokine receptors in patients with non-small-cell lung cancer.},
	volume = {91},
	doi = {10.1038/sj.bjc.6602248},
	abstract = {The relationship between circulating C-reactive protein concentrations and potential cytokine and receptor mediators (interleukin-6, leukaemia inhibitory factor ({LIF}), ciliary neurotrophic factor ({CNTF}), soluble {IL}-6 receptor, soluble  gp130, soluble {TNF} receptor, interleukin-1 receptor antagonist and interleukin-8  ({IL}-8)) of this acute phase protein were examined in healthy subjects (n=11) and  patients with non-small-cell lung cancer (n=50). Leukaemia inhibitory factor and  {CNTF} were below detection limits in all controls and patients. C-reactive protein, interleukin-6, soluble gp130, soluble {TNF} receptor, interleukin-1 receptor antagonist and {IL}-8 concentrations were significantly elevated in cancer patients (P{\textless} or =0.001). Cancer patients with elevated C-reactive protein concentrations had greater concentrations of interleukin-6 (P{\textless}0.01) and interleukin-1 receptor antagonist (P{\textless}0.05). On regression analysis only interleukin-6 was independently associated with C-reactive protein (r=0.616, P{\textless}0.001). Interleukin-6 is an important independent mediator of elevated},
	pages = {1993--1995},
	number = {12},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McKeown}, D. J. and Brown, D. J. F. and Kelly, A. and Wallace, A. M. and {McMillan}, D. C.},
	date = {2004-12-13},
	pmid = {15570310},
	pmcid = {PMC2410147},
	keywords = {Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung/*blood, C-Reactive Protein/*analysis, Cytokines/*blood, Enzyme-Linked Immunosorbent Assay, Female, Humans, Lung Neoplasms/*blood, Male, Middle Aged, Receptors, Cytokine/*blood, Tumor Markers, Biological/*blood}
}

@article{sohn_preoperative_2000,
	title = {Do preoperative biliary stents increase postpancreaticoduodenectomy complications?},
	volume = {4},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10769088},
	abstract = {It has been suggested that the placement of endoscopic or percutaneous biliary stents prior to pancreaticoduodenectomy increases postoperative morbidity. A retrospective review of a prospectively collected database was performed. Patients undergoing preoperative biliary stenting were compared with patients who did not undergo stenting. In addition, outcomes after endoscopic and percutaneous stenting were compared. Patients who had undergone operative biliary bypass prior to pancreaticoduodenectomy were excluded from the analysis. Between January 1994 and December 1997, 567 patients underwent pancreaticoduodenectomy without prior operative biliary bypass. Preoperative biliary stenting was performed in 408 patients (72\%), whereas the remaining 159 patients (28\%) did not undergo biliary stenting. In the stented group, 64\% had stents placed via a percutaneous approach and 36\% had stents placed endoscopically. The stented patients were older (mean 63.1 years vs. 61.4 years; P = 0.05) and were more likely to be white (92\% vs. 82\%; P = 0.005). Those who had stents placed were more likely to have jaundice (67\% vs. 38\%; P {\textless}0.0001) and fever (5\% vs. 1\%; P = 0.03) as presenting symptoms. There were no differences in multiple intraoperative parameters when the two groups were compared. Patients who had stents placed had a perioperative mortality rate of 1.7\% compared to 2.5\% in those who did not (P = 0.3). Although the overall complication rates were 35\% in those who had stents placed and 30\% in those who did not (P = {NS}), patients with stents experienced a significantly increased incidence of pancreatic fistula (10\% vs. 4\%; P = 0.02) and wound infection (10\% vs. 4\%; P = 0.02). The incidences of other postoperative complications were similar between the stented and unstented groups. Eight patients (3\%) in the percutaneously stented group developed significant hemobilia after stent placement, whereas none of the patients undergoing endoscopic stent placement developed hemobilia (P = 0.03). There were no statistical differences in other complications between the percutaneously and endoscopically stented groups. Preoperative biliary stenting did not increase the overall complication rate or mortality rate in patients undergoing pancreaticoduodenectomy. Stenting does appear to increase the rate of pancreatic fistula formation, possibly as a result of pancreatic inflammation related to the stenting procedure. Stenting also increases the rate of wound infection, likely secondary to contaminated bile (bactibilia) after instrumentation of the biliary tree. Preoperative biliary stenting is safe but should be used selectively because of the above-mentioned risks. The method of stenting should be based on local expertise.},
	pages = {258--67; discussion 267--8},
	number = {3},
	journaltitle = {J Gastrointest Surg},
	author = {Sohn, T A and Yeo, C J and Cameron, J L and Pitt, H A and Lillemoe, K D},
	date = {2000-06}
}

@article{connor_minimally_2003,
	title = {Minimally invasive retroperitoneal pancreatic necrosectomy},
	volume = {20},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12748429},
	abstract = {Open surgery for pancreatic necrosis is associated with considerable morbidity and mortality. We report the results of a recently developed minimally invasive technique that we adopted in 1998.},
	pages = {270--7},
	number = {4},
	journaltitle = {Dig Surg},
	author = {Connor, S and Ghaneh, P and Raraty, M and Sutton, R and Rosso, E and Garvey, C J and Hughes, M L and Evans, J C and Rowlands, P and Neoptolemos, J P},
	date = {2003}
}

@article{bradshaw_identification_1995,
	title = {Identification of free radicals produced in rat erythrocytes exposed to hemolytic concentrations of phenylhydroxylamine.},
	volume = {18},
	abstract = {Previous studies have shown that incubation of rat red blood cells in vitro with  phenylhydroxylamine (50-300 {microM}) induces rapid splenic sequestration of the red cells on reintroduction to isologous rats. {EPR} and the spin trapping agent, 5,5-dimethyl-1-pyrroline-N-oxide ({DMPO}), were utilized to determine if free radical species could be identified under these experimental conditions. Hemolytic concentrations of phenylhydroxylamine, in the presence of {DMPO} and},
	pages = {279--285},
	number = {2},
	journaltitle = {Free radical biology \& medicine},
	shortjournal = {Free Radic Biol Med},
	author = {Bradshaw, T. P. and {McMillan}, D. C. and Crouch, R. K. and Jollow, D. J.},
	date = {1995-02},
	pmid = {7744312},
	keywords = {*Hemolysis, Animals, Cyclic N-Oxides/blood, Dose-Response Relationship, Drug, Electron Spin Resonance Spectroscopy, Erythrocyte Count, Erythrocytes/drug effects/*metabolism, Free Radicals, Glutathione/blood, Hydroxylamines/administration \& dosage/*pharmacology, Kinetics, Male, Rats, Rats, Sprague-Dawley, Spin Labels}
}

@article{hirazawa_depressed_1999,
	title = {Depressed cytotoxic activity of hepatic nonparenchymal cells in rats with obstructive jaundice},
	volume = {126},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10568190},
	abstract = {{BACKGROUND}: The nonparenchymal cells ({NPC}) of the liver have strong cytotoxic activity. Our hypothesis is that their activity may be imparted by obstructive jaundice and show recovery after biliary drainage. {METHODS}: In Donryu rats, we performed either a sham operation (group C; n = 5), production of irreversible obstructive jaundice (group J; n = 5), or production of reversible obstructive jaundice for 7 days, with biliary drainage then provided for 3 days (group Ds; n = 5) or for 14 days (group Dl; n = 5). Natural killer ({NK})-cell activities shown against {YAC}-1 lymphoma cells of hepatic {NPC} and peripheral blood mononuclear cells were assessed. We then measured the growth of experimental liver metastases 13 days after inoculation of a tumor cell line ({AH}130) into the portal vein of rats that had undergone similar biliary manipulations (group {mC}, group {mJ}, group {mDs}, and group {mDl}; n = 5 in each group). {RESULTS}: The highest number of {NK} activities by {NPC} in group J (11.5\%) and group Ds (37.7\%) were significantly lower than those in group C (68.8\%) and group Dl (90.5\%; effector/target ratios, 40:1; P {\textless} .01). {NK} activity of peripheral blood mononuclear cells was similar among groups. Metastatic liver tumors in group {mJ} (10.2\% +/- 2.6\%) and group {mDs} (5.4\% +/- 1.5\%) were significantly larger than in group {mC} (0.4\% +/- 0.1\%) and group {mDl} (0.5\% +/- 0.3\%; P {\textless} .02). {CONCLUSIONS}: Obstructive jaundice depressed the {NK} activity of hepatic {NPC} and enhanced the growth of liver metastases. To counter this depression, adequate biliary drainage was required. These results suggest that preoperative biliary drainage to relieve obstructive jaundice might help to prevent liver metastases after surgery for biliary tract or pancreatic tumors.},
	pages = {900--7},
	number = {5},
	journaltitle = {Surgery},
	author = {Hirazawa, K and Hazama, S and Oka, M},
	date = {1999-11}
}

@article{kemp_evaluation_2008,
	title = {Evaluation of the mitochondrial respiration of cardiac myocytes in rats submitted to mechanical bile duct obstruction},
	volume = {23 Suppl 1},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18516451},
	abstract = {{PURPOSE}: The objective of the present study was to evaluate the capacity of the myocardium for energy production by the analysis of mitochondrial respiration in rats with jaundice submitted to bile duct ligature. {METHODS}: Sixteen male Wistar rats were divided into 2 Groups: Group {SO} submitted to nontherapeutic laparotomy (sham operation) and Group {IC} (icteric group) submitted to bile duct ligature. After 7 days, laparotomy was again performed in all animals for cardiac muscle extraction and analysis. Mitochondrial oxygen consumption was determined by stage 3 velocity and stage 4 velocity. The respiratory control ratio ({RCR}) was obtained by the ratio of stage 3 to stage 4 velocity. Statistical analysis was performed by the Mann-Whitney test, with the level of significance set at 5\% (p{\textless}0.05). {RESULTS}: Statistical analysis revealed a significant drop in oxygen consumption during stage 3 mitochondrial respiration in group {IC} compared with {SO}, whereas the values obtained during stage 4 were basically identical for the two groups. Likewise, {RCR} values exhibited a significant reduction. {CONCLUSION}: The cellular respiration of the "jaundiced heart" is depressed. This was demonstrated by the reduced capacity of cardiac mitochondria to consume oxygen and synthesize {ATP}, supporting the idea of a latent cardiac impairment responsible for the hemodynamic decompensation occurring during cholestasis.},
	pages = {66--71; discussion 71},
	journaltitle = {Acta Cir Bras},
	author = {Kemp, Rafael and Castro-e-Silva, Orlando de and Santos, José Sebastião dos and Sankarankutty, Ajith Kumar and Correa, Rodrigo Borges and Baldo, Caroline Floreoto and Souza, Maria Elisa Jordani and Jordani, Maria Cecilia},
	date = {2008},
	note = {Cited 0 times},
	file = {Kemp et al. - 2008 - Evaluation of the mitochondrial respiration of car.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VZ7MKX3S\\Kemp et al. - 2008 - Evaluation of the mitochondrial respiration of car.pdf:application/pdf}
}

@article{vaz_pro-inflammatory_2011,
	title = {Pro-inflammatory cytokines intensify the activation of {NO}/{NOS}, {JNK}1/2 and caspase cascades in immature neurons exposed to elevated levels of unconjugated bilirubin},
	volume = {229},
	issn = {00144886},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0014488611000872},
	doi = {10.1016/j.expneurol.2011.03.004},
	pages = {381--390},
	number = {2},
	journaltitle = {Experimental Neurology},
	author = {Vaz, Ana R. and Silva, Sandra L. and Barateiro, Andreia and Fernandes, Adelaide and Falcão, Ana S. and Brito, Maria A. and Brites, Dora},
	urldate = {2014-01-27},
	date = {2011-06},
	file = {Vaz et al. - 2011 - Pro-inflammatory cytokines intensify the activatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\77KSK7WR\\Vaz et al. - 2011 - Pro-inflammatory cytokines intensify the activatio.pdf:application/pdf}
}

@article{kausch_carcinom_1912,
	title = {Das carcinom der papilla duodeni und seine radikale Entfeinung},
	pages = {439--486},
	number = {78},
	journaltitle = {Beitr Z Clin Chir},
	shortjournal = {Beitr Z Clin Chir},
	author = {Kausch, W},
	date = {1912}
}

@article{taggart_effect_1991,
	title = {Effect of surgical injury and intraoperative hypothermia on whole body protein metabolism.},
	volume = {260},
	abstract = {Whole body protein turnover and urinary nitrogen and 3-methyl-L-histidine (3-{MH})  excretion were measured before and after cardiac surgery using cardiopulmonary bypass in 20 male patients randomized to an intraoperative blood temperature of 28 or 20 degrees C. Rates of whole body protein synthesis ({WBPS}) and breakdown ({WBPB}) were determined from the 15N isotopic enrichment of urinary urea, ammonium, and from a calculated end-product average ({EPA}) after a primed 24-h infusion of [15N]glycine. In the postoperative period, there was a 40\% increase in median nitrogen excretion in the 28 degrees C group (P less than 0.03) and a 22\% increase in the 20 degrees C group (P = 0.10). There was a 79\% increase in the median postoperative 3-{MH} excretion in the 28 degrees C group (P = 0.01) and  a 66\% increase in the median postoperative 3-{MH} excretion in the 20 degrees C group (P less than 0.01). Postoperatively, there was a 23\% fall in the median value of {WBPS} in the 28 degrees C group (P less than 0.01) and an 11\% fall in the 20 degrees C group [not significant ({NS})] measured by 15N enrichment of urinary urea. In contrast, when {WBPS} was measured from isotopic enrichment of urinary ammonium, there was an increase in the median value of the postoperative rates of {WBPS} in both groups, by 20\% in the 28 degrees C group (P = {NS}) and 29\% in the 20  degrees C group (P = 0.03). There was no significant change in the rate of {WBPS} and {WBPB}, judged by the postoperative {EPA} in either group.({ABSTRACT} {TRUNCATED} {AT}  250 {WORDS})},
	pages = {E118--125},
	number = {1},
	journaltitle = {The American journal of physiology},
	shortjournal = {Am J Physiol},
	author = {Taggart, D. P. and {McMillan}, D. C. and Preston, T. and Shenkin, A. and Wheatley, D. J. and Burns, H. J.},
	date = {1991-01},
	pmid = {1987786},
	keywords = {*Coronary Artery Bypass, *Hypothermia, Induced, Adult, Glycine/metabolism, Humans, Male, Methylhistidines/urine, Middle Aged, Nitrogen Isotopes, Nitrogen/metabolism, Proteins/*metabolism}
}

@article{mcmillan_effect_2003,
	title = {The effect of deprivation and the systemic inflammatory response on outcome following curative resection for colorectal cancer.},
	volume = {89},
	doi = {10.1038/sj.bjc.6601156},
	abstract = {The presence of a systemic inflammatory response predicted cancer-specific ({HR} 2.55, 95\% {CI} 1.22-5.32, P{\textless}0.05) and overall survival ({HR} 2.12, 95\% {CI} 1.17-3.87,  P{\textless}0.05), independent of Dukes stage, in patients who had undergone apparently curative surgery for colorectal cancer (n=158). Deprivation predicted overall survival ({HR} 1.26, 95\% {CI} 1.04-1.51, P{\textless}0.05) independent of Dukes stage.},
	pages = {612--614},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and Canna, K. and {McArdle}, C. S.},
	date = {2003-08-18},
	pmid = {12915865},
	pmcid = {PMC2376934},
	keywords = {*Poverty, Aged, Colorectal Neoplasms/blood/mortality/*surgery, C-Reactive Protein/analysis, Female, Follow-Up Studies, Humans, Male, Neoplasm Staging, Prognosis, Survival Rate, Time Factors, Treatment Outcome}
}

@article{krachler_cardiopulmonary_2014,
	title = {Cardiopulmonary fitness is a function of lean mass, not total body weight: The {DR}’s {EXTRA} study},
	issn = {2047-4873, 2047-4881},
	url = {http://cpr.sagepub.com/content/early/2014/11/07/2047487314557962},
	doi = {10.1177/2047487314557962},
	shorttitle = {Cardiopulmonary fitness is a function of lean mass, not total body weight},
	abstract = {Background Division by total body weight is the usual way to standardise peak oxygen uptake (peak {VO}2) for body size. However, this method systematically underestimates cardiopulmonary fitness in obese individuals. Our aim was to analyse whether lean-mass is a better base for a body mass-independent standard of cardiopulmonary fitness.
Methods A population based sample of 578 men (body mass index ({BMI}) 19–47 kg/m2) and 592 women ({BMI} 16–49 kg/m2) 57–78 years of age. Peak {VO}2 was assessed by respiratory gas analysis during a maximal exercise test on a cycle ergometer. We studied the validity of the weight-ratio and the lean mass-ratio standards in a linear regression model.
Results The weight-ratio standard implies an increase of peak {VO}2 per additional kg body weight with 20.7 ml/min (95\% confidence interval ({CI}): 20.3–21.1) in women and 26.9 ml/min (95\% {CI}: 26.4–27.5) in men. The observed increase per kg is only 8.5 ml/min (95\% {CI}: 6.5–10.5) in men and 10.4 ml/min (95\% {CI}: 7.5–13.4) in women. For the lean mass-ratio standard expected and observed increases in peak {VO}2 per kg lean mass were 32.3 (95\% {CI}: 31.8–32.9) and 34.6 (95\% {CI}: 30.0–39.1) ml/min for women and 36.2 (95\% {CI}: 35.6–36.8) and 37.3 (95\% {CI}: 32.1–42.4) ml/min in men. The lean mass-ratio standard is a body mass-independent measure of cardiopulmonary fitness in 100\% of women and 58\% of men; corresponding values for the weight-ratio standard were 11\% and 16\%.
Conclusions For comparisons of cardiopulmonary fitness across different categories of body mass, the lean mass-ratio standard should be used.},
	pages = {2047487314557962},
	journaltitle = {European Journal of Preventive Cardiology},
	shortjournal = {European Journal of Preventive Cardiology},
	author = {Krachler, Benno and Savonen, Kai and Komulainen, Pirjo and Hassinen, Maija and Lakka, Timo A. and Rauramaa, Rainer},
	urldate = {2015-05-02},
	date = {2014-11-07},
	langid = {english},
	pmid = {25381337},
	keywords = {Body Composition, cardiopulmonary fitness, cardiorespiratory fitness, Exercise capacity, exercise physiology, exercise testing},
	file = {Krachler et al. - 2014 - Cardiopulmonary fitness is a function of lean mass.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NK2KVKT5\\Krachler et al. - 2014 - Cardiopulmonary fitness is a function of lean mass.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\B6CFFGUJ\\2047487314557962.html:text/html}
}

@article{brown_relationship_2007,
	title = {The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer.},
	volume = {60},
	doi = {10.1136/jcp.2005.033217},
	abstract = {{BACKGROUND}: The Glasgow Prognostic Score ({GPS}), an inflammation-based prognostic  score formed from standard thresholds of C reactive protein ({CRP}) and albumin, has prognostic value in patients with advanced cancer. Little is known about the  general biochemical disturbance associated with the systemic inflammatory response in cancer. {AIM}: To examine the relationship between the {GPS} and blood biochemistry in patients with advanced lung and gastrointestinal cancer. {METHODS}: The {GPS} (albumin {\textless}35 g/l = 1 and {CRP} {\textgreater}10 mg/l = 1 combined to form a prognostic score of 0 (normal) and 1 or 2 (abnormal)) and a variety of biochemical variables were examined in patients (n = 50) with advanced lung or gastrointestinal cancer  and in a healthy control group (n = 13). {RESULTS}: The {GPS} was normal in all the controls, but abnormal in 78\% of the cancer group. Serum levels of sodium, chloride, creatine kinase, zinc and vitamin D were lower in the cancer group (all p{\textless}0.01), whereas levels of calcium, copper (both p{\textless}0.05), alkaline phosphatase, gamma-glutamyl transferase (both p{\textless}0.001) and lactate dehydrogenase (p{\textless}0.10) were raised. In the patient group, with increasing {GPS}, there was a median reduction in Karnofsky Performance Status (25\%), haemoglobin (22\%), sodium (3\%), zinc (15\%) and survival (93\%, all p{\textless}0.05) and a median increase in white cell count (129\%),  alkaline phosphatase (217\%), gamma-glutamyl transferase (371\%) and lactate dehydrogenase (130\%, all p{\textless}0.05). {CRP} levels were strongly and similarly correlated with alkaline phosphatase and gamma-glutamyl transferase, accounting for more than 25\% of the variation in their activities. {CONCLUSION}: Several correlations were seen between biochemical variables and increasing {GPS}. In particular, chronic activation of the systemic inflammatory response in cancer was associated with increase in gamma-glutamyl transferase and alkaline phosphatase activity in patients with advanced lung and gastrointestinal cancer.},
	pages = {705--708},
	number = {6},
	journaltitle = {Journal of clinical pathology},
	shortjournal = {J Clin Pathol},
	author = {Brown, D. J. F. and Milroy, R. and Preston, T. and {McMillan}, D. C.},
	date = {2007-06},
	pmid = {16644880},
	pmcid = {PMC1955069},
	keywords = {Adult, Aged, Aged, 80 and over, Alkaline Phosphatase/blood, C-Reactive Protein/analysis, Female, gamma-Glutamyltransferase/blood, Gastrointestinal Neoplasms/blood/*complications, Humans, Lung Neoplasms/blood/*complications, Male, Middle Aged, Prognosis, Serum Albumin/analysis, Severity of Illness Index, Systemic Inflammatory Response Syndrome/blood/*etiology, Tumor Markers, Biological/*blood}
}

@article{winter_does_2006,
	title = {Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114014},
	abstract = {Pancreatic duct stenting remains an attractive strategy to reduce the incidence of pancreatic fistulas following pancreaticoduodenectomy ({PD}) with encouraging results in both retrospective and prospective studies. We performed a prospective randomized trial to test the hypothesis that internal pancreatic duct stenting reduces the development of pancreatic fistulas following {PD}. Two hundred thirty-eight patients were randomized to either receive a pancreatic stent (S) or no stent ({NS}), and stratified according to the texture of the pancreatic remnant (soft/normal versus hard). Four patients were excluded from the study; in three instances due to a pancreatic duct that was too small to cannulate and in the other instance because a total pancreatectomy was performed. Patients who randomized to the S group had a 6-cm-long segment of a plastic pediatric feeding tube used to stent the pancreaticojejunostomy anastomosis. In patients with a soft pancreas, 57 randomized to the S group and 56 randomized to the {NS} group. In patients with a hard pancreas, 58 randomized to the S group and 63 randomized to the {NS} group. The S and {NS} groups for the entire study population, as well as for the subgroup of high-risk patients with soft pancreata, were similar as regard to demographics, past medical history, preoperative symptoms, preoperative procedures, and intraoperative data. The pancreatic fistula rate for the entire study population was 9.4\%. The fistula rates in the S and {NS} subgroups with hard pancreata were similar, at 1.7\% and 4.8\% (P = 0.4), respectively. The fistula rates in the S and {NS} subgroups with soft pancreata were also similar, at 21.1\% and 10.7\% (P = 0.1), respectively. A nonstatistically significant increase in the pancreatic fistula rate in the S group persisted after adjusting for the operating surgeon and technical details of the operation (e.g., anastomotic technique, anastomotic orientation, pancreatic duct size, and number of intra-abdominal drains placed). In patients with soft pancreata, 63\% percent of the pancreatic fistulas in stented patients required adjustment to the clinical pathway (including two deaths), compared to 47\% of the pancreatic fistulas in patients in the {NS} group (P = 0.3). Internal pancreatic duct stenting does not decrease the frequency or the severity of postoperative pancreatic fistulas.},
	pages = {1280--90; discussion 1290},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Chang, David C and Riall, Taylor S and Schulick, Richard D and Choti, Michael A and Coleman, {JoAnn} and Hodgin, Mary B and Sauter, Patricia K and Sonnenday, Christopher J and Wolfgang, Christopher L and Marohn, Michael R and Yeo, Charles J},
	date = {2006-11}
}

@article{moller_colorectal_2012,
	title = {Colorectal cancer survival in socioeconomic groups in England: Variation is mainly in the short term after diagnosis},
	volume = {48},
	doi = {10.1016/j.ejca.2011.05.018},
	shorttitle = {Colorectal cancer survival in socioeconomic groups in England},
	abstract = {The objective of this study was to examine differences in cancer survival between socioeconomic groups in England, with particular attention to survival in the short term of follow-up. Patients and methods: Individuals diagnosed with colorectal cancer between 1996 and 2004 in England were identified from cancer registry records. Five-year cumulative relative survival and excess death rates were computed. Results: For colon cancer there was a very high excess death rate in the first month of follow-up, and the excess death rate was highest in the socioeconomically deprived groups. In subsequent periods, excess mortality rates were much lower and there was less socioeconomic variation. The pattern of variation in excess death rates was generally similar in rectal cancer but the socioeconomic difference in death rates persisted several years longer. If the excess death rates in the entire colorectal cancer patient population were the same as those observed in the most affluent socioeconomic quintile, the annual reduction would be 360 deaths in colon cancer and 336 deaths in rectal cancer patients. These deaths occurred almost entirely in the first month and the first year after diagnosis. Conclusion: Recent developments in the national cancer control agenda have included an increasing emphasis on outcome measures, with short-term cancer survival an operational measure of variation and progress in cancer control. In providing clues to the nature of the survival differences between socioeconomic groups, the results presented here give strong support for this strategy. (C) 2011 Elsevier Ltd. All rights reserved.},
	pages = {46--53},
	number = {1},
	journaltitle = {European Journal of Cancer},
	author = {Moller, Henrik and Sandin, Fredrik and Robinson, David and Bray, Freddie and Klint, Asa and Linklater, Karen M. and Lambert, Paul C. and Pahlman, Lars and Holmberg, Lars and Morris, Eva},
	date = {2012-01},
	note = {{WOS}:000299866200006}
}

@article{oliphant_contribution_2013,
	title = {Contribution of surgical specialization to improved colorectal cancer survival.},
	volume = {100},
	rights = {(c) 2013 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons Ltd.},
	doi = {10.1002/bjs.9227},
	abstract = {{BACKGROUND}: Reorganization of colorectal cancer services has led to surgery being increasingly, but not exclusively, delivered by specialist surgeons. Outcomes from colorectal cancer surgery have improved, but the exact determinants remain unclear. This study explored the determinants of outcome after colorectal cancer  surgery over time. {METHODS}: Postoperative mortality (within 30 days of surgery) and 5-year relative survival rates for patients in the West of Scotland undergoing surgery for colorectal cancer between 1991 and 1994 were compared with rates for those having surgery between 2001 and 2004. {RESULTS}: The 1823 patients  who had surgery in 2001-2004 were more likely to have had stage I or {III} tumours, and to have undergone surgery with curative intent than the 1715 patients operated on in 1991-1994. The proportion of patients presenting electively who received surgery by a specialist surgeon increased over time (from 14.9 to 72.8 per cent; P {\textless} 0.001). Postoperative mortality increased among patients treated by non-specialists over time (from 7.4 to 10.3 per cent; P = 0.026). Non-specialist  surgery was associated with an increased risk of postoperative death (adjusted odds ratio 1.72, 95 per cent confidence interval (c.i.) 1.17 to 2.55; P = 0.006)  compared with specialist surgery. The 5-year relative survival rate increased over time and was higher among those treated by specialist compared with non-specialist surgeons (62.1 versus 53.0 per cent; P {\textless} 0.001). Compared with the earlier period, the adjusted relative excess risk ratio for the later period was  0.69 (95 per cent c.i. 0.61 to 0.79; P {\textless} 0.001). Increased surgical specialization accounted for 18.9 per cent of the observed survival improvement.  {CONCLUSION}: Increased surgical specialization contributed significantly to the observed improvement in longer-term survival following colorectal cancer surgery.},
	pages = {1388--1395},
	number = {10},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Oliphant, R. and Nicholson, G. A. and Horgan, P. G. and Molloy, R. G. and {McMillan}, D. C. and Morrison, D. S.},
	date = {2013-09},
	pmid = {23939852},
	keywords = {*Colorectal Surgery, *Specialization, Adult, Aged, Anastomotic Leak/mortality, Colonic Neoplasms/*mortality/surgery, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Mortality/trends, Rectal Neoplasms/*mortality/surgery, Scotland/epidemiology, Socioeconomic Factors, Survival Analysis, Treatment Outcome}
}

@article{mayo_impact_2011,
	title = {Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery},
	volume = {150},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21878237},
	abstract = {{BACKGROUND}: Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. {METHODS}: This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. {RESULTS}: We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33\% improved their physical function, 38\% stayed within 20 m of their baseline score, and 29\% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have recovered to their baseline walking capacity than those with no change or deterioration (77\% vs 59\% and 32\%; P = .0007). Patients who deteriorated were at greater risk of complications requiring reoperation and/or intensive care management. Significant predictors of poorer recovery included deterioration during prehabilitation, age {\textgreater}75 years, high anxiety, complications requiring intervention, and timing of follow-up assessment. {CONCLUSION}: In a group of patients undergoing scheduled colorectal surgery, meaningful changes in functional capacity can be achieved over several weeks of prehabilitation. Patients and those who care for them, especially those with poor physical capacity, should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy.},
	pages = {505--14},
	number = {3},
	journaltitle = {Surgery},
	author = {Mayo, Nancy E and Feldman, Liane and Scott, Susan and Zavorsky, Gerald and Kim, Do Jun and Charlebois, Patrick and Stein, Barry and Carli, Francesco},
	date = {2011-09},
	file = {Mayo et al. - 2011 - Impact of preoperative change in physical function.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\II3ZMMSU\\Mayo et al. - 2011 - Impact of preoperative change in physical function.pdf:application/pdf}
}

@article{mackay_c-reactive_2011,
	title = {C-reactive protein as a predictor of postoperative infective complications following elective colorectal resection: {CRP} predicting infective complications},
	volume = {13},
	issn = {14628910},
	url = {http://doi.wiley.com/10.1111/j.1463-1318.2010.02236.x},
	doi = {10.1111/j.1463-1318.2010.02236.x},
	shorttitle = {C-reactive protein as a predictor of postoperative infective complications following elective colorectal resection},
	pages = {583--587},
	number = {5},
	journaltitle = {Colorectal Disease},
	author = {{MacKay}, G. J. and Molloy, R. G. and O’Dwyer, P. J.},
	urldate = {2015-07-04},
	date = {2011-05},
	langid = {english},
	file = {MacKay et al. - 2011 - C-reactive protein as a predictor of postoperative.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4BIHHGNX\\MacKay et al. - 2011 - C-reactive protein as a predictor of postoperative.pdf:application/pdf}
}

@article{gonzalez_obesity_2014,
	title = {Obesity paradox in cancer: new insights provided by body composition},
	volume = {99},
	issn = {0002-9165, 1938-3207},
	url = {http://ajcn.nutrition.org/content/99/5/999},
	doi = {10.3945/ajcn.113.071399},
	shorttitle = {Obesity paradox in cancer},
	abstract = {Background: Obesity, defined by body mass index ({BMI}), appears to have a paradoxical protective effect in several chronic diseases.
Objective: We investigated the obesity paradox in cancer patients by using body composition.
Design: The study was an observational study of 175 cancer patients assessed before chemotherapy. Obesity was defined as {BMI} (in kg/m2) ≥30 or fat mass index ({FMI}; fat mass divided by the square of height) ≥5.2 (men) and ≥8.2 (women) measured by using a bioelectrical impedance analysis. Low muscle mass (sarcopenia) was defined as fat-free mass index (fat-free mass divided by the square of height) {\textless}17.5 (men) and {\textless}15.1 (women).
Results: Most patients were women (65.7\%) and had a mean (±{SD}) age of 56.9 ± 12.8 y. According to {BMI} criteria, 60\% of patients were overweight or obese. The median survival time for overweight (2.64 y; range: 0.23–3.16 y) and obese (2.61 y; range: 0.26–3.20 y) patients was significantly higher than for patients with a normal (2.04 y; range: 0.06–3.05 y) or low (0.52 y; range: 0.19–0.98 y) {BMI} (P {\textless} 0.001). Sarcopenic patients had shorter survival, regardless of their {FMI}. Obesity predicted higher survival rates only when sarcopenia was absent. In a multivariate Cox regression model, sarcopenia was an independent predictor of higher mortality ({HR}: 5.19; 95\% {CI}: 2.58, 10.43) after we controlled for {BMI}, age, and tumor stage.
Conclusions: The obesity paradox is present in cancer patients only when obesity is defined by {BMI}. Patients with sarcopenic obesity had the poorest prognosis. Cancer patients with high mortality risk can be identified by a body-composition assessment.},
	pages = {999--1005},
	number = {5},
	journaltitle = {The American Journal of Clinical Nutrition},
	shortjournal = {Am J Clin Nutr},
	author = {Gonzalez, Maria Cristina and Pastore, Carla A. and Orlandi, Silvana P. and Heymsfield, Steven B.},
	urldate = {2015-08-08},
	date = {2014-05-01},
	langid = {english},
	pmid = {24572565},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\78TCC34B\\Gonzalez et al. - 2014 - Obesity paradox in cancer new insights provided b.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IIQJX7MB\\999.html:text/html}
}

@article{steeg_tumor_2006,
	title = {Tumor metastasis: mechanistic insights and clinical challenges},
	volume = {12},
	rights = {© 2006 Nature Publishing Group},
	issn = {1078-8956},
	url = {http://www.nature.com/nm/journal/v12/n8/full/nm1469.html},
	doi = {10.1038/nm1469},
	shorttitle = {Tumor metastasis},
	abstract = {Metastatic disease is the primary cause of death for most cancer patients. Complex and redundant pathways involving the tumor cell and the microenvironment mediate tumor invasion at the primary site, survival and arrest in the bloodstream, and progressive outgrowth at a distant site. Understanding these pathways and their dynamic interactions will help identify promising molecular targets for cancer therapy and key obstacles to their clinical development.},
	pages = {895--904},
	number = {8},
	journaltitle = {Nature Medicine},
	shortjournal = {Nat Med},
	author = {Steeg, Patricia S.},
	urldate = {2015-05-27},
	date = {2006-08},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JD2TDHP7\\Steeg - 2006 - Tumor metastasis mechanistic insights and clinica.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\INZUHKKQ\\nm1469.html:text/html}
}

@article{emick_hospital_2006,
	title = {Hospital readmission after pancreaticoduodenectomy},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114011},
	abstract = {Data exist on the morbidity and mortality of patients undergoing pancreaticoduodenectomy ({PD}), but there are few reports about hospital readmissions after this procedure. Our aim was to evaluate the number of and reasons for readmission after {PD} and the factors influencing readmission. We reviewed the initial hospitalization and readmissions for 1643 patients undergoing {PD} compared patients requiring readmission to patients that did not require readmission. Twenty-six percent of patients were readmitted a total of 678 times after {PD}. Patients readmitted were younger than those not readmitted (61.8 versus 64.6 years, P {\textless} 0.0001). Vessel resection, abscess formation, wound infection, postoperative percutaneous biliary stents, estimated blood loss {\textgreater}1000 ml, and age {\textless} or =65 years were independently associated with readmission. The length of stay for all patients decreased over time, from 10.5 days in 1996 to 7 days in 2003. The percentage of patients being readmitted also decreased from 33\% in 1996 to 20\% (P = 0.004) in 2003. The readmission rate after {PD} was 26\%. Younger age, blood loss, postoperative complications, and vessel resection were independent risk factors for readmission. The early hospital readmission rate has not increased in association with a decreased {LOS}, supporting the idea that reduction in {LOS} did not lead to increased readmission rates.},
	pages = {1243--52; discussion 1252--3},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Emick, Dawn M and Riall, Taylor S and Cameron, John L and Winter, Jordan M and Lillemoe, Keith D and Coleman, Joann and Sauter, Patricia K and Yeo, Charles J},
	date = {2006-11}
}

@article{roxburgh_clinical_2014,
	title = {The clinical utility of the combination of T stage and venous invasion to predict survival in patients undergoing surgery for colorectal cancer.},
	volume = {259},
	doi = {10.1097/SLA.0000000000000229},
	abstract = {{OBJECTIVE}: To examine the clinical utility of improved detection of venous invasion ({VI}) in patients undergoing potentially curative resection of colorectal cancer. {BACKGROUND}: {VI} is a feature of colorectal cancer ({CRC}) progression. Elastica staining can be used to improve detection of {VI} and correspondingly its  prediction of patient survival. {METHODS}: A single-center, observational study of  pathology variables, including detection of {VI} by staining for elastica, using 631 stage I to {III} {CRC} specimens, collected from 1997 to 2009 (176 analyzed retrospectively and 455 analyzed prospectively), was performed. {RESULTS}: {VI} was detected in 56\% of patients with {CRC}. Over a median follow-up period of 73 months, 238 patients died (134 from cancer). On multivariate analysis, {VI} by elastica staining was associated with a shorter survival duration, independent of other pathology features, in all cases [hazard ratio ({HR}) = 3.94, 95\% confidence  interval ({CI}): 2.33-6.65, P {\textless} 0.001] and in node-negative cases ({HR} = 3.55, 95\% {CI}: 1.81-6.97; P {\textless} 0.001). In the absence of elastica-detected {VI}, with the exception of T stage, no other pathology features were associated with survival time. Therefore, the combination of T stage and {VI} ({TVI}) on survival was examined. Five-year cancer mortality could be stratified between 100\% and 54\% for patients with node-negative tumors and between 100\% and 33\% for patients with node-positive tumors. In all cases, the {TVI} had similar predictive value as that  of T stage and node status ({TNM}). In node-negative disease, {TVI} had superior predictive value. {CONCLUSIONS}: The results of the present study have prompted the development of a novel tumor staging system based on {TVI}. The {TVI} has clinical utility, especially in node-negative disease, in predicting outcome following curative resection for {CRC}.},
	pages = {1156--1165},
	number = {6},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Roxburgh, Campbell S. D. and {McMillan}, Donald C. and Richards, Colin H. and Atwan, Manal and Anderson, John H. and Harvey, Tim and Horgan, Paul G. and Foulis, Alan K.},
	date = {2014-06},
	pmid = {24100338},
	keywords = {*Colectomy, *Veins, Aged, Colorectal Neoplasms/mortality/*pathology/surgery, Female, Follow-Up Studies, Great Britain/epidemiology, Humans, Laparotomy, Male, Neoplasm Invasiveness, Neoplasm Staging/*utilization, Prognosis, Retrospective Studies, Survival Rate/trends, Time Factors, Vascular Neoplasms/*pathology/surgery}
}

@article{rodrigues_bilirubin_2000-1,
	title = {Bilirubin and amyloid-b peptide induce cytochrome c release through mitochondrial membrane permeabilization},
	volume = {6},
	url = {http://www.researchgate.net/publication/12180966_Bilirubin_and_amyloid-beta_peptide_induce_cytochrome_c_release_through_mitochondrial_membrane_permeabilization/file/79e4150b8d435b3c63.pdf},
	pages = {936--46},
	number = {11},
	journaltitle = {Mol Med},
	author = {Rodrigues, Cecília {MP} and Solá, Susana and Silva, Rui and Brites, Dora},
	urldate = {2014-01-27},
	date = {2000},
	file = {Rodrigues et al. - 2000 - Bilirubin and amyloid-b peptide induce cytochrome .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZT4BK2D7\\Rodrigues et al. - 2000 - Bilirubin and amyloid-b peptide induce cytochrome .pdf:application/pdf}
}

@article{balentine_intra-abdominal_2010,
	title = {Intra-abdominal fat predicts survival in pancreatic cancer},
	volume = {14},
	issn = {1873-4626},
	doi = {10.1007/s11605-010-1297-5},
	abstract = {{BACKGROUND}: Body mass index ({BMI}) has proven unreliable in predicting survival following pancreaticoduodenectomy for cancer. While measures of intra-abdominal fat correlate with medical and postoperative complications of obesity, the impact of intra-abdominal fat on pancreatic cancer survival is uncertain. We hypothesized that the quantity of intra-abdominal fat would predict survival following resection of pancreatic cancer.
{METHODS}: Preoperative {CT} imaging was used to measure intra-abdominal fat. Cox regression analyses were used to identify independent predictors of survival.
{RESULTS}: Sixty-one patients from 2000-2009 underwent pancreaticoduodenectomy for exocrine pancreatic adenocarcinoma. After adjusting for age and perineural invasion status, preoperative {BMI} did not predict overall survival (p {\textless} 0.827). Unlike {BMI}, quartile of intra-abdominal fat predicted survival. Relative to patients with the least intra-abdominal fat (lowest quartile), those with more intra-abdominal fat demonstrated worse overall survival, but in a non-linear fashion. Individuals in the second quartile showed a fourfold increase in likelihood of death ({HR} 4.018, 95\% {CI} 1.099-14.687, p {\textless} 0.035) relative to the lowest quartile. Patients in the third ({HR} 2.124, 95\% {CI} 0.278-16.222, p {\textless} 0.468) and fourth quartile ({HR} 1.354, 95\% {CI} 0.296-6.190, p {\textless} 0.696) also showed greater risk of death.
{CONCLUSIONS}: Measuring intra-abdominal fat identifies a subset of patients with worse prognosis in pancreatic cancer.},
	pages = {1832--1837},
	number = {11},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Balentine, Courtney J. and Enriquez, Jose and Fisher, William and Hodges, Sally and Bansal, Vivek and Sansgiry, Shubhada and Petersen, Nancy J. and Berger, David H.},
	date = {2010-11},
	pmid = {20725799},
	keywords = {Adenocarcinoma, Aged, Body Mass Index, Female, Humans, Intra-Abdominal Fat, Male, Obesity, Pancreatic Neoplasms, Pancreaticoduodenectomy, prognosis, Risk Factors, Survival Rate, Tomography, X-Ray Computed},
	file = {Balentine et al. - 2010 - Intra-abdominal Fat Predicts Survival in Pancreati.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QWK9QRI2\\Balentine et al. - 2010 - Intra-abdominal Fat Predicts Survival in Pancreati.pdf:application/pdf}
}

@article{hebert_multicenter_1999,
	title = {A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group},
	volume = {340},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9971864},
	abstract = {To determine whether a restrictive strategy of red-cell transfusion and a liberal strategy produced equivalent results in critically ill patients, we compared the rates of death from all causes at 30 days and the severity of organ dysfunction.},
	pages = {409--17},
	number = {6},
	journaltitle = {N Engl J Med},
	author = {Hébert, P C and Wells, G and Blajchman, M A and Marshall, J and Martin, C and Pagliarello, G and Tweeddale, M and Schweitzer, I and Yetisir, E},
	date = {1999-02}
}

@article{vaughan-shaw_neutrophil_2012,
	title = {Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly},
	volume = {10},
	issn = {1743-9191},
	url = {http://www.journal-surgery.net/article/S1743919112000283/abstract},
	doi = {10.1016/j.ijsu.2012.02.010},
	abstract = {Introduction
Accurate prediction of outcome after emergency surgery in elderly patients may assist decision-making. Many scoring systems require post-operative data (e.g. P-{POSSUM}) whilst others have failed to gain widespread use. Recent reports suggest that C-reactive protein ({CRP}) and the neutrophil lymphocyte (N/L ratio) ratio may predict surgical outcome.
Methods
A retrospective review of all patients aged 80 years or over undergoing emergency abdominal surgery over a 22 month period was conducted. Outcome and clinical data were collected. Univariate, multivariate and recursive analyses were performed for outcome at 30 days, 6 months and 12 months. Findings were validated in a second independent dataset.
Results
88 patients were included in the test dataset, median age 84 years. 30-day mortality was 31\%, 6-month mortality 43\% and 12-month mortality 50\%. Univariate analysis identified N/L ratio, {CRP}, midline laparotomy, and surgical risk score to predict outcome at each time point. Recursive analysis showed, N/L ratio ≥22 best predicted 30-day outcome (p=0.0018). Multivariate analysis identified N/L ratio to be an independent predictor of 30-day outcome (p=0.004) yet {CRP} did not predict outcome at any time point. An independent dataset (n=84) confirmed N/L ratio to be a prognostic factor at 30 days (p=0.001), 6 months (p{\textless}0.001) and 12 months (p=0.001).
Conclusion
N/L ratio is an easily calculable pre-operative measure that may have utility in the prediction of outcome after emergency abdominal surgery in the elderly. Further work to validate this measure in a larger, prospective setting and determine the underlying mechanisms that mediate outcome are necessary.},
	pages = {157--162},
	number = {3},
	journaltitle = {International Journal of Surgery},
	author = {Vaughan-Shaw, P. G. and Rees, J. R. E. and King, A. T.},
	urldate = {2015-08-20},
	date = {2012-01-01},
	keywords = {Abdomen, Acute, Aged 80 and over, Laparotomy, Multivariate Analysis, National Health Service, {NHS}, Outcome Assessment (Health Care), Post-operative complications},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MFXDMSF4\\Vaughan-Shaw et al. - 2012 - Neutrophil lymphocyte ratio in outcome prediction .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\B3JN9KP4\\abstract.html:text/html}
}

@article{friedman_risk_1999,
	title = {The risk of surgery in patients with liver disease},
	volume = {29},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/hep.510290639/abstract},
	pages = {1617--1623},
	number = {6},
	journaltitle = {Hepatology},
	author = {Friedman, Lawrence S.},
	urldate = {2014-01-27},
	date = {1999},
	file = {Friedman - 1999 - The risk of surgery in patients with liver disease.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EMDTX2KX\\Friedman - 1999 - The risk of surgery in patients with liver disease.pdf:application/pdf}
}

@article{mcmillan_prospective_1999,
	title = {A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss.},
	volume = {79},
	doi = {10.1038/sj.bjc.6690077},
	abstract = {The use of megestrol acetate in the treatment of weight loss in gastrointestinal  cancer patients has been disappointing. The aim of the present study was to compare the combination of megestrol acetate and placebo with megestrol acetate and ibuprofen in the treatment of weight loss in such patients. At baseline, 4-6  weeks and 12 weeks, patients underwent measurements of anthropometry, concentrations of albumin and C-reactive protein and assessment of appetite, performance status and quality of life using {EuroQol}-{EQ}-5D and {EORTC} {QLQ}-C30. Thirty-eight and 35 patients (median weight loss 18\%) were randomized to megestrol acetate/placebo or megestrol acetate/ibuprofen, respectively, for 12 weeks. Forty-six (63\%) of patients failed to complete the 12-week assessment. Of  those evaluable at 12 weeks, there was a decrease in weight (median 2.8 kg) in the megestrol acetate/placebo group compared with an increase (median 2.3 kg) in  the megestrol acetate/ibuprofen group (P{\textless}0.001). There was also an improvement in the {EuroQol}-{EQ}-5D quality of life scores of the latter group (P{\textless}0.05). The combination of megestrol acetate/ibuprofen appeared to reverse weight loss and appeared to improve quality of life in patients with advanced gastrointestinal cancer. Further trials of this novel regimen in weight-losing patients with hormone-insensitive cancers are warranted.},
	number = {3},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and Wigmore, S. J. and Fearon, K. C. and O'Gorman, P. and Wright, C. E. and {McArdle}, C. S.},
	date = {1999-02},
	pmid = {10027319},
	pmcid = {PMC2362415},
	keywords = {Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal/*administration \& dosage, Appetite, Appetite Stimulants/*administration \& dosage, Combined Modality Therapy, C-Reactive Protein, Female, Gastrointestinal Neoplasms/*complications/pathology, Humans, Ibuprofen/*administration \& dosage, Male, Megestrol Acetate/*administration \& dosage, Middle Aged, Nutritional Status, Palliative Care, Prospective Studies, Quality of Life, Treatment Outcome, Weight Loss}
}

@article{elsberger_presence_2011,
	title = {Presence of tumoural C-reactive protein correlates with progressive prostate cancer.},
	volume = {14},
	doi = {10.1038/pcan.2011.5},
	abstract = {C-reactive protein ({CRP}) is an acute phase protein implicated in the progression  of cancer. A positive correlation between tumour stage and plasma {CRP} levels was  demonstrated in prostate cancer, indicating a relationship between raised {CRP} levels and more aggressive disease, suggesting a role for inflammatory response in tumour progression. Aim of this study was to assess the tumoural presence and  cellular location of {CRP} and establish if these are linked to clinicopathological features of the cohort and patient survival. Tissue microarray technology was employed to analyse 50 matched pairs of hormone sensitive and refractory prostate cancers. Immunohistochemistry was performed using antibody to {CRP}. {CRP} was assessed using the weighted histoscore method. {CRP} presence was observed in the cytoplasm and nucleus of selected tumours. Cytoplasmic {CRP} correlated positively  with metastases at diagnosis (P=0.039), whereas nuclear {CRP} presence correlated with metastases at relapse (P=0.006). A trend towards an increase in cytoplasmic  and nuclear {CRP} presence from hormone sensitive to hormone refractory tumours was noticed. No significant association between tumoural {CRP} presence, time to biochemical relapse or disease-specific survival was observed. Tumoural {CRP} is likely to have a role in progression of prostate cancer, as it is associated with increased presence of metastases at the time of diagnosis and time of relapse. A  larger powered study is necessary to establish if {CRP} presence is associated with disease-specific survival.},
	pages = {122--128},
	number = {2},
	journaltitle = {Prostate cancer and prostatic diseases},
	shortjournal = {Prostate Cancer Prostatic Dis},
	author = {Elsberger, B. and Lankston, L. and {McMillan}, D. C. and Underwood, M. A. and Edwards, J.},
	date = {2011-06},
	pmid = {21358753},
	keywords = {*Disease Progression, Aged, C-Reactive Protein/*analysis, Follow-Up Studies, Humans, Male, Prostatic Neoplasms/*blood/pathology, Retrospective Studies, Survival Rate, Tumor Markers, Biological/*blood}
}

@article{sultan_cardiopulmonary_2014,
	title = {Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation},
	volume = {2014},
	issn = {0962-9351},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098894/},
	doi = {10.1155/2014/727451},
	abstract = {Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing ({CPET})—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio ({NLR}) and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold ({AT}) and malignancy. In a first cohort of 240 colorectal patients, {AT} was identified as the sole factor associated with higher {NLR} (P = 0.03) and absolute and relative lymphopenia (P = 0.01). Preoperative leukocyte subsets and monocyte {CD}14+ expression (downregulated by endotoxin and indicative of chronic inflammation) were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte {CD}14+ expression was lower in gastrointestinal patients (n = 43) compared to age-matched orthopaedic patients (n = 31). The circulating {CD}14+{CD}16− monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome.},
	journaltitle = {Mediators of Inflammation},
	shortjournal = {Mediators Inflamm},
	author = {Sultan, Pervez and Edwards, Mark R. and Gutierrez del Arroyo, Ana and Cain, David and Sneyd, J. Robert and Struthers, Richard and Minto, Gary and Ackland, Gareth L.},
	urldate = {2015-05-05},
	date = {2014},
	pmid = {25061264},
	pmcid = {PMC4098894},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IRJBA24A\\Sultan et al. - 2014 - Cardiopulmonary Exercise Capacity and Preoperative.pdf:application/pdf}
}

@book{_nspire_????,
	title = {{nSpire} Health},
	url = {http://www.nspirehealth.com/}
}

@article{wente_postpancreatectomy_2007,
	title = {Postpancreatectomy hemorrhage ({PPH}): an International Study Group of Pancreatic Surgery ({ISGPS}) definition},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17629996},
	abstract = {{BACKGROUND}: Postoperative hemorrhage is one of the most severe complications after pancreatic surgery. Due to the lack of an internationally accepted, universal definition of postpancreatectomy hemorrhage ({PPH}), the incidences reported in the literature vary considerably, even in reports from randomized controlled trials. Because of these variations in the definition of what constitutes a {PPH}, the incidences of its occurrence are not comparable. {METHODS}: The International Study Group of Pancreatic Surgery ({ISGPS}) developed an objective, generally applicable definition of {PPH} based on a literature review and consensus clinical experience. {RESULTS}: Postpancreatectomy hemorrhage is defined by 3 parameters: onset, location, and severity. The onset is either early ({\textless} or =24 hours after the end of the index operation) or late ({\textgreater}24 hours). The location is either intraluminal or extraluminal. The severity of bleeding may be either mild or severe. Three different grades of {PPH} (grades A, B, and C) are defined according to the time of onset, site of bleeding, severity, and clinical impact. {CONCLUSIONS}: An objective, universally accepted definition and clinical grading of {PPH} is important for the appropriate management and use of interventions in {PPH}. Such a definition also would allow comparisons of results from future clinical trials. Such standardized definitions are necessary to compare, in a nonpartisan manner, the outcomes of studies and the evaluation of novel operative treatment modalities in pancreatic surgery.},
	pages = {20--5},
	number = {1},
	journaltitle = {Surgery},
	author = {Wente, Moritz N and Veit, Johannes A and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J and Izbicki, Jakob R and Neoptolemos, John P and Padbury, Robert T and Sarr, Michael G and Yeo, Charles J and Büchler, Markus W},
	date = {2007-07}
}

@article{cho_postoperative_2013,
	title = {Postoperative Complications Influence Prognosis and Recurrence Patterns in Periampullary Cancer},
	volume = {37},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/s00268-013-2106-6},
	doi = {10.1007/s00268-013-2106-6},
	abstract = {Background The present study was performed to elucidate the influence of postoperative complications on the prognosis and recurrence patterns of periampullary cancer after pancreaticoduodenectomy ({PD}). Methods Clinical data were reviewed from 200 consecutive patients who had periampullary cancer and underwent {PD} between October 2003 and July 2010, and survival outcomes and recurrence patterns were analyzed. Postoperative complications were classified according to a modification of Clavien’s classification. Results Overall, 86 major complications of grade {II} or higher occurred in 71 patients. The patients were classified into two groups according to the presence of postoperative complications of grade {II} or higher: group Cx−, absence of complications (n = 129); and group Cx+, presence of complications (n = 71). There were no differences in gender, mean age, tumor node metastasis stage, biliary drainage, type of resection, and radicality between the two groups (P {\textgreater} 0.05). The 3-year overall and disease-free survival rates of the group Cx+ patients (31.0 and 22.3 \%, respectively) were significantly lower than those of the group Cx− patients (49.0 and 40.0 \%; P = 0.003 and 0.002, respectively). The multivariate analysis showed that postoperative complications (P = 0.001; {RR} = 1.887; 95 \% confidence interval [{CI}] 1.278–2.785), a T stage of T3 or T4 (P = 0.001; {RR} = 2.503; 95 \% {CI} 1.441–4.346), positive node metastasis (P = 0.001; {RR} = 2.093; 95 \% {CI}, 1.378–3.179), R1 or R2 resection (P = 0.023; {RR} = 1.863; 95 \% {CI} 1.090–3.187), and angiolymphatic invasion (P = 0.013; {RR} = 1.676; 95 \% {CI} 1.117–2.513) were independent prognostic factors for disease-free survival. Regarding recurrence patterns, group Cx+ patients exhibited more distant recurrences than did group Cx− patients (P = 0.025). Conclusions Postoperative complications affect prognosis and recurrence patterns in patients with periampullary cancer after {PD}.},
	pages = {2234--2241},
	number = {9},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J Surg},
	author = {Cho, Jai Young and Han, Ho-Seong and Yoon, Yoo-Seok and Hwang, Dae Wook and Jung, Kyuwhan and Kim, Young Ki},
	urldate = {2015-05-25},
	date = {2013-05-31},
	langid = {english},
	keywords = {Abdominal Surgery, Cardiac Surgery, general surgery, surgery, Thoracic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MJ54X9RP\\Cho et al. - 2013 - Postoperative Complications Influence Prognosis an.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FXC848C2\\10.html:text/html}
}

@article{jamieson_relationship_2012,
	title = {The relationship between tumor inflammatory cell infiltrate and outcome in patients with pancreatic ductal adenocarcinoma},
	volume = {19},
	issn = {1534-4681},
	doi = {10.1245/s10434-012-2370-y},
	abstract = {{BACKGROUND}: The tumor-associated inflammatory cell infiltrate is recognized to have prognostic value in various common solid tumors. However, the prognostic value of the tumor inflammatory cell infiltrate has not been established in pancreatic ductal adenocarcinoma ({PDAC}) nor has its relationship with the systemic inflammatory response.
{METHODS}: Retrospective study was made of 173 patients who underwent surgery between 1997 and 2009. Routine pathology specimens were scored according to density of the tumor inflammatory cell infiltrate, and biochemical data were collected preoperatively.
{RESULTS}: Low-grade tumor inflammatory cell infiltrate was associated with earlier tumor recurrence (P {\textless} 0.001) and particularly in the liver (P = 0.027). It was also associated with T3 tumors (P {\textless} 0.05), lymph node involvement (P {\textless} 0.05), and resection margin involvement (P {\textless} 0.05). On univariate survival analysis, age {\textless}65 years (P {\textless} 0.05), {mGPS} (P {\textless} 0.001), increased tumor stage (P {\textless} 0.01), nodal involvement (P {\textless} 0.01), size (P {\textless} 0.05), grade (P {\textless} 0.05), perineural invasion (P {\textless} 0.05), venous invasion (P {\textless} 0.01), resection margin involvement (P ≤ 0.001), vascular reconstruction (P {\textless} 0.05), and no adjuvant chemotherapy (P {\textless} 0.05) were associated with poor survival. In contrast, high-grade tumor inflammatory cell infiltrate was associated with better survival (P {\textless} 0.001). On multivariate survival analysis, {mGPS} [hazard ratio ({HR}): 1.77, 95\% confidence interval (95\% {CI}): 1.19-2.62, P = 0.005], tumor stage ({HR}: 2.21, 95\% {CI}: 1.16-4.23, P = 0.016), resection margin involvement ({HR}: 2.19, 95\% {CI}: 1.41-3.44, P = 0.001), venous invasion ({HR}: 1.79, 95\% {CI}: 1.22-2.63, P = 0.003), tumor inflammatory cell infiltrate ({HR}: 0.37, 95\% {CI}: 0.25-0.55, P = 0.0001), and adjuvant chemotherapy (P = 0.04) were independently prognostic.
{CONCLUSIONS}: The results of the study show, for the first time, that the presence of a high-grade tumor inflammatory cell infiltrate is an independent predictor of prolonged overall survival following resection for {PDAC}. Furthermore, measures of the local and the systemic inflammatory response were inversely associated.},
	pages = {3581--3590},
	number = {11},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Jamieson, Nigel B and Mohamed, Mohamed and Oien, Karin A and Foulis, Alan K and Dickson, Euan J and Imrie, Clem W and Carter, C Ross and {McKay}, Colin J and {McMillan}, Donald C},
	date = {2012-10},
	pmid = {22555345},
	keywords = {Adenocarcinoma, Adenocarcinoma/*secondary/*therapy, Aged, Aged, Chemotherapy, Adjuvant, Chemotherapy, Adjuvant, Female, Female, Humans, Humans, Inflammation, Inflammation/*pathology, Kaplan-Meier Estimate, Kaplan-Meier Estimate, Lymphatic Metastasis, Lymphatic Metastasis, Male, Male, Middle Aged, Middle Aged, Multivariate Analysis, Multivariate Analysis, Neoplasm Grading, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Invasiveness, Neoplasm Staging, Neoplasm Staging, Observer Variation, Observer Variation, Pancreatectomy, Pancreatectomy, Pancreatic Neoplasms, Pancreatic Neoplasms/*pathology/*therapy, Retrospective Studies, Retrospective Studies, Treatment Outcome, Treatment Outcome}
}

@article{gupta_determinants_2011,
	title = {Determinants of outcomes in pancreatic surgery and use of hospital resources},
	volume = {104},
	issn = {1096-9098},
	doi = {10.1002/jso.21923},
	abstract = {{BACKGROUND} {AND} {OBJECTIVES}: Outcomes for patients undergoing major pancreatic surgery have improved, but a subset of patients that significantly utilize more resources exists. Variables that can lead to an increase in resource utilization in patients undergoing pancreatic surgery were identified.
{METHODS}: Patients undergoing pancreatic surgery for neoplasms were identified from the {NSQIP} database (2006-2008). Indices associated with increased resource utilization that we included were operative time ({OT}), length of stay ({LOS}), intraoperative {RBC} transfusion, return to operating room, and occurrence of postoperative complications. Analysis of covariance and multivariable logistic regression were performed.
{RESULTS}: The 4,306 included patients had a median age of 66 years and 50.3\% were males. The 30-day morbidity and mortality were 29.3\% and 3.2\%, respectively. Median {OT} was 362  min and median {LOS} was 10 days. Malignancy, neoadjuvant radiation, and medical co-morbidities were associated with increased {OT} (P {\textless} 0.0001 for all). Declining preoperative functional status was the most important predictor of {LOS} (P {\textless} 0.0001). Age, male gender, hypertension, severe {COPD}, and higher {BMI} were significantly associated with postoperative complications (P {\textless} 0.050 for all).
{CONCLUSIONS}: Morbidity after pancreatic surgery remains high. Age, obesity, performance status, medical co-morbidities, and neoadjuvant radiation affect outcomes and may lead to increased use of hospital resources.},
	pages = {634--640},
	number = {6},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J Surg Oncol},
	author = {Gupta, Prateek K. and Turaga, Kiran K. and Miller, Weldon J. and Loggie, Brian W. and Foster, Jason M.},
	date = {2011-11-01},
	pmid = {21520092},
	keywords = {Adult, Aged, Aged, 80 and over, Cohort Studies, Comorbidity, Female, Follow-Up Studies, Health Resources, Hospitals, Humans, length of stay, Male, Middle Aged, Pancreatic Neoplasms, postoperative complications, Prospective Studies, Risk Factors, Survival Rate, Treatment Outcome}
}

@article{hennessey_preoperative_2010,
	title = {Preoperative Hypoalbuminemia is an Independent Risk Factor for the Development of Surgical Site Infection Following Gastrointestinal Surgery: A Multi-Institutional Study},
	volume = {252},
	issn = {0003-4932},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000658-201008000-00017},
	doi = {10.1097/SLA.0b013e3181e9819a},
	shorttitle = {Preoperative Hypoalbuminemia is an Independent Risk Factor for the Development of Surgical Site Infection Following Gastrointestinal Surgery},
	pages = {325--329},
	number = {2},
	journaltitle = {Annals of Surgery},
	author = {Hennessey, Derek B. and Burke, John P. and Ni-Dhonochu, Tara and Shields, Conor and Winter, Desmond C. and Mealy, Kenneth},
	urldate = {2015-08-21},
	date = {2010-08},
	langid = {english},
	file = {Hennessey et al. - 2010 - Preoperative Hypoalbuminemia is an Independent Ris.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\992ZUT7I\\Hennessey et al. - 2010 - Preoperative Hypoalbuminemia is an Independent Ris.pdf:application/pdf}
}

@article{seyama_long-term_2003,
	title = {Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate},
	volume = {238},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12832968},
	abstract = {{OBJECTIVE}: To demonstrate our strategy for hilar bile duct cancer and to elucidate prognostic factors and the surgeon's role in long-term survival. {SUMMARY} {BACKGROUND} {DATA}: Extended hemihepatectomy is recognized as a curative treatment of hilar bile duct cancer but is not always safe because of the risk of postoperative liver failure. A safe and beneficial strategy is required. {METHODS}: Fifty-eight consecutive major hepatectomies for hilar bile duct cancer were reviewed retrospectively. Appropriate preoperative treatments, biliary drainage, and portal embolization were performed before major hepatectomies. The short- and long-term results of our strategy are presented and analyzed. {RESULTS}: Biliary drainage and portal embolization were performed in 39 patients (67.2\%) and 31 patients (53.4\%), respectively. Major hepatectomies comprised 27 extended right and 22 extended left hemihepatectomies and 9 hepatoduodenopancreatectomies. Operative morbidity and mortality rates were 43\% and 0\%, respectively. There was no postoperative liver failure. The overall 5-year survival rate was 40\%. Univariate analysis showed that residual tumor status, lymph node involvement, and perineural invasion were associated with patients' long-term survival. A surgical margin over 5 mm resulted in better long-term survival. The delay resulting from preoperative treatment was not detrimental to long-term survival. Multivariate analysis showed that lymph node involvement was the only prognostic factor. {CONCLUSIONS}: Our strategy, which includes preoperative biliary drainage and portal embolization, led to a reduction in the risks associated with major hepatectomy for hilar bile duct cancer, and resulted in zero mortality. Surgeons should aim at complete clearance of the tumor with an adequate surgical margin to ensure optimal long-term survival.},
	pages = {73--83},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Seyama, Yasuji and Kubota, Keiichi and Sano, Keiji and Noie, Tamaki and Takayama, Tadatoshi and Kosuge, Tomoo and Makuuchi, Masatoshi},
	date = {2003-07}
}

@article{burguillo_using_2010,
	title = {Using game theory and Competition-based Learning to stimulate student motivation and performance},
	volume = {55},
	issn = {03601315},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0360131510000527},
	doi = {10.1016/j.compedu.2010.02.018},
	pages = {566--575},
	number = {2},
	journaltitle = {Computers \& Education},
	author = {Burguillo, Juan C.},
	urldate = {2015-06-06},
	date = {2010-09},
	langid = {english},
	file = {09e4150f93e7d2a8cc000000.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FVRPJXUG\\09e4150f93e7d2a8cc000000.pdf:application/pdf}
}

@article{mcardle_impact_2005,
	title = {Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer},
	volume = {92},
	rights = {Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons, Ltd.},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.5054/abstract},
	doi = {10.1002/bjs.5054},
	abstract = {Background:
The impact of anastomotic leakage on immediate postoperative mortality in patients undergoing potentially curative resection for colorectal cancer is well recognized. Its impact on long-term survival is less clear. The aim of the present study was to evaluate the relationship between anastomotic leakage and long-term survival in patients undergoing potentially curative resection for colorectal cancer.
Methods:
A total of 2235 patients who underwent potentially curative resection for colorectal cancer between 1991 and 1994 in Scotland were included in the study. Five-year survival rates and adjusted hazard ratios were calculated.
Results:
Fourteen (16 per cent) of the 86 patients with an anastomotic leak died within 30 days of surgery compared with 83 (3·9 per cent) of 2149 without a leak. The 5-year cancer-specific survival rate, including postoperative deaths, was 42 per cent in patients with an anastomotic leak compared with 66·9 per cent in those with no leak (P {\textless} 0·001). Excluding postoperative deaths, respective values were 50 and 68·0 per cent (P {\textless} 0·001). The adjusted relative hazard ratios, for patients with an anastomotic leak compared with those without a leak, and excluding 30-day mortality, were 1·61 (95 per cent confidence interval (c.i.) 1·19 to 2·16; P = 0·002) for overall survival and 1·99 (95 per cent c.i. 1·42 to 2·79; P {\textless} 0·001) for cancer-specific survival.
Conclusion:
Development of an anastomotic leak is associated with worse long-term survival after potentially curative resection for colorectal cancer. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons, Ltd.},
	pages = {1150--1154},
	number = {9},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {{McArdle}, C. S. and {McMillan}, D. C. and Hole, D. J.},
	urldate = {2015-05-25},
	date = {2005-09-01},
	langid = {english},
	keywords = {Adult, Aged, Anastomosis, Surgical, Colorectal Neoplasms/mortality/*surgery, Female, Humans, Male, Middle Aged, Prognosis, Proportional Hazards Models, Scotland/epidemiology, Surgical Wound Dehiscence/*mortality, Survival Analysis, Survival Rate},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5B92TEPF\\McArdle et al. - 2005 - Impact of anastomotic leakage on long-term surviva.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EIHUCWFP\\abstract.html:text/html}
}

@article{epstein_aerobic_2004,
	title = {Aerobic capacity is associated with 100-day outcome after hepatic transplantation},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15004771},
	abstract = {The shortage of donor organs highlights the need to better identify patients most likely to benefit from hepatic transplantation. Reduced aerobic capacity (decreased peak oxygen consumption [{VO}(2)] during symptom-limited cardiopulmonary exercise testing) is frequently present in cirrhosis. Peak {VO}(2) during cardiopulmonary exercise testing may predict short-term outcome after hepatic transplantation. Symptom-limited testing was performed on a cycle ergometer (continuous ramp protocol) and {VO}(2) determined using a metabolic cart. One hundred fifty-six patients were tested; 59 subsequently underwent hepatic transplantation. Results showed that survivors and nonsurvivors were similar in age, duration of liver disease, Child-Pugh score, {MELD} score, resting cardiovascular function, pulmonary function, and gas exchange. The 6 (10.2\%) patients dying within 100 days of transplantation were more likely to have reduced aerobic capacity (peak {VO}(2) {\textless}60\% predicted and {VO}(2) at anaerobic threshold [{VO}(2)-{AT}] {\textless}50\% predicted peak {VO}(2)) compared to survivors (4/6 vs. 7/53, P {\textless}.01). Using a multiple logistic regression model controlling for duration and severity of liver disease and time to transplantation, reduced aerobic capacity was independently associated with 100-day mortality. In conclusion, reduced aerobic capacity during cardiopulmonary exercise testing is associated with decreased short-term survival after hepatic transplantation. Further study is needed to determine if cardiopulmonary exercise testing can be used to improve allocation of donor organs. To ensure optimum allocation of donor organs, it is important to identify patients most likely to benefit from transplantation. Investigators have identified a number of preoperative, intraoperative, and postoperative factors that predict increased risk for postoperative mortality. Unfortunately, predictive accuracy has not been high, and the timing of factor identification does not optimize organ utilization. Identification of predictors of survival at the time of listing for transplantation might lead to better resource allocation.},
	pages = {418--24},
	number = {3},
	journaltitle = {Liver Transpl},
	author = {Epstein, Scott K and Freeman, Richard B and Khayat, Ahmad and Unterborn, John N and Pratt, Daniel S and Kaplan, Marshall M},
	date = {2004-03},
	file = {Epstein et al. - 2004 - Aerobic capacity is associated with 100-day outcom.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J5GDBBEX\\Epstein et al. - 2004 - Aerobic capacity is associated with 100-day outcom.pdf:application/pdf}
}

@article{srivastava_outcome_2001,
	title = {Outcome following pancreaticoduodenectomy in patients undergoing preoperative biliary drainage},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11721113},
	abstract = {{OBJECTIVE}: To assess the role of preoperative biliary drainage ({PBD}) in the early outcome following pancreaticoduodenectomy ({PD}) for periampullary tumors. {DESIGN}: Retrospective analysis of prospective database. {PATIENTS} {AND} {METHODS}: 121 {PDs} were performed for periampullary tumors between 1989 and 1998. 54 patients were operated following a {PBD} (group A) while 67 patients were operated without {PBD}. 50 patients underwent internal biliary drainage while 4 patients underwent external biliary drainage. Of the 67 patients without {PBD}, serum bilirubin was {\textgreater}10 mg\% in 41 patients (group B) while 26 patients had bilirubin level of {\textless}10 mg\% (group C). {RESULT}: Patients were well matched for age, sex distribution, presence of medical risk factors, duration of surgery, operative blood loss and stage of disease. Group A patients had a higher incidence of wound infection (43 vs. 24\%; p = 0.03), intra-abdominal abscess (28 vs. 15\%; p = 0.06), pancreaticojejunal anastomotic leak (20 vs. 5\%; p = 0.01) and overall infective complications (52 vs. 29\%; p = 0.01) compared to group B patients, and a higher overall infective complication rate than group C patients (52 vs. 27\%; p = 0.02). Group B patients had a higher incidence of intra-abdominal bleeding compared to group A (20 vs. 6\%; p = 0.01) and group C patients (20 vs. 4\%; p = 0.03). Reoperation rate was significantly higher in group B compared to group A patients (27 vs. 13\%; p = 0.04). The mortality rates were not significantly different in the three groups. {CONCLUSION}: Patients with jaundice ({\textgreater}10 mg\%) have a higher risk of bleeding complications while those with {PBD} have more infective complications. {PBD} should be judicially employed in selected patients.},
	pages = {381--7},
	number = {5},
	journaltitle = {Dig Surg},
	author = {Srivastava, S and Sikora, S S and Kumar, A and Saxena, R and Kapoor, V K},
	date = {2001}
}

@article{topp_effect_2002,
	title = {The effect of bed rest and potential of prehabilitation on patients in the intensive care unit},
	volume = {13},
	url = {http://journals.lww.com/aacnadvancedcriticalcare/Abstract/2002/05000/The_Effect_of_Bed_Rest_and_Potential_of.11.aspx},
	pages = {263--276},
	number = {2},
	journaltitle = {{AACN} Advanced Critical Care},
	author = {Topp, Robert and Ditmyer, Marcia and King, Karen and Doherty, Kristen and Hornyak {III}, Joseph},
	urldate = {2014-01-27},
	date = {2002},
	file = {Topp et al. - 2002 - The effect of bed rest and potential of prehabilit.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P378SJNZ\\Topp et al. - 2002 - The effect of bed rest and potential of prehabilit.pdf:application/pdf}
}

@article{chen_expandable_2005,
	title = {Expandable metal biliary stents before pancreaticoduodenectomy for pancreatic cancer: a Monte-Carlo decision analysis},
	volume = {3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16361049},
	abstract = {{BACKGROUND} \& {AIMS}: Endoscopic placement of plastic or self-expandable metal biliary stents ({SEMS}) relieves obstructive jaundice from pancreatic cancer. Short-length, distally placed {SEMS} do not preclude subsequent pancreaticoduodenectomy. We sought to determine whether {SEMS} placement in patients whose surgical status is uncertain is cost-effective for management of obstructive jaundice. {METHODS}: A Markov model was constructed to evaluate costs and outcomes associated with endoscopic biliary stenting for obstructive jaundice. Strategies evaluated were: (1) initial plastic stent with plastic stents for subsequent occlusions in nonsurgical candidates after staging (plastic followed-up by [f/u] plastic), (2) initial plastic with subsequent {SEMS} (plastic f/u metal), (3) initial short-length {SEMS} with subsequent plastic (metal f/u plastic), and (4) initial short-length {SEMS} with subsequent expandable metal stent (metal f/u metal). Published stent occlusion rates, {ERCP} complication rates and outcomes, cholangitis rates and outcomes, pancreatic cancer mortality rates, and Whipple complication rates were used. Costs were based on 2004 Medicare standard allowable charges and were accrued until all patients reached an absorbing health state (death or pancreaticoduodenectomy) or 24 cycles (24 mo) ended. {RESULTS}: Average costs per patient from Monte Carlo simulation were: (1) metal f/u metal, \$19,935; (2) plastic f/u metal, 20,157 dollars; (3) metal f/u plastic, 20,871 dollars; and (4) plastic f/u plastic, 20,878 dollars. For initial plastic stents to be preferred over short-length metal stents, 70\% or more of pancreatic cancers would need to be potentially resectable by pancreaticoduodenectomy. {CONCLUSIONS}: In patients undergoing {ERCP} before definitive cancer staging, short-length {SEMS} is the preferred initial cost-minimizing strategy.},
	pages = {1229--37},
	number = {12},
	journaltitle = {Clin Gastroenterol Hepatol},
	author = {Chen, Victor K and Arguedas, Miguel R and Baron, Todd H},
	date = {2005-12}
}

@article{dousset_[surgical_2000,
	title = {[Surgical treatment of pancreatic adenocarcinoma: limitations and latest developments]},
	volume = {137},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10992051},
	abstract = {Duodenopancreatectomy with preservation of the tail for pancreatic adenocarcinoma is not contraindicated by age except in case of comorbidity. Curative excision is contraindicated in case of metastasis to the liver, peritoneum or distal nodes or in case of arterial invasion. Inversely, isolated venous invasion is not incompatible with curative surgery if one can accept the potential overmortality due to the vascular risk. Palliative surgery may be indicated for tumors limited to the pancreas in selected patients as it appears to improve survival and quality of life over derivation surgery. Preoperative biliary drainage using an endoscopic, a percutaneous or a surgical approach increases the rate of surgical complications and mortality and should be avoided, especially when the resectability of the tumor is not formally established. Wide node dissection does not modify prognosis after excision and would not be warranted on the basis of current data. Preserving the pyloris increases the rate of postoperative gastroparesia without bringing the expected nutritional advantages. It is not warranted in this indication. The type of pancreas anastomosis (pancreatogastric or pancreatojejunal) does not modify the incidence of complications or pancreatic fistulae. The rate of pancreatic fistulae and postoperative complications is decreased by preventive administration of octreotide, particularly when the pancreas is healthy. The prevalence of postoperative gastroparesia is decreased by preventive treatment with intravenous erythromycin. Progress will undoubtedly issue from complimentary treatments combining radiotherapy and chemotherapy},
	pages = {214--20},
	number = {4},
	journaltitle = {J Chir (Paris)},
	author = {Dousset, B and Molinier, N},
	date = {2000-08}
}

@article{haga_estimation_1999,
	title = {Estimation of Physiologic Ability and Surgical Stress (E-{PASS}) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10192731},
	abstract = {Overwhelming surgical stress exceeding a patient's reserve capacity causes a disruption of homeostasis, leading to various postoperative complications. This study was undertaken to develop a new scoring system, "E-{PASS}", standing for the Estimation of Physiologic Ability and Surgical Stress, that predicts the postsurgical risk by quantification of the patient's reserve and surgical stress. E-{PASS} comprises the preoperative risk score ({PRS}), the surgical stress score ({SSS}), and the comprehensive risk score ({CRS}) that is determined by both scores. These scores were computed by a multiple regression analysis conducted on 292 consecutive patients who underwent elective common gastrointestinal operations at one hospital between 1992 and 1995 (internal group). The usefulness of the scores was evaluated in 989 consecutive patients who underwent the same surgical procedures during the same period at another hospital (external group). The morbidity and mortality rates increased similarly in both groups as the {CRS} increased. A marked step-up of both rates was observed at a {CRS} {\textgreater} 1.0, reaching mortality rates of 20\% in the internal subjects and 28.5\% in the external subjects. These results suggest that the E-{PASS} scoring system is reproducible, and that it may be useful for surgical decision making. This system requires no special examinations and can be used in every hospital.},
	pages = {219--25},
	number = {3},
	journaltitle = {Surg Today},
	author = {Haga, Y and Ikei, S and Ogawa, M},
	date = {1999},
	keywords = {Aged, Digestive System Surgical Procedures, Elective Surgical Procedures, Female, Humans, Male, Middle Aged, postoperative complications, Regression Analysis, Risk Factors, Stress, Physiological, Surgical Procedures, Operative}
}

@article{wig_usefulness_1999,
	title = {Usefulness of percutaneous transhepatic biliary drainage in patients with surgical jaundice–a prospective randomised study},
	volume = {47},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10999118},
	abstract = {Patients with obstructive jaundice undergoing surgical procedures have a significant risk of morbidity and mortality. The role of preoperative percutaneous transhepatic biliary drainage ({PTBD}) was evaluated in a randomized trial.},
	pages = {271--4},
	number = {3},
	journaltitle = {J Assoc Physicians India},
	author = {Wig, J D and Kumar, H and Suri, S and Gupta, N M},
	date = {1999-03},
	note = {Cochrane review paper}
}

@article{copeland_comparative_1993,
	title = {Comparative vascular audit using the {POSSUM} scoring system},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8323212},
	abstract = {Comparative audit using overall mortality and morbidity figures can be misleading as they do not take into account variations in surgical procedure and patient fitness. To examine these effects we have compared vascular surgery in two differing hospitals, during a similar 9-month period, using the {POSSUM} scoring system. In one unit, 255 patients underwent vascular surgery with an operative mortality of 9.4\%, and morbidity of 37.3\%. In the other unit, 89 patients underwent vascular procedures with an operative mortality of 20.2\% and morbidity of 47.2\%. At first sight there appear to be significant differences in operative outcome between the two units. However, analysis using the {POSSUM} system predicts a mortality rate of 10.2\% for unit A and 20.2\% for unit B (morbidity rates of 38.4\% for unit A and 50.6\% for unit B). Receiver operating curve ({ROC}) analysis demonstrated no significant difference between the two units (see Table {III}). {POSSUM} analysis may be of use in comparative audit.},
	pages = {175--7},
	number = {3},
	journaltitle = {Ann R Coll Surg Engl},
	author = {Copeland, G P and Jones, D and Wilcox, A and Harris, P L},
	date = {1993-05}
}

@article{lamb_clinical_2012,
	title = {Clinical utility of the Glasgow Prognostic Score in patients undergoing curative  nephrectomy for renal clear cell cancer: basis of new prognostic scoring systems.},
	volume = {106},
	doi = {10.1038/bjc.2011.556},
	abstract = {{BACKGROUND}: Measurement of the systemic inflammatory response in malignancy has been recently refined using a selective combination of C-reactive protein and albumin (modified Glasgow Prognostic Score, {mGPS}). This has prognostic value in patients with metastatic kidney cancer. This study examines the prognostic value  of the {mGPS} in patients undergoing curative nephrectomy for clear cell cancer. {METHODS}: Patients with localised renal cell carcinoma undergoing potentially curative resection between March 1997 and July 2007 in a single institution were  prospectively studied. The {mGPS}, University of California Los Angeles Integrated  Staging System ({UISS}), 'Stage Size Grade Necrosis' ({SSIGN}), Kattan and Leibovich  scores were constructed. {RESULTS}: A total of 169 patients were studied. The minimum follow-up was 49 months; the median follow-up of the survivors was 98 months. During this period, 35 patients died of their cancer; a further 24 patients died of intercurrent disease. On univariate survival analysis of the scoring systems, Kattan (P{\textless}0.05), {UISS} (P{\textless}0.001), {SSIGN} (P{\textless}0.001) and Leibovich (P{\textless}0.001) were significantly associated with cancer-specific survival. Using cancer-specific mortality at 4 years as an endpoint, the area under the receiver  operator curve was 0.726 (95\% {CI} 0.629-0.822; P=0.001) for Kattan, 0.776 (95\% {CI}  0.671-0.880; P{\textless}0.001) for {UISS}, 0.812 (95\% {CI} 0.733-0.892; P{\textless}0.001) for {SSIGN}, 0.778 (95\% {CI} 0.666-0.889; P{\textless}0.001) for Leibovich and 0.800 (95\% {CI} 0.687-0.912;  P{\textless}0.001) for the {mGPS} scoring system. On multivariate analysis of significant independent scoring systems and {mGPS}, {UISS} ({HR} 3.08, 95\% {CI} 1.54-6.19, P=0.002) and {mGPS} ({HR} 5.13, 95\% {CI} 2.89-9.11, P{\textless}0.001) were significant independent predictors of cancer-specific survival. {CONCLUSIONS}: The present prospective study shows that the {mGPS}, an inflammation-based prognostic score, is at least equivalent to and independent of other current validated prognostic scoring systems for patients undergoing curative nephrectomy for renal clear cell cancer. The {mGPS} is simple, measured preoperatively, based on well-standardised, widely available protein assays, and therefore provides an objective and rational basis  before treatment for future staging systems in patients with operable renal cancer.},
	pages = {279--283},
	number = {2},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Lamb, G. W. A. and Aitchison, M. and Ramsey, S. and Housley, S. L. and {McMillan}, D. C.},
	date = {2012-01-17},
	pmid = {22166802},
	pmcid = {PMC3261680},
	keywords = {*Nephrectomy, Algorithms, Carcinoma, Renal Cell/pathology/*surgery, Female, Follow-Up Studies, Humans, Kidney Neoplasms/pathology/*surgery, Male, Middle Aged, Predictive Value of Tests, Prognosis}
}

@article{da_costa_staged_2014,
	title = {Staged multidisciplinary step-up management for necrotizing pancreatitis: Management strategies for necrotizing pancreatitis},
	volume = {101},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.9346},
	doi = {10.1002/bjs.9346},
	shorttitle = {Staged multidisciplinary step-up management for necrotizing pancreatitis},
	pages = {e65--e79},
	number = {1},
	journaltitle = {British Journal of Surgery},
	author = {da Costa, D. W. and Boerma, D. and van Santvoort, H. C. and Horvath, K. D. and Werner, J. and Carter, C. R. and Bollen, T. L. and Gooszen, H. G. and Besselink, M. G. and Bakker, O. J.},
	urldate = {2015-04-28},
	date = {2014-01},
	langid = {english},
	file = {da Costa et al. - 2014 - Staged multidisciplinary step-up management for ne.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\A8F2MNWX\\da Costa et al. - 2014 - Staged multidisciplinary step-up management for ne.pdf:application/pdf}
}

@article{elahi_systemic_2005,
	title = {The systemic inflammatory response predicts overall and cancer specific survival  in patients with malignant lymphoma.},
	volume = {11},
	abstract = {{BACKGROUND}: The value of C-reactive protein concentrations in the assessment of prognosis in patients with advanced lymphoma has not been clearly defined. {MATERIAL}/{METHODS}: Patients with a diagnosis of non-Hodgkin's lymphoma (n = 108) and Hodgkin's lymphoma, (n = 39) and who had measurements of C-reactive protein were studied retrospectively and the data was reviewed over 8 years. {RESULTS}: Median survival, from the time of sampling, was 7.4 months. On univariate analysis there was a significant relationship between the duration of cancer specific survival and tumour type (p {\textless} 0.05), circulating concentrations of albumin (p {\textless} 0.001) and C-reactive protein (p {\textless} 0.001). In contrast, only},
	pages = {CR75--78},
	number = {2},
	journaltitle = {Medical science monitor : international medical journal of experimental and clinical research},
	shortjournal = {Med Sci Monit},
	author = {Elahi, Maqsood M. and {McMillan}, Donald C. and {McArdle}, Colin S. and Angerson, Wilson J. and Soukop, Michael and Johnstone, Jennie and Sattar, Naveed},
	date = {2005-02},
	pmid = {15668636},
	keywords = {C-Reactive Protein/metabolism, Female, Humans, Inflammation/blood/*complications/immunology, Lymphoma/blood/*complications/*diagnosis/immunology, Male, Middle Aged, Neoplasm Staging, Prognosis, Survival Rate}
}

@article{martignoni_effect_2001,
	title = {Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy},
	volume = {181},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11248177},
	abstract = {{BACKGROUND}: The role of preoperative biliary drainage in patients with biliary obstruction undergoing pancreatoduodenectomy remains controversial. Several authors failed to show any effect of preoperative biliary drainage, whereas others even reported an increased morbidity following pancreatoduodenectomy. {METHODS}: Retrospective analysis was performed in a consecutive series of 257 patients undergoing pancreatoduodenectomy between November 1993 and November 1999. {RESULTS}: Ninety-nine patients (38\%) underwent preoperative biliary drainage for a median time period of 10 days (range 1 to 41) prior to resection. Cumulative postoperative morbidity was 47\% (120 patients), the reoperation rate was 4.3\% (11 patients), and mortality was 2.3\% (6 patients). There was no difference in total morbidity, infectious complications, reoperation rate, mortality, or long-term survival between patients with or without preoperative biliary drainage. {CONCLUSIONS}: Preoperative biliary instrumentation and biliary drainage do not affect early or late outcome in patients undergoing pancreatoduodenectomy.},
	pages = {52--9; discussion 87},
	number = {1},
	journaltitle = {Am J Surg},
	author = {Martignoni, M E and Wagner, M and Krähenbühl, L and Redaelli, C A and Friess, H and Büchler, M W},
	date = {2001-01}
}

@article{poyton_mitochondrial_2009,
	title = {Mitochondrial generation of free radicals and hypoxic signaling},
	volume = {20},
	issn = {10432760},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1043276009000885},
	doi = {10.1016/j.tem.2009.04.001},
	pages = {332--340},
	number = {7},
	journaltitle = {Trends in Endocrinology \& Metabolism},
	author = {Poyton, Robert O. and Ball, Kerri A. and Castello, Pablo R.},
	urldate = {2015-04-28},
	date = {2009-09},
	langid = {english},
	file = {Poyton et al. - 2009 - Mitochondrial generation of free radicals and hypo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CBIWFH84\\Poyton et al. - 2009 - Mitochondrial generation of free radicals and hypo.pdf:application/pdf}
}

@article{proctor_derived_2012,
	title = {A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer.},
	volume = {107},
	doi = {10.1038/bjc.2012.292},
	abstract = {{BACKGROUND}: The neutrophil lymphocyte ratio ({NLR}) has prognostic value in patients with a variety of cancers. Many chemotherapeutic trial databases hold information on white cell and neutrophil counts only. The aim of the present study was to compare the prognostic value of the {NLR} with a derived score ({dNLR}), composed of white cell and neutrophil counts. {METHODS}: Patients (n=27,031) who were sampled incidentally between 2000 and 2007 for neutrophil, lymphocyte and white cell counts, and also had a diagnosis of cancer (Scottish Cancer Registry), were identified. Of this group, 12,118 patients who had been sampled within 2 years of their cancer diagnosis were studied. {RESULTS}: On follow-up, there were 7366 deaths, of which 6198 (84\%) were cancer deaths. The median time from blood sampling to diagnosis was 2.1 months. The area under the receiver-operating characteristic ({ROC}) curve for cancer-specific survival was 0.650 for the {NLR} and 0.640 for the {dNLR}. The {NLR} and {dNLR} were independently associated with survival  in all cancers studied (all P{\textless}0.001). The optimal thresholds, on the basis of hazard ratios and area under the curve, were 4 : 1 for the {NLR} and 2 : 1 for the  {dNLR}. {CONCLUSION}: The results of the present study show that the {dNLR} has similar prognostic value to the {NLR}. Therefore, the universally available {dNLR} is to be commended for use in the risk stratification of patients undergoing chemotherapy.},
	pages = {695--699},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Proctor, M. J. and {McMillan}, D. C. and Morrison, D. S. and Fletcher, C. D. and Horgan, P. G. and Clarke, S. J.},
	date = {2012-08-07},
	pmid = {22828611},
	pmcid = {PMC3419948},
	keywords = {*Leukocyte Count, *Lymphocyte Count, Aged, Colorectal Neoplasms/blood/mortality, Female, Humans, Male, Middle Aged, Neoplasms/*blood/mortality, Neutrophils/*immunology, Prognosis}
}

@article{pitt_hepato-pancreato-biliary_2007,
	title = {Hepato-pancreato-biliary fat: the good, the bad and the ugly},
	volume = {9},
	issn = {1365-182X},
	url = {http://doi.wiley.com/10.1080/13651820701286177},
	doi = {10.1080/13651820701286177},
	shorttitle = {Hepato-pancreato-biliary fat},
	pages = {92--97},
	number = {2},
	journaltitle = {{HPB}},
	author = {Pitt, Henry A.},
	urldate = {2015-04-28},
	date = {2007},
	langid = {english},
	file = {Pitt - 2007 - Hepato-pancreato-biliary fat the good, the bad an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4BSC42GE\\Pitt - 2007 - Hepato-pancreato-biliary fat the good, the bad an.pdf:application/pdf}
}

@article{navaneethan_minimally_2009,
	title = {Minimally invasive techniques in pancreatic necrosis},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19855233},
	abstract = {Traditional open surgical necrosectomy for treatment of infected pancreatic necrosis is associated with high morbidity and mortality, leading to a shift toward minimally invasive endoscopic, radiologic, and laparoscopic approaches. Percutaneous drainage is useful as a temporizing method to control sepsis and as an adjunctive treatment to surgical intervention. It is limited because of the requirement for frequent catheter care and the need for repeated procedures. Endoscopic transgastric or transduodenal therapies with endoscopic debridement/necrosectomy have recently been described and are highly successful in carefully selected patients. It avoids the need for open necrosectomy and can be used in poor operative candidates. Laparoscopic necrosectomy is also promising for treatment of pancreatic necrosis. However, the need for inducing a pneumoperitoneum and the potential risk of infection limit its usefulness in patients with critical illness. Retroperitoneal access with a nephroscope is used to directly approach the necrosis with complete removal of a sequestrum. Retroperitoneal drainage using the delay-until-liquefaction strategy also appears to be successful to treat pancreatic necrosis. The anatomic location of the necrosis, clinical comorbidities, and operator experience determine the best approach for a particular patient. Tertiary care centers with sufficient expertise are increasingly using minimally invasive procedures to manage pancreatic necrosis.},
	pages = {867--75},
	number = {8},
	journaltitle = {Pancreas},
	author = {Navaneethan, Udayakumar and Vege, Santhi Swaroop and Chari, Suresh T and Baron, Todd H},
	date = {2009-11}
}

@article{arkadopoulos_preoperative_2014,
	title = {Preoperative biliary drainage of severely jaundiced patients increases morbidity of pancreaticoduodenectomy: results of a case-control study},
	volume = {38},
	issn = {1432-2323},
	doi = {10.1007/s00268-014-2669-x},
	shorttitle = {Preoperative biliary drainage of severely jaundiced patients increases morbidity of pancreaticoduodenectomy},
	abstract = {{BACKGROUND}: Recent studies have indicated that preoperative biliary drainage ({PBD}) should not be routinely performed in patients suffering from obstructive jaundice before surgery. The severity of jaundice that mandates {PBD} has yet to be defined. Our aim was to investigate whether {PBD} is truly justified in severely jaundiced patients before pancreaticoduodenectomy. The parameters evaluated were overall morbidity, length of hospital stay, and total in-hospital mortality.
{METHODS}: From January 2000 to December 2012, a total of 240 patients underwent pancreaticoduodenectomy for periampullary tumors. Group A comprised 76 patients with preoperative serum bilirubin ≥15 mg/dl who did not undergo {PBD} before surgery. Group B comprised another 76 patients, matched for age and tumor localization (papillary vs. pancreatic head) who underwent {PBD} 2-4 weeks before pancreaticoduodenectomy and were identified from the same database.
{RESULTS}: Less operative time was required in the 'no {PBD}' group compared with the '{PBD}' group (210 vs. 240 min). Total intraoperative blood loss and blood transfusions were also significantly less in the 'no {PBD}' group. There was no difference detected in the rate of pancreatic fistula or biliary fistula formation. Group A patients demonstrated significantly lower morbidity than group B (24 vs. 36 \%, respectively) and therefore required briefer hospitalization (11 vs. 16 days). Mild infectious complications appear to be the main factor that enhanced morbidity in the {PBD} group. However, total in-hospital mortality was not significantly different between the two groups.
{CONCLUSIONS}: Even severe jaundice should not be considered as an indication for {PBD} before pancreaticoduodenectomy, as {PBD} increases infections and postoperative morbidity, therefore delaying definite treatment.},
	pages = {2967--2972},
	number = {11},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J Surg},
	author = {Arkadopoulos, Nikolaos and Kyriazi, Maria A. and Papanikolaou, Ioannis S. and Vasiliou, Pantelis and Theodoraki, Kassiani and Lappas, Christos and Oikonomopoulos, Nikolaos and Smyrniotis, Vassilios},
	date = {2014-11},
	pmid = {24952079},
	keywords = {Aged, Blood Loss, Surgical, Blood Transfusion, Case-Control Studies, Common Bile Duct Neoplasms, Drainage, Duodenal Neoplasms, Female, Hospital Mortality, Humans, Intraabdominal Infections, {JAUNDICE}, Obstructive, length of stay, Male, Middle Aged, Operative Time, Pancreatic Neoplasms, Pancreaticoduodenectomy, preoperative care}
}

@article{mcmillan_systemic_2003,
	title = {Systemic inflammatory response predicts survival following curative resection of  colorectal cancer.},
	volume = {90},
	doi = {10.1002/bjs.4038},
	abstract = {{BACKGROUND}: Some studies have shown that the presence of a systemic inflammatory  response, as evidenced by raised circulating concentrations of C-reactive protein ({CRP}), predicted recurrence and overall survival in patients with colorectal cancer. The aim of this study was to examine the relationship between the inflammatory response and overall and cancer-specific survival in patients undergoing potentially curative resection for colorectal cancer. {METHODS}: A total of 174 patients considered to have undergone curative resection were studied. Circulating {CRP} concentrations were measured before and/or after operation. {RESULTS}: The majority of patients were aged 65 years or more, had colonic tumours and Dukes' stage B lesions. During follow-up, 47 patients (27 per cent) developed recurrence and 59 (34 per cent) died. On univariate analysis, age (P {\textless} 0.01), Dukes' stage (P {\textless} 0.001), and {CRP} levels before (P {\textless} 0.01) and after (P {\textless} 0.01) operation were significantly associated with overall and cancer-specific survival. On multivariate analysis of patients in whom preoperative {CRP} concentration was measured, age (P {\textless} 0.01), Dukes' stage (P {\textless} 0.05) and {CRP} concentration (P {\textless} 0.01) were independently associated with both overall and cancer-specific survival. {CONCLUSION}: In patients who have undergone potentially  curative resection for colorectal cancer, the presence of a systemic inflammatory response predicts a poor outcome.},
	pages = {215--219},
	number = {2},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {{McMillan}, D. C. and Canna, K. and {McArdle}, C. S.},
	date = {2003-02},
	pmid = {12555298},
	keywords = {Adolescent, Adult, Aged, Colorectal Neoplasms/*blood/mortality, C-Reactive Protein/*analysis, Follow-Up Studies, Humans, Inflammation/blood, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Survival Analysis, Systemic Inflammatory Response Syndrome/blood/*etiology}
}

@article{richards_systematic_2010,
	title = {A systematic review of {POSSUM} and its related models as predictors of post-operative mortality and morbidity in patients undergoing surgery for colorectal cancer.},
	volume = {14},
	doi = {10.1007/s11605-010-1333-5},
	abstract = {{INTRODUCTION}: The Physiological and Operative Severity Score for the {enUmeration}  of Mortality and morbidity ({POSSUM}) model and its Portsmouth (P-{POSSUM}) and colorectal ({CR}-{POSSUM}) modifications are used extensively to predict and audit post-operative mortality and morbidity. This aim of this systematic review was to assess the predictive value of the {POSSUM} models in colorectal cancer surgery. {METHODS}: Major electronic databases, including Medline, Embase, Cochrane Library  and Pubmed were searched for original studies published between 1991 and 2010. Two independent reviewers assessed each study against inclusion and exclusion criteria. All data was specific to colorectal cancer surgery. Predictive value was assessed by calculating observed to expected (O/E) ratios. {RESULTS}: Nineteen  studies were included in final review. The mortality analysis included ten studies (4,799 patients) on {POSSUM}, 17 studies (6,576 patients) on P-{POSSUM} and 14 studies (5,230 patients) on {CR}-{POSSUM}. Weighted O/E ratios for mortality were  0.31 ({CI} 0.31-0.32) for {POSSUM}, 0.90 ({CI} 0.88-0.92) for P-{POSSUM} and 0.64 ({CI} 0.63-0.65) for {CR}-{POSSUM}. The morbidity analysis included four studies (768 patients) on {POSSUM} with a weighted O/E ratio of 0.96 ({CI} 0.94-0.98). {CONCLUSIONS}: P-{POSSUM} was the most accurate model for predicting post-operative mortality after colorectal cancer surgery. The original {POSSUM} model was accurate in predicting post-operative complications.},
	pages = {1511--1520},
	number = {10},
	journaltitle = {Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J Gastrointest Surg},
	author = {Richards, Colin Hewitt and Leitch, Fiona E. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2010-10},
	pmid = {20824372},
	keywords = {*Health Status Indicators, Colectomy/mortality/*statistics \& numerical data, Colorectal Neoplasms/*surgery, Digestive System Surgical Procedures/mortality/statistics \& numerical data, Humans, Models, Theoretical, Morbidity, Predictive Value of Tests, Rectal Neoplasms/surgery}
}

@article{padillo_randomized_2005,
	title = {Randomized clinical trial of the effect of intravenous fluid administration on hormonal and renal dysfunction in patients with obstructive jaundice undergoing endoscopic drainage},
	volume = {92},
	issn = {00071323},
	url = {http://doi.wiley.com/10.1002/bjs.4790},
	doi = {10.1002/bjs.4790},
	pages = {39--43},
	number = {1},
	journaltitle = {British Journal of Surgery},
	author = {Padillo, F. J. and Briceño, J. and Cruz, A. and Chicano, M. and Naranjo, A. and Vallejo, J. and Martín-Malo, A. and Pera-Madrazo, C. and Sitges-Serra, A.},
	urldate = {2014-01-27},
	date = {2005-01},
	file = {Padillo et al. - 2005 - Randomized clinical trial of the effect of intrave.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\V6KH6SZF\\Padillo et al. - 2005 - Randomized clinical trial of the effect of intrave.pdf:application/pdf}
}

@article{shah_limitations_2012,
	title = {Limitations of Patient-Associated Co-Morbidity Model in Predicting Postoperative Morbidity and Mortality in Pancreatic Operations},
	volume = {16},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/article/10.1007/s11605-012-1857-y},
	doi = {10.1007/s11605-012-1857-y},
	abstract = {Background Patient-associated co-morbidities are a potential cause of postoperative complications. The National Surgical Quality Improvement Project ({NSQIP}) collects data on patient outcomes to provide risk-adjusted outcomes data to participating hospitals. However, operations which may have a high distribution of technically-related complications, such as pancreatic operations, may not be adequately assessed using such predictive models. Methods A combined data set of {NSQIP} Public Use files ({PUF}) from 2005 to 2008 was created. Using this database, multiple logistic regression analyses were used to generate a predictive model of 30-day postoperative morbidity and mortality for pancreatic operations and all other operations recorded in {NSQIP}. Receiver-operator characteristic curves were generated and the area under those curves ({AUROC}) used to generate a c-statistic to assess the model’s discriminatory ability. Observed-to-expected (O/E) ratios of for mortality and morbidity using not only patient-associated co-morbidities, but operation-associated information, such as work relative-value units and Current Procedural Terminology codes, were generated. Data were analyzed in {SPSS}. Results In the 4-year period analyzed, there were 7,097 complex pancreatic procedures done which were compared to 568,371 procedures that were not. For postoperative mortality, the {AUROC} was less for pancreatic operations (0.741) compared to all other operation (0.947) and all other inpatient operations (0.927). Similarly for postoperative morbidity, the {AUROC} was less for pancreatic operations (0.598) compared to all other operations (0.764) and all other inpatient operations (0.817). However, the O/E ratios were similar in both groups for mortality (all other operations, 0.94 vs. pancreatic operations, 0.92) and morbidity (0.98 for both). Conclusions These data imply that the factors used to assess postoperative mortality and morbidity may not completely explain postoperative outcomes in pancreatic operations. These procedures are technically demanding and can have morbidities not related to pre-existing co-morbid conditions; therefore, preoperative prediction based on pre-existing co-morbidities may have limitations in these types of operations.},
	pages = {986--992},
	number = {5},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Shah, Rupen and Velanovich, Vic and Syed, Zeeshan and Swartz, Andrew and Rubinfeld, Ilan},
	urldate = {2015-05-26},
	date = {2012-03-14},
	langid = {english},
	keywords = {Gastroenterology, Pancreatic operations, Patient-associated co-morbidity model, Postoperative morbidity, surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GRW3GBD3\\Shah et al. - 2012 - Limitations of Patient-Associated Co-Morbidity Mod.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U6S249JA\\10.html:text/html}
}

@article{nagano_hepatic_1994,
	title = {Hepatic mitochondrial changes in experimental obstructive jaundice complicated by biliary infection},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7851851},
	abstract = {The effects of biliary infection on the structural and functional changes in the liver in obstructive jaundice was studied using rats as experimental animals. Biliary infection with obstructive jaundice was induced in the animals by injecting Escherichia coli into the common bile duct through a nylon tube cannulated into the duct. This was followed by the clamping of the tube. For the controls, the tube was clamped in the absence of Escherichia coli. After 3, 7, 14 and 21 days, the animals were sacrificed, and some serum enzyme activities, histological changes in the liver, and the coupling efficiency of mitochondria isolated from the liver were investigated. The phosphorylating ability of hepatic mitochondria was more seriously affected when the obstruction was complicated by cholangitis. We suggest that, when associated with obstructive jaundice, biliary infection should be carefully treated prior to hepatectomy.},
	pages = {432--7},
	number = {5},
	journaltitle = {Hepatogastroenterology},
	author = {Nagano, I and Kato, S and Nimura, Y and Wakabayashi, T},
	date = {1994-10}
}

@article{mokart_procalcitonin_2005,
	title = {Procalcitonin, interleukin 6 and systemic inflammatory response syndrome ({SIRS}): early markers of postoperative sepsis after major surgery},
	volume = {94},
	issn = {0007-0912},
	doi = {10.1093/bja/aei143},
	shorttitle = {Procalcitonin, interleukin 6 and systemic inflammatory response syndrome ({SIRS})},
	abstract = {{BACKGROUND}: Patients who undergo major surgery for cancer are at high risk of postoperative sepsis. Early markers of septic complications would be useful for diagnosis and therapeutic management in patients with postoperative sepsis. The aim of this study was to investigate the association between early (first postoperative day) changes in interleukin 6 ({IL}-6), procalcitonin ({PCT}) and C-reactive protein ({CRP}) serum concentrations and the occurrence of subsequent septic complications after major surgery.
{METHODS}: Serial blood samples were collected from 50 consecutive patients for determination of {IL}-6, {PCT} and {CRP} serum levels. Blood samples were obtained on the morning of surgery and on the morning of the first postoperative day.
{RESULTS}: Sixteen patients developed septic complications during the first five postoperative days (group 1), and 34 patients developed no septic complications (group 2). On day 1, {PCT} and {IL}-6 levels were significantly higher in group 1 (P-values of 0.003 and 0.006, respectively) but {CRP} levels were similar. An {IL}-6 cut-off point set at 310 pg ml(-1) yielded a sensitivity of 90\% and a specificity of 58\% to differentiate group 1 patients from group 2 patients. When associated with the occurrence of {SIRS} on day 1 these values reached 100\% and 79\%, respectively. A {PCT} cut-off point set at 1.1 ng ml(-1) yielded a sensitivity of 81\% and a specificity of 72\%. When associated with the occurrence of {SIRS} on day 1, these values reached 100\% and 86\%, respectively.
{CONCLUSIONS}: {PCT} and {IL}-6 appear to be early markers of subsequent postoperative sepsis in patients undergoing major surgery for cancer. These findings could allow identification of postoperative septic complications.},
	pages = {767--773},
	number = {6},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br J Anaesth},
	author = {Mokart, D. and Merlin, M. and Sannini, A. and Brun, J. P. and Delpero, J. R. and Houvenaeghel, G. and Moutardier, V. and Blache, J. L.},
	date = {2005-06},
	pmid = {15849208},
	keywords = {Adult, Biological Markers, Calcitonin, C-Reactive Protein, Epidemiologic Methods, Female, Gastrointestinal Neoplasms, Genital Neoplasms, Female, Humans, Interleukin-6, Male, Middle Aged, postoperative complications, Protein Precursors, Systemic Inflammatory Response Syndrome}
}

@article{nishimura_mechanism_1985,
	title = {Mechanism of liver mitochondrial dysfunction associated with bile duct obstruction},
	volume = {35},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4084344},
	abstract = {To elucidate the mechanism of liver mitochondrial dysfunction induced by obstructive jaundice, the following experiments were performed. In vivo study: Using Wistar male rats, bile ducts were ligated, and serum levels of total bilirubin (T-Bil), {GOT}, {GPT}, mitochondrial {GOT} ({mGOT}) and total bile acids ({TBA}) were measured at 3 and 7 days after the ligation. Then, the liver was isolated to determine mitochondrial functions and to measure the content of fatty acids in mitochondrial phospholipids by high performance liquid chromatography. The levels of T-Bil, {GOT}, {GPT}, {mGOT} and {TBA} were elevated by the bile duct ligation. Mitochondrial functions were deteriorated, and contents of arachidonic acid, palmitic acid and stearic acid in mitochondrial phospholipids decreased. Pretreatment with coenzyme Q10 (E-0216, {CoQ}10), an antidetergent agent, prevented not only the development of mitochondrial dysfunction and the decrease in mitochondrial phospholipids but also the elevation of {GOT}, {GPT}, and {mGOT} although {CoQ}10 did not prevent the elevation of T-Bil and {TBA} levels. In vitro study: Using intact rat liver mitochondria, the effect of taurocholic acid ({TCA}), one of the physiological bile salts, on the mitochondrial function and on mitochondrial phospholipids was examined. Incubation of mitochondria with {TCA} induced a dose-dependent deterioration of mitochondrial function and the increase in the content of solubilized phospholipids. The protective effect of {CoQ}10 was also observed in the in vitro study. These results indicate that degradation of mitochondrial phospholipids by bile acids is responsible for the early phase of liver dysfunction induced by obstructive jaundice.},
	pages = {1427--30},
	number = {9},
	journaltitle = {Arzneimittelforschung},
	author = {Nishimura, D and Imoto, M and Satake, T and Sugiyama, S and Ozawa, T},
	date = {1985}
}

@article{pehlivan_effects_2011,
	title = {The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial},
	volume = {17},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21881371},
	abstract = {The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Pehlivan E, Turna A, Gurses A, Gurses {HN}. Source Chest Diseases and Thoracic Surgery, Yedikule Teaching Hospital, Istanbul, Turkey. Abstract {BACKGROUND}: We planned to investigate the effect of preoperative short period intensive physical therapy on lung functions, gas-exchange, and capacity of diffusion, and ventilation-perfusion distribution of patients with non-small cell lung cancer. {METHODS}: Sixty patients with lung cancer, who were deemed operable, were randomly allocated into two groups. Intensive physical therapy was performed in patients in the study group before operation. Both groups received routine physical therapy after operation. {RESULTS}: There was no difference in pulmonary function tests between the two groups. Intensive physical therapy statistically significantly increased peripheral blood oxygen saturation. At least one complication was noted in 5 patients (16.7\%) in the control group, and 2 (6.7\%), in the study group. However, there was no statistically significant difference (p = 0,4). The hospital stay has been found to be statistically significantly shortened by intensive physical therapy (p {\textless}0.001). Ventilation-perfusion distribution was found to be significantly effected by intensive physical therapy. The change was prominent in the the contralateral lung (p {\textless}0.001). {CONCLUSIONS}: Intensive physical therapy appeared to increase oxygen saturation, reduce hospital stay, and change the ventilation/perfusion distribution. It had a significant, positive effect on the exercise capacity of patients.},
	pages = {461--8},
	number = {5},
	journaltitle = {Ann Thorac Cardiovasc Surg},
	author = {Pehlivan, Esra and Turna, Akif and Gurses, Atilla and Gurses, Hulya Nilgun},
	date = {2011-10}
}

@article{palani_velu_serum_2014,
	title = {Serum amylase on the night of surgery predicts clinically significant pancreatic  fistula after pancreaticoduodenectomy.},
	volume = {16},
	rights = {(c) 2013 International Hepato-Pancreato-Biliary Association.},
	doi = {10.1111/hpb.12184},
	abstract = {{OBJECTIVES}: Drainage after pancreaticoduodenectomy ({PD}) remains controversial because the risk for uncontrolled postoperative pancreatic fistula ({POPF}) must be balanced against the potential morbidity associated with prolonged and possibly unnecessary drainage. This study investigated the utility of the level of serum amylase on the night of surgery [postoperative day ({PoD}) 0 serum amylase] to predict {POPF}. {METHODS}: A total of 185 patients who underwent {PD} were studied. Occurrences of {POPF} were graded using the International Study Group on Pancreatic Fistula ({ISGPF}) classification. Receiver operating characteristic ({ROC}) analysis  identified a threshold value of {PoD} 0 serum amylase associated with clinically significant {POPF} ({ISGPF} Grades B and C) in a test cohort (n = 45). The accuracy of this threshold value was then tested in a validation cohort (n = 140). {RESULTS}: Overall, 43 (23.2\%) patients developed clinically significant {POPF}. The  threshold value of {PoD} 0 serum amylase for the identification of clinically significant {POPF} was {\textgreater}/= 130 {IU}/l (P = 0.003). Serum amylase of {\textless}130 {IU}/l had a negative predictive value of 88.8\% for clinically significant {POPF} (P {\textless} 0.001). Serum amylase of {\textgreater}/= 130 {IU}/l on {PoD} 0 and a soft pancreatic parenchyma were independent risk factors for clinically significant {POPF}. {CONCLUSIONS}: Postoperative day 0 serum amylase of {\textless}130 {IU}/l allows for the early and accurate  categorization of patients at least risk for clinically significant {POPF} and may  identify patients suitable for early drain removal.},
	pages = {610--619},
	number = {7},
	journaltitle = {{HPB} : the official journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Palani Velu, Lavanniya K. and Chandrabalan, Vishnu V. and Jabbar, Salman and {McMillan}, Donald C. and {McKay}, Colin J. and Carter, C. Ross and Jamieson, Nigel B. and Dickson, Euan J.},
	date = {2014-07},
	pmid = {24246024},
	pmcid = {PMC4105898},
	keywords = {Amylases/*blood, Area Under Curve, Biological Markers/blood, Device Removal, Drainage/adverse effects/instrumentation, Female, Humans, Male, Middle Aged, Pancreatic Fistula/blood/enzymology/*etiology/mortality, Pancreaticoduodenectomy/*adverse effects/mortality, Predictive Value of Tests, Retrospective Studies, Risk Factors, {ROC} Curve, Time Factors, Treatment Outcome}
}

@article{zhu_risk_2010,
	title = {Risk factors and outcome of pancreatic fistula after consecutive pancreaticoduodenectomy with pancreaticojejunostomy for patients with malignant tumor},
	volume = {22},
	issn = {1000-9604, 1993-0631},
	url = {http://link.springer.com/10.1007/s11670-010-0032-9},
	doi = {10.1007/s11670-010-0032-9},
	pages = {32--41},
	number = {1},
	journaltitle = {Chinese Journal of Cancer Research},
	author = {Zhu, Wei-hua and Li, Shu and Zhang, Da-fang and Peng, Ji-run and Jin, Zhong-tian and Li, Guang-ming and Wang, Fu-shun and Zhu, Ji-ye and Leng, Xi-sheng},
	urldate = {2015-05-18},
	date = {2010-03},
	langid = {english},
	file = {796-MS.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PZSUDWJ2\\796-MS.pdf:application/pdf}
}

@article{johnson_persistent_2004,
	title = {Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15306596},
	abstract = {In predicted severe acute pancreatitis, many patients develop organ failure and recover without local complications, and mortality is only 14-30\%. It has been suggested that half of patients with progressive early organ failure may die, but there are no data to relate death or local complications to duration of early (week 1) organ failure.},
	pages = {1340--4},
	number = {9},
	journaltitle = {Gut},
	author = {Johnson, C D and Abu-Hilal, M},
	date = {2004-09}
}

@article{tamijmarane_application_2008,
	title = {Application of Portsmouth modification of physiological and operative severity scoring system for enumeration of morbidity and mortality (P-{POSSUM}) in pancreatic surgery},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18400108},
	abstract = {{BACKGROUND}: Pancreatoduodenectomy ({PD}) is associated with high incidence of morbidity and mortality. We have applied P-{POSSUM} in predicting the incidence of outcome after {PD} to identify those who are at the highest risk of developing complications. {METHOD}: A prospective database of 241 consecutive patients who had {PD} from January 2002 to September 2005 was retrospectively updated and analysed. P-{POSSUM} score was calculated for each patient and correlated with observed morbidity and mortality. {RESULTS}: 30 days mortality was 7.8\% and morbidity was 44.8\%. Mean physiological score was 16.07 +/- 3.30. Mean operative score was 13.67 +/- 3.42. Mean operative score rose to 20.28 +/- 2.52 for the complex major operation (p {\textless} 0.001) with 2 fold increase in morbidity and 3.5 fold increase in mortality. For groups of patients with a physiological score of (less than or equal to) 18, the O:P (observed to Predicted) morbidity ratio was 1.3-1.4 and, with a physiological score of {\textgreater}18, the O:P ratio was nearer to 1. Physiological score and white cell count were significant in a multivariate model. {CONCLUSION}: P-{POSSUM} underestimated the mortality rate. While P-{POSSUM} analysis gave a truer prediction of morbidity, underestimation of morbidity and potential for systematic inaccuracy in prediction of complications at lower risk levels is a significant issue for pancreatic surgery.},
	pages = {39},
	journaltitle = {World J Surg Oncol},
	author = {Tamijmarane, Appou and Bhati, Chandra S and Mirza, Darius F and Bramhall, Simon R and Mayer, David A and Wigmore, Stephen J and Buckels, John Ac},
	date = {2008}
}

@article{gloor_late_2001,
	title = {Late mortality in patients with severe acute pancreatitis},
	volume = {88},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11442530},
	abstract = {Mortality due to severe or necrotizing acute pancreatitis most often results from multiorgan dysfunction syndrome ({MODS}) occurring either early (within the first 14 days) or 2 weeks or more after the onset of symptoms due to septic complications. The aim of this study was to analyse the course of the disease in patients who died from severe acute pancreatitis.},
	pages = {975--9},
	number = {7},
	journaltitle = {Br J Surg},
	author = {Gloor, B and Müller, C A and Worni, M and Martignoni, M E and Uhl, W and Büchler, M W},
	date = {2001-07}
}

@article{iscar_functional_2009,
	title = {Functional Capacity Before and After Liver Transplantation},
	volume = {41},
	issn = {00411345},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S004113450900150X},
	doi = {10.1016/j.transproceed.2009.02.013},
	pages = {1014--1015},
	number = {3},
	journaltitle = {Transplantation Proceedings},
	author = {Iscar, M. and Montoliu, M.A. and Ortega, T. and Rodriguez, B. and Rodríguez, M. and Glez-Pinto, I. and Alonso, P.},
	urldate = {2014-01-27},
	date = {2009-04},
	file = {Iscar et al. - 2009 - Functional Capacity Before and After Liver Transpl.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\W8IBXNE6\\Iscar et al. - 2009 - Functional Capacity Before and After Liver Transpl.pdf:application/pdf}
}

@article{abdullah_ampullary_2009,
	title = {Ampullary carcinoma: effect of preoperative biliary drainage on surgical outcome},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19533815},
	abstract = {{AIM}: To evaluate the influence of preoperative biliary drainage on morbidity and mortality after surgical resection for ampullary carcinoma. {METHODS}: We analyzed retrospectively data for 82 patients who underwent potentially curative surgery for ampullary carcinoma between September 1993 and July 2007 at the Singapore General Hospital, a tertiary referral hospital. Diagnosis of ampullary carcinoma was confirmed histologically. Thirty-five patients underwent preoperative biliary drainage ({PBD} group), and 47 were not drained (non-{PBD} group). The mode of biliary drainage was endoscopic retrograde cholangiopancreatography (n = 33) or percutaneous biliary drainage (n = 2). The following parameters were analyzed: wound infection, intra-abdominal abscess, intra-abdominal or gastrointestinal bleeding, septicemia, biliary or pancreatic leakage, pancreatitis, gastroparesis, and re-operation rate. Mortality was assessed at 30 d (hospital mortality) and also long-term. The statistical endpoint of this study was patient survival after surgery. {RESULTS}: The groups were well matched for demographic criteria, clinical presentation and operative characteristics, except for lower hemoglobin in the non-{PBD} group (10.9 +/- 1.6 vs 11.8 +/- 1.6 in the {PBD} group). Of the parameters assessing postoperative morbidity, incidence of wound infection was significantly less in the {PBD} than the non-{PBD} group [1 (2.9\%) vs 12 (25.5\%)]. However, the rest of the parameters did not differ significantly between the groups, i.e. sepsis [10 (28.6\%) vs 14 (29.8\%)], intra-abdominal bleeding [1 (2.9\%) vs 5 (10.6\%)], intra-abdominal abscess [1 (2.9\%) vs 8 (17\%)], gastrointestinal bleeding [3 (8.6\%) vs 5 (10.6\%)], pancreatic leakage [2 (5.7\%) vs 3 (6.4\%)], biliary leakage [2 (5.7\%) vs 3 (6.4\%)], pancreatitis [2 (5.7\%) vs 2 (4.3\%)], gastroparesis [6 (17.1\%) vs 10 (21.3\%)], need for blood transfusion [10 (28.6\%) vs 17 (36.2\%)] and re-operation rate [1 (2.9\%) vs 5 (10.6\%)]. There was no early mortality in either group. Median survival was 44 mo (95\% {CI}: 34.2-53.8) in the {PBD} group and 41 mo (95\% {CI}: 27.7-54.3; P = 0.86) in the non-{PBD} group. {CONCLUSION}: Biliary drainage before surgery for ampullary cancer significantly reduced postoperative wound infection. Overall mortality was not influenced by preoperative drainage.},
	pages = {2908--12},
	number = {23},
	journaltitle = {World J Gastroenterol},
	author = {Abdullah, Sheikh Anwar and Gupta, Tarun and Jaafar, Khairul Azhar and Chung, Yaw Fui Alexander and Ooi, London Lucien Peng Jin and Mesenas, Steven Joseph},
	date = {2009-06}
}

@article{oliphant_validation_2015,
	title = {Validation of a modified clinical risk score to predict cancer-specific survival  for stage {II} colon cancer.},
	volume = {4},
	rights = {(c) 2014 The Authors. Cancer Medicine published by John Wiley \& Sons Ltd.},
	doi = {10.1002/cam4.352},
	abstract = {Many patients with stage {II} colon cancer will die of their disease despite curative surgery. Therefore, identification of patients at high risk of poor outcome after surgery for stage {II} colon cancer is desirable. This study aims to  validate a clinical risk score to predict cancer-specific survival in patients undergoing surgery for stage {II} colon cancer. Patients undergoing surgery for stage {II} colon cancer in 16 hospitals in the West of Scotland between 2001 and 2004 were identified from a prospectively maintained regional clinical audit database. Overall and cancer-specific survival rates up to 5 years were calculated. A total of 871 patients were included. At 5 years, cancer-specific survival was 81.9\% and overall survival was 65.6\%. On multivariate analysis, age  {\textgreater}/=75 years (hazard ratio ({HR}) 2.11, 95\% confidence intervals ({CI}) 1.57-2.85; P{\textless}0.001) and emergency presentation ({HR} 1.97, 95\% {CI} 1.43-2.70; P{\textless}0.001) were independently associated with cancer-specific survival. Age and mode of presentation {HRs} were added to form a clinical risk score of 0-2. The cancer-specific survival at 5 years for patients with a cumulative score 0 was 88.7\%, 1 was 78.2\% and 2 was 65.9\%. These results validate a modified simple clinical risk score for patients undergoing surgery for stage {II} colon cancer. The combination of these two universally documented clinical factors provides a solid foundation for the examination of the impact of additional clinicopathological and treatment factors on overall and cancer-specific survival.},
	pages = {84--89},
	number = {1},
	journaltitle = {Cancer medicine},
	shortjournal = {Cancer Med},
	author = {Oliphant, Raymond and Horgan, Paul G. and Morrison, David S. and {McMillan}, Donald C.},
	date = {2015-01},
	pmid = {25487740},
	pmcid = {PMC4312121}
}

@article{knight_evaluation_2010,
	title = {Evaluation of surgical outcome scores according to {ISGPS} definitions in patients undergoing pancreatic resection},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20938180},
	abstract = {To evaluate the role of the Physiological and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}), the Portsmouth variant (p-{POSSUM}) and the Glasgow Prognostic Score ({GPS}) in predicting outcome after pancreatic surgery with reference to the International Study Group of Pancreatic Surgery ({ISGPS}) definitions of post-pancreatectomy complications.},
	pages = {367--74},
	number = {5},
	journaltitle = {Dig Surg},
	author = {Knight, B C and Kausar, A and Manu, M and Ammori, B A and Sherlock, D J and O'Reilly, D A},
	date = {2010},
	file = {Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H8XCSFWD\\Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:application/pdf;Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TM6IXC45\\Knight et al. - 2010 - Evaluation of surgical outcome scores according to.pdf:application/pdf}
}

@collection{sternberg_histology_1997,
	location = {Philadelphia},
	edition = {2. ed},
	title = {Histology for pathologists},
	isbn = {978-0-397-51718-3},
	pagetotal = {1200},
	publisher = {Lippincott-Raven},
	editor = {Sternberg, Stephen S.},
	date = {1997},
	keywords = {Histologie, Histology, Histology, Pathological, Histopathologie, Pathology},
	file = {The Impact of Obesity on Surgical Outcome after PD.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FDI3HJ2X\\The Impact of Obesity on Surgical Outcome after PD.pdf:application/pdf;The Impact of Obesity on Surgical Outcome after PD.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AQQB58B5\\The Impact of Obesity on Surgical Outcome after PD.pdf:application/pdf}
}

@article{roxburgh_tumour_2009,
	title = {Tumour inflammatory infiltrate predicts survival following curative resection for node-negative colorectal cancer.},
	volume = {45},
	doi = {10.1016/j.ejca.2009.04.011},
	abstract = {{BACKGROUND}: A pronounced tumour inflammatory infiltrate is known to confer a good outcome in colorectal cancer. Klintrup and colleagues reported a structured assessment of the inflammatory reaction at the invasive margin scoring low grade  or high grade. The aim of the present study was to examine the prognostic value of tumour inflammatory infiltrate in node-negative colorectal cancer. {METHODS}: Two hundred patients had undergone surgery for node-negative colorectal cancer between 1997 and 2004. Specimens were scored with Jass' and Klintrup's criteria for peritumoural infiltrate. Pathological data were taken from the reports at that time. {RESULTS}: Low-grade inflammatory infiltrate assessed using Klintrup's criteria was an independent prognostic factor in node-negative disease. In patients with a low-risk Petersen Index (n=179), low-grade infiltrate carried a threefold increased risk of cancer death. Low-grade infiltrate was related to increasing T stage and an infiltrating margin. {CONCLUSION}: Assessment of inflammatory infiltrate using Klintrup's criteria provides independent prognostic information on node-negative colorectal cancer. A high-grade local inflammatory response may represent effective host immune responses impeding tumour growth.},
	pages = {2138--2145},
	number = {12},
	journaltitle = {European journal of cancer (Oxford, England : 1990)},
	shortjournal = {Eur J Cancer},
	author = {Roxburgh, Campbell S. D. and Salmond, Jonathan M. and Horgan, Paul G. and Oien, Karin A. and {McMillan}, Donald C.},
	date = {2009-08},
	pmid = {19409772},
	keywords = {Aged, Colorectal Neoplasms/*mortality/*pathology/surgery, Female, Humans, Inflammation/mortality/pathology, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Predictive Value of Tests, Prognosis, Risk Assessment, Survival Analysis}
}

@article{park_relationship_2014,
	title = {The relationship between tumour stroma percentage, the tumour microenvironment and survival in patients with primary operable colorectal cancer.},
	volume = {25},
	doi = {10.1093/annonc/mdt593},
	abstract = {{BACKGROUND}: Tumour stroma percentage ({TSP}) has previously been reported to predict survival in patients with colorectal cancer ({CRC}); however, whether this  is independent of other aspects of the tumour microenvironment is unknown. In the present study, the relationship between {TSP}, the tumour microenvironment and survival was examined in patients undergoing elective, curative {CRC} resection. {PATIENTS} {AND} {METHODS}: Patients undergoing resection at a single centre (1997-2008) were identified from a prospective database. {TSP} was measured at the  invasive margin and its association with cancer-specific survival ({CSS}) and clinicopathological characteristics examined. {RESULTS}: Three hundred and thirty-one patients were included in the analysis. {TSP} was associated with {CSS} in patients with stage I-{III} disease [hazard ratio ({HR}) 1.84, 95\% confidence interval ({CI}) 1.17-2.92, P = 0.009], independent of age, systemic inflammation, N stage, venous invasion and Klintrup-Makinen score. Furthermore, {TSP} was associated with reduced {CSS} in patients with node-negative disease ({HR} 2.14, 95\%  {CI} 1.01-4.54, P = 0.048) and those who received adjuvant chemotherapy ({HR} 2.83, 95\% {CI} 1.23-6.53, P = 0.015), independent of venous invasion and host inflammatory responses. {TSP} was associated with several adverse pathological characteristics, including advanced T and N stage. Furthermore, {TSP} was associated with an infiltrative invasive margin and inversely associated with necrosis. {CONCLUSIONS}: The {TSP} was a significant predictor of survival in patients undergoing elective, curative {CRC} resection, independent of adverse pathological characteristics and host inflammatory responses. In addition, {TSP} was strongly associated with local tumour growth and invasion.},
	pages = {644--651},
	number = {3},
	journaltitle = {Annals of oncology : official journal of the European Society for Medical Oncology / {ESMO}},
	shortjournal = {Ann Oncol},
	author = {Park, J. H. and Richards, C. H. and {McMillan}, D. C. and Horgan, P. G. and Roxburgh, C. S. D.},
	date = {2014-03},
	pmid = {24458470},
	keywords = {*Tumor Microenvironment, Aged, Chemotherapy, Adjuvant, Colon/surgery, Colorectal Neoplasms/mortality/*pathology/surgery, Female, Humans, Lymphocytes, Tumor-Infiltrating/*cytology, Male, Rectum/surgery}
}

@article{selberg_effect_1995,
	title = {Effect of increased protein intake and nutritional status on whole-body protein metabolism of {AIDS} patients with weight loss.},
	volume = {44},
	abstract = {The aim of this study was to investigate nutritional status and protein metabolism during total parenteral nutrition ({TPN}) in {AIDS} patients with weight loss. Six patients on treatment for {AIDS}-associated complications were investigated and reviewed {TPN} that supplied energy equivalent to 1.5 times the resting energy expenditure ({REE}). Amino acid ({AA}) supply increased from 0.6 g/kg  body weight ({BW})/d on days 1 to 3 and 1.2 on days 4 to 6 to 1.8 on days 7 to 9. Nonprotein energy was given as equicaloric amounts of glucose and fat emulsion. There were repeated measurements of nitrogen balance and whole-body protein turnover ({WBPT}) using a bolus 15N-glycine method on the morning of days 3, 6, and 9. Principal findings were as follows: (1) increasing the supply of {AAs} significantly improves nitrogen balance in {AIDS} patients; (2) there is no simple  linear effect of increasing amounts of {AAs} on {WBPT} in {AIDS} patients; (3) {WBPT} is  high and variable in these patients; and (4) mean {WBPT} of each patient is significantly correlated with body cell mass ({BCM}) as a proportion of {BW} (P {\textless} .001, r = .92). We conclude that poor nutritional status in {AIDS} patients with weight loss is associated with high {WBPT}. However, these patients can attain at least transiently positive nitrogen balance with sufficient protein intake, predominantly through an increase in whole-body protein synthesis ({WBPS}).},
	pages = {1159--1165},
	number = {9},
	journaltitle = {Metabolism: clinical and experimental},
	shortjournal = {Metabolism},
	author = {Selberg, O. and Suttmann, U. and Melzer, A. and Deicher, H. and Muller, M. J. and Henkel, E. and {McMillan}, D. C.},
	date = {1995-09},
	pmid = {7666789},
	keywords = {*Nutritional Status, *Parenteral Nutrition, Total, *Weight Loss, Acquired Immunodeficiency Syndrome/*metabolism, Adult, Amino Acids/administration \& dosage, Dietary Proteins/*administration \& dosage, Energy Intake, Energy Metabolism, Female, Humans, Male, Middle Aged, Nitrogen/metabolism, Proteins/*metabolism}
}

@article{wasserman_lactate_1967,
	title = {Lactate and related acid base and blood gas changes during constant load and graded exercise.},
	volume = {96},
	issn = {0008-4409},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936113/},
	pages = {775--783},
	number = {12},
	journaltitle = {Canadian Medical Association Journal},
	shortjournal = {Can Med Assoc J},
	author = {Wasserman, K.},
	urldate = {2015-08-22},
	date = {1967-03-25},
	pmid = {6020874},
	pmcid = {PMC1936113},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X6FP929I\\Wasserman - 1967 - Lactate and related acid base and blood gas change.pdf:application/pdf}
}

@article{banks_classification_2013,
	title = {Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23100216},
	abstract = {The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary.},
	author = {Banks, Peter A and Bollen, Thomas L and Dervenis, Christos and Gooszen, Hein G and Johnson, Colin D and Sarr, Michael G and Tsiotos, Gregory G and Vege, Santhi Swaroop},
	date = {2013-01}
}

@article{cao_expression_2009,
	title = {Expression of {HIF}-1alpha and {VEGF} in colorectal cancer: association with clinical outcomes and prognostic implications},
	volume = {9},
	issn = {1471-2407},
	url = {http://www.biomedcentral.com/1471-2407/9/432},
	doi = {10.1186/1471-2407-9-432},
	shorttitle = {Expression of {HIF}-1alpha and {VEGF} in colorectal cancer},
	pages = {432},
	number = {1},
	journaltitle = {{BMC} Cancer},
	author = {Cao, Dan and Hou, Mei and Guan, Yong-song and Jiang, Ming and Yang, Yu and Gou, Hong-feng},
	urldate = {2015-04-28},
	date = {2009},
	langid = {english},
	file = {Cao et al. - 2009 - Expression of HIF-1alpha and VEGF in colorectal ca.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\93GSI4GH\\Cao et al. - 2009 - Expression of HIF-1alpha and VEGF in colorectal ca.pdf:application/pdf}
}

@article{winter_biochemical_2007,
	title = {Biochemical markers predict morbidity and mortality after pancreaticoduodenectomy},
	volume = {204},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17481534},
	abstract = {{BACKGROUND}: The association between routinely ordered perioperative laboratory tests and postoperative morbidity and mortality after pancreaticoduodenectomy has not been well characterized. {STUDY} {DESIGN}: Routine perioperative laboratory data were analyzed for 2,894 patients who underwent a pancreaticoduodenectomy over a 25-year period. Laboratory values were initially categorized as being above or below the 75th percentile for the study population, and biochemical markers of morbidity and mortality were identified using multivariate logistic regression. The most significant biochemical markers were studied in greater detail by regrouping patients into low, intermediate, and high categories. {RESULTS}: Significant multivariate predictors of a postoperative complication included preoperative blood urea nitrogen{\textgreater} or =18 mg/{dL}, preoperative albumin{\textless} or =3.5 g/{dL}, and postoperative amylase{\textgreater} or =292 U/L. Significant multivariate predictors of a postoperative death included preoperative albumin{\textless} or =3.5 g/{dL} and postoperative aminotransferase{\textgreater} or =187 U/L. Postoperative hyperamylasemia was found to be associated, in particular, with an increased pancreatic fistula rate. Pancreatic fistula rates in the low (0 to 99 U/L), intermediate (100 to 399 U/L), and high ({\textgreater} or = 400 U/L) postoperative amylase groups were 4\%, 14\%, and 20\%, respectively. Postoperative mortality rates in patients with low (0 to 499 U/L), intermediate (500 to 1,999 U/L), and high ({\textgreater} or = 2,000 U/L) postoperative aminotransferase groups were 0.9\%, 5\%, and 29\%, respectively. Postoperative mortality rates in the high ({\textgreater} 3.5 g/{dL}), intermediate (2.6 to 3.5 g/{dL}), and low (0 to 2.5 g/{dL}) albumin groups were 0.9\%, 3\%, and 7\%, respectively. {CONCLUSIONS}: Routine perioperative laboratory tests can help surgeons identify patients who are at increased risk for morbidity and mortality after pancreaticoduodenectomy.},
	pages = {1029--36; discussion 1037--8},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Winter, Jordan M and Cameron, John L and Yeo, Charles J and Alao, Babatunde and Lillemoe, Keith D and Campbell, Kurtis A and Schulick, Richard D},
	date = {2007-05}
}

@article{peng_impact_2012,
	title = {Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma},
	volume = {16},
	issn = {1873-4626},
	doi = {10.1007/s11605-012-1923-5},
	abstract = {{INTRODUCTION}: Assessing patient-specific risk factors for long-term mortality following resection of pancreatic adenocarcinoma can be difficult. Sarcopenia--the measurement of muscle wasting--may be a more objective and comprehensive patient-specific factor associated with long-term survival.
{METHODS}: Total psoas area ({TPA}) was measured on preoperative cross-sectional imaging in 557 patients undergoing resection of pancreatic adenocarcinoma between 1996 and 2010. Sarcopenia was defined as the presence of a {TPA} in the lowest sex-specific quartile. The impact of sarcopenia on 90-day, 1-year, and 3-year mortality was assessed relative to other clinicopathological factors.
{RESULTS}: Mean patient age was 65.7 years and 53.1 \% was male. Mean {TPA} among men (611 mm²/m²) was greater than among women (454 mm²/m²). Surgery involved pancreaticoduodenectomy (86.0 \%) or distal pancreatectomy (14.0 \%). Mean tumor size was 3.4 cm; 49.9 \% and 88.5 \% of patients had vascular and perineural invasion, respectively. Margin status was R0 (59.0 \%) and 77.7 \% patients had lymph node metastasis. Overall 90-day mortality was 3.1 \% and overall 1- and 3-year survival was 67.9 \% and 35.7 \%, respectively. Sarcopenia was associated with increased risk of 3-year mortality ({HR} = 1.68; P {\textless} 0.001). Tumor-specific factors such as poor differentiation on histology ({HR} = 1.75), margin status ({HR} = 1.66), and lymph node metastasis ({HR} = 2.06) were associated with risk of death at 3-years (all P {\textless} 0.001). After controlling for these factors, sarcopenia remained independently associated with an increased risk of death at 3 years ({HR} = 1.63; P {\textless} 0.001).
{CONCLUSIONS}: Sarcopenia was a predictor of survival following pancreatic surgery, with sarcopenic patients having a 63 \% increased risk of death at 3 years. Sarcopenia was an objective measure of patient frailty that was strongly associated with long-term outcome independent of tumor-specific factors.},
	pages = {1478--1486},
	number = {8},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Peng, Peter and Hyder, Omar and Firoozmand, Amin and Kneuertz, Peter and Schulick, Richard D. and Huang, Donghang and Makary, Martin and Hirose, Kenzo and Edil, Barish and Choti, Michael A. and Herman, Joseph and Cameron, John L. and Wolfgang, Christopher L. and Pawlik, Timothy M.},
	date = {2012-08},
	pmid = {22692586},
	pmcid = {PMC3578313},
	keywords = {Adenocarcinoma, Adult, Aged, Aged, 80 and over, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Pancreatectomy, Pancreatic Neoplasms, Pancreaticoduodenectomy, preoperative care, Psoas Muscles, Retrospective Studies, Risk assessment, Risk Factors, Sarcopenia, Survival Rate, Treatment Outcome}
}

@article{xiong_meta-analysis_2014,
	title = {Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy},
	volume = {101},
	rights = {© 2014 {BJS} Society Ltd. Published by John Wiley \& Sons Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.9553/abstract},
	doi = {10.1002/bjs.9553},
	abstract = {Background

Surgical reconstruction following pancreaticoduodenectomy ({PD}) is associated with significant morbidity and mortality. Because of great variability in definitions of specific complications, it remains unclear whether there is a difference in complication rates following the two commonest types of reconstruction, pancreaticogastrostomy ({PG}) and pancreaticojejunostomy ({PJ}). Published consensus definitions for postoperative pancreatic fistula ({POPF}) have led to a series of randomized clinical trials ({RCTs}) uniquely placed to address this question.


Methods

A literature search was carried out to identify all {RCTs} comparing postoperative complications of {PG} versus {PJ} reconstruction following {PD} published between January 1995 and December 2013. Pooled odds ratios ({ORs}) with 95 percent confidence intervals (c.i.) were calculated using fixed-effect or random-effects models.


Results

In total, seven {RCTs} with 1121 patients were included. Four of these trials applied definitions as published by the International Study Group on Pancreatic Fistula ({ISGPF}). Using {ISGPF} definitions, the incidence of {POPF} was lower in patients undergoing {PG} than in those having {PJ} ({OR} 0·50, 95 per cent c.i. 0·34 to 0·73; P {\textless} 0·001). Using definitions applied by each individual study, {PG} was associated with significantly lower rates of {POPF} ({OR} 0·51, 0·36 to 0·71; P {\textless} 0·001), intra-abdominal fluid collection ({OR} 0·50, 0·34 to 0·74; P {\textless} 0·001) and biliary fistula ({OR} 0·42, 0·18 to 0·93; P = 0·03) than {PJ}.


Conclusion

Meta-analysis of four {RCTs} based on {ISGPF} criteria, and seven {RCTs} using non-standard criteria, revealed that {PG} reduced the incidence of {POPF} after {PD} compared with {PJ}.},
	pages = {1196--1208},
	number = {10},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Xiong, J. J. and Tan, C. L. and Szatmary, P. and Huang, W. and Ke, N. W. and Hu, W. M. and Nunes, Q. M. and Sutton, R. and Liu, X. B.},
	urldate = {2015-05-17},
	date = {2014-09-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RFVPD4PE\\Xiong et al. - 2014 - Meta-analysis of pancreaticogastrostomy versus pan.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JZWJWF9Q\\abstract.html:text/html}
}

@article{mohammed_relationship_2013,
	title = {The relationship between lymphovascular invasion and angiogenesis, hormone receptors, cell proliferation and survival in patients with primary operable invasive ductal breast cancer.},
	volume = {13},
	doi = {10.1186/1472-6890-13-31},
	abstract = {{BACKGROUND}: Several well-established tumour prognostic factors are used to guide  the clinical management of patients with breast cancer. Lymphovascular invasion and angiogenesis have also been reported to have some promise as prognostic factors. The aim of the present study was to examine the prognostic value of tumour lymphovascular invasion and microvessel density compared with that of established prognostic factors in invasive ductal breast cancer. {METHODS}: In addition to hormone receptor status and Ki-67 proliferative activity, lymphovascular invasion and microvessel density and their relationship with survival were examined in patients with invasive ductal breast cancer. Full sections and tissue microarrays (n = 384 patients) were utilised to assess these  factors and were scored by appropriate methods. {RESULTS}: On univariate analysis tumour size (P {\textless} 0.05), lymph node involvement (P {\textless} 0.01), lymphovascular invasion (P {\textless} 0.05), microvessel density (P {\textless} 0.05) and local- regional treatment (P {\textless} 0.01) were associated with poorer survival in {ER} negative tumours. On multivariate analysis in {ER} negative tumours lymph node involvement (P {\textless} 0.01) and local- regional treatment (P {\textless} 0.05) were independently associated with poorer cancer-specific survival. On univariate analysis tumour grade (P {\textless} 0.05),  lymph node involvement (P {\textless} 0.001), {HER}-2 (P {\textless} 0.05), Ki-67 (P {\textless} 0.01) and lymphovascular invasion (P {\textless} 0.001) were associated with poorer survival in {ER} positive tumours. On multivariate analysis lymph node involvement (P {\textless} 0.001), Ki-67 (P {\textless} 0.001) and lymphovascular invasion (P {\textless} 0.05) were independently associated with poorer cancer-specific survival in {ER} positive tumours. {CONCLUSION}: Lymphovascular invasion but not microvessel density was independently associated with poorer survival in patients with {ER} positive but not {ER} negative  invasive ductal breast cancer.},
	number = {1},
	journaltitle = {{BMC} clinical pathology},
	shortjournal = {{BMC} Clin Pathol},
	author = {Mohammed, Zahra Ma and {McMillan}, Donald C. and Edwards, Joanne and Mallon, Elizabeth and Doughty, Julie C. and Orange, Clare and Going, James J.},
	date = {2013},
	pmid = {24274633},
	pmcid = {PMC4175483}
}

@article{song_baroreflex_2009,
	title = {Baroreflex sensitivity is impaired in patients with obstructive jaundice},
	volume = {111},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19672165},
	abstract = {{BACKGROUND}: Obstructive jaundice is associated with enhanced susceptibility to hypotensive shock, renal failure, and toxic effects of endotoxin, which results in high perioperative morbidity and mortality. Since the normal arterial baroreflex function is necessary for hemodynamic homeostasis and improving survival in sepsis, this study aimed to determine whether baroreflex sensitivity was impaired in jaundiced patients. {METHODS}: Thirty-five patients with obstructive jaundice scheduled for surgery were included, and 30 nonjaundiced patients served as controls. A modified Oxford pharmacologic technique was used for evaluating baroreflex sensitivity immediately before the surgery. Potential factors that may affect baroreflex sensitivity in jaundice, such as liver biochemistry, plasma concentrations of methionine-enkephalin, atrial natriuretic peptide and nitrate, were also measured. {RESULTS}: Patients with obstructive jaundice had decreased sensitivity in both the sympathetic and vagal components of the baroreflex, as compared with the controls (P {\textless} 0.01). There was a significant inverse correlation between plasma atrial natriuretic peptide concentration and decreased sympathetic baroreflex sensitivity in the jaundiced group (r = -0.44, P = 0.008). {CONCLUSIONS}: Baroreflex sensitivity is impaired in patients with obstructive jaundice, which may contribute to their enhanced susceptibility to the well-known perioperative complications. The underlying mechanisms for such a change may be associated with an increased level of plasma atrial natriuretic peptide.},
	pages = {561--5},
	number = {3},
	journaltitle = {Anesthesiology},
	author = {Song, Jian-Gang and Cao, Yun-Fei and Sun, Yu-Ming and Ge, Yan-Hu and Xu, Xue-Wu and Yang, Li-Qun and Liu, Zhi-Qiang and Song, Shao-Li and Yu, Wei-Feng},
	date = {2009-09},
	file = {Song et al. - 2009 - Baroreflex sensitivity is impaired in patients wit.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IWJTMM88\\Song et al. - 2009 - Baroreflex sensitivity is impaired in patients wit.pdf:application/pdf}
}

@article{cicoira_prediction_2004,
	title = {Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue},
	volume = {10},
	issn = {10719164},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S107191640300811X},
	doi = {10.1016/j.cardfail.2003.12.009},
	pages = {421--426},
	number = {5},
	journaltitle = {Journal of Cardiac Failure},
	author = {Cicoira, Mariantonietta and Davos, Constantinos H. and Francis, Darrel P. and Doehner, Wolfram and Zanolla, Luisa and Franceschini, Lorenzo and Piepoli, Massimo F. and Coats, Andrew J.S. and Zardini, Piero and Poole-Wilson, Philip A. and Anker, Stefan D.},
	urldate = {2014-01-27},
	date = {2004-10},
	file = {Cicoira et al. - 2004 - Prediction of mortality in chronic heart failure f.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FXZRC4MU\\Cicoira et al. - 2004 - Prediction of mortality in chronic heart failure f.pdf:application/pdf}
}

@article{isla_pancreaticoduodenectomy_2007,
	title = {Pancreaticoduodenectomy for periampullary malignancies: the effect of bile colonization on the postoperative outcome},
	volume = {392},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17089176},
	abstract = {{OBJECTIVES}: The presence of bacteria in the bile of patients undergoing biliary tract surgery has been proposed as associated to an increased incidence of postoperative complications. The present study was designed to determine whether colonization of the bile has an adverse effect in terms of postoperative infectious or noninfectious complications and mortality in a homogenous population of patients suffering from periampullary region malignancies, who all underwent resectional (curative) procedures. {MATERIALS} {AND} {METHODS}: Between January 1997 and December 2002, 115 patients (n = 115) suffering from periampullary region malignancies underwent resectional procedures. Fifty-two of the above patients were referred having undergone preoperative internal biliary drainage. During the operation, bile was routinely isolated from the common bile duct and was sent for culture and sensitivity. Based on the bile culture results, the patients were divided in sterile and colonized group and were retrospectively compared in terms of postoperative outcome and mortality. {RESULTS}: Of the 115 bile cultures, 67 were colonized with bacteria and 48 were sterile. Postoperatively, 40 patients developed 35 noninfectious and 21 infectious complications. Univariate analysis did not disclose statistically significant differences in overall, noninfectious or infectious morbidity and mortality between the two groups of patients. Although not statistically significant, a higher incidence (22 vs 10\%) of postoperative leaks in the colonized group of patients was noticed. Multiple regression analysis disclosed that colonized bile was independently related to the advanced age, preoperative biliary drainage presence, elevated preoperative serum bilirubin levels and low preoperative serum albumin levels but did not predispose to an increased postoperative morbidity, mortality, or reoperation rate. {CONCLUSION}: The present study did not conclude in any statistically significant differences in the postoperative infectious and noninfectious morbidity as well as mortality, between colonized and sterile groups of patients who underwent resectional procedures for malignancies of the periampullary region. Although internal biliary drainage introduces microorganisms into the biliary tree, this colonization does not increase the risk of either infectious or noninfectious complications or postoperative death. Thus, the likelihood of bacterobilia should not contraindicate the procedure in selected cases.},
	pages = {67--73},
	number = {1},
	journaltitle = {Langenbecks Arch Surg},
	author = {Isla, Alberto M and Griniatsos, John and Riaz, Ali and Karvounis, Evangelos and Williamson, Robin C N},
	date = {2007-01}
}

@article{fernandez_use_2000,
	title = {The use of cardiopulmonary exercise test in patients with mitochondrial myopathies},
	volume = {114},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10734620},
	abstract = {{BACKGROUND}: Exercise tests has been used in the diagnosis of metabolic myopathies. If there is an abnormal response pattern in mild mitochondrial myopathy ({MM}) and her role in the initial suspect diagnostic is unknown. {SUBJECTS} {AND} {METHODS}: Prospective study of 26 patients with mitochondrial myopathy (15 men, 11 women) and a control group of 14 sedentary volunteers (9 men, 5 woman) with similar antropometric characteristics. We have made pulmonary function tests and treadmill exercise with serial venous sampling of blood lactate, piruvate, ketone bodies, free fatty acids and creatinkinase. {RESULTS}: Patients with {MM} showed exercise limitation with lower maximal power ({MM} = 143 [47] vatts, C = 187 [40] vatts, p = 0.006), maximal oxygen uptake ({MM} = 27 [8] ml/min/kg, C = 40 [7] ml/min/kg, p = 0.001) and maximal oxygen pulse ({MM} = 11 [3] ml/beat, C = 14 [3] ml/beat, p = 0.006). For the same oxygen uptake the heart rate was higher and the anaerobic threshold was earlier in {MM} patients ({MM} = 48\% [14], C = 62\% [12], p = 0.01). We found a considerable slower maximal oxygen uptake in patients with lipid increase in muscle biopsy (n = 15). Acetoacetate curves, beta-hydroxybutyrate, free fatty acids and creatinkinase were similar in both groups. The exercise test was pathologic in 17/26 of the patients. The sensitivity of the exercise test for maximal oxygen uptake was 0.65. {CONCLUSIONS}: The cardiopulmonary exercise test is a useful test in the suspect initial diagnostic of patients with mild mitochondrial myopathy because the majority of patients show a pathologic test.},
	pages = {121--7},
	number = {4},
	journaltitle = {Med Clin (Barc)},
	author = {Fernández, J and Montemayor, T and Bautista, J and Márquez, R and Jiménez, L and Arenas, J and Campos, Y and Castillo, J},
	date = {2000-02}
}

@article{thomas_adjuvant_2010,
	title = {Adjuvant therapy in pancreatic cancer},
	volume = {28},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21088421},
	abstract = {Pancreatic cancer is one of the major causes of cancer death in Europe with a 5-year survival rate of less than 5\%. Although surgery cannot guarantee a cure, the 5-year survival does improve to around 10\% following resection and increases to 20-30\% with adjuvant chemotherapy. The European Study Group for Pancreatic Cancer ({ESPAC}) 1 trial was the first adequately powered, randomized study to assess chemoradiotherapy ({CRT}), concurrent with 5-fluorouracil (5-{FU}) and chemotherapy [5-{FU}/folinic acid ({FA})] in resected pancreatic cancer. There was a survival benefit for adjuvant chemotherapy, but not for adjuvant {CRT}. Adjuvant {CRT} also did not improve survival in the {EORTC} multicenter prospective randomized trial by Klinkenbijl et al. (1999). The phase 3 {RTOG} 9704 trial compared pre- and postchemoradiation gemcitabine to pre- and postchemoradiation 5-{FU}. Overall there was no difference in overall survival between the 2 arms. Adjuvant gemcitabine significantly improved disease-free survival and later overall survival compared to surgery alone in the {CONKO}-001 randomized trial. The {ESPAC}-3(v2) trial compared adjuvant gemcitabine versus 5-{FU}/{FA}. The final 2-year analysis demonstrated median survival from resection of patients treated with 5-{FU}/{FA} was 23.0 months (95\% {CI}: 21.1, 25.0) and 23.6 months (95\% {CI}: 21.4, 26.4) for patients treated with gemcitabine. Further randomized studies will assess the role of adjuvant combination chemotherapy ({ESPAC}-4). The key to the future of adjuvant therapy in pancreatic cancer will be the identification of novel and effective agents, and better biomarker technology underpinned by translational research which will inform the design of future trials.},
	pages = {684--92},
	number = {4},
	journaltitle = {Dig Dis},
	author = {Thomas, Amy and Dajani, Khaled and Neoptolemos, John P and Ghaneh, Paula},
	date = {2010}
}

@article{hill_simple_2010,
	title = {A Simple Risk Score to Predict In-Hospital Mortality After Pancreatic Resection for Cancer},
	volume = {17},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-010-0947-x},
	doi = {10.1245/s10434-010-0947-x},
	abstract = {Background Pancreatectomy for cancer continues to have substantial perioperative risk, and the factors affecting mortality are ill defined. An integer-based risk score based on national data might help clarify the risk of in-hospital mortality in patients undergoing pancreatic resection. Methods Records with the diagnosis of pancreatic cancer were queried from the Nationwide Inpatient Sample for 1998–2006. Procedures were categorized as proximal, distal, or nonspecified pancreatectomies on the basis of {ICD}-9 codes. Logistic regression and bootstrap methods were used to create an integer risk score for estimating the risk of in-hospital mortality using patient demographics, comorbidities (Charlson comorbidity score), procedure, and hospital type. A random sample of 80\% of the cohort was used to create the risk score with a 20\% internal validation set. Results A total of 5715 patient discharges were identified. Composite in-hospital mortality was 5.8\%. Predictors used for the final model were age group, Charlson score, sex, type of pancreatectomy, and hospital volume status (low-, medium-, or high-volume center). Integer values were assigned to these characteristics and then used for calculating an additive score. Three clinically useful score groups were defined to stratify the risk of in-hospital mortality (mortality was 2.0, 6.2, and 13.9\%, respectively; P {\textless} 0.0001), with a 6.95-fold difference between the low- and high-risk groups. There was sufficient discrimination of both the derivation set and the validation set, with c statistics of 0.71 and 0.72, respectively. Conclusions An integer-based risk score can be used to accurately predict in-hospital mortality after pancreatectomy and may be useful for preoperative risk stratification and patient counseling.},
	pages = {1802--1807},
	number = {7},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Hill, Joshua S. and Zhou, Zheng and Simons, Jessica P. and Ng, Sing Chau and {McDade}, Theodore P. and Whalen, Giles F. and Tseng, Jennifer F.},
	urldate = {2015-05-26},
	date = {2010-02-13},
	langid = {english},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8GC3BQCK\\Hill et al. - 2010 - A Simple Risk Score to Predict In-Hospital Mortali.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\64GZA2BQ\\10.html:text/html}
}

@article{farhan-alanie_systemic_2015,
	title = {Systemic inflammatory response and survival in patients undergoing curative resection of oral squamous cell carcinoma.},
	volume = {53},
	rights = {Copyright (c) 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.bjoms.2014.10.007},
	abstract = {Prognostic stratification in squamous cell carcinoma ({SCC}) of the head and neck has traditionally relied on the pathological staging of a tumour, but it is increasingly being recognised that host-related factors have an important role in the assessment of survival and recurrence. We aimed to evaluate the prognostic value of systemic inflammation scores including the modified Glasgow Prognostic Score ({mGPS}) in patients undergoing potentially curative resection for oral {SCC}.  We retrospectively identified 178 patients who had curative operations for cancer of the oral cavity and soft palate between January 2006 and April 2011. Among the inclusion criteria were preoperative estimates of C-reactive protein and serum albumin. We analysed established pathological prognostic factors and scores for systemic inflammation as predictors of cancer-specific and overall survival. On univariate analysis, the {mGPS} was a significant predictor of both cancer-specific (p{\textless}0.001) and overall survival (p{\textless}0.001), and it remained an independent predictor of cancer-specific ({HR}: 2.12, 95\% {CI} 1.49 to 3.00; p{\textless}0.001) and overall survival ({HR}: 1.69, 95\% {CI} 1.23 to 2.31; p=0.001) on Cox regression analysis. The {mGPS} of activated systemic inflammation seems to be a powerful adverse prognostic indicator in resectable oral {SCC}.},
	pages = {126--131},
	number = {2},
	journaltitle = {The British journal of oral \& maxillofacial surgery},
	shortjournal = {Br J Oral Maxillofac Surg},
	author = {Farhan-Alanie, O. M. and {McMahon}, J. and {McMillan}, D. C.},
	date = {2015-02},
	pmid = {25440150}
}

@article{palani_velu_routine_2014,
	title = {Routine Drainage After Pancreaticoduodenectomy: Serum Amylase Can Guide Early, Selective Drain Removal.},
	doi = {10.1097/SLA.0000000000000758},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Palani Velu, Lavanniya K. and Chandrabalan, Vishnuvardhan and {McMillan}, Donald C. and {McKay}, Colin J. and Carter, C. Ross and Jamieson, Nigel B. and Dickson, Euan J.},
	date = {2014-05-30},
	pmid = {24887980}
}

@article{park_comment_2014,
	title = {Comment on 'Tumour-infiltrating inflammation and prognosis in colorectal cancer:  systematic review and meta-analysis'.},
	volume = {111},
	doi = {10.1038/bjc.2014.296},
	number = {12},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Park, J. H. and Roxburgh, C. S. D. and {McMillan}, D. C.},
	date = {2014-12-09},
	pmid = {25349973},
	pmcid = {PMC4264427},
	keywords = {Colorectal Neoplasms/*pathology, Humans, Inflammation/*pathology, Lymphocytes, Tumor-Infiltrating/*pathology, T-Lymphocyte Subsets/*pathology}
}

@article{lygidakis_evaluation_1987,
	title = {Evaluation of preoperative biliary drainage in the surgical management of pancreatic head carcinoma},
	volume = {153},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3434110},
	abstract = {In a consecutive series of 38 patients, resectional surgery was performed for carcinoma of the caput pancreatis (ampullary, distal common bile duct and pancreatic duct). In group A (n = 19), preoperative biliary drainage was accomplished via an endoprosthesis introduced during endoscopic retrograde cholangiopancreatography. Group B (n = 19) had no preoperative biliary drainage. The interval from admission to operation averaged 15 days in group A and 4 days in group B. Two group B patients died of causes unrelated to absence of preoperative biliary drainage. In group B, however, the intrabiliary pressure was higher than in group A and was associated with heightened incidence of biliary infection, bacteremia and intraoperative bleeding. The intergroup difference in incidence of early complications was statistically significant. The findings support the value of preoperative biliary drainage in patients who are candidates for surgical treatment of carcinoma of the pancreatic head.},
	pages = {665--8},
	number = {11},
	journaltitle = {Acta Chir Scand},
	author = {Lygidakis, N J and van der Heyde, M N and Lubbers, M J},
	date = {1987-12}
}

@article{kopetz_perioperative_2008,
	title = {Perioperative chemotherapy for resectable hepatic metastases},
	volume = {371},
	issn = {01406736},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0140673608604298},
	doi = {10.1016/S0140-6736(08)60429-8},
	pages = {963--965},
	number = {9617},
	journaltitle = {The Lancet},
	author = {Kopetz, Scott and Vauthey, Jean-Nicolas},
	urldate = {2015-05-27},
	date = {2008-03},
	langid = {english},
	file = {PIIS0140673608604559.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\G3Q3HHJV\\PIIS0140673608604559.pdf:application/pdf}
}

@article{richards_relationships_2012,
	title = {The relationships between body composition and the systemic inflammatory response in patients with primary operable colorectal cancer.},
	volume = {7},
	doi = {10.1371/journal.pone.0041883},
	abstract = {{BACKGROUND}: Weight loss is recognised as a marker of poor prognosis in patients with cancer but the aetiology of cancer cachexia remains unclear. The aim of the  present study was to examine the relationships between {CT} measured parameters of  body composition and the systemic inflammatory response in patients with primary  operable colorectal cancer. {PATIENT} {AND} {METHODS}: 174 patients with primary operable colorectal cancer who underwent resection with curative intent (2003-2010). Image analysis of {CT} scans was used to measure total fat index (cm(2)/m(2)), subcutaneous fat index (cm(2)/m(2)), visceral fat index (cm(2)/m(2)) and skeletal muscle index (cm(2)/m(2)). Systemic inflammatory response was measured by serum white cell count ({WCC}), neutrophil:lymphocyte ratio ({NLR}) and the Glasgow Prognostic Score ({mGPS}). {RESULTS}: There were no relationships between any parameter of body composition and serum {WCC} or {NLR}. There was a significant relationship between low skeletal muscle index and an elevated systemic inflammatory response, as measured by the {mGPS} (p = 0.001). This was confirmed by linear relationships between skeletal muscle index and both},
	number = {8},
	journaltitle = {{PloS} one},
	shortjournal = {{PLoS} One},
	author = {Richards, Colin H. and Roxburgh, Campbell S. D. and {MacMillan}, Mark T. and Isswiasi, Sanad and Robertson, Ewen G. and Guthrie, Graeme K. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2012},
	pmid = {22870258},
	pmcid = {PMC3411715},
	keywords = {*Body Fat Distribution, *Colorectal Neoplasms/blood/physiopathology/radiotherapy/surgery, *Systemic Inflammatory Response Syndrome/blood/etiology/physiopathology/radiotherapy, Adult, Aged, Aged, 80 and over, Female, Humans, Leukocyte Count, Male, Middle Aged, Tomography, X-Ray Computed},
	file = {PLoS Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UGITREKN\\Richards et al. - 2012 - The Relationships between Body Composition and the.pdf:application/pdf}
}

@article{mannell_factors_1986,
	title = {Factors influencing survival after resection for ductal adenocarcinoma of the pancreas},
	volume = {203},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3008674},
	abstract = {Twenty-three patients with pancreatic cancer who survived greater than or equal to 3 years after surgical treatment and 56 who survived less than 12 months were studied. The association of steatorrhea with long survival was significant (p less than 0.05), and the association of back pain with short survival showed a trend toward significance (p = 0.06). Other presenting symptoms, as well as the age, sex, or past medical history of the patients; the gross morphology of the tumor and regional lymph nodes; the operations performed; and the use of postoperative adjuvant therapy had no significant influence on survival. Certain histopathologic characteristics of the resected specimens were significantly associated (p less than 0.05) with a poor prognosis: malignant infiltration of the pancreatic capsule, proximity of the tumor to lymphatic and blood vessels, a round-cell infiltrate at the tumor margin, and epithelial atypia in the uninvolved pancreatic ducts. The association of Broders' grades 3 and 4 in the primary tumor and metastases to lymph nodes showed a trend toward significance with short survival. Multivariate analysis confirmed that the associations of Broders' grades 3 and 4 in the primary tumor, a round-cell infiltrate at the tumor margin, and atypia of the pancreatic ductal epithelium with short survival were statistically significant.},
	pages = {403--7},
	number = {4},
	journaltitle = {Ann Surg},
	author = {Mannell, A and van Heerden, J A and Weiland, L H and Ilstrup, D M},
	date = {1986-04},
	file = {Mannell et al. - 1986 - Factors influencing survival after resection for d.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P7BJ29GE\\Mannell et al. - 1986 - Factors influencing survival after resection for d.pdf:application/pdf}
}

@article{povoski_association_1999,
	title = {Association of preoperative biliary drainage with postoperative outcome following pancreaticoduodenectomy},
	volume = {230},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10450725},
	abstract = {{OBJECTIVE}: To determine whether preoperative biliary instrumentation and preoperative biliary drainage are associated with increased morbidity and mortality rates after pancreaticoduodenectomy. {SUMMARY} {BACKGROUND} {DATA}: Pancreaticoduodenectomy is accompanied by a considerable rate of postoperative complications and potential death. Controversy exists regarding the impact of preoperative biliary instrumentation and preoperative biliary drainage on morbidity and mortality rates after pancreaticoduodenectomy. {METHODS}: Two hundred forty consecutive cases of pancreaticoduodenectomy performed between January 1994 and January 1997 were analyzed. Multiple preoperative, intraoperative, and postoperative variables were examined. Pearson chi square analysis or Fisher's exact test, when appropriate, was used for univariate comparison of all variables. Logistic regression was used for multivariate analysis. {RESULTS}: One hundred seventy-five patients (73\%) underwent preoperative biliary instrumentation (endoscopic, percutaneous, or surgical instrumentation). One hundred twenty-six patients (53\%) underwent preoperative biliary drainage (endoscopic stents, percutaneous drains/stents, or surgical drainage). The overall postoperative morbidity rate after pancreaticoduodenectomy was 48\% (114/240). Infectious complications occurred in 34\% (81/240) of patients. Intraabdominal abscess occurred in 14\% (33/240) of patients. The postoperative mortality rate was 5\% (12/240). Preoperative biliary drainage was determined to be the only statistically significant variable associated with complications (p = 0.025), infectious complications (p = 0.014), intraabdominal abscess (p = 0.022), and postoperative death (p = 0.037). Preoperative biliary instrumentation alone was not associated with complications, infectious complications, intraabdominal abscess, or postoperative death. {CONCLUSIONS}: Preoperative biliary drainage, but not preoperative biliary instrumentation alone, is associated with increased morbidity and mortality rates in patients undergoing pancreaticoduodenectomy. This suggests that preoperative biliary drainage should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Such a change in current preoperative management may improve patient outcome after pancreaticoduodenectomy.},
	pages = {131--42},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Povoski, S P and Karpeh, M S Jr and Conlon, K C and Blumgart, L H and Brennan, M F},
	date = {1999-08}
}

@article{zyromski_obesity_2009,
	title = {Obesity potentiates the growth and dissemination of pancreatic cancer},
	volume = {146},
	issn = {1532-7361},
	doi = {10.1016/j.surg.2009.02.024},
	abstract = {{BACKGROUND}: Obesity is an independent risk factor for pancreatic cancer development and progression, although the mechanisms underlying this association are completely unknown. The aim of the current study was to investigate the influence of obesity on pancreatic cancer growth using a novel in vivo model.
{METHODS}: Lean (C57BL/6 J) and obese (Lep(Db) and Lep(Ob)) mice were inoculated with murine pancreatic cancer cells ({PAN}02), and studied after 5 weeks of tumor growth. Tumor histology was evaluated by hematoxylin and eosin staining, cellular proliferation was assessed by 5-bromodeoxyuridine, and apoptosis was measured by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling assay. Serum adiponectin, leptin, and insulin levels were assayed.
{RESULTS}: Obese mice developed larger tumors, and a significantly greater number of mice developed metastases; mortality was also greater in obese mice. Tumor apoptosis did not differ among strains, but tumors from both obese strains had greater proliferation relative to those growing in lean animals. Serum adiponectin concentration correlated negatively and serum insulin concentration correlated positively with tumor proliferation. Intratumoral adipocyte mass in tumors from both obese strains was significantly greater than that in tumors of lean mice.
{CONCLUSION}: Data from this novel in vivo model suggest that the altered adipokine milieu and insulin resistance observed in obesity may lead directly to changes in tumor microenvironment, thereby promoting pancreatic cancer growth and dissemination.},
	pages = {258--263},
	number = {2},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Zyromski, Nicholas J. and Mathur, Abhishek and Pitt, Henry A. and Wade, Terrence E. and Wang, Sue and Nakshatri, Poornima and Swartz-Basile, Deborah A. and Nakshatri, Harikrishna},
	date = {2009-08},
	pmid = {19628082},
	keywords = {Adipocytes, Adiponectin, Animals, Apoptosis, Blood Glucose, Cell Line, Tumor, Cell Proliferation, Insulin Resistance, Leptin, Mice, Mice, Inbred C57BL, Mice, Obese, Neoplasm Metastasis, Neoplasm Transplantation, Obesity, Pancreatic Neoplasms}
}

@article{torchio_exercise_2010,
	title = {Exercise ventilatory inefficiency and mortality in patients with chronic obstructive pulmonary disease undergoing surgery for non-small-cell lung cancer},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20356758},
	abstract = {{OBJECTIVE}: Surgical resection is the treatment of choice to cure patients with non-small-cell lung cancer ({NSCLC}); nevertheless, the assessment of the lower limit of surgical tolerance remains difficult. Ventilatory inefficiency (measured as the ventilation to {CO}(2) production ratio (V'(E)/V'({CO}2) slope) is a survival predictor in pulmonary hypertension ({PH}) and chronic heart failure ({CHF}) and is considered a marker of {PH} in chronic obstructive pulmonary disease ({COPD}). The aim of this study was to investigate the role of V'(E)/V'({CO}2) slope as preoperative mortality and morbidity predictor in {COPD} patients submitted to lung resection for {NSCLC} and considered operable according to current standards. {METHODS}: A retrospective analysis was performed in 145 consecutive {COPD} patients with lung cancer (128 males and 17 females), with a mean age of 64 years (range: 41-82 years) who were referred for preoperatory evaluation. Because of bronchial obstruction or reduced pulmonary diffusion capacity for carbon monoxide (D(L,{CO})), all these patients were considered operable only after a cardiopulmonary exercise test showed a preserved cardiopulmonary function. {RESULTS}: A total of 98 lobectomies, eight bilobectomies and 39 pneumonectomies (13 left and 26 right) were performed. Twenty-one patients (14.5\%) suffered severe cardio-respiratory complications; 15/106 patients (14.2\%) after lobectomy/bilobectomy and 6/39 (15.4\%) after pneumonectomy. Five patients (3.4\%) died within 30 days after surgery (3/106 after lobectomy/bilobectomy (2.8\%) and 2/39 after pneumonectomy (5.1\%)). Considering all functional parameters before surgery and the postoperative predicted values, a logistic regression analysis individuated the V'(E)/V'({CO}2) slope as the only independent mortality predictor (odds ratio ({OR}): 1.24 z=2.77; p{\textless}0.007). The V'(O2 peak) was instead the best predictor for the occurrence of severe cardiopulmonary postoperative complications ({OR}: 0.05, z=-2.39, p{\textless}0.02). {CONCLUSIONS}: In {COPD} patients, a high V'(E)/V'({CO}2) slope before lung resection is an independent mortality predictor even in the presence of an acceptable cardiopulmonary performance. {COPD} patients with high V'(E)/V'({CO}2) slope before surgery must be carefully screened to exclude pulmonary hypertension, especially before surgical procedures with large parenchymal exeresis.},
	pages = {14--9},
	number = {1},
	journaltitle = {Eur J Cardiothorac Surg},
	author = {Torchio, Roberto and Guglielmo, Marco and Giardino, Roberto and Ardissone, Francesco and Ciacco, Claudio and Gulotta, Carlo and Veljkovic, Aleksandar and Bugiani, Massimiliano},
	date = {2010-07}
}

@article{kocher_risk-adjustment_2005,
	title = {Risk-adjustment in hepatobiliary pancreatic surgery},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15832416},
	abstract = {{AIM}: The present study evaluates the performance of the {POSSUM}, the American Society of Anesthetists ({ASA}), {APACHE} and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary ({HPB}) surgery. We describe especially the limitations and advantages of risk in stratifying the patients. {METHODS}: We investigated 177 randomly chosen patients undergoing elective complex {HPB} surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors. Primary endpoint was in-hospital mortality and morbidity. Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality. {RESULTS}: The operative mortality in the series was 3.95\%. This compared well with the p-{POSSUM} and {APACHE} predicted mortality of 4.31\% and 4.29\% respectively. Post-operative complications amounted to 45\% with 24 (13.6\%) patients having a major adverse event. On multivariate analysis the pre-operative {POSSUM} physiological score ({OR} = 1.18, P = 0.009) was superior in predicting complications compared to the {ASA} (P = 0.108), {APACHE} (P = 0.117) or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio ({INR}), pulse rate, and intra-operative blood loss were independent risk factors. A combination of the {POSSUM} variables and {INR} offered the optimal combination of risk factors for risk prognostication in {HPB} surgery. {CONCLUSION}: Morbidity for elective {HPB} surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities.},
	pages = {2450--5},
	number = {16},
	journaltitle = {World J Gastroenterol},
	author = {Kocher, Hemant M and Tekkis, Paris P and Gopal, Palepu and Patel, Ameet G and Cottam, Simon and Benjamin, Irving S},
	date = {2005-04}
}

@article{lee_[management_1992,
	title = {[The management of obstructive jaundice caused by pancreatic head carcinoma and periampullary carcinoma]},
	volume = {91 Suppl 3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1362907},
	abstract = {We had treated 115 patients with malignant obstructive jaundice, including 69 pancreatic head carcinoma and 46 periampullary carcinoma during the period between 1982 and 1991. In the 115 jaundiced patients 33 had undergone pancreaticoduodenectomy, 50 had bypass operation and the remaining 32 patients undergone percutaneous transhepatic biliary drainage ({PTBD}) only. No operative mortality happened for the 33 pancreaticoduodenectomies. Postoperative complications occurred in 12 patients. Leakage from the choledochojejunostomy was the most often occurred complications, it was found in 7 patients (21.2\%). Intraabdominal abscesses happened in six patients (18.2\%) which recovered by treating with ultrasound-guided catheteral drainage. Leakage from pancreaticojejunostomy was also found in five patients (15.2\%), the complication recovered uneventfully after administration of total parenteral nutrition and good abdominal drainage. Twenty-two out 33 patients with pancreaticoduodenectomy received preoperative biliary drainage. However, despite preoperative biliary drainage, 10 of 22 patients (45.5\%) still suffered postoperative complications. It implied that hyperbilirubinemia would trend to carry a high postoperative morbility. The prognosis for our patients with pancreatic head carcinoma was extremely poor. The mean survival period for all of them was not exceeding 12 months. Those who had {PTBD} as the sole treatment had the shortest survival period, which was 3.4 +/- 3.1 months only. On the other hand, the mean survival period for those who had periampullary cancer and had pancreaticoduodenectomy was 35.5 +/- 27.2 months, while it was 13.3 +/- 10.1 and 11.8 +/- 10.0 months for those having bypass operation and {PTBD} respectively.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {S208--13},
	journaltitle = {J Formos Med Assoc},
	author = {Lee, K T and Tsai, C C and Ker, C G and Sheen, P C},
	date = {1992-09}
}

@article{grose_impact_2015,
	title = {The impact of comorbidity upon determinants of outcome in patients with lung cancer.},
	volume = {87},
	rights = {Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved.},
	doi = {10.1016/j.lungcan.2014.11.012},
	abstract = {{BACKGROUND}: Survival from lung cancer remains poor in Scotland, {UK}. It is believed that comorbidity may play an important role in this. The goal of this study was to determine the value of a novel comorbidity scoring system ({SCSS}) and to compare it with the already established Charlson Comorbidity Index and the modified Glasgow Prognostic Score ({mGPS}). We also wished to explore the relationship between comorbidity, {mGPS} and Performance Status ({PS}). In addition we investigated a number of standard prognostic markers and demographics. This study aimed to determine which of these factors most accurately predicted survival. {METHODS}: Between 2005 and 2008 all newly diagnosed lung cancer patients coming through the Multi-Disciplinary Teams ({MDTs}) in four Scottish Centres were  included in the study. Patient demographics, World Health Organization/Eastern Cooperative Oncology Group performance status, clinico-pathological features, {mGPS}, comorbidity and proposed primary treatment modality were recorded. Univariate survival analysis was carried out using Kaplan-Meier method and the log rank test. {RESULTS}: This large unselected population based cohort study of lung cancer patients has demonstrated that a number of important factors have significant impact in terms of survival. It has gone further by showing that the  factors which influence survival are different, depending upon the stage of cancer at diagnosis and the potential treatment strategy. The novel comorbidity scoring system, the {SCSS}, has compared very favourably with the more established  {CCI}. {CONCLUSION}: This study has identified that a variety of factors are independent prognostic determinants of outcome in lung cancer. There appear to be clear differences between the early and late stage groups.},
	pages = {186--192},
	number = {2},
	journaltitle = {Lung cancer (Amsterdam, Netherlands)},
	shortjournal = {Lung Cancer},
	author = {Grose, Derek and Morrison, David S. and Devereux, Graham and Jones, Richard and Sharma, Dave and Selby, Colin and Docherty, Kirsty and {McIntosh}, David and Nicolson, Marianne and {McMillan}, Donald C. and Milroy, Robert},
	date = {2015-02},
	pmid = {25498829}
}

@article{forrest_evaluation_2003,
	title = {Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer.},
	volume = {89},
	doi = {10.1038/sj.bjc.6601242},
	abstract = {A score based on the combination of the systemic inflammatory response and albumin hazards ratio ({HR}) 1.70, 95\% {CI} 1.23 - 2.35, P=0.001) was comparable in prognostic value to that based on stage and performance status ({HR} 1.48, 95\% {CI} 1.12 - 1.95, P=0.006) in patients with inoperable non-small-cell lung cancer. The former is simple to measure and well standardised.},
	pages = {1028--1030},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Forrest, L. M. and {McMillan}, D. C. and {McArdle}, C. S. and Angerson, W. J. and Dunlop, D. J.},
	date = {2003-09-15},
	pmid = {12966420},
	pmcid = {PMC2376960},
	keywords = {Adenocarcinoma/blood/diagnosis, Albumins/*analysis, Carcinoma, Non-Small-Cell Lung/blood/*diagnosis, Carcinoma, Squamous Cell/blood/diagnosis, C-Reactive Protein/*analysis, Female, Humans, Hypoalbuminemia/complications, Inflammation, Karnofsky Performance Status, Lung Neoplasms/blood/*diagnosis, Male, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Retrospective Studies, Tumor Markers, Biological/*analysis}
}

@article{mckay_high_1999,
	title = {High early mortality rate from acute pancreatitis in Scotland, 1984-1995},
	volume = {86},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10540138},
	abstract = {Death from acute pancreatitis within the first week after admission is usually a consequence of multiple organ dysfunction. Reports from specialist centres suggest that, with improvements in resuscitation and supportive care, such deaths are becoming uncommon but it is unclear if this is reflected in a decrease in early mortality rate from acute pancreatitis in the general population.},
	pages = {1302--5},
	number = {10},
	journaltitle = {Br J Surg},
	author = {{McKay}, C J and Evans, S and Sinclair, M and Carter, C R and Imrie, C W},
	date = {1999-10}
}

@article{phypers_test-retest_2011-1,
	title = {Test-retest reliability of the oxygen uptake efficiency slope in surgical patients},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21707558},
	abstract = {The oxygen uptake efficiency slope is a measure of cardiopulmonary fitness, that can be obtained from a sub-maximal cardiopulmonary exercise test. It has been evaluated in medical patients but its reliability in surgical populations remains uncertain. We conducted a test-retest study with the aim of establishing the reliability of the oxygen uptake efficiency slope in relation to that of the anaerobic threshold and peak oxygen uptake, in general surgical patients. Twenty-six patients over 60 years old completed two symptom-limited, incremental cycle ergometry tests within 7 days. The mean ({SD}) anaerobic threshold was 13.0 (3.0) {mlO}(2) .kg(-1) .min(-1) . There were no significant differences between mean test and retest values of anaerobic threshold (p = 0.50), peak oxygen uptake (p = 0.76) or oxygen uptake efficiency slope (p = 0.42). Reliability coefficients (95\% {CI}) for the anaerobic threshold, oxygen uptake efficiency slope and peak oxygen uptake were 66.7\% (45.3-87.9\%), 89.0\% (81.0-96.9\%) and 91.7\% (85.7-97.8\%), respectively. The oxygen uptake efficiency slope was determined easily in all patients and found to have excellent reliability. Its clinical utility in determining pre-operative fitness warrants further evaluation.},
	pages = {659--66},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Phypers, B J and Robiony-Rogers, D and Pickering, R M and Garden, A L},
	date = {2011-08}
}

@article{jones_effects_2007,
	title = {Effects of presurgical exercise training on cardiorespiratory fitness among patients undergoing thoracic surgery for malignant lung lesions},
	volume = {110},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17582629},
	abstract = {{BACKGROUND}: To determine the effects of preoperative exercise training on cardiorespiratory fitness in patients undergoing thoracic surgery for malignant lung lesions. {METHODS}: Using a single-group design, 25 patients with suspected operable lung cancer were provided with structured exercise training until surgical resection. Exercise training consisted of 5 endurance cycle ergometry sessions per week at intensities varying from 60\% to 100\% of baseline peak oxygen consumption ({VO}(2 peak)). Participants underwent cardiopulmonary exercise testing, 6-minute walk (6 {MW}), and pulmonary function testing at baseline, immediately before, and 30 days after surgical resection. {RESULTS}: Five patients were deemed ineligible before surgical resection and were removed from the analysis. Of the remaining 20 patients follow-up assessments were obtained for 18 (90\%) before resection and 13 (65\%) patients postresection. The overall adherence rate was 72\%. Intention-to-treat analysis indicated that mean {VO}(2peak) increased by 2.4 {mL} . kg(-1) . min(-1)(95\% confidence interval [{CI}], 1.0-3.8; P = .002) and 6MW distance increased 40 m (95\% {CI}, 16-64; P = .003) baseline to presurgery. Per protocol analyses indicated that patients who attended {\textgreater}or=80\% of prescribed sessions increased {VO}(2peak) and 6 {MWD} by 3.3 {mL}.kg(-1).min(-1) (95\% {CI}, 1.1-5.4; P = .006) and 49 meters (95\% {CI}, 12-85; P = .013), respectively. Exploratory analyses indicated that presurgical exercise capacity decreased postsurgery, but did not decrease beyond baseline values. {CONCLUSIONS}: Preoperative exercise training is a beneficial intervention to improve cardiorespiratory fitness in patients undergoing pulmonary resection. This benefit may have important implications for surgical outcome and postsurgical recovery in this population. Larger randomized controlled trials are warranted.},
	pages = {590--8},
	number = {3},
	journaltitle = {Cancer},
	author = {Jones, Lee W and Peddle, Carolyn J and Eves, Neil D and Haykowsky, Mark J and Courneya, Kerry S and Mackey, John R and Joy, Anil A and Kumar, Vikaash and Winton, Timothy W and Reiman, Tony},
	date = {2007-08},
	file = {Jones et al. - 2007 - Effects of presurgical exercise training on cardio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IQF8FI9U\\Jones et al. - 2007 - Effects of presurgical exercise training on cardio.pdf:application/pdf}
}

@article{mackenzie_c-reactive_2006,
	title = {C-reactive protein concentrations during bacteraemia: a comparison between patients with and without liver dysfunction},
	volume = {32},
	issn = {0342-4642, 1432-1238},
	url = {http://link.springer.com/article/10.1007/s00134-006-0251-1},
	doi = {10.1007/s00134-006-0251-1},
	shorttitle = {C-reactive protein concentrations during bacteraemia},
	abstract = {Objective To evaluate the value of serum C-reactive protein ({CRP}) concentrations as a marker of sepsis in patients with biochemical evidence of liver dysfunction. Design A retrospective case-control comparison of serum {CRP} concentrations between patients with and those without liver dysfunction (prothrombin time over 18 s and serum bilirubin ≥ 20 μmol/l) during their first episode of bacteraemia. Setting The neurosciences and general adult intensive care units of a university teaching hospital. Patients Any patient from the above settings with a first episode of bacteraemia (first isolate of pathogenic bacteria from blood cultures) over a 3-year period. Measurements and results After exclusions 126 first episodes of bacteraemia were identified, of which 33 were in patients with liver dysfunction. Serum {CRP} concentrations were significantly lower in patients with liver dysfunction (median 103 mg/l, {IQR} 29–204) than in those without (146 mg/l, 74, {\textgreater} 250). Conclusions Patients with biochemical evidence of liver disease generate significantly lower serum {CRP} concentrations during bacteraemia than patients without liver dysfunction. Serum {CRP} concentrations should be interpreted with caution in patients with liver disease to diagnose and monitor bacterial sepsis.},
	pages = {1344--1351},
	number = {9},
	journaltitle = {Intensive Care Medicine},
	shortjournal = {Intensive Care Med},
	author = {Mackenzie, Iain and Woodhouse, Joe},
	urldate = {2015-08-21},
	date = {2006-06-24},
	langid = {english},
	keywords = {Acute-phase proteins, Anesthesiology, Biological marker, C-Reactive Protein, Emergency Medicine, Infection, Intensive / Critical Care Medicine, Outcome and Process Assessment (Health Care), Pain Medicine, Pediatrics, Pneumology/Respiratory System, Sepsis},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7R24TX35\\Mackenzie and Woodhouse - 2006 - C-reactive protein concentrations during bacteraem.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VUFSSISE\\10.html:text/html}
}

@article{shafique_modified_2013,
	title = {The modified Glasgow prognostic score in prostate cancer: results from a retrospective clinical series of 744 patients.},
	volume = {13},
	doi = {10.1186/1471-2407-13-292},
	abstract = {{BACKGROUND}: As the incidence of prostate cancer continues to rise steeply, there  is an increasing need to identify more accurate prognostic markers for the disease. There is some evidence that a higher modified Glasgow Prognostic Score ({mGPS}) may be associated with poorer survival in patients with prostate cancer but it is not known whether this is independent of other established prognostic factors. Therefore the aim of this study was to describe the relationship between {mGPS} and survival in patients with prostate cancer after adjustment for other prognostic factors. {METHODS}: Retrospective clinical series on patients in Glasgow, Scotland, for whom data from the Scottish Cancer Registry, including Gleason score, Prostate Specific Antigen ({PSA}), C-reactive protein ({CRP}) and albumin, six months prior to or following the diagnosis, were included in this study. {RESULTS}: Seven hundred and forty four prostate cancer patients were identified; of these, 497 (66.8\%) died during a maximum follow up of 11.9 years.  Patients with {mGPS} of 2 had poorest 5-year and 10-year relative survival, of 32.6\% and 18.8\%, respectively. Raised {mGPS} also had a significant association with excess risk of death at five years ({mGPS} 2: Relative Excess Risk = 3.57, 95\% {CI} 2.31-5.52) and ten years ({mGPS} 2: Relative Excess Risk = 3.42, 95\% {CI} 2.25-5.21) after adjusting for age, socioeconomic circumstances, Gleason score, {PSA} and previous in-patient bed days. {CONCLUSIONS}: The {mGPS} is an independent and objective prognostic indicator for survival of patients with prostate cancer. It  may be useful in determining the clinical management of patients with prostate cancer in addition to established prognostic markers.},
	journaltitle = {{BMC} cancer},
	shortjournal = {{BMC} Cancer},
	author = {Shafique, Kashif and Proctor, Michael J. and {McMillan}, Donald C. and Leung, Hing and Smith, Karen and Sloan, Billy and Morrison, David S.},
	date = {2013},
	pmid = {23768149},
	pmcid = {PMC3686580},
	keywords = {Aged, Combined Modality Therapy, Follow-Up Studies, Humans, Male, Neoplasm Grading, Neoplasm Staging, Prognosis, Prostatic Neoplasms/*mortality/*pathology/therapy, Retrospective Studies, Survival Rate}
}

@article{neoptolemos_randomized_2004,
	title = {A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer},
	volume = {350},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15028824},
	abstract = {{BACKGROUND}: The effect of adjuvant treatment on survival in pancreatic cancer is unclear. We report the final results of the European Study Group for Pancreatic Cancer 1 Trial and update the interim results. {METHODS}: In a multicenter trial using a two-by-two factorial design, we randomly assigned 73 patients with resected pancreatic ductal adenocarcinoma to treatment with chemoradiotherapy alone (20 Gy over a two-week period plus fluorouracil), 75 patients to chemotherapy alone (fluorouracil), 72 patients to both chemoradiotherapy and chemotherapy, and 69 patients to observation. {RESULTS}: The analysis was based on 237 deaths among the 289 patients (82 percent) and a median follow-up of 47 months (interquartile range, 33 to 62). The estimated five-year survival rate was 10 percent among patients assigned to receive chemoradiotherapy and 20 percent among patients who did not receive chemoradiotherapy (P=0.05). The five-year survival rate was 21 percent among patients who received chemotherapy and 8 percent among patients who did not receive chemotherapy (P=0.009). The benefit of chemotherapy persisted after adjustment for major prognostic factors. {CONCLUSIONS}: Adjuvant chemotherapy has a significant survival benefit in patients with resected pancreatic cancer, whereas adjuvant chemoradiotherapy has a deleterious effect on survival.},
	pages = {1200--10},
	number = {12},
	journaltitle = {N Engl J Med},
	author = {Neoptolemos, John P and Stocken, Deborah D and Friess, Helmut and Bassi, Claudio and Dunn, Janet A and Hickey, Helen and Beger, Hans and Fernandez-Cruz, Laureano and Dervenis, Christos and Lacaine, François and Falconi, Massimo and Pederzoli, Paolo and Pap, Akos and Spooner, David and Kerr, David J and Büchler, Markus W},
	date = {2004-03},
	file = {Neoptolemos et al. - 2004 - A randomized trial of chemoradiotherapy and chemot.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EG6CVQUN\\Neoptolemos et al. - 2004 - A randomized trial of chemoradiotherapy and chemot.pdf:application/pdf}
}

@article{ramsey_evaluation_2007,
	title = {Evaluation of an inflammation-based prognostic score in patients with metastatic  renal cancer.},
	volume = {109},
	doi = {10.1002/cncr.22400},
	abstract = {{BACKGROUND}: Recently, it was shown that an inflammation-based prognostic score, the Glasgow Prognostic Score ({GPS}), provides additional prognostic information in patients with advanced cancer. The objective of the current study was to examine  the value of the {GPS} compared with established scoring systems in predicting cancer-specific survival in patients with metastatic renal cancer. {METHODS}: One hundred nineteen patients who underwent immunotherapy for metastatic renal cancer were recruited. The Memorial Sloan-Kettering Cancer Center ({MSKCC}) score and the  Metastatic Renal Carcinoma Comprehensive Prognostic System ({MRCCPS}) score were calculated as described previously. Patients who had both an elevated C-reactive  protein level ({\textgreater}10 mg/L) and hypoalbuminemia ({\textless}35 g/L) were allocated a {GPS} of 2. Patients who had only 1 of those 2 biochemical abnormalities were allocated a {GPS} of 1. Patients who had neither abnormality were allocated a {GPS} of 0. {RESULTS}: On multivariate analysis of significant individual factors, only calcium (hazard ratio [{HR}], 3.21; 95\% confidence interval [95\% {CI}], 1.51-6.83; P = .002), white cell count ({HR}, 1.66; 95\% {CI}, 1.17-2.35; P = .004), albumin ({HR}, 2.63; 95\% {CI}, 1.38-5.03; P = .003), and C-reactive protein ({HR}, 2.85; 95\% {CI}; 1.49-5.45; P = .002) were associated independently with cancer-specific survival. On multivariate analysis of the different scoring systems, the {MSKCC} ({HR}, 1.88; 95\%  {CI}, 1.22-2.88; P = .004), the {MRCCPS} ({HR}, 1.42; 95\% {CI}, 0.97-2.09; P = .071), and the {GPS} ({HR}, 2.35; 95\% {CI}, 1.51-3.67; P {\textless} .001) were associated independently with cancer-specific survival. {CONCLUSIONS}: An inflammation-based prognostic score ({GPS}) predicted survival independent of established scoring systems in patients with metastatic renal cancer.},
	pages = {205--212},
	number = {2},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {Ramsey, Sara and Lamb, Gavin W. A. and Aitchison, Michael and Graham, John and {McMillan}, Donald C.},
	date = {2007-01-15},
	pmid = {17149754},
	keywords = {Carcinoma, Renal Cell/blood/*diagnosis/therapy, C-Reactive Protein/analysis, Female, Humans, Inflammation/blood/*diagnosis, Kidney Neoplasms/blood/*diagnosis/therapy, Male, Middle Aged, Multivariate Analysis, Neoplasm Metastasis, Predictive Value of Tests, Prognosis, Serum Albumin/analysis, Survival Analysis}
}

@article{welsch_persisting_2008,
	title = {Persisting elevation of C-reactive protein after pancreatic resections can indicate developing inflammatory complications},
	volume = {143},
	issn = {0039-6060},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606007003698},
	doi = {10.1016/j.surg.2007.06.010},
	abstract = {Background
Serum C-reactive protein ({CRP}) is an established discriminating factor for necrotizing pancreatitis. In this study, the {CRP} response with respect to inflammatory postoperative complications was examined in a large, homogeneous series of pancreatic resections in order to define a relevant clinical parameter for early detection of inflammatory postoperative complications.
Methods
688 consecutive pancreatic resections with jejunal anastomosis were screened for inflammatory postoperative complications based on a prospective database. Ninety-one patients had at least one inflammatory postoperative complication and were compared to a subgroup of 60 consecutive patients with uneventful postoperative courses.
Results
In the postoperative setting after pancreatic resection, {CRP} peaked on postoperative day ({POD}) 3 with a median serum {CRP} of 132 mg/L, and gradually decreased thereafter in patients with an uncomplicated postoperative course. In complicated cases (with the exception of cholangitis), increase in {CRP} was significantly greater, peaked on {POD} 3 (median {CRP} 173 mg/L), and persisted thereafter, whereas white blood cell count and body temperature did not differ significantly from uneventful courses until {POD} 6. The median day of diagnosis of inflammatory postoperative complications was {POD} 9. A cutoff {CRP} value of 140 mg/{dL} on {POD} 4 yielded a positive predictive value of 89.1\% (adjusted to the prevalence of inflammatory postoperative complications: 48.7\%) with a specificity of 87.1\% and a sensitivity of 69.5\% for inflammatory postoperative complications.
Conclusion
Persistence of {CRP} elevation above 140 mg/{dL} on {POD} 4 is predictive of inflammatory postoperative complications and should prompt an intense clinical search for major septic processes (e.g. pancreatic fistula or abscess) if pneumonia and wound infection are unlikely or excluded.},
	pages = {20--28},
	number = {1},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Welsch, Thilo and Frommhold, Klaus and Hinz, Ulf and Weigand, Markus A. and Kleeff, Jörg and Friess, Helmut and Büchler, Markus W. and Schmidt, Jan},
	urldate = {2015-05-24},
	date = {2008-01},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZWSNX4FR\\Welsch et al. - 2008 - Persisting elevation of C-reactive protein after p.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\V664GDC4\\S0039606007003698.html:text/html}
}

@online{_ovid:_????,
	title = {Ovid: External Link},
	url = {http://ovidsp.tx.ovid.com/sp-3.16.0a/ovidweb.cgi?WebLinkFrameset=1&S=DNGGFPCBNEDDJFKKNCKKOHLBFFCCAA00&returnUrl=ovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.22.23%257c0%257c00001432-201006000-00011%26S%3dDNGGFPCBNEDDJFKKNCKKOHLBFFCCAA00&directlink=http%3a%2f%2fgraphics.tx.ovid.com%2fovftpdfs%2fFPDDNCLBOHKKNE00%2ffs046%2fovft%2flive%2fgv023%2f00001432%2f00001432-201006000-00011.pdf&filename=Effect+of+major+abdominal+surgery+on+the+host+immune+response+to+infection.&pdf_key=FPDDNCLBOHKKNE00&pdf_index=/fs046/ovft/live/gv023/00001432/00001432-201006000-00011},
	urldate = {2015-07-15},
	file = {Ovid\: External Link:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\87TEHB8V\\ovidweb.html:text/html}
}

@article{parekh_laparoscopic-assisted_2006,
	title = {Laparoscopic-assisted pancreatic necrosectomy: A new surgical option for treatment of severe necrotizing pancreatitis},
	volume = {141},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16983033},
	abstract = {Open surgery for pancreatic debridement is often associated with major morbidity such as wound complications, fascial dehiscence, and intestinal fistulae. Hand-assisted laparoscopic surgery ({HALS}) is useful for complex abdominal procedures since the benefits of traditional laparoscopic surgery are retained. Published experience with {HALS} for pancreatic debridement is limited to anecdotal case reports.},
	pages = {895--902; discussion 902--3},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Parekh, Dilip},
	date = {2006-09}
}

@article{winter_clinicopathologic_2010,
	title = {Clinicopathologic analysis of ampullary neoplasms in 450 patients: implications for surgical strategy and long-term prognosis},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19911239},
	abstract = {{BACKGROUND}: Whether ampullary neoplasms are best surgically managed by pancreaticoduodenectomy versus local ampullectomy is controversial. We sought to examine the outcome of patients undergoing pancreaticoduodenectomy versus ampullectomy, as well as to identify factors predictive of lymph node metastasis in patients with ampullary neoplasms. {METHODS}: Between 1970 and 2007, 450 patients who underwent surgical resection of ampullary adenoma or adenocarcinoma were identified from a prospective, single-institution database. Data on clinicopathologic factors, morbidity, mortality, and survival were analyzed. {RESULTS}: The initial surgical procedure was pancreaticoduodenectomy in 96.7\% patients and ampullectomy in 3.3\%. Final diagnosis was invasive adenocarcinoma (77.1\%) or adenoma (22.9\%). Median tumor size was similar for adenomas associated with an adenocarcinoma (2.5 cm) versus adenomas without invasive cancer (2.9 cm; P=0.71). Morbidity was comparable with pancreaticoduodenectomy (52.2\%) versus ampullectomy (33.3\%; P=0.15), as was 30-day mortality (pancreaticoduodenectomy, 2.1\% versus ampullectomy, 0\%; P=0.6). Metastatic disease to regional lymph nodes was present in 54.5\% patients with adenocarcinoma. Factors associated with presence of lymph node metastasis included tumor size {\textgreater} or = 1 cm ({OR} 2.1), poor histologicgrade ({OR} 4.8), perineural invasion ({OR} 3.0), microscopic vessel invasion ({OR} 6.6), and depth of invasion {\textgreater} {pT}1 ({OR} 4.3; all P{\textless}0.05). Specifically, risk of lymph node metastasis increased with T stage (T1, 28.0\%; T2, 50.9\%; T3, 71.7\%; T4, 77.3\%; P{\textless}0.001). {CONCLUSION}: When surgery is indicated, radical resection is required for early invasive adenocarcinoma of the ampulla of Vater, as lymph node metastases are present in nearly 30\% of patients with T1 disease. Pancreaticoduodenectomy should be the preferred approach for most ampullary neoplasms that require surgical resection.},
	pages = {379--87},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Olino, Kelly and Herman, Joseph M and de Jong, Mechteld C and Hruban, Ralph H and Wolfgang, Christopher L and Eckhauser, Frederic and Edil, Barish H and Choti, Michael A and Schulick, Richard D and Pawlik, Timothy M},
	date = {2010-02}
}

@article{castello-simoes_effects_2013,
	title = {Effects of aerobic exercise training on variability and heart rate kinetic during submaximal exercise after gastric bypass surgery--a randomized controlled trial},
	volume = {35},
	issn = {1464-5165},
	doi = {10.3109/09638288.2012.694575},
	abstract = {{BACKGROUND}: This study aimed to determine whether morbidly obese women have an alteration of heart rate ({HR}) kinetics and {HR} variability ({HRV}) during the 6-min walk test (6MWT) and if an aerobic exercise training can modify these indexes after gastric bypass surgery ({GBS}).
{DESIGN} {AND} {METHODS}: Nineteen morbidly obese women were randomized to a trained ({TG}) or control group and 12 women of eutrophic group ({EG}) were also evaluated. The obese women were tested on two occasions: 1 week before and 4 months after {GBS} through record of {HR} and R-R intervals during 6MWT for analysis {HR} kinetics. The {TG} underwent an aerobic exercise training program on a treadmill (1-h session, totaling 36 sessions over 12-week).
{RESULTS}: Both obese groups demonstrated a significant reduction of {rMSSD} and slower {HR} kinetics during the 6MWT when compared to the {EG}. In addition, only the {TG} demonstrated a significant improvement in {HRV} indexes, walking distance, faster time constant and mean response time of {HR} during 6MWT after training (p {\textless} 0.05).
{CONCLUSION}: Morbidly obese women have slower {HR} kinetics and altered cardiac modulation during submaximal exercise. However, aerobic exercise training can produce beneficial adaptations in {HRV} and faster {HR} kinetics following {GBS}.},
	pages = {334--342},
	number = {4},
	journaltitle = {Disability and Rehabilitation},
	shortjournal = {Disabil Rehabil},
	author = {Castello-Simões, Viviane and Polaquini Simões, Rodrigo and Beltrame, Thomas and Bassi, Daniela and Maria Catai, Aparecida and Arena, Ross and Azambuja, Noé Carvalho and do Nascimento Ortega, João and Borghi-Silva, Audrey},
	date = {2013-02},
	pmid = {22725971},
	keywords = {Adult, Analysis of Variance, Autonomic Nervous System, Body Mass Index, Exercise, Exercise Test, Exercise Therapy, Female, Follow-Up Studies, Gastric Bypass, Heart Rate, Humans, Obesity, Morbid, Oxygen Consumption, Physical fitness, Prospective Studies, Risk Factors, Spirometry, Treatment Outcome, Walking}
}

@article{chang_improving_2008,
	title = {Improving outcomes for operable pancreatic cancer: Is access to safer surgery the problem?},
	volume = {23},
	issn = {08159319, 14401746},
	url = {http://doi.wiley.com/10.1111/j.1440-1746.2008.05471.x},
	doi = {10.1111/j.1440-1746.2008.05471.x},
	shorttitle = {Improving outcomes for operable pancreatic cancer},
	pages = {1036--1045},
	number = {7},
	journaltitle = {Journal of Gastroenterology and Hepatology},
	author = {Chang, David K and Merrett, Neil D and Biankin, Andrew V and {NSW Pancreatic Cancer Network}},
	urldate = {2014-01-27},
	date = {2008-07},
	file = {Chang et al. - 2008 - Improving outcomes for operable pancreatic cancer.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P5DXBSNZ\\Chang et al. - 2008 - Improving outcomes for operable pancreatic cancer.pdf:application/pdf}
}

@article{wright_use_2008,
	title = {The use of orthopaedic {POSSUM} as an audit tool for fractured neck of femur},
	volume = {39},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18316084},
	abstract = {In this prospective study, 230 patients who were operated on for a fractured neck of femur were evaluated using the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}). We observed 25 deaths (10.9\%) and 95 patients had a post-operative complication (41.3\%). The orthopaedic {POSSUM} equations yielded an overall predicted mortality of 21 patients and morbidity in 106 patients. This gave observed to expected (O:E) ratios of 1.19 and 0.95 respectively meaning that {POSSUM} agreed well with the observed mortality and morbidity. We concluded that {POSSUM} accurately predicts mortality and morbidity in patients with femoral neck fractures and when used as an audit tool would provide a fairer system of comparison and would allow an unbiased interpretation of results when changes in patient management are made.},
	pages = {430--5},
	number = {4},
	journaltitle = {Injury},
	author = {Wright, D M and Blanckley, S and Stewart, G J and Copeland, G P},
	date = {2008-04}
}

@article{crumley_elevated_2006,
	title = {An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal  cancer.},
	volume = {94},
	doi = {10.1038/sj.bjc.6603150},
	abstract = {There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients undergoing resection for a variety of tumours. The aim of the present study was to examine the relationship between clinico-pathological status, preoperative C-reactive protein concentration and cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer. One hundred and twenty patients attending the upper gastrointestinal surgical unit in the Royal Infirmary, Glasgow, who were selected for potentially curative surgery, were included in the study. Laboratory measurements of haemoglobin, white cell, lymphocyte and platelet counts, albumin and C-reactive protein were carried out at the time of diagnosis. All patients underwent en-bloc resection with lymphadenectomy and survived at least 30 days following surgery. On multivariate analysis, only the positive to total lymph node ratio (hazard ratio ({HR}) 2.02, 95\% confidence interval ({CI}) 1.44-2.84, P{\textless}0.001) and preoperative C-reactive protein concentration ({HR} 3.53, 95\% {CI} 1.88-6.64, P{\textless}0.001) were independent predictors of cancer-specific survival. The patient group with no evidence of a preoperative systemic inflammatory response (C-reactive protein {\textless} or =10 mg l(-1)) had a median survival of 79 months compared with 19 months in the elevated systemic inflammatory response group (P{\textless}0.001). The results of the present study indicate  that in patients selected to undergo potentially curative resection for gastro-oesophageal cancer, the presence of an elevated preoperative C-reactive protein concentration is an independent predictor of poor cancer-specific survival.},
	pages = {1568--1571},
	number = {11},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Crumley, A. B. C. and {McMillan}, D. C. and {McKernan}, M. and Going, J. J. and Shearer, C. J. and Stuart, R. C.},
	date = {2006-06-05},
	pmid = {16685271},
	pmcid = {PMC2361311},
	keywords = {Aged, C-Reactive Protein/*metabolism, Esophageal Neoplasms/*mortality/pathology/*surgery, Esophagogastric Junction, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Metastasis, Stomach Neoplasms/*mortality/pathology/*surgery, Survival Analysis, Time Factors}
}

@article{nespoli_impact_2006,
	title = {Impact of postoperative infections on survival in colon cancer patients},
	volume = {7 Suppl 2},
	issn = {1096-2964},
	doi = {10.1089/sur.2006.7.s2-41},
	abstract = {{PURPOSE}: We investigated the prognostic significance of postoperative infections for the outcome of 192 patients with colon cancer.
{METHODS}: The 5-year survival rates were analyzed by the Kaplan-Meier technique. Univariate and multivariate analyses were done to evaluate prognostic variables using Cox's proportional hazard model.
{RESULTS}: Forty-three patients developed deep incisional or organ/space surgical site infections. The groups with and without infection were comparable. Multivariate analysis showed that only Dukes' stage (p=0.048) and postoperative infection (p=0.011) were independently associated with outcome. In patients with infective complications, the survival rate was significantly lower than in subjects without infection (log rank p=0.0004).
{CONCLUSIONS}: These results stress the importance of evaluating variables other than the classical tumor stage in predicting long-term cancer outcome.},
	pages = {S41--43},
	journaltitle = {Surgical Infections},
	shortjournal = {Surg Infect (Larchmt)},
	author = {Nespoli, Angelo and Gianotti, Luca and Bovo, Giorgio and Brivio, Fernando and Nespoli, Luca and Totis, Mauro},
	date = {2006},
	pmid = {16895503},
	keywords = {Colectomy, Colonic Neoplasms, Humans, Infection, postoperative complications, Proportional Hazards Models, Surgical Wound Infection, Survival Analysis, Survival Rate}
}

@article{boer_estimated_1984,
	title = {Estimated lean body mass as an index for normalization of body fluid volumes in humans},
	volume = {247},
	issn = {0002-9513},
	abstract = {Blood volume was measured in 66 healthy subjects (38 males, 28 females), and extracellular fluid volume in 54 subjects (31 males, 23 females). Volumes were normalized against body weight, height, body surface area, leanness index, and lean body mass (estimated from body weight and height). The regression lines of body fluid volumes against lean body mass passed through the origin on extrapolation and were not different for males and females. None of the other indices fulfilled these criteria. It is concluded that estimated lean body mass is a suitable index for normalization of body fluid volumes. A single set of normal reference values can be used for males and females.},
	pages = {F632--636},
	number = {4},
	journaltitle = {The American Journal of Physiology},
	shortjournal = {Am. J. Physiol.},
	author = {Boer, P.},
	date = {1984-10},
	pmid = {6496691},
	keywords = {Blood Volume, Body Fluids, Body Height, Body Surface Area, Body Water, Body Weight, Extracellular Space, Female, Humans, Male, Plasma Volume, Reference Values, Sex Factors}
}

@article{hennis_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery},
	volume = {87},
	issn = {0032-5473},
	url = {http://pmj.bmj.com/cgi/doi/10.1136/pgmj.2010.107185},
	doi = {10.1136/pgmj.2010.107185},
	pages = {550--557},
	number = {1030},
	journaltitle = {Postgraduate Medical Journal},
	author = {Hennis, P. J. and Meale, P. M. and Grocott, M. P. W.},
	urldate = {2014-01-27},
	date = {2011-06-21},
	file = {Hennis et al. - 2011 - Cardiopulmonary exercise testing for the evaluatio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\W4W4RCXN\\Hennis et al. - 2011 - Cardiopulmonary exercise testing for the evaluatio.pdf:application/pdf}
}

@article{mansouri_comment_2013,
	title = {Comment on Luo et al.: diabetes mellitus and the incidence and mortality of colorectal cancer: a meta-analysis of 24 cohort studies.},
	volume = {15},
	doi = {10.1111/codi.12280},
	number = {8},
	journaltitle = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
	shortjournal = {Colorectal Dis},
	author = {Mansouri, D. and {McMillan}, D. C. and Crighton, E. M. and Horgan, P. G.},
	date = {2013-08},
	pmid = {23663655},
	keywords = {*Diabetes Complications, Colorectal Neoplasms/*etiology, Diabetes Mellitus, Type 2/*complications, Female, Humans, Male}
}

@article{mezhir_matched_2009,
	title = {A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19774424},
	abstract = {{BACKGROUND}: Preoperative biliary drainage ({PBD}) prior to pancreaticoduodenectomy ({PD}) continues to be routine in many centers despite retrospective and randomized data showing that {PBD} increases perioperative infectious complications. {METHODS}: Review of a prospectively maintained database identified 340 consecutive patients with pancreatic adenocarcinoma who underwent {PD} between 2000 and 2005. From this cohort, 94 {PBD} and 94 nonstented (no-{PBD}) patients were matched for age, gender, preoperative albumin, and bilirubin levels ({PBD} group: prestent bilirubin; no-{PBD} group: preoperative bilirubin). {RESULTS}: The majority of {PBD} patients (89\%) underwent internal endoscopic biliary drainage. Stent-related complications occurred in 46 patients (23\%) and resulted in a significant delay in time to resection. In the matched-pair comparison, there was more operative blood loss in {PBD} patients, but similar operative times, transfusions, and hospital stay. Bile cultures were positive in 82\% of {PBD} patients versus 7\% no {PBD}. There was a statistically significant increase in infectious complications including wound infections and intra-abdominal abscess in {PBD} patients, but equal incidence of anastomotic leak. {CONCLUSIONS}: In this case-matched control study, {PBD} was associated with a stent-related complication rate of 23\% and resulted in a twofold increase in postpancreatectomy infectious complications. The routine use of {PBD} remains unjustified.},
	pages = {2163--9},
	number = {12},
	journaltitle = {J Gastrointest Surg},
	author = {Mezhir, James J and Brennan, Murray F and Baser, Raymond E and D'Angelica, Michael I and Fong, Yuman and {DeMatteo}, Ronald P and Jarnagin, William R and Allen, Peter J},
	date = {2009-12},
	file = {Mezhir et al. - 2009 - A matched case-control study of preoperative bilia.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UJW23W2X\\Mezhir et al. - 2009 - A matched case-control study of preoperative bilia.pdf:application/pdf}
}

@article{lai_patients_2013,
	title = {Patients' inability to perform a preoperative cardiopulmonary exercise test or demonstrate an anaerobic threshold is associated with inferior outcomes after major colorectal surgery},
	volume = {111},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/111/4/607},
	doi = {10.1093/bja/aet193},
	abstract = {Background Surgical patients with poor functional capacity, determined by oxygen consumption at anaerobic threshold ({AT}) during cardiopulmonary exercise testing ({CPET}), experience longer hospital stays and worse short- and medium-term survival. However, previous studies excluded patients who were unable to perform a {CPET} or who failed to demonstrate an {AT}. We hypothesized that such patients are at risk of inferior outcomes after elective surgery.
Methods All patients undergoing major colorectal surgery attempted {CPET} to assist in the planning of care. Patients were stratified by their test results into Fit ({AT} ≥ 11.0 ml O2 kg−1 min−1), Unfit ({AT} {\textless} 11.0 ml O2 kg−1 min−1), or Unable to {CPET} groups (failed to pedal or demonstrate an {AT}). For each group, we determined hospital stay and mortality.
Results Between March 2009 and April 2010, 269 consecutive patients were screened, and proceeded to bowel resection. Median hospital stay was 8 days ({IQR} 5.1–13.4) and there were 44 deaths (16\%) at 2 yr; 26 (9.7\%) patients were categorized as Unable to {CPET}, 69 (25.7\%) Unfit and 174 (64.7\%) Fit. There were statistically significant differences between the three groups in hospital stay [median ({IQR}) 14.0 (10.5–23.8) vs 9.9 (5.5–15) vs 7.1 (4.9–10.8) days, P {\textless} 0.01] and mortality at 2 yr [11/26 (42\%) vs 14/69 (20\%) vs 19/174 (11\%), respectively (P {\textless} 0.01)] although the differences between Unable and Unfit were not statistically different.
Conclusions Patients' inability to perform {CPET} is associated with inferior outcomes after major colorectal surgery. Future studies evaluating {CPET} in risk assessment for major surgery should report outcomes for this subgroup.},
	pages = {607--611},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Lai, C. W. and Minto, G. and Challand, C. P. and Hosie, K. B. and Sneyd, J. R. and Creanor, S. and Struthers, R. A.},
	urldate = {2015-05-05},
	date = {2013-10-01},
	langid = {english},
	pmid = {23744818},
	keywords = {Exercise Test, general surgery, length of stay, mortality, preoperative care, Risk assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7CTNDV3E\\Lai et al. - 2013 - Patients' inability to perform a preoperative card.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2S2CDN4W\\607.html:text/html}
}

@article{tzeng_morbidity_2014,
	title = {Morbidity and mortality after pancreaticoduodenectomy in patients with borderline resectable type C clinical classification},
	volume = {18},
	issn = {1873-4626},
	doi = {10.1007/s11605-013-2371-6},
	abstract = {{BACKGROUND}: We previously described the clinical classification of patients with resectable pancreatic tumor anatomy but marginal performance status ({PS}) or reversible comorbidities as "borderline resectable type C" ({BR}-C). This study was designed to analyze the incidence and risk factors for post-pancreaticoduodenectomy ({PD}) morbidity/mortality in a multi-institutional cohort of {BR}-C patients.
{METHODS}: Elective {PDs} were evaluated from the 2005-10 {ACS}-{NSQIP} database. {BR}-C was defined as age ≥ 80, poor {PS}, weight loss {\textgreater} 10 \%, pulmonary disease, recent myocardial infarction/angina, stroke history, and/or preoperative sepsis. Variables associated with 30-day postoperative major complications ({PMC}) and mortality were analyzed.
{RESULTS}: A total of 3,033/8,266 (36.7 \%) patients were {BR}-C. {BR}-C patients were more likely to suffer {PMC} (31.3 vs. 26.2 \%) and mortality (4.1 vs. 2.3 \%). {BR}-C patients with {PMC} suffered 50 \% higher mortality versus non-{BR}-C patients with {PMC} (11.5 vs. 7.7 \%) (all p {\textless} 0.001). For {BR}-C patients, multivariate analysis identified the following risk factors for {PMC} or mortality: albumin {\textless} 3.5 g/{dL}, dyspnea, preoperative sepsis, age ≥ 80, poor {PS}, anesthesia score ≥ 4, and intraoperative transfusion ≥ 4 units.
{CONCLUSIONS}: Nationwide, one third of patients undergoing {PD} are medically borderline. These {BR}-C patients are at higher risk for and less able to be rescued from {PMC}. Surgeons should identify and optimize comorbidities and utilize prehabilitation to address functional deficits before elective {PD}.},
	pages = {146--155; discussion 155--156},
	number = {1},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Tzeng, Ching-Wei D. and Katz, Matthew H. G. and Fleming, Jason B. and Lee, Jeffrey E. and Pisters, Peter W. T. and Holmes, Holly M. and Varadhachary, Gauri R. and Wolff, Robert A. and Abbruzzese, James L. and Vauthey, Jean-Nicolas and Aloia, Thomas A.},
	date = {2014-01},
	pmid = {24129825},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Age Factors, Blood Transfusion, Dyspnea, Female, Health Status, Humans, Male, Middle Aged, Pancreatic Neoplasms, Pancreaticoduodenectomy, Risk Factors, Sepsis, Serum Albumin, Young Adult}
}

@article{jamieson_prospective_2011,
	title = {A prospective comparison of the prognostic value of tumor- and patient-related factors in patients undergoing potentially curative surgery for pancreatic ductal adenocarcinoma.},
	volume = {18},
	doi = {10.1245/s10434-011-1560-3},
	abstract = {{BACKGROUND}: Outcome prediction after resection with curative intent for pancreatic ductal adenocarcinoma remains a challenge. There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients undergoing resection for a variety of common solid tumors. Our aim was to prospectively evaluate the prognostic value of tumor- and patient-related factors including the systemic inflammatory response in patients undergoing potentially curative surgery for pancreatic ductal adenocarcinoma of the head of pancreas. {METHODS}: The prognostic impact of  tumor factors such as stage and host factors, including the systemic inflammatory response (modified Glasgow Prognostic Score [{mGPS}]), were evaluated in a prospective study of 135 patients who underwent elective pancreaticoduodenectomy  for pancreatic ductal adenocarcinoma from January 2002 to April 2009. {RESULTS}: In addition to the established tumor-related pathological factors (in particular margin involvement; hazard ratio [{HR}] 2.82, 95\% confidence interval [{CI}] 1.65-4.84, P {\textless} 0.001), an elevated {mGPS} ({HR} 2.26, 95\% {CI} 1.43-3.57, P {\textless} 0.001) was independently associated with lower overall survival after pancreaticoduodenectomy. Additionally, in an adjuvant therapy subgroup of 74 patients, both margin involvement and an elevated {mGPS} remained independently associated with reduced overall survival. {CONCLUSIONS}: We have prospectively validated the influence of tumor-related and patient-related factors. Margin involvement and the preoperative {mGPS} were the most important determinants of overall survival in patients undergoing potentially curative pancreaticoduodenectomy. Furthermore, both had independent prognostic value in those patients receiving adjuvant chemotherapy. In the future, this may be considered a stratification factor for entry onto therapeutic trials.},
	pages = {2318--2328},
	number = {8},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Jamieson, Nigel B. and Denley, Simon M. and Logue, Jennifer and {MacKenzie}, Douglas J. and Foulis, Alan K. and Dickson, Euan J. and Imrie, Clem W. and Carter, Ross and {McKay}, Colin J. and {McMillan}, Donald C.},
	date = {2011-08},
	pmid = {21267785},
	keywords = {*Pancreaticoduodenectomy, Adenocarcinoma/pathology/*surgery, Aged, Carcinoma, Pancreatic Ductal/pathology/*surgery, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Neoplasm Grading, Neoplasm Staging, Oncology, Pancreatic Neoplasms/pathology/*surgery, Prognosis, Prospective Studies, surgery, Surgical Oncology, Survival Rate},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NPAPK748\\Jamieson et al. - 2011 - A Prospective Comparison of the Prognostic Value o.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UZBR85AM\\10.html:text/html}
}

@article{dindo_classification_2004,
	title = {Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey},
	volume = {240},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15273542},
	abstract = {Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. This shortcoming hampers comparison of outcome data among different centers and therapies and over time.},
	pages = {205--13},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Dindo, Daniel and Demartines, Nicolas and Clavien, Pierre-Alain},
	date = {2004-08}
}

@article{mohammed_comparison_2013,
	title = {Comparison of visual and automated assessment of microvessel density and their impact on outcome in primary operable invasive ductal breast cancer.},
	volume = {44},
	rights = {Copyright (c) 2013 Elsevier Inc. All rights reserved.},
	doi = {10.1016/j.humpath.2012.11.023},
	abstract = {Angiogenesis is essential for tumor growth and metastasis, and several studies have reported increased angiogenesis, as quantified by microvessel density, to be a powerful prognostic tool in breast cancer. Therefore, there is considerable interest in automated assessment of microvessel density with possible benefits in improved accuracy, increased precision, and handling workload. Visual and automated assessment of microvessel density ({CD}34(+)) and survival were examined  in patients with primary operable invasive ductal breast cancer. Tissue microarrays (n = 356 patients) immunostained for microvessel density ({CD}34(+)) were scored visually and automatically with the Slidepath Tissue {IA} system (Dublin, Ireland). Visual and automated microvessel density ({CD}34(+)) were in agreement (interclass correlation coefficient = 0.69, P {\textless} .001). Visual but not the automated method for microvessel density ({CD}34(+)) was associated with locoregional treatment and metastasis. On univariate survival analysis, visual but not automated method for microvessel density ({CD}34(+)) was associated with recurrence-free and cancer-specific survival in patients with invasive ductal breast cancer (P {\textless} .01). Although automated assessment of microvessel density ({CD}34(+)) is in reasonable agreement, it poorly predicts outcome in patients with operable invasive ductal breast cancer.},
	pages = {1688--1695},
	number = {8},
	journaltitle = {Human pathology},
	shortjournal = {Hum Pathol},
	author = {Mohammed, Zahra M. A. and Orange, Clare and {McMillan}, Donald C. and Mallon, Elizabeth and Doughty, Julie C. and Edwards, Joanne and Going, James J.},
	date = {2013-08},
	pmid = {23574778},
	keywords = {Automation, Breast Neoplasms/*blood supply/mortality/pathology, Carcinoma, Ductal, Breast/*blood supply/mortality/pathology, Cytodiagnosis/*methods, Disease-Free Survival, Female, Humans, Image Interpretation, Computer-Assisted/*methods, Immunohistochemistry, Microvessels/pathology, Middle Aged, Neovascularization, Pathologic, Tissue Array Analysis}
}

@article{leung_relationships_2012,
	title = {The relationships between plasma and red cell vitamin B2 and B6 concentrations and the systemic and local inflammatory responses in patients with colorectal cancer.},
	volume = {64},
	doi = {10.1080/01635581.2012.661512},
	abstract = {B vitamins have been implicated in cancer pathogenesis. It is therefore of interest that plasma B6 falls as part of the systemic inflammatory response ({SIR}), whereas red cell concentrations do not. The modified Glasgow Prognostic Score ({mGPS}) is a validated inflammation-based prognostic score that consists of  a combination of albumin and C-reactive protein concentrations. The aim of this study was to examine the relationships between the concentrations of plasma and red cell vitamin B concentrations, the local and systemic inflammatory response in patients with colorectal cancer. Preoperative venous blood of 108 patients with colorectal cancer were analyzed for C-reactive protein, albumin, flavin adenine dinucleotide ({FAD}), and pyridoxal phosphate ({PLP}), and lymphocyte counts. Pathological slides were retrieved for assessment of inflammatory cell infiltration. Increasing {mGPS} was associated with lower plasma {PLP} concentrations (P {\textless} 0.01) but not plasma and red cell {FAD} and red cell {PLP} concentrations. Increasing tumor stage was associated with the presence of venous invasion (P {\textless} 0.01) and low-grade inflammatory cell infiltrate (P {\textless} 0.05) but not the {SIR}, {FAD}, or {PLP} concentrations. A low-grade inflammatory cell infiltrate was not significantly associated with any other parameter. The presence of a {SIR} was associated with lower concentrations of plasma {PLP} but not red cell {PLP} concentrations in patients with colorectal cancer. Neither {FAD} and {PLP} were associated with the tumor inflammatory cell infiltrate.},
	pages = {515--520},
	number = {4},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {Leung, Elaine Y. L. and Roxburgh, Campbell S. and Talwar, Dinesh and O'Reilly, Denis S. and {McKee}, Ruth F. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2012},
	pmid = {22439733},
	keywords = {Adult, Aged, Aged, 80 and over, Colorectal Neoplasms/blood/*pathology, C-Reactive Protein/analysis/metabolism, Erythrocytes/cytology/*metabolism, Female, Flavin-Adenine Dinucleotide/blood, Humans, Inflammation/blood/pathology, Male, Middle Aged, Preoperative Period, Prospective Studies, Pyridoxal Phosphate/blood, Riboflavin/*blood, Serum Albumin/analysis, Vitamin B 6/*blood, Vitamin B Complex/*blood}
}

@article{winter_1423_2006,
	title = {1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17114007},
	abstract = {Pancreaticoduodenectomy ({PD}) with the possible addition of neoadjuvant or adjuvant therapy is the standard of care in the United States for adenocarcinoma originating in the pancreatic head, neck, and uncinate process. We reviewed 1423 patients who underwent a {PD} for a malignancy originating in the pancreas at our institution between 1970 and 2006. We examined 1175 {PDs} for ductal adenocarcinomas in greater detail. Eighteen different histological types of pancreatic cancer were identified; the most common diagnoses included ductal adenocarcinoma, neuroendocrine carcinoma, and {IPMN} with invasive cancer. Patients with ductal adenocarcinoma were analyzed in detail. The median age was 66 years, with patients in the present decade significantly older (68 years), on average, than patients in the three prior decades (e.g., 60 years in 1970, P = 0.02). The median tumor diameter was 3 cm; 42\% of the resections had positive margins and 78\% had positive lymph nodes. The perioperative morbidity was 38\%. The median postoperative stay declined over time, from 16 days in the 1980s to 8 days in the 2000s (P {\textless} 0.001). The perioperative mortality declined from 30\% in the 1970s to 1\% in the 2000s (P {\textless} 0.001). The median survival for all patients with ductal adenocarcinoma was 18 months (1-year survival = 65 \%, 2-year survival = 37\%, 5-year survival = 18\%). In a Cox proportional hazards model, pathological factors having a significant impact on survival included tumor diameter, resection margin status, lymph node status, and histologic grade. This is the largest single-institution experience with {PD} for pancreatic cancer. Patients who have cancers with favorable pathological features have a statistically significant improved long-term survival.},
	pages = {1199--210; discussion 1210--1},
	number = {9},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Arnold, Meghan A and Chang, David C and Coleman, Joann and Hodgin, Mary B and Sauter, Patricia K and Hruban, Ralph H and Riall, Taylor S and Schulick, Richard D and Choti, Michael A and Lillemoe, Keith D and Yeo, Charles J},
	date = {2006-11}
}

@article{winter_duodenojejunostomy_2008,
	title = {Duodenojejunostomy leaks after pancreaticoduodenectomy},
	volume = {12},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17968631},
	abstract = {{BACKGROUND}: A duodenojejunostomy ({DJ}) or gastrojejunostomy ({GJ}) leak is a potentially fatal complication after pancreaticoduodenectomy ({PD}). However, due to its rarity, this complication has not been fully characterized. {METHODS}: We reviewed 3,029 {PDs} performed at our institution over a 26-year period and identified patients who suffered a leak at the {DJ} or {GJ} anastomosis. Perioperative data from patients with such a leak were examined in detail and were compared to patients who did not experience such a leak after {PD}. {RESULTS}: A total of 13 patients experienced a {DJ} or {GJ} leak after {PD}, amounting to a 0.4\% leak rate. Common clinical signs of a leak included an acute abdomen, enterocutaneous fistula, and a fever. Twelve of thirteen patients also had a leukocytosis, with five patients having a peak white blood cell count exceeding 30,000 cells/mm(3). The median time interval between surgery and diagnosis of the {DJ} or {GJ} leak was 10 days; three patients were diagnosed after being discharged from the hospital and one patient was diagnosed on the day of their planned discharge. In a multivariate model, perioperative risk factors for a {DJ} or {GJ} leak included a preoperative {BUN}-to-creatinine ratio {\textgreater} 20 (odds ratio = 6, p = 0.01), intraoperative blood loss {\textgreater} or =1 l (odds ratio = 6, p = 0.03), and a total pancreatectomy (odds ratio = 7, p = 0.005). In the {DJ} or {GJ} leak group, 12 of 13 patients were managed operatively. The median postoperative length of stay was 35 days after {PD}, and four patients died within 4 months of surgery as a result of their complicated postoperative course. {CONCLUSION}: {DJ} or {GJ} leaks occur infrequently after {PD}, but are associated with substantial morbidity. The clinical presentation is usually delayed, and surgical management is the preferred approach. Early diagnosis, attention to preoperative volume status, and continued efforts to control blood loss may minimize the impact of {DJ} or {GJ} leaks in some instances.},
	pages = {263--9},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Winter, Jordan M and Cameron, John L and Yeo, Charles J and Lillemoe, Keith D and Campbell, Kurtis A and Schulick, Richard D},
	date = {2008-02}
}

@article{jones_cardiopulmonary_2012,
	title = {Cardiopulmonary Function and Age-Related Decline Across the Breast Cancer Survivorship Continuum},
	volume = {30},
	issn = {0732-183X, 1527-7755},
	url = {http://jco.ascopubs.org/content/30/20/2530},
	doi = {10.1200/JCO.2011.39.9014},
	abstract = {Purpose To evaluate cardiopulmonary function (as measured by peak oxygen consumption [{VO}2peak]) across the breast cancer continuum and its prognostic significance in women with metastatic disease.
Patients and Methods Patients with breast cancer representing four cross-sectional cohorts—that is, (1) before, (2) during, and (3) after adjuvant therapy for nonmetastatic disease, and (4) during therapy in metastatic disease—were studied. A cardiopulmonary exercise test ({CPET}) with expired gas analysis was used to assess {VO}2peak. A Cox proportional hazards model was used to estimate the risk of death according to {VO}2peak category ({\textless} 15.4 v ≥ 15.4 {mL} · kg−1 · min−1) with adjustment for clinical factors.
Results A total of 248 women (age, 55 ± 8 years) completed a {CPET}. Mean {VO}2peak was 17.8 ± a standard deviation of 4.3 {mL} · kg−1 · min−1, the equivalent of 27\% ± 17\% below age-matched healthy sedentary women. For the entire cohort, 32\% had a {VO}2peak less than 15.4 {mL} · kg−1 · min−1—the {VO}2peak required for functional independence. {VO}2peak was significantly different across breast cancer cohorts for relative ({mL} · kg−1 · min−1) and absolute (L · min−1) {VO}2peak (P = .017 and P {\textless} .001, respectively); {VO}2peak was lowest in women with metastatic disease. In patients with metastatic disease (n = 52), compared with patients achieving a {VO}2peak ≤ 1.09 L · min−1, the adjusted hazard ratio for death was 0.32 (95\% {CI}, 0.16 to 0.67, P = .002) for a {VO}2peak more than 1.09 L · min−1.
Conclusion Patients with breast cancer have marked impairment in {VO}2peak across the entire survivorship continuum. {VO}2peak may be an independent predictor of survival in metastatic disease.},
	pages = {2530--2537},
	number = {20},
	journaltitle = {Journal of Clinical Oncology},
	shortjournal = {{JCO}},
	author = {Jones, Lee W. and Courneya, Kerry S. and Mackey, John R. and Muss, Hyman B. and Pituskin, Edith N. and Scott, Jessica M. and Hornsby, Whitney E. and Coan, April D. and Herndon, James E. and Douglas, Pamela S. and Haykowsky, Mark},
	urldate = {2015-05-27},
	date = {2012-07-10},
	langid = {english},
	pmid = {22614980},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5JWXWUEU\\Jones et al. - 2012 - Cardiopulmonary Function and Age-Related Decline A.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N2ZCTDTJ\\2530.html:text/html}
}

@article{yu_population-based_2005,
	title = {A population-based study from New South Wales, Australia 1996-2001: Area variation in survival from colorectal cancer},
	volume = {41},
	doi = {10.1016/j.ejca.2005.05.018},
	shorttitle = {A population-based study from New South Wales, Australia 1996-2001},
	abstract = {In this study, we have investigated the impact of area of residence on survival from colon and rectal cancer. Relative survival and relative excess risk of death from cancer were calculated for each of 17 health areas in New South Wales, Australia. There were statistically significant differences in survival across areas for both cancers after adjusting for demographic factors. The variation remained for colon cancer but was reduced for rectal cancer after adjustment for spread of disease at diagnosis. This persistent variation in colon cancer survival suggests that variation in treatment contributes to it, and there is separate evidence for such variation. Of the 7186 patients whose deaths within five years were attributable to colorectal cancer, 784 could have had their survival increased to more than five years if the excess risk of death in all areas was reduced to the 20th centile of its distribution. Estimates such as this can assist in prioritising improvements in cancer services. (C) 2005 Elsevier Ltd. All rights reserved.},
	pages = {2715--2721},
	number = {17},
	journaltitle = {European Journal of Cancer},
	author = {Yu, X. Q. and O'Connell, D. L. and Gibberd, R. W. and Armstrong, B. K.},
	date = {2005-11},
	note = {{WOS}:000233928300030}
}

@article{carter_percutaneous_2000,
	title = {Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience},
	volume = {232},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421126/},
	shorttitle = {Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis},
	pages = {175},
	number = {2},
	journaltitle = {Annals of surgery},
	author = {Carter, C. Ross and {McKay}, Colin J. and Imrie, Clement W.},
	urldate = {2014-01-27},
	date = {2000},
	file = {Carter et al. - 2000 - Percutaneous necrosectomy and sinus tract endoscop.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7SJZUU9C\\Carter et al. - 2000 - Percutaneous necrosectomy and sinus tract endoscop.pdf:application/pdf}
}

@article{beger_surgical_1989,
	title = {Surgical management of necrotizing pancreatitis},
	volume = {69},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2658162},
	abstract = {The most important diagnostic step in the management of patients with severe acute pancreatitis is the discrimination between acute interstitial and necrotizing pancreatitis. Measurement of C-reactive protein, lactic acid dehydrogenase, alpha-1-antitrypsin, and alpha-2-macroglobulin and contrast-enhanced {CT} are useful in detecting the necrotizing course of acute pancreatitis. C-reactive protein, lactic acid dehydrogenase, and contrast-enhanced {CT} offer detection rates of 85 per cent to more than 90 per cent for pancreatic necrosis. Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data. Patients with focal pancreatic necrosis, in general, respond well to medical treatment and do not need surgery. Extended (50 per cent or more) pancreatic necroses, infected necroses, and intrapancreatic parenchymal necroses plus extrapancreatic fatty tissue necroses are indicators for surgical management. The decision for the timing of operation in patients with proved necrotizing pancreatitis should be based on clinical criteria: the development of an acute surgical abdomen, generalized sepsis, shock, persisting or increasing organ dysfunction, or some combination thereof despite maximum intensive care treatment for at least 3 days. Major pancreatic resection for the treatment of necrotizing pancreatitis appears disadvantageous. Necrosectomy and continuous local lavage allow debridement of devitalized tissue and preservation of vital pancreatic tissue. Postoperative local lavage thus results in an atraumatic evacuation of necrotic tissue, the bacterial material, and biologically active substances. The hospital mortality rate of patients treated with necrosectomy and continuous local lavage (the Ulm protocol) is below 10 per cent. Nevertheless, controlled prospective clinical trials should be performed in order to bring more precision to our clinical decisions in respect to the role of surgery for this disease.},
	pages = {529--49},
	number = {3},
	journaltitle = {Surg Clin North Am},
	author = {Beger, H G},
	date = {1989-06}
}

@article{west_effect_2015-1,
	title = {The Effect of beta-blockade on objectively measured physical fitness in patients with abdominal aortic aneurysms - A blinded interventional study},
	volume = {114},
	issn = {1471-6771},
	doi = {10.1093/bja/aev026},
	abstract = {{BACKGROUND}: Perioperative beta-blockade is widely used, especially before vascular surgery; however, its impact on exercise performance assessed using cardiopulmonary exercise testing ({CPET}) in this group is unknown. We hypothesized that beta-blocker therapy would significantly improve {CPET}-derived physical fitness in this group.
{METHODS}: We recruited patients with abdominal aortic aneurysms ({AAA}) of {\textless}5.5 cm under surveillance. All patients underwent {CPET} on and off beta-blockers. Patients routinely prescribed beta-blockers underwent a first {CPET} on medication. Beta-blockers were stopped for one week before a second {CPET}. Patients not routinely taking beta-blockers underwent the first {CPET} off treatment, then performed a second {CPET} after commencement of bisoprolol for at least 48 h. Oxygen uptake ([Formula: see text]) at estimated lactate threshold ([Formula: see text]) and [Formula: see text] at peak were primary outcome variables. A linear mixed-effects model was fitted to investigate any difference in adjusted {CPET} variables on and off beta-blockers.
{RESULTS}: Forty-eight patients completed the study. No difference was observed in [Formula: see text] at [Formula: see text] and [Formula: see text] at peak; however, a significant decrease in [Formula: see text] at [Formula: see text] and peak, an increase in workload at [Formula: see text], O2 pulse and heart rate both at [Formula: see text] and peak was found with beta-blockers. Patients taking beta-blockers routinely (chronic group) had worse exercise performance (lower [Formula: see text]).
{CONCLUSIONS}: Beta blockade has a significant impact on {CPET}-derived exercise performance, albeit without changing [Formula: see text] at [Formula: see text] and [Formula: see text] at peak. This supports performance of preoperative {CPET} on or off beta-blockers depending on local perioperative practice.
{CLINICAL} {TRIAL} {REGISTRATION}: {NCT} 02106286.},
	pages = {878--885},
	number = {6},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br J Anaesth},
	author = {West, M. A. and Parry, M. and Asher, R. and Key, A. and Walker, P. and Loughney, L. and Pintus, S. and Duffy, N. and Jack, S. and Torella, F.},
	date = {2015-06},
	pmid = {25716221}
}

@article{yang_risk_2005,
	title = {Risk factors of pancreatic leakage after pancreaticoduodenectomy},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15832417},
	abstract = {{AIM}: To analyze the risk factors for pancreatic leakage after pancreaticoduodenectomy ({PD}) and to evaluate whether duct-to-mucosa pancreaticojejunostomy could reduce the risk of pancreatic leakage. {METHODS}: Sixty-two patients who underwent {PD} at our hospital between January 2000 and November 2003 were reviewed retrospectively. The primary diseases of the patients included pancreas cancer, ampullary cancer, bile duct cancer, islet cell cancer, duodenal cancer, chronic pancreatitis, pancreatic cystadenoma, and gastric cancer. Standard {PD} was performed for 25 cases, {PD} with extended lymphadenectomy for 27 cases, pylorus-preserving {PD} for 10 cases. A duct-to-mucosa pancreaticojejunostomy was performed for patients with a hard pancreas and a dilated pancreatic duct, and a traditional end-to-end invagination pancreaticojejunostomy for patients with a soft pancreas and a non-dilated duct. Patients were divided into two groups according to the incidence of postoperative pancreaticojejunal anastomotic leakage: 10 cases with leakage and 52 cases without leakage. Seven preoperative and six intraoperative risk factors with the potential to affect the incidence of pancreatic leakage were analyzed with {SPSS}10.0 software. Logistic regression was then used to determine the effect of multiple factors on pancreatic leakage. {RESULTS}: Of the 62 patients, 10 (16.13\%) were identified as having pancreatic leakage after operation. Other major postoperative complications included delayed gastric emptying (eight patients), abdominal bleeding (four patients), abdominal abscess (three patients) and wound infection (two patients). The overall surgical morbidity was 43.5\% (27/62). The hospital mortality in this series was 4.84\% (3/62), and the mortality associated with pancreatic fistula was 10\% (1/10). Sixteen cases underwent duct-to-mucosa pancreaticojejunostomy and 1 case (1/16, 6.25\%) developed postoperative pancreatic leakage, 46 cases underwent invagination pancreaticojejunostomy and 9 cases (9/46, 19.6\%) developed postoperative pancreatic leakage. General risk factors including patient age, gender, history of jaundice, preoperative nutrition, pathological diagnosis and the length of postoperative stay were similar in the two groups. There was no statistical difference in the incidence of pancreatic leakage between the patients who received the prophylactic use of octreotide after surgery and the patients who did not undergo somatostatin therapy. Moreover, multivariate logistic regression analysis showed that none of the above factors seemed to be associated with pancreatic fistula. Two intraoperative risk factors, pancreatic duct size and texture of the remnant pancreas, were found to be significantly associated with pancreatic leakage. The incidence of pancreatic leakage was 4.88\% in patients with a pancreatic duct size greater than or equal to 3 mm and was 38.1\% in those with ducts smaller than 3 mm (P = 0.002). The pancreatic leakage rate was 2.94\% in patients with a hard pancreas and was 32.1\% in those with a soft pancreas (P = 0.004). Operative time, blood loss and type of resection were similar in the two patient groups. The incidence of pancreatic leakage was 6.25\% (1/16) in patients with duct-to-mucosa anastomosis, and was 19.6\% (9/46) in those with traditional invagination anastomosis. Although the difference of pancreatic leakage between the two groups was obvious, no statistical significance was found. This may be due to the small number of patients with duct-to-mucosa anastomosis. By further analyzing with multivariate logistic regression, both pancreatic duct size and texture of the remnant pancreas were demonstrated to be independent risk factors (P = 0.007 and 0.017, {OR} = 11.87 and 15.45). Although anastomotic technique was not a significant factor, pancreatic leakage rate was much less in cases that underwent duct-to-mucosa pancreaticojejunostomy. {CONCLUSION}: Pancreatic duct size and texture of the remnant pancreas are risk factors influencing pancreatic leakage after {PD}. Duct-to-mucosa pancreaticojejunostomy, as a safe and useful anastomotic technique, can reduce pancreatic leakage rate after {PD}.},
	pages = {2456--61},
	number = {16},
	journaltitle = {World J Gastroenterol},
	author = {Yang, Yin-Mo and Tian, Xiao-Dong and Zhuang, Yan and Wang, Wei-Min and Wan, Yuan-Lian and Huang, Yan-Ting},
	date = {2005-04}
}

@article{pereira_increased_1994,
	title = {Increased cardiac endocrine activity after common bile duct ligation in the rabbit. Atrial endocrine cells in obstructive jaundice},
	volume = {219},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8297180},
	abstract = {This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice.},
	pages = {73--8},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Pereira, J A and Torregrosa, M A and Martínez-Ródenas, F and Clària, J and Pallarés, L and Gubern, J M and Ruano-Gil, D and Sitges-Serra, A},
	date = {1994-01}
}

@article{rodriguez_debridement_2008,
	title = {Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients},
	volume = {247},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18216536},
	abstract = {To examine the surgical indications and clinical outcomes of a large cohort of patients with necrotizing pancreatitis.},
	pages = {294--9},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Rodriguez, J Ruben and Razo, A Oswaldo and Targarona, Javier and Thayer, Sarah P and Rattner, David W and Warshaw, Andrew L and Fernández-del Castillo, Carlos},
	date = {2008-02}
}

@article{whipple_treatment_1935,
	title = {Treatment of Carcinoma of Ampulla of Vater},
	volume = {102},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1391173/},
	abstract = {Images
null},
	pages = {763--779},
	number = {4},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Whipple, Allen O. and Parsons, William Barclay and Mullins, Clinton R.},
	urldate = {2015-05-12},
	date = {1935-10},
	pmid = {17856666},
	pmcid = {PMC1391173},
	file = {Whipple et al. - 1935 - TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4UDT6RQR\\Whipple et al. - 1935 - TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER.pdf:application/pdf}
}

@article{clark_preoperative_2007,
	title = {Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma},
	volume = {9},
	issn = {1365-182X},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2215360/},
	doi = {10.1080/13651820701774891},
	abstract = {Background and aims. Recognized prognostic factors for resected pancreatic ductal adenocarcinoma ({PDAC}) include tumour size, differentiation, resection margin involvement and lymph node metastases. A further prognostic factor of less certain significance is lymphocyte count. The aim of this study was to investigate whether preoperative lymphocyte count is a prognostic indicator in patients with {PDAC}. Material and methods. Patients who had undergone a potentially curative pancreaticoduodenectomy ({PD}) for {PDAC} between 1998 and 2005 were analysed. Standard prognostic factors, preoperative lymphocyte count, preoperative neutrophil count and survival data were collected. Results. Of the 44 patients studied, univariate analysis identified predictors of a poor survival as lymph node status (node positive (+ve) 10.3 [5.4–20.9] months versus node negative (−ve) 14.2 [10.9–31.4] months; p=0.038), posterior resection margin invasion (margin +ve 7.0 [5.1–15.0] months versus margin −ve 13.1 [10.0–28.3] months; p=0.025) and lymphocyte count below the reference range ({\textless}1.5×109/litre 8.8 [7.0–13.1] months versus ≥1.5×109/litre 14.3 [7.0–28.3] months; p=0.029). Low preoperative lymphocyte count (p=0.027) and posterior margin invasion (p=0.023) retained significance on multivariate analysis. Preoperative neutrophil to lymphocyte ratio was not a significant prognostic factor. Conclusion. Preoperative lymphocyte count is a significant prognostic factor in patients with {PDAC}.},
	pages = {456--460},
	number = {6},
	journaltitle = {{HPB} : The Official Journal of the International Hepato Pancreato Biliary Association},
	shortjournal = {{HPB} (Oxford)},
	author = {Clark, E.J. and Connor, S. and Taylor, M.A. and Madhavan, K.K. and Garden, O.J. and Parks, R.W.},
	urldate = {2015-05-18},
	date = {2007},
	pmid = {18345294},
	pmcid = {PMC2215360},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U3Q25XMF\\Clark et al. - 2007 - Preoperative lymphocyte count as a prognostic fact.pdf:application/pdf}
}

@article{older_anaerobic_2013,
	title = {Anaerobic threshold, is it a magic number to determine fitness for surgery?},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964343/},
	doi = {10.1186/2047-0525-2-2},
	abstract = {The use of cardiopulmonary exercise testing ({CPET}) to evaluate cardiac and respiratory function was pioneered as part of preoperative assessment in the mid 1990s. Surgical procedures have changed since then. The patient population may have aged; however, the physiology has remained the same. The use of an accurate physiological evaluation remains as germane today as it was then. Certainly no ‘magic’ is involved. The author recognizes that not everyone accepts the classical theories of the anaerobic threshold ({AT}) and that there is some discussion around lactate and exercise. The article looks at aerobic capacity as an important predictor of perioperative mortality and also looks at some aspects of {CPET} relative to surgical risk evaluation.},
	pages = {2},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Older, Paul},
	urldate = {2015-05-05},
	date = {2013-02-21},
	pmid = {24472514},
	pmcid = {PMC3964343},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D92PH65P\\Older - 2013 - Anaerobic threshold, is it a magic number to deter.pdf:application/pdf}
}

@article{pratt_possum_2008,
	title = {{POSSUM} accurately predicts morbidity for pancreatic resection},
	volume = {143},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18154928},
	abstract = {{BACKGROUND}: The Physiologic and Operative Severity Score for the {enUmeration} of Mortality and Morbidity ({POSSUM}) is a predictive scoring system for postoperative morbidity. While numerous studies validate its application to major abdominal surgery, few exclusively consider pancreatic resections, whose unique complications are costly and problematic. We examined whether {POSSUM} could accurately reflect clinical and economic outcomes in pancreatic resection. {METHODS}: 326 consecutive pancreatic resections (227 pancreaticoduodenectomies, 87 distal, 7 central, and 5 total pancreatectomies) were performed between October 2001 and January 2007. {POSSUM} score was prospectively calculated for each case, and patients were stratified to quintiles of morbidity risk: {\textless} or = 20\%, 20-40\%, 40-60\%, 60-80\%, {\textgreater} or = 80\%. Actual clinical and economic outcomes were compared across the groups. Predictive risk assessment was further evaluated independently within each resection type. Logistic regression analysis was performed to identify specific {POSSUM} parameters predictive of postoperative morbidity. {RESULTS}: Observed and Expected morbidity rates were equivalent (53.1\% vs 55.5\%) with an overall O/E ratio of 0.96. Although no patients presented with {POSSUM} scores below 20\%, a relatively equal distribution was assigned to the remaining risk cohorts. Clinical and economic outcomes progressively worsened with escalations in {POSSUM} scores. Increasing morbidity risk was associated with significantly longer hospital stays, higher rates of complications, and more blood transfusions, {ICU} management, and discharge to rehabilitation facilities. This had considerable economic impact, as mean hospital costs rose from \$19,951 in the 20-40\% risk cohort, to \$31,281 in the {\textgreater} or = 80\% group. Breakdown by operation type demonstrates that {POSSUM} definitively predicts morbidity following both proximal and distal resection, but more accurately forecasts the need for {ICU} management and rehabilitation placement when pancreatoduodenectomy is performed. Multivariate analysis revealed that one-half of {POSSUM} parameters were significant contributors for postoperative morbidity, with age, preoperative hemoglobin concentration, and intraoperative blood loss demonstrating the strongest correlations. {CONCLUSION}: {POSSUM} is a valuable perioperative scoring system for evaluating variance in pancreatic surgical methods and outcomes, and can be employed to guide management decisions that impact postoperative recovery.},
	pages = {8--19},
	number = {1},
	journaltitle = {Surgery},
	author = {Pratt, Wande and Joseph, Saju and Callery, Mark P and Vollmer, Charles M Jr},
	date = {2008-01}
}

@article{schnelldorfer_preoperative_2005,
	title = {Do preoperative pancreatic stents increase operative morbidity for chronic pancreatitis?},
	volume = {52},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16334798},
	abstract = {{BACKGROUND}/{AIMS}: Recent studies suggest that preoperative placement of bile duct stents increases morbidity after pancreatic surgery. The influence of pancreatic duct stenting on outcome after pancreatic surgery is unknown. {METHODOLOGY}: The records of 264 consecutive patients who underwent lateral pancreaticojejunostomy, pancreaticoduodenectomy, or distal pancreatectomy for chronic pancreatitis were retrospectively reviewed and analyzed. {RESULTS}: There were 137 patients who received preoperative endoscopic pancreatic stents. The remainder underwent preoperative {ERCP} without stent placement. Both groups had a similar stage of disease measured by endoscopic, clinical, and histological findings. The overall postoperative morbidity was higher in the stent group (19.7\% vs. 42.3\%, p{\textless}0.001, odds ratio 3.0). Intra-abdominal complications occurred more frequently in the stent group (10.2\% vs. 32.8\%, p{\textless}0.001), including a difference in pancreatic leaks. There was no difference in extra-abdominal complications (10.2\% vs. 13.1\%) and mortality (1.6\% vs. 1.5\%). {CONCLUSIONS}: Patients who undergo pancreatic duct stenting and require surgical drainage at a later point have a threefold increased risk for peri-operative complications. An increase in intra-abdominal complications might be related to stent associated pancreatic duct injuries, stent occlusion, and bacterial colonization of the stent.},
	pages = {1878--82},
	number = {66},
	journaltitle = {Hepatogastroenterology},
	author = {Schnelldorfer, Thomas and Lewin, David N and Adams, David B},
	date = {2005-12}
}

@article{roxburgh_elastica_2010,
	title = {Elastica staining for venous invasion results in superior prediction of cancer-specific survival in colorectal cancer.},
	volume = {252},
	doi = {10.1097/SLA.0b013e3181f1c60d},
	abstract = {{OBJECTIVE}: To examine the prognostic implications of routine elastica staining for venous invasion on prediction of cancer-specific survival in colorectal cancer. {SUMMARY} {BACKGROUND} {DATA}: Venous invasion is an important high risk feature in colorectal cancer, although prevalence in published studies ranges from 10\% to 90\%. To resolve the disparity, elastica stains have been used in our  institution to provide a more objective judgment since 2002. {METHODS}: The study included 419 patients undergoing curative elective colorectal cancer resection between 1997 and 2006. Patients were grouped prior to (1997-2001 [cohort 1]) and  following the introduction of elastica staining (2003-2006 [cohort 2]). {FINDINGS}: Clinicopathologic characteristics and 3-year survival rates were similar in both  groups. Rate of detected venous invasion increased from 18\% to 58\% following introduction of elastica staining (P {\textless} 0.001). The 3-year cancer-specific survival rate associated with the absence of venous invasion was 84\% in cohort 1, compared with 96\% in cohort 2 (P {\textless} 0.01). Elastica staining improved the prognostic value of venous invasion, showing the area under the receiver operator curve rising from 0.59 (P = 0.040; 1997-2001) to 0.68 (P {\textless} 0.001; 2003-2006), using cancer mortality as an end point. A direct comparison between H\&E alone and elastica Hematoxylin and Eosin (H\&E) was made in 53 patients. The area under the  receiver operator curve increased from 0.58, P = 0.293 (H\&E alone) to 0.74, P = 0.003 for venous invasion detected using the elastica method. {CONCLUSIONS}: Increased detection of venous invasion with elastica staining, compared with H\&E  staining, provides superior prediction of cancer survival in colorectal cancer. This relationship was seen in the comparison of 2 consecutive cohorts and in a direct comparison in a single cohort. Based on these results, elastica staining should be incorporated into the routine pathologic assessment of venous invasion  in colorectal cancer.},
	pages = {989--997},
	number = {6},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Roxburgh, Campbell S. D. and {McMillan}, Donald C. and Anderson, John H. and {McKee}, Ruth F. and Horgan, Paul G. and Foulis, Alan K.},
	date = {2010-12},
	pmid = {21107109},
	keywords = {Aged, Colorectal Neoplasms/*mortality/*pathology, Coloring Agents, Female, Humans, Male, Neoplasm Invasiveness/diagnosis, Predictive Value of Tests, Prognosis, Rubber/*analysis, Survival Analysis, Veins/*pathology}
}

@article{mcardle_comparison_2004,
	title = {Comparison of total, complexed and free prostate-specific antigens and their ratios in the detection of prostate cancer in a non-screened population.},
	volume = {41},
	doi = {10.1258/000456304323019569},
	abstract = {{BACKGROUND}: The role of prostate-specific antigen ({PSA}) isoforms in the detection of prostate cancer in a non-screened population in the {UK} remains to be determined. {METHODS}: Consecutive patients undergoing diagnostic transrectal ultrasound-guided biopsy of the prostate were studied. Prior to biopsy, a blood sample was obtained and total, complexed and free {PSA} concentrations measured. {RESULTS}: Of the 171 patients included in the study, 103 were found to have prostate cancer. There were significant differences in total and complexed {PSA} concentrations and in the ratio of free-to-total {PSA} (all P {\textless}0.001) between patients with prostate cancer and those with benign disease. Receiver operating characteristics ({ROC}) curve analysis showed that the corresponding areas under the curves were similar. Restricting the analysis to the 77 patients who had total {PSA} concentrations between 2 and 10 micro g/L, {ROC} curve analysis showed that total and complexed {PSA} concentrations failed to discriminate between benign and malignant disease. In contrast, the areas under the {ROC} curve were greater for the free-to-total ratio (P = 0.033). {CONCLUSION}: These results show that in patients with total {PSA} concentrations between 2 and 10 micro g/L, the free-to-total {PSA} ratio was superior to total {PSA} concentration in discriminating between patients with benign and malignant disease.},
	pages = {201--206},
	issue = {Pt 3},
	journaltitle = {Annals of clinical biochemistry},
	shortjournal = {Ann Clin Biochem},
	author = {{McArdle}, P. A. and Pollock, M. A. and Wallace, A. M. and {McMillan}, D. C. and Crooks, J. E. and Underwood, M. A.},
	date = {2004-05},
	pmid = {15117433},
	keywords = {*Mass Screening, Biological Markers, Great Britain, Humans, Male, Predictive Value of Tests, Prostate-Specific Antigen/*analysis, Prostatic Neoplasms/blood/*diagnosis, Retrospective Studies, {ROC} Curve, Sensitivity and Specificity}
}

@article{margarson_serum_1998,
	title = {Serum albumin: touchstone or totem?},
	volume = {53},
	rights = {Blackwell Science Ltd},
	issn = {1365-2044},
	url = {http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2044.1998.00438.x/abstract},
	doi = {10.1046/j.1365-2044.1998.00438.x},
	shorttitle = {Serum albumin},
	abstract = {A decrease in serum albumin concentrations is an almost inevitable finding in disease states, and is primarily mediated in the acute phase by alterations in vascular permeability and redistribution. This change is not disease specific but marked changes that persist are generally associated with a poorer prognosis. Critical appraisal of long-standing practices and the availability of alternative colloid solutions have led to a reduction in albumin replacement therapy, and a widespread tolerance of lower albumin concentrations in patients. The factors determining serum albumin concentrations, their measurement and the implications of hypoalbuminaemia are reviewed. The clinical value of serum albumin measurement is discussed.},
	pages = {789--803},
	number = {8},
	journaltitle = {Anaesthesia},
	shortjournal = {Anaesthesia},
	author = {Margarson, M. P. and Soni, N.},
	urldate = {2015-08-21},
	date = {1998-08-01},
	langid = {english},
	keywords = {Albumin, Protein},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PJZD7QBH\\Margarson and Soni - 1998 - Serum albumin touchstone or totem.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HAEIMF2V\\abstract.html:text/html}
}

@article{oliphant_impact_2014,
	title = {The impact of surgical specialisation on survival following elective colon cancer surgery.},
	volume = {29},
	doi = {10.1007/s00384-014-1965-0},
	abstract = {{PURPOSE}: Reorganisation of cancer services in the {UK} and across Europe has led to elective surgery for colon cancer being increasingly, but not exclusively, delivered by specialist colorectal surgeons. This study examines survival after elective colon cancer surgery performed by specialist compared to non-specialist  surgeons. {METHOD}: Patients undergoing elective surgery for colon cancer in 16 hospitals between 2001 and 2004 were identified from a prospectively maintained regional audit database. Post-operative mortality ({\textless}30 days) and 5-year relative  survival in those receiving surgery under the care of a specialist or non-specialist surgeon were compared. {RESULTS}: A total of 1,856 patients were included, of which, 1,367 (73.7\%) were treated by a specialist and 489 (26.4\%) by a non-specialist surgeon. Those treated by a specialist were more likely to be deprived, undergo surgery in a high volume unit and have higher lymph node yields than those treated by a non-specialist. Post-operative mortality was lower (4.5 versus 7.0\%; P = 0.032) and 5-year relative survival was higher (72.2 versus 65.6\%; P = 0.012) among those treated by a specialist surgeon. In multivariate analysis, surgery by non-specialists was independently associated with increased  post-operative mortality (adjusted odds ratio ({OR}) 1.69; P {\textless} 0.001) and poorer},
	pages = {1143--1150},
	number = {9},
	journaltitle = {International journal of colorectal disease},
	shortjournal = {Int J Colorectal Dis},
	author = {Oliphant, Raymond and Nicholson, Gary A. and Horgan, Paul G. and {McMillan}, Donald C. and Morrison, David S.},
	date = {2014-09},
	pmid = {25034593},
	keywords = {*Clinical Competence, *Colorectal Surgery, *Elective Surgical Procedures, Adult, Aged, Aged, 80 and over, Colonic Neoplasms/*mortality/pathology/*surgery, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Scotland/epidemiology, Socioeconomic Factors, Survival Rate, Treatment Outcome, Young Adult}
}

@article{gaag_preoperative_2008,
	title = {Preoperative Biliary Drainage in Patients with Obstructive Jaundice: History and Current Status},
	volume = {13},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/article/10.1007/s11605-008-0618-4},
	doi = {10.1007/s11605-008-0618-4},
	shorttitle = {Preoperative Biliary Drainage in Patients with Obstructive Jaundice},
	abstract = {Rationale Preoperative biliary drainage ({PBD}) has been introduced to improve outcome after surgery in patients suffering from obstructive jaundice due to a potentially resectable proximal or distal bile duct/pancreatic head lesion. In experimental models, {PBD} is almost exclusively associated with beneficial results: improved liver function and nutritional status; reduction of systemic endotoxemia; cytokine release; and, as a result, an improved immune response. Mortality was significantly reduced in these animal models. Human studies show conflicting results. Findings For distal obstruction, currently the “best-evidence” available clearly shows that routine {PBD} does not yield the appreciated improvement in postoperative morbidity and mortality in patients undergoing resection. Moreover, {PBD} harbors its own complications. However, most of the available data are outdated or suffer from methodological deficits. Conclusion The highest level of evidence for {PBD} to be performed in proximal obstruction, as well as over the preferred mode, is lacking but, nevertheless, assimilated in the treatment algorithm for many centers. Logistics and waiting lists, although sometimes inevitable, could be factors that might influence the decision to opt for {PBD}, as well as an extended diagnostic workup with laparoscopy (on indication) or scheduled preoperative chemotherapy.},
	pages = {814--820},
	number = {4},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Gaag, N. A. van der and Kloek, J. J. and Castro, S. M. M. de and Busch, O. R. C. and Gulik, T. M. van and Gouma, D. J.},
	urldate = {2015-08-21},
	date = {2008-08-23},
	langid = {english},
	keywords = {Biliary drainage, Gastroenterology, {OBSTRUCTIVE} {JAUNDICE}, Pancreatic head tumor, Proximal bile duct tumor, surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IB3JFV8Z\\Gaag et al. - 2008 - Preoperative Biliary Drainage in Patients with Obs.pdf:application/pdf;Gaag et al. - 2008 - Preoperative Biliary Drainage in Patients with Obs.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CHKPU7VG\\Gaag et al. - 2008 - Preoperative Biliary Drainage in Patients with Obs.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\53GZ3I9C\\10.html:text/html}
}

@article{carlisle_mid-term_2007,
	title = {Mid-term survival after abdominal aortic aneurysm surgery predicted by cardiopulmonary exercise testing},
	volume = {94},
	issn = {0007-1323},
	doi = {10.1002/bjs.5734},
	abstract = {{BACKGROUND}: Cardiopulmonary exercise ({CPX}) testing measures how efficiently subjects meet increased metabolic demand. This study aimed to determine whether preoperative {CPX} testing predicted postoperative survival following elective abdominal aortic aneurysm ({AAA}) repair.
{METHODS}: Some 130 patients had {CPX} testing before elective open {AAA} repair. Additional preoperative, operative and postoperative variables were recorded prospectively. Median follow-up was 35 months. The correlation of variables with survival was assessed by single and multiple regression analyses.
{RESULTS}: {CPX} testing identified 30 of 130 patients who had been unfit before surgery. Two years after surgery the Kaplan-Meier survival estimate was 55 per cent for the 30 unfit patients, compared with 97 per cent for the 100 fit patients. The absolute difference in survival between these two groups at 2 years was 42 (95 per cent confidence interval 18 to 65) per cent (P {\textless} 0.001).
{CONCLUSION}: Preoperative {CPX} testing, combined with simple co-morbidity scoring, identified patients unlikely to survive in the mid-term, even after successful {AAA} repair.},
	pages = {966--969},
	number = {8},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Carlisle, J. and Swart, M.},
	date = {2007-08},
	pmid = {17440956},
	keywords = {Analysis of Variance, Aortic Aneurysm, Abdominal, Carbon Dioxide, Elective Surgical Procedures, Exercise Test, Humans, Maximal Expiratory Flow-Volume Curves, Oxygen Consumption, Physical fitness, postoperative complications, preoperative care, Risk assessment, Survival Analysis},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D4ZUXU9V\\Carlisle and Swart - 2007 - Mid-term survival after abdominal aortic aneurysm .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GKR4SCZ8\\abstract.html:text/html}
}

@article{jenkins_relationship_2007,
	title = {The relationship between patient physiology and cancer-specific survival following curative resection of colorectal cancer},
	volume = {96},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17242695},
	abstract = {The impact of patient physiology on cancer-specific survival is poorly documented. Patient physiology predicted overall, cancer-specific (Physiology Score{\textgreater}30; {HR} 8.64 (95\% {CI} 3.00-24.92); P=0.0005) and recurrence-free survival (Physiology Score {\textgreater}30; {HR} 7.44 (95\% {CI} 1.99-27.73); P=0.003) independent of Dukes stage following potentially curative surgery for colorectal cancer. This independent negative association with survival is a novel observation.},
	pages = {213--7},
	number = {2},
	journaltitle = {Br J Cancer},
	author = {Jenkins, J T and O'Neill, G and Morran, C G},
	date = {2007-01}
}

@article{m_cyna_reply_2011,
	title = {A reply},
	volume = {66},
	issn = {00032409},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2011.06759.x},
	doi = {10.1111/j.1365-2044.2011.06759.x},
	pages = {392--393},
	number = {5},
	journaltitle = {Anaesthesia},
	author = {M Cyna, A. and Fahy, C. and Costi, D. and {McGuirk}, S.},
	urldate = {2014-01-27},
	date = {2011-05},
	file = {M Cyna et al. - 2011 - A reply.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X4R3GS7I\\M Cyna et al. - 2011 - A reply.pdf:application/pdf}
}

@article{janz_three-year_1997,
	title = {Three-Year Follow-up of Changes in Aerobic Fitness during Puberty: The Muscatine Study},
	volume = {68},
	issn = {0270-1367, 2168-3824},
	url = {http://www.tandfonline.com/doi/abs/10.1080/02701367.1997.10608861},
	doi = {10.1080/02701367.1997.10608861},
	shorttitle = {Three-Year Follow-up of Changes in Aerobic Fitness during Puberty},
	pages = {1--9},
	number = {1},
	journaltitle = {Research Quarterly for Exercise and Sport},
	author = {Janz, Kathleen F. and Mahoney, Larry T.},
	urldate = {2015-05-03},
	date = {1997-03},
	langid = {english},
	file = {02701367%2E1997%2E10608861.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\F7PN8GGA\\02701367%2E1997%2E10608861.pdf:application/pdf;Janz and Mahoney - 1997 - Three-Year Follow-up of Changes in Aerobic Fitness.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QFQFVZ2R\\Janz and Mahoney - 1997 - Three-Year Follow-up of Changes in Aerobic Fitness.pdf:application/pdf}
}

@article{harten_postoperative_2006,
	title = {Postoperative serum urea is associated with 30-day mortality in patients undergoing emergency abdominal surgery.},
	volume = {43},
	doi = {10.1258/000456306777695717},
	abstract = {{BACKGROUND}: Emergency abdominal surgery carries considerable postoperative morbidity and mortality. Hypovolaemia is considered to be a cause of renal hypoperfusion, which is associated with a decreased clearance of serum urea and creatinine. This study examines whether the perioperative serum urea and creatinine concentrations are predictors of mortality in patients undergoing emergency abdominal surgery. {METHODS}: Consecutive patients (n=300) who underwent  emergency abdominal surgery were studied. Age- and sex-specific reference intervals were used for the data analysis. Patients with incomplete biochemical (n=51) or mortality data (n=31) or with pre-existing renal failure (n=9) were excluded from the analysis. {RESULTS}: 209 patients were analysed, of whom 162 (78\%) remained alive and 47 (22\%) died following surgery. The non-survivors were  older (P{\textless}0.05), had undergone more extensive surgery (P{\textless}0.001) and were more likely to have been admitted to the intensive care unit (P{\textless}0.001). The serum urea concentration was higher preoperatively (P{\textless}0.05) and on day one postoperatively (P{\textless}0.001) in the non-survivors. On multivariate logistic regression analysis, age (odds ratio [{OR}] 3.27, 95\% confidence interval [{CI}] 1.43-7.47, P{\textless}0.005), severity of surgery ({OR} 2.21, 95\% {CI} 1.14-4.29, P{\textless}0.019), admission to intensive care ({OR}  0.54, 95\% {CI} 0.11-0.54, P{\textless}0.001), seniority of anaesthetist ({OR} 0.50, 95\% {CI} 0.27-0.90, P{\textless}0.022) and day one urea ({OR} 3.33, 95\% {CI} 1.39-7.99, P{\textless}0.007) were independently associated with 30-day mortality. {CONCLUSIONS}: These results indicate that an increased serum urea concentration, but not serum creatinine concentration, in the postoperative period is associated with an increase in},
	pages = {295--299},
	issue = {Pt 4},
	journaltitle = {Annals of clinical biochemistry},
	shortjournal = {Ann Clin Biochem},
	author = {Harten, J. and Hay, A. and {McMillan}, D. C. and {McArdle}, C. S. and O'Reilly, D. St J. and Kinsella, J.},
	date = {2006-07},
	pmid = {16824280},
	keywords = {Abdomen, Aged, Age Factors, Creatinine/blood, Emergency Medicine, Female, Humans, Kidney Diseases/blood, Male, Middle Aged, Perfusion, Postoperative Period, Regression Analysis, Sex Factors, Urea/*blood}
}

@article{mcmillan_measurement_2001,
	title = {Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer.},
	volume = {41},
	doi = {10.1080/01635581.2001.9680613},
	abstract = {The assessment of prognosis in patients with advanced cancer remains problematical. The value of C-reactive protein concentration in this context has  not been clearly defined. Patients with a diagnosis of colorectal (n = 182), gastric (n = 87), breast (n = 99), or bronchogenic (n = 404) cancer and who had measurements of C-reactive protein and albumin were identified. Median survival,  from the time of sampling, ranged from 478 days in the colorectal cancer patients to 60 days in patients with bronchogenic cancer. On univariate analysis, there was, in each tumor type, a significant relationship between the duration of survival and both log10 C-reactive protein and albumin concentrations (P {\textless} or = 0.0002). On multivariate analysis, in each tumor type, log10 C-reactive protein remained a significant independent predictor of survival (P {\textless} or = 0.0002). When  all four groups of cancer patients were analyzed (n = 772), the hazard ratio for  a 10-fold increase in C-reactive protein concentration in cancer-specific survival was 2.21 (95\% confidence interval = 1.92-2.56, P {\textless} 0.0001) and the corresponding hazard ratio for non-cancer survival was 5.48 (95\% confidence interval = 3.55-8.46, P {\textless} 0.0001). The results of the present study indicate that in advanced cancer patients the presence of a systemic inflammatory response and  the magnitude of that response predict the duration of cancer-specific and non-cancer survival.},
	pages = {64--69},
	number = {1},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {{McMillan}, D. C. and Elahi, M. M. and Sattar, N. and Angerson, W. J. and Johnstone, J. and {McArdle}, C. S.},
	date = {2001},
	pmid = {12094630},
	keywords = {Adult, Aged, Analysis of Variance, Breast Neoplasms/blood/mortality, Carcinoma, Bronchogenic/blood/mortality, Colorectal Neoplasms/blood/mortality, C-Reactive Protein/*analysis, Female, Humans, Inflammation/*blood, Lung Neoplasms/blood/mortality, Male, Middle Aged, Neoplasms/*mortality, Prognosis, Serum Albumin/analysis, Stomach Neoplasms/blood/mortality, Survival Rate}
}

@article{seifert_transluminal_2009,
	title = {Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the {GEPARD} Study)},
	volume = {58},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19282306},
	abstract = {As with endoscopic transmural drainage of peripancreatic fluid collections, the same transluminal access can be expanded to introduce an endoscope through the gastrointestinal wall into the retroperitoneum and remove infected pancreatic necroses under direct visual control. This study reports the first large series with long-term follow-up.},
	pages = {1260--6},
	number = {9},
	journaltitle = {Gut},
	author = {Seifert, H and Biermer, M and Schmitt, W and Jürgensen, C and Will, U and Gerlach, R and Kreitmair, C and Meining, A and Wehrmann, T and Rösch, T},
	date = {2009-09}
}

@article{mcfadden_game_2012,
	title = {Game theory: Applications for surgeons and the operating room environment},
	volume = {152},
	issn = {0039-6060},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606012003121},
	doi = {10.1016/j.surg.2012.06.019},
	shorttitle = {Game theory},
	abstract = {Background
Game theory is an economic system of strategic behavior, often referred to as the “theory of social situations.” Very little has been written in the medical literature about game theory or its applications, yet the practice of surgery and the operating room environment clearly involves multiple social situations with both cooperative and non-cooperative behaviors.
Methods
A comprehensive review was performed of the medical literature on game theory and its medical applications. Definitive resources on the subject were also examined and applied to surgery and the operating room whenever possible.
Results
Applications of game theory and its proposed dilemmas abound in the practicing surgeon's world, especially in the operating room environment.
Conclusion
The surgeon with a basic understanding of game theory principles is better prepared for understanding and navigating the complex Operating Room system and optimizing cooperative behaviors for the benefit all stakeholders.},
	pages = {915--922},
	number = {5},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {{McFadden}, David W. and Tsai, Mitchell and Kadry, Bassam and Souba, Wiley W.},
	urldate = {2015-06-06},
	date = {2012-11},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EI48U4NG\\McFadden et al. - 2012 - Game theory Applications for surgeons and the ope.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UR8TRQPU\\S0039606012003121.html:text/html}
}

@article{schneider_patient_2012,
	title = {Patient readmission and mortality after surgery for hepato-pancreato-biliary malignancies},
	volume = {215},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22921328},
	abstract = {The incidence and associated risk factors for readmission after hepato-pancreato-biliary surgery are poorly characterized. The objective of the current study was to compare readmission after pancreatic vs hepatobiliary surgical procedures, as well as to identify potential factors associated with higher readmission within 30 days of discharge.},
	pages = {607--15},
	number = {5},
	journaltitle = {J Am Coll Surg},
	author = {Schneider, Eric B and Hyder, Omar and Wolfgang, Christopher L and Hirose, Kenzo and Choti, Michael A and Makary, Martin A and Herman, Joseph M and Cameron, John L and Pawlik, Timothy M},
	date = {2012-11}
}

@article{grant_cardiopulmonary_2015,
	title = {Cardiopulmonary exercise testing and survival after elective abdominal aortic aneurysm repair},
	volume = {114},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/114/3/430},
	doi = {10.1093/bja/aeu383},
	abstract = {Background Cardiopulmonary exercise testing ({CPET}) is increasingly used in the preoperative assessment of patients undergoing major surgery. The objective of this study was to investigate whether {CPET} can identify patients at risk of reduced survival after abdominal aortic aneurysm ({AAA}) repair.
Methods Prospectively collected data from consecutive patients who underwent {CPET} before elective open or endovascular {AAA} repair ({EVAR}) at two tertiary vascular centres between January 2007 and October 2012 were analysed. A symptom-limited maximal {CPET} was performed on each patient. Multivariable Cox proportional hazards regression modelling was used to identify risk factors associated with reduced survival.
Results The study included 506 patients with a mean age of 73.4 (range 44–90). The majority (82.6\%) were men and most (64.6\%) underwent {EVAR}. The in-hospital mortality was 2.6\%. The median follow-up was 26 months. The 3-year survival for patients with zero or one sub-threshold {CPET} value (V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textless}10.2 ml kg−1 min−1, peak V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}{\textless}15 ml kg−1 min−1 or V˙E/V˙{CO}2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mtext{\textgreater}E/{\textless}/mml:mtext{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}C{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textgreater}42) was 86.4\% compared with 59.9\% for patients with three sub-threshold {CPET} values. Risk factors independently associated with survival were female sex [hazard ratio ({HR})=0.44, 95\% confidence interval ({CI}) 0.22–0.85, P=0.015], diabetes ({HR}=1.95, 95\% {CI} 1.04–3.69, P=0.039), preoperative statins ({HR}=0.58, 95\% {CI} 0.38–0.90, P=0.016), haemoglobin g dl−1 ({HR}=0.84, 95\% {CI} 0.74–0.95, P=0.006), peak V˙O2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater}{\textless}15 ml kg−1 min−1 ({HR}=1.63, 95\% {CI} 1.01–2.63, P=0.046), and V˙E/V˙{CO}2{\textless}mml:math{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mtext{\textgreater}E/{\textless}/mml:mtext{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:mover{\textgreater}{\textless}mml:mi{\textgreater}V{\textless}/mml:mi{\textgreater}{\textless}mml:mo{\textgreater}˙{\textless}/mml:mo{\textgreater}{\textless}/mml:mover{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}C{\textless}/mml:mi{\textgreater}{\textless}mml:mrow{\textgreater}{\textless}mml:msub{\textgreater}{\textless}mml:mi mathvariant="normal"{\textgreater}O{\textless}/mml:mi{\textgreater}{\textless}mml:mn{\textgreater}2{\textless}/mml:mn{\textgreater}{\textless}/mml:msub{\textgreater}{\textless}/mml:mrow{\textgreater}{\textless}/mml:math{\textgreater} at {AT}{\textgreater}42 ({HR}=1.68, 95\% {CI} 1.00–2.80, P=0.049).
Conclusions {CPET} variables are independent predictors of reduced survival after elective {AAA} repair and can identify a cohort of patients with reduced survival at 3 years post-procedure. {CPET} is a potentially useful adjunct for clinical decision-making in patients with {AAA}.},
	pages = {430--436},
	number = {3},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {Grant, S. W. and Hickey, G. L. and Wisely, N. A. and Carlson, E. D. and Hartley, R. A. and Pichel, A. C. and Atkinson, D. and {McCollum}, C. N.},
	urldate = {2015-05-05},
	date = {2015-03-01},
	langid = {english},
	pmid = {25481223},
	keywords = {abdominal aortic aneurysm, cardiopulmonary exercise test, cardiovascular surgical procedure, endovascular procedures},
	file = {Grant et al. - 2015 - Cardiopulmonary exercise testing and survival afte.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2T8UNAGG\\Grant et al. - 2015 - Cardiopulmonary exercise testing and survival afte.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XN4GUMQT\\430.html:text/html}
}

@article{myers_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing in small abdominal aortic aneurysm: profile, safety, and mortality estimates},
	volume = {18},
	issn = {1741-8275},
	doi = {10.1177/1741826710389384},
	shorttitle = {Cardiopulmonary exercise testing in small abdominal aortic aneurysm},
	abstract = {{AIM}: Few data are available regarding exercise testing in patients with abdominal aortic aneurysm ({AAA}) disease. The purpose of this study was to evaluate safety and to characterize the hemodynamic and cardiopulmonary ({CPX}) response to exercise in a large group of patients with {AAA}.
{METHODS}: Three hundred and six patients with {AAA} ≥3.0 to ≤5.0 cm (mean 72 ± 8 years) underwent {CPX} as part of a randomized trial of exercise training. {CPX} and hemodynamic responses, ischemic events, rhythm disturbances, and risk estimates based on treadmill scores were quantified and compared to an age-matched group of 2155 veterans referred for exercise testing for clinical reasons.
{RESULTS}: Peak {VO}(2) was similar between patients with {AAA} and the referral group (20.0 ± 6 ml/kg/min; 77 percent of age-predicted and 20.3 ± 7 ml/kg/min; 80 percent of age-predicted, respectively). The incidence of exercise-induced hypotension and hypertension was higher in {AAA} patients versus the referral group (2.9 and 3.6 percent vs {\textless}1.0 percent, p {\textless} 0.001), but there were no occurrences of ventricular tachycardia (≥3 beats) or other serious events in the {AAA} subjects. The Duke Treadmill Score and {VA} Treadmill Scores, which estimate annual cardiovascular events and all-cause mortality, respectively, were similar between groups.
{CONCLUSIONS}: Patients with {AAA} have a slightly higher incidence of hyper- and hypotensive responses to exercise than age-matched referrals, but no serious events related to {CPX} occurred. {AAA} patients can undergo maximal {CPX} safely and have risk scores based on treadmill test results that are similar to age-matched referral subjects. These findings extend recent studies using sub-maximal evaluations to stratify risk in patients considered for surgery, and support the routine use of exercise testing for risk evaluation and the functional assessment of patients with {AAA}.},
	pages = {459--466},
	number = {3},
	journaltitle = {European Journal of Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of Cardiology, Working Groups on Epidemiology \& Prevention and Cardiac Rehabilitation and Exercise Physiology},
	shortjournal = {Eur J Cardiovasc Prev Rehabil},
	author = {Myers, Jonathan and Powell, Alyssa and Smith, Kimberly and Fonda, Holly and Dalman, Ronald L. and {Stanford AAA SCCOR Investigators}},
	date = {2011-06},
	pmid = {21450647},
	keywords = {Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, California, Disease Progression, Electrocardiography, Exercise Test, Female, Follow-Up Studies, Hemodynamics, Humans, Male, Middle Aged, prognosis, Prospective Studies, Reproducibility of Results, Risk Factors, Severity of Illness Index, Survival Rate}
}

@article{ishizawa_selective_2007,
	title = {Selective versus total biliary drainage for obstructive jaundice caused by a hepatobiliary malignancy},
	volume = {193},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17236839},
	abstract = {{BACKGROUND}: Controversy exists regarding which approach is preferable among types of biliary drainage for obstructive jaundice before major hepatectomy: selective biliary drainage ({SBD}) only on the future remnant liver ({FRL}) or total biliary drainage ({TBD}). {METHODS}: There were 42 consecutive patients who underwent {SBD} (n = 15) or {TBD} (n = 27) for obstructive jaundice caused by a hepatobiliary malignancy, and subsequent portal vein embolization ({PVE}) before extended hemihepatectomy. The hypertrophy ratio, defined as the ratio of the {FRL} volume after {PVE} to that before {PVE}, was evaluated. The bilirubin clearance also was calculated. {RESULTS}: The hypertrophy ratio was higher in patients with {SBD} than in those with {TBD} (median, 128\%; range, 111-152\% vs median, 121\%; range, 102-138\%; P = .013). The bilirubin clearance of {FRL} with {SBD} was markedly improved after {PVE} compared with that in patients with {TBD}. {CONCLUSIONS}: {SBD} is superior to {TBD} in promoting hypertrophy of the {FRL} induced by {PVE} and in guaranteeing good liver function before major hepatectomy.},
	pages = {149--54},
	number = {2},
	journaltitle = {Am J Surg},
	author = {Ishizawa, Takeaki and Hasegawa, Kiyoshi and Sano, Keiji and Imamura, Hiroshi and Kokudo, Norihiro and Makuuchi, Masatoshi},
	date = {2007-02}
}

@article{koyama_mitochondrial_1980,
	title = {Mitochondrial function of rat liver in biliary obstruction},
	volume = {131},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6447387},
	abstract = {An investigation was performed of the liver mitochondrial respiratory function in rats after 1, 3 and 6 weeks of biliary obstruction and the following results were obtained: 1) Various parameters of liver mitochondrial respiratory function, such as respiratory control ratio, {ADP}/O, O2 consumption in state 3 respiration and adenosine triphosphate synthesis were found to decrease with prolongation of biliary obstruction. 2) The mitochondrial respiratory enzymes, cytochrome a (+a3) and cytochrome c(+c1) showed that both decreased in contents with prolongation of obstruction, particularly the latter. 3) The activation ratio of {ATPase} (latent {ATPase}/dinitrophenol stimulated {ATPase}) was increased after long term biliary obstruction, which was thought to indicate the severe damage of mitochondrial membrane. 4) Investigation of the respiratory function with the various respiratory substrates showed that the locations of mitochondrial respiratory inhibition in obstructive jaundice are at sites 1 and 2, which is the same as the situation seen in nonspecific damage of mitochondria. 5) There was a high degree of mitochondrial respiratory disturbance by bile acids, particularly {CDCA}, which is thought to be one of the causal factors of liver dysfunction in obstructive jaundice. 6) Mitochondrial respiratory function was markedly disturbed in hypotension, and the degree of which correlated with length of time of biliary obstruction.},
	pages = {59--69},
	number = {1},
	journaltitle = {Tohoku J Exp Med},
	author = {Koyama, K and Ito, K and Ouchi, K and Sato, T},
	date = {1980-05}
}

@article{xiong_systematic_2012,
	title = {Systematic review and meta-analysis of outcomes after intraoperative pancreatic duct stent placement during pancreaticoduodenectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22622664},
	abstract = {Postoperative pancreatic leakage after pancreaticoduodenectomy is often serious. Although some studies have suggested that stenting the anastomosis can reduce the incidence of this complication, the value of stenting in the setting of pancreaticoduodenectomy remains unclear.},
	pages = {1050--61},
	number = {8},
	journaltitle = {Br J Surg},
	author = {Xiong, J J and Altaf, K and Mukherjee, R and Huang, W and Hu, W M and Li, A and Ke, N W and Liu, X B},
	date = {2012-08}
}

@article{roxburgh_perioperative_2013,
	title = {The perioperative immune/inflammatory insult in cancer surgery},
	volume = {2},
	issn = {null},
	url = {http://dx.doi.org/10.4161/onci.27324},
	doi = {10.4161/onci.27324},
	abstract = {Within the tumor microenvironment, non-specific innate immune responses can suppress adaptive cytotoxic immunity and hence promote tumor progression. Surgery and trauma provokes high-grade, non-specific inflammatory responses that suppress cell-mediated immunity. Here, the surgical resection of neoplastic lesions is considered in the context of antitumor immunity, providing the rationale for development of perioperative interventions to maintain the immunological competence of the host.},
	pages = {e27324},
	number = {12},
	journaltitle = {{OncoImmunology}},
	author = {Roxburgh, Campbell S. and Horgan, Paul G. and {McMillan}, Donald C.},
	urldate = {2015-05-18},
	date = {2013-12-01},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GTSM2EMV\\Roxburgh et al. - 2013 - The perioperative immuneinflammatory insult in ca.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TSDGEAZW\\onci.html:text/html}
}

@article{dellinger_determinant-based_2012,
	title = {Determinant-Based Classification of Acute Pancreatitis Severity: An International Multidisciplinary Consultation},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22735715},
	abstract = {{OBJECTIVE}:: To develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. {BACKGROUND}:: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric description of occurrences that are merely associated with severity. {METHODS}:: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. {RESULT}:: The new international classification of severity is based on the actual local and systemic determinants of severity, rather than description of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity-mild, moderate, severe, and critical. {CONCLUSIONS}:: This classification is the result of a consultative process amongst pancreatologists from 49 countries. It provides a set of concise up-to-date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.},
	journaltitle = {Ann Surg},
	author = {Dellinger, E Patchen and Forsmark, Christopher E and Layer, Peter and Lévy, Philippe and Maraví-Poma, Enrique and Petrov, Maxim S and Shimosegawa, Tooru and Siriwardena, Ajith K and Uomo, Generoso and Whitcomb, David C and Windsor, John A},
	date = {2012-09},
	file = {Dellinger et al. - 2012 - Determinant-Based Classification of Acute Pancreat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\S8M2RQCS\\Dellinger et al. - 2012 - Determinant-Based Classification of Acute Pancreat.pdf:application/pdf}
}

@article{roxburgh_determinants_2012,
	title = {Determinants of short- and long-term outcome in patients undergoing simultaneous  resection of colorectal cancer and synchronous colorectal liver metastases.},
	volume = {27},
	doi = {10.1007/s00384-011-1339-9},
	abstract = {{PURPOSE}: The optimal surgical strategy for patients presenting with colorectal liver metastases has yet to be determined. Short- and long-term outcomes must be  considered if simultaneous resection of primary and liver metastases is to gain acceptance. We examine the prognostic value of patient and tumour characteristics in predicting short- and long-term outcomes following simultaneous resection for  synchronous disease. {METHODS}: Forty-six patients undergoing simultaneous resection between April 2002 and June 2010 in a single institution were included. Patient characteristics included preoperative {ASA} grade and {POSSUM}. Tumour characteristics included {TNM} stage, Petersen Index and the Clinical Risk Score. {RESULTS}: There were no postoperative deaths. The most common complications were atrial fibrillation (seven patients) and pneumonia (seven patients). Mean hospital stay with an uncomplicated postoperative recovery was 11 days versus 17  days with complicated recovery. Age (p = 0.015), {ASA} grade (p = 0.010) and {POSSUM} score (p = 0.032) were associated with postoperative complications. No pathological characteristics of the primary or secondary tumours related to surgical morbidity. Median follow-up was 37 months (5-87) during which 24 patients died, 23 from cancer. Twenty-seven had disease recurrence. N stage of the primary (p = 0.035), high-risk Petersen Index of the primary (p = 0.010) and  Clinical Risk Score {\textgreater}/= 3 (p = 0.005) were associated with poorer recurrence-free and cancer-specific survival. {CONCLUSIONS}: Post operative morbidity was determined by patient factors rather than operative or tumour characteristics. In addition to the Clinical Risk Score, pathological characteristics of the primary  are important determinants of long-term outcome following simultaneous resection  for synchronous disease.},
	pages = {363--369},
	number = {3},
	journaltitle = {International journal of colorectal disease},
	shortjournal = {Int J Colorectal Dis},
	author = {Roxburgh, C. S. D. and Richards, C. H. and Moug, S. J. and Foulis, A. K. and {McMillan}, D. C. and Horgan, P. G.},
	date = {2012-03},
	pmid = {22086199},
	keywords = {Aged, Blood Loss, Surgical, Chemotherapy, Adjuvant, Chi-Square Distribution, Colectomy/adverse effects, Colonic Neoplasms/*pathology/*surgery, Disease-Free Survival, Female, Hepatectomy, Humans, Liver Neoplasms/secondary/*surgery, Lymphatic Metastasis, Male, Middle Aged, Neoadjuvant Therapy, Proportional Hazards Models, Rectal Neoplasms/*pathology/*surgery, Time Factors, Treatment Outcome}
}

@article{roxburgh_comparison_2009,
	title = {Comparison of tumour-based (Petersen Index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancer.},
	volume = {100},
	doi = {10.1038/sj.bjc.6604926},
	abstract = {After resection, it is important to identify colon cancer patients, who are at a  high risk of recurrence and who may benefit from adjuvant treatment. The Petersen Index ({PI}), a prognostic model based on pathological criteria is validated in Dukes' B and C disease. Similarly, the modified Glasgow Prognostic Score ({mGPS}) based on biochemical criteria has also been validated. This study compares both the scores in patients undergoing curative resection of colon cancer. A total of  244 patients underwent elective resection between 1997 and 2005. The {PI} was constructed from pathological reports; the {mGPS} was measured pre-operatively. The median follow-up was 67 months (minimum 36 months) during which 109 patients died; 68 of them from cancer. On multivariate analysis of age, Dukes' stage, {PI} and {mGPS}, age (hazard ratio, {HR}, 1.74, P=0.001), Dukes' stage ({HR}, 3.63, P{\textless}0.001), {PI} ({HR}, 2.05, P=0.010) and {mGPS} ({HR}, 2.34, P{\textless}0.001) were associated independently with cancer-specific survival. Three-year cancer-specific survival  rates for Dukes' B patients with the low-risk {PI} were 98, 92 and 82\% for the {mGPS} of 0, 1 and 2, respectively (P{\textless}0.05). The high-risk {PI} population is small, in particular for Dukes' B disease (9\%). The {mGPS} further stratifies those patients  classified as low risk by the {PI}. Combining both the scoring systems could identify patients who have undergone curative surgery but are at high-risk of cancer-related death, therefore guiding management and trial stratification.},
	pages = {701--706},
	number = {5},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Roxburgh, C. S. D. and Crozier, J. E. M. and Maxwell, F. and Foulis, A. K. and Brown, J. and {McKee}, R. F. and Anderson, J. H. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2009-03-10},
	pmid = {19209171},
	pmcid = {PMC2653755},
	keywords = {Adult, Aged, Aged, 80 and over, Colonic Neoplasms/diagnosis/mortality/*pathology/*surgery, Female, Humans, Inflammation/*pathology, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging/*methods, Predictive Value of Tests, Prognosis, Research Design, Survival Analysis}
}

@article{sogaard_impact_2013,
	title = {The impact of comorbidity on cancer survival: a review},
	volume = {5},
	issn = {1179-1349},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820483/},
	doi = {10.2147/CLEP.S47150},
	shorttitle = {The impact of comorbidity on cancer survival},
	abstract = {Background
A number of studies have shown poorer survival among cancer patients with comorbidity. Several mechanisms may underlie this finding. In this review we summarize the current literature on the association between patient comorbidity and cancer prognosis. Prognostic factors examined include tumor biology, diagnosis, treatment, clinical quality, and adherence.

Methods
All English-language articles published during 2002–2012 on the association between comorbidity and survival among patients with colon cancer, breast cancer, and lung cancer were identified from {PubMed}, {MEDLINE} and Embase. Titles and abstracts were reviewed to identify eligible studies and their main results were then extracted.

Results
Our search yielded more than 2,500 articles related to comorbidity and cancer, but few investigated the prognostic impact of comorbidity as a primary aim. Most studies found that cancer patients with comorbidity had poorer survival than those without comorbidity, with 5-year mortality hazard ratios ranging from 1.1 to 5.8. Few studies examined the influence of specific chronic conditions. In general, comorbidity does not appear to be associated with more aggressive types of cancer or other differences in tumor biology. Presence of specific severe comorbidities or psychiatric disorders were found to be associated with delayed cancer diagnosis in some studies, while chronic diseases requiring regular medical visits were associated with earlier cancer detection in others. Another finding was that patients with comorbidity do not receive standard cancer treatments such as surgery, chemotherapy, and radiation therapy as often as patients without comorbidity, and their chance of completing a course of cancer treatment is lower. Postoperative complications and mortality are higher in patients with comorbidity. It is unclear from the literature whether the apparent undertreatment reflects appropriate consideration of greater toxicity risk, poorer clinical quality, patient preferences, or poor adherence among patients with comorbidity.

Conclusion
Despite increasing recognition of the importance of comorbid illnesses among cancer patients, major challenges remain. Both treatment effectiveness and compliance appear compromised among cancer patients with comorbidity. Data on clinical quality is limited.},
	pages = {3--29},
	issue = {Suppl 1},
	journaltitle = {Clinical Epidemiology},
	shortjournal = {Clin Epidemiol},
	author = {Søgaard, Mette and Thomsen, Reimar Wernich and Bossen, Kristine Skovgaard and Sørensen, Henrik Toft and Nørgaard, Mette},
	urldate = {2015-05-26},
	date = {2013-11-01},
	pmid = {24227920},
	pmcid = {PMC3820483},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EFD2ZAWZ\\Søgaard et al. - 2013 - The impact of comorbidity on cancer survival a re.pdf:application/pdf}
}

@article{bernal_aerobic_2014,
	title = {Aerobic capacity during cardiopulmonary exercise testing and survival with and without liver transplantation for patients with chronic liver disease},
	volume = {20},
	rights = {© 2013 American Association for the Study of Liver Diseases},
	issn = {1527-6473},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/lt.23766/abstract},
	doi = {10.1002/lt.23766},
	abstract = {Chronic liver disease ({CLD}) is associated with muscle wasting, reduced exercise tolerance and aerobic capacity ({AC}). Measures of {AC} determined with cardiopulmonary exercise testing ({CPET}) may predict survival after liver transplantation ({LT}), but the relationship with nontransplant outcomes is uncertain. In patients assessed for {LT}, we examined the relationship of {CPET} {AC} parameters with the severity of liver disease, nutritional state, and survival with and without {LT}. Patients assessed for elective first {LT} who underwent {CPET} and an anthropometric assessment at a single center were studied. {CPET}-derived measures of {AC} that were evaluated included the peak oxygen consumption ({VO}2 peak) and the anaerobic threshold ({AT}). Three hundred ninety-nine patients underwent {CPET}, and 223 underwent {LT}; 45\% of the patients had a {VO}2 peak {\textless} 50\% of the predicted value, and 31\% had an {AT} {\textless} 9 {mL}/kg/minute. The {VO}2 peak and {AT} values correlated with the Model for End-Stage Liver Disease score, but they more closely correlated with serum sodium and albumin levels. The handgrip strength correlated strongly with the {VO}2 peak. Patients with impaired {AC} had prolonged hospitalization after {LT}, and nonsurvivors had lower {AT} values than survivors 1 year after transplantation (P {\textless} 0.05); this was significant in a multivariate analysis. One hundred seventy-six patients did not undergo {LT}; the 1-year mortality rate was 34.6\%. The {AT} (P {\textless} 0.05) and {VO}2 peak values (P {\textless} 0.001) were lower for nonsurvivors. In a multivariate analysis, {AT} was independently associated with nonsurvival. In conclusion, {AC} was markedly impaired in many patients with {CLD}. In patients who did not undergo transplantation, impaired {AT} was predictive of mortality, and in patients undergoing {LT}, it was related to postoperative hospitalization and survival. {AC} should be evaluated as a modifiable factor for improving patient survival whether or not {LT} is anticipated. Liver Transpl 20:54–62, 2014. © 2013 {AASLD}.},
	pages = {54--62},
	number = {1},
	journaltitle = {Liver Transplantation},
	shortjournal = {Liver Transpl},
	author = {Bernal, William and Martin-Mateos, Rosa and Lipcsey, Miklós and Tallis, Caroline and Woodsford, Kyne and Mcphail, Mark J. and Willars, Christopher and Auzinger, Georg and Sizer, Elizabeth and Heneghan, Michael and Cottam, Simon and Heaton, Nigel and Wendon, Julia},
	urldate = {2015-05-27},
	date = {2014-01-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XCJA6XXI\\Bernal et al. - 2014 - Aerobic capacity during cardiopulmonary exercise t.pdf:application/pdf;Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\XV4UXRES\\Bernal et al. - 2014 - Aerobic capacity during cardiopulmonary exercise t.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U3K8WMPB\\abstract\;jsessionid=4D21AA7F2E7CCA18231E388B14F88311.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\N4AQM8QG\\abstract.html:text/html}
}

@article{kato_hepatic_1994,
	title = {Hepatic recovery after biliary drainage in experimental obstructive jaundice complicated by biliary infection},
	volume = {41},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7959541},
	abstract = {The effects of an association of biliary infection and bile stasis on the recovery process of the impaired structure and function of the cholestatic liver after biliary drainage were studied in experimental animals. Obstructive jaundice was induced by clamping a tube inserted into the common bile duct of rats, while at the same time Escherichia coli bacteria were introduced into the tube to induce biliary infection. After one week, the biliary obstruction was removed. After 14 days of biliary drainage, the impaired structure and function of the cholestatic liver without biliary infection were remarkably improved, having returned almost to normal, while in the cases with biliary infection, the impairments were far less improved, especially with respect to mitochondrial function. These results suggest that major hepatic surgery should not be employed in patients with obstructive jaundice in the presence of biliary infection and should be delayed until hepatic function has recovered sufficiently after biliary drainage.},
	pages = {217--21},
	number = {3},
	journaltitle = {Hepatogastroenterology},
	author = {Kato, S and Nagano, I and Nimura, Y and Wakabayashi, T},
	date = {1994-06}
}

@article{laaninen_difference_2014,
	title = {Difference in Early Activation of {NF}-κB and {MCP}-1 in Acinar-Cell-Rich versus Fibrotic Human Pancreas Exposed to Surgical Trauma and Hypoxia},
	volume = {2014},
	issn = {1687-6121},
	doi = {10.1155/2014/460363},
	abstract = {Objectives. Previously we have shown that a pancreas with over 40\% acinar cells is exposed to postoperative pancreatitis and other complications after pancreaticoduodenectomy ({PD}). Our aim was to analyze the expression of {NF}-κB and {MCP}-1 in the cut edge of human pancreas after {PD} in both acinar-cell-rich and fibrotic pancreata. Methods. Several pancreatic samples from six patients, three with acinar-cell-rich and three with fibrotic pancreata, were exposed to surgical trauma in {PD}, and thereafter to hypoxemia for 15 minutes, 2-2.5 hours, 4 hours, or 6 hours, to mimic postoperative conditions of the pancreatic remnant in a patient. Immunohistochemical analysis of inflammation markers ({NF}-κB, {MCP}-1) was performed. Results. In the acinar-cell-rich pancreata, intra-acinar {NF}-κB and {MCP}-1 expression increased from mild at 15 minutes to high during the first 4 hours, whereas in ductal cells {MCP}-1 staining was highly intense at both time points. Acinar cell {NF}-κB and {MCP}-1 expression and ductal cell {MCP}-1 expression were also observed in the fibrotic pancreata, but the activation remained low throughout the 6 hours. Conclusions. In acinar-cell-rich pancreas, an extensive inflammatory cascade begins almost immediately after surgical trauma. Fibrosis may limit the progression of inflammatory process in pancreas.},
	pages = {460363},
	journaltitle = {Gastroenterology Research and Practice},
	shortjournal = {Gastroenterol Res Pract},
	author = {Laaninen, Matias and Bläuer, Merja and Sand, Juhani and Nordback, Isto and Laukkarinen, Johanna},
	date = {2014},
	pmid = {25147563},
	pmcid = {PMC4131420}
}

@article{guthrie_comment_2013,
	title = {Comment on 'Stage-dependent alterations of the serum cytokine pattern in colorectal carcinoma'.},
	volume = {108},
	doi = {10.1038/bjc.2013.161},
	pages = {1915--1916},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Guthrie, G. and {McMillan}, D. C.},
	date = {2013-05-14},
	pmid = {23579213},
	pmcid = {PMC3658529},
	keywords = {Chemokine {CCL}2/*blood, Colorectal Neoplasms/*blood/*pathology, Female, Humans, Interleukins/*blood, Male, Platelet-Derived Growth Factor/*metabolism}
}

@article{gaujoux_impact_2012,
	title = {Impact of obesity and body fat distribution on survival after pancreaticoduodenectomy for pancreatic adenocarcinoma},
	volume = {19},
	issn = {1534-4681},
	doi = {10.1245/s10434-012-2301-y},
	abstract = {{BACKGROUND}: Epidemiologic studies have reported a positive correlation between body mass index ({BMI}) and pancreatic cancer risk, but clinical relevance of obesity and/or body fat distribution on tumor characteristics and cancer-related outcome remain controversial. We sought to assess the influence of obesity and body fat distribution on pathologic characteristics and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma.
{METHODS}: Demographic and biometric data were collected on 328 patients undergoing pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In a subset of patients, pancreatic fatty infiltration and fibrosis were assessed pathologically, and visceral fat area ({VFA}) was evaluated. Influence of {BMI} and body fat distribution on tumor characteristics and survival were evaluated.
{RESULTS}: A significant positive correlation between {BMI} and {VFA} was observed, with a wide range of {VFA} value within each {BMI} class. According to {BMI} or {VFA} distribution, there were no significant differences in patient characteristics, intraoperative or perioperative outcome, or pathologic characteristics, with the exception of significantly higher blood loss in patients with an increased body weight or {VFA}. Unadjusted overall and disease-free survival between {BMI} class and {VFA} quartile were not significantly different.
{CONCLUSIONS}: In this study, obesity and body fat distribution were not correlated with specific tumor characteristics or cancer-related outcome.},
	pages = {2908--2916},
	number = {9},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Gaujoux, Sébastien and Torres, Javiera and Olson, Sara and Winston, Corrine and Gonen, Mithat and Brennan, Murray F. and Klimstra, David S. and D'Angelica, Michael and {DeMatteo}, Ronald and Fong, Yuman and House, Michael and Jarnagin, William and Kurtz, Robert C. and Allen, Peter J.},
	date = {2012-09},
	pmid = {22411205},
	keywords = {Adenocarcinoma, Aged, Blood Loss, Surgical, Body Fat Distribution, Body Mass Index, Disease-Free Survival, Female, Humans, Intra-Abdominal Fat, Kaplan-Meier Estimate, Male, Middle Aged, Obesity, Operative Time, Pancreatic Neoplasms, Pancreaticoduodenectomy, Proportional Hazards Models, Statistics, Nonparametric, Survival Rate}
}

@article{yeo_progressive_2012,
	title = {A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22321518},
	abstract = {{BACKGROUND}: As patients with pancreas and periampullary cancer ({PPC}) experience improved survival rates and longevity, the focus shifts toward living life while surviving cancer. Fatigue is the most commonly reported symptom in all cancer patients. Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients. {STUDY} {DESIGN}: One hundred two patients with resected {PPC} consented to participate in this study and were randomized to either an intervention group ({IG}) or a usual care group ({UCG}). Subjects completed visual analog scales, the {FACIT}-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge. {RESULTS}: Patients in the {IG} and {UCG} were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, preoperative fatigue and pain levels, adjuvant therapy, and baseline walking distance. Patients in the {IG} had significantly improved scores on the {FACIT}-Fatigue Scale at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the {IG} were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared with the {UCG}. Using hierarchical cluster analysis, 3 mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the {IG}. {CONCLUSIONS}: This is the first prospective, randomized controlled trial to report that participation in a home walking program confers a significant benefit in resected {PPC} patients with regard to fatigue levels, physical functioning, and health-related quality of life.},
	journaltitle = {J Am Coll Surg},
	author = {Yeo, Theresa P and Burrell, Sherry A and Sauter, Patricia K and Kennedy, Eugene P and Lavu, Harish and Leiby, Benjamin E and Yeo, Charles J},
	date = {2012-02},
	file = {Yeo et al. - 2012 - A Progressive Postresection Walking Program Signif.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WPT3X9GN\\Yeo et al. - 2012 - A Progressive Postresection Walking Program Signif.pdf:application/pdf}
}

@article{sohn_pancreaticoduodenectomy:_2003,
	title = {Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12600445},
	abstract = {Although the mortality rate after pancreaticoduodenectomy has decreased, the morbidity rate remains high. Major morbidity is often managed with the aid of interventional radiologists. The objective of this study was to evaluate the cooperative roles of interventional radiologists and pancreatic surgeons in complex pancreatic surgery, specifically pancreaticoduodenectomy. Our pancreaticoduodenectomy database was reviewed for all patients undergoing pancreaticoduodenectomy between January 1, 1995 and December 31, 2000. The interventional radiologic procedures for each patient were evaluated. A total of 1061 patients underwent pancreaticoduodenectomy. The overall mortality and morbidity rates were 2.3\% and 35\%, respectively. Five hundred ninety patients (56\%) had no interventional radiologic procedures, whereas 471 patients (44\%) had interventional radiologic procedures. Of those, 342 (32\%) had preoperative biliary drainage ({PBD}) and 129 (12\%) required postoperative interventional radiologic procedures. Percutaneous aspiration/catheter drainage was required in 84 patients for intra-abdominal abscess, biloma, or lymphocele, with 24 requiring two or more abscess drains. Thirty-nine patients underwent postoperative {PBD} for bile leaks due to anastomotic disruption, undrained biliary segments, or T-tube/bile stent dislodgment. Eighteen patients had hemobilia/gastrointestinal bleeding treated by angiography with embolization. The reoperation rate for the entire cohort of 1061 patients was 4.1\% (n = 43). Nineteen of the 129 patients (15\%) requiring postoperative radiologic intervention required reoperation. Although 4 of 18 patients who required embolization for bleeding subsequently required surgical intervention for the same reason, only 4 of 84 patients undergoing abscess drainage later required operation for anastomotic disruption or unsuccessful percutaneous drainage. As would be expected, the patients who required postoperative radiologic intervention (n = 129) had a higher incidence of postoperative complications including pancreatic fistula (20\% vs. 6\%, P {\textless} 0.01), bile leakage (22\% vs. 1\%, P {\textless} 0.01), and wound infection (16\% vs. 8\%, P {\textless} 0.01). With the complications in these 129 patients, the postoperative mortality rate was only 6.2\% compared to 1.7\% in patients who did not require radiologic intervention (n = 932, P {\textless} 0.01). The median postoperative length of stay was 15 days in those patients requiring postoperative radiologic intervention, 10 days in those not requiring intervention (P {\textless} 0.01; postoperative interventional radiology vs. no postoperative interventional radiology), and 29.5 days for patients needing reoperation. Interventional radiologists play a critical role in the management of some patients undergoing pancreaticoduodenectomy. Although complications such as anastomotic leaks, abscess formation, and bleeding can result in increased mortality and a longer hospital stay, the skills of the interventional radiology team provide expert management of some life-threatening complications, thus avoiding reoperation, speeding recovery times, and minimizing morbidity.},
	pages = {209--19},
	number = {2},
	journaltitle = {J Gastrointest Surg},
	author = {Sohn, Taylor A and Yeo, Charles J and Cameron, John L and Geschwind, Jeffrey F and Mitchell, Sally E and Venbrux, Anthony C and Lillemoe, Keith D},
	date = {2003-02}
}

@article{mcardle_relationship_2004,
	title = {The relationship between interleukin-6 and C-reactive protein in patients with benign and malignant prostate disease.},
	volume = {91},
	doi = {10.1038/sj.bjc.6602211},
	abstract = {The relationship between interleukin-6 and C-reactive protein was evaluated in patients with benign (n=59) and malignant (n=86) prostate disease. The correlation coefficients for patients with benign prostatic disease and prostate  cancer were rs=0.632, P{\textless}0.001 and rs=0.663, P{\textless}0.001, respectively. These results  indicate that the relationship between interleukin-6 and C-reactive protein is similar in patients with benign and malignant prostate disease.},
	pages = {1755--1757},
	number = {10},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McArdle}, P. A. and {McMillan}, D. C. and Sattar, N. and Wallace, A. M. and Underwood, M. A.},
	date = {2004-11-15},
	pmid = {15505624},
	pmcid = {PMC2410056},
	keywords = {Aged, C-Reactive Protein/*metabolism, Humans, Interleukin-6/*blood, Male, Middle Aged, Prostatic Diseases/*metabolism, Prostatic Neoplasms/*blood}
}

@article{moon_[result_2003,
	title = {[A result of surgical treatment for ductal adenocarcinoma of the head of the pancreas]},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14532721},
	abstract = {{BACKGROUND}/{AIMS}: Ductal adenocarcinoma of the head of the pancreas can only be cured with pancreaticoduodenectomy. However, the prognosis after resection has been poor. This study analyzed the possible prognostic factors of resected ductal adenocarcinoma through pancreaticoduodenectomy in a single institution. {METHODS}: Between Oct. 1994 and May. 2002, 81 patients underwent pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas. Perioperative and pathologic factors were analyzed with univariate and multivariate analysis. {RESULTS}: The overall 5-year survival rate of the 81 patients was 10.8\% with median survival of 11.8 months. Ninety-six percent of the patients were in stage {IIa}, {IIb} or {III}. In univariate analysis, factors favoring survival were as follows: {CA}19-9 antigen{\textless}or=200 U/{mL} (p=0.0055), no preoperative biliary drainage (p=0.018), operation time{\textless}or=6.5 hr (p=0.009), R0 (curative) resection (p=0.0001), negative gross vascular invasion (p=0.0012), tumor size{\textless}or=3 cm (p=0.002), T lesion{\textless}or=T3 (p=0.0014), no tumor necrosis (p=0.0041), no duodenal invasion (p=0.0004) and postoperative chemoradiation therapy (p=0.0365). In multivariate analysis, R0 resection (p{\textless}0.001), T lesion{\textless}or=T3 (p=0.03) and no duodenal invasion (p=0.001) were independent predictors of prognosis. In 20 patients, who had T lesion{\textless}or=T3 without duodenal invasion and R0 resection, the 5-year survival rate was 67.8\%. {CONCLUSIONS}: After pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas, a favorable 5-year survival rate can be achieved in the group of patients who have T lesion{\textless}or=T3 without duodenal invasion and R0 resection.},
	pages = {156--63},
	number = {2},
	journaltitle = {Korean J Gastroenterol},
	author = {Moon, Hyoun Jong and Jang, Kee Tack and Heo, Jin Seok and Choi, Seong Ho and Joh, Jae Won and Kim, Yong Il},
	date = {2003-08}
}

@article{stotz_increased_2013,
	title = {Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer},
	volume = {109},
	rights = {© 2013 Nature Publishing Group},
	issn = {0007-0920},
	url = {http://www.nature.com/bjc/journal/v109/n2/full/bjc2013332a.html},
	doi = {10.1038/bjc.2013.332},
	abstract = {Background: The neutrophil-lymphocyte ratio ({NLR}) has been proposed as an indicator of systemic inflammatory response. Previous findings from small-scale studies revealed conflicting results about its independent prognostic significance with regard to different clinical end points in pancreatic cancer ({PC}) patients. Therefore, the aim of our study was the external validation of the prognostic significance of {NLR} in a large cohort of {PC} patients.
Methods: Data from 371 consecutive {PC} patients, treated between 2004 and 2010 at a single centre, were evaluated retrospectively. The whole cohort was stratified into two groups according to the treatment modality. Group 1 comprised 261 patients with inoperable {PC} at diagnosis and group 2 comprised 110 patients with surgically resected {PC}. Cancer-specific survival ({CSS}) was assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of the {NLR}, the modified Glasgow prognostic score ({mGPS}) and the platelet-lymphocyte ratio univariate and multivariate Cox regression models were applied.
Results: Multivariate analysis identified increased {NLR} as an independent prognostic factor for inoperable {PC} patients (hazard ratio ({HR})=2.53, confidence interval ({CI})=1.64–3.91, P{\textless}0.001) and surgically resected {PC} patients ({HR}=1.61, {CI}=1.02–2.53, P=0.039). In inoperable {PC} patients, the {mGPS} was associated with poor {CSS} only in univariate analysis ({HR}=1.44, {CI}=1.04–1.98).
Conclusion: Risk prediction for cancer-related end points using {NLR} does add independent prognostic information to other well-established prognostic factors in patients with {PC}, regardless of the undergoing therapeutic modality. Thus, the {NLR} should be considered for future individual risk assessment in patients with {PC}.},
	pages = {416--421},
	number = {2},
	journaltitle = {British Journal of Cancer},
	shortjournal = {Br J Cancer},
	author = {Stotz, M. and Gerger, A. and Eisner, F. and Szkandera, J. and Loibner, H. and Ress, A. L. and Kornprat, P. and Zoughbi, W. A. and Seggewies, F. S. and Lackner, C. and Stojakovic, T. and Samonigg, H. and Hoefler, G. and Pichler, M.},
	urldate = {2015-05-18},
	date = {2013-07-23},
	langid = {english},
	keywords = {Inflammation, pancreatic cancer, prognosis},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AIMFBT3K\\Stotz et al. - 2013 - Increased neutrophil-lymphocyte ratio is a poor pr.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J8VKZAI2\\bjc2013332a.html:text/html}
}

@article{giovannini_endoscopic_2001,
	title = {Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11571690},
	abstract = {Endoscopic biliary stenting is the most common method of treating obstructive jaundice. We present a new technique of biliary drainage using endoscopic ultrasound ({EUS}) and {EUS}-guided puncture of the common bile duct ({CBD}). A 56-year-old man with obstructive jaundice was referred for {EUS} and endoscopic retrograde cholangiopancreatography ({ERCP}) because a computed tomography ({CT}) scan had shown a pancreatic mass in the head of the pancreas and a dilated {CBD}. The patient was enrolled in a preoperative chemoradiotherapy protocol and biliary stenting was required. Deep cannulation was not obtained even after a precut and the procedure was stopped. Using a therapeutic {EUS} scope ({FG} 38X Pentax), the {CBD} was punctured with a 5-F needle-knife under {EUS} guidance and a cholangiogram was obtained. A 0.35-inch guide wire was introduced into the {CBD}. The {EUS} scope was removed and a duodenoscope was introduced, allowing the placement through the duodenum of a 10-F plastic stent. The {CBD} was drained properly. No complication occurred.},
	pages = {898--900},
	number = {10},
	journaltitle = {Endoscopy},
	author = {Giovannini, M and Moutardier, V and Pesenti, C and Bories, E and Lelong, B and Delpero, J R},
	date = {2001-10}
}

@article{crozier_preoperative_2007,
	title = {Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer.},
	volume = {94},
	rights = {Copyright (c) 2007 British Journal of Surgery Society Ltd.},
	doi = {10.1002/bjs.5706},
	abstract = {{BACKGROUND}: The aim of the present study was to evaluate the relationship between the preoperative and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for colorectal cancer. {METHODS}: One hundred and eighty patients with colorectal cancer were studied. Circulating concentrations of C-reactive protein ({CRP}) were measured before surgery and in the immediate postoperative period. {RESULTS}: The peak in {CRP} concentration occurred on day 2 (P {\textless} 0.001). During the course of the study 59 patients died, 30 from cancer and 29 from intercurrent disease. Day 2 {CRP} concentrations were dichotomized. In univariable analysis, advanced tumour node metastasis stage (P = 0.002), a raised preoperative {CRP} level (P {\textless} 0.001) and the presence of hypoalbuminaemia (P = 0.043) were associated with poorer cancer-specific survival. {CONCLUSION}: Preoperative but not postoperative {CRP} concentrations are associated with poor tumour-specific survival in patients undergoing potentially curative resection for colorectal cancer.},
	pages = {1028--1032},
	number = {8},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Crozier, J. E. M. and {McKee}, R. F. and {McArdle}, C. S. and Angerson, W. J. and Anderson, J. H. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2007-08},
	pmid = {17437250},
	keywords = {Adult, Aged, Colorectal Neoplasms/blood/*mortality/surgery, C-Reactive Protein/metabolism, Female, Humans, Intraoperative Complications/*mortality, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Survival Analysis, Systemic Inflammatory Response Syndrome/*mortality}
}

@article{gioffre_[pre-_2002,
	title = {[Pre- and postoperative external biliary drainage in patients with obstructive jaundice caused by neoplasm of the pancreatic head]},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12043471},
	abstract = {The external biliary drainage in severe jaundice secondary to pancreatic carcinoma acts differently in pre, intra, and postoperative period. In the preoperative period the drainage enables to lower the direct bilirubinemia and the intrahepatic biliary stasis and consequently the complications linked to the impaired hepatic and renal function. During the operation the catheter acts as a guide in performing the biliodigestive anastomosis. In the postoperative period the external drainage of most of daily biliary secretion protects the biliodigestive anastomosis during the postoperative paralytic ileus, and prevents the fistula development along the pancreatic jejunal anastomosis.},
	pages = {45--7},
	number = {1},
	journaltitle = {G Chir},
	author = {Gioffrè, L and Bosco, M R and Meloni, V and Vietri, F},
	date = {2002-02}
}

@article{olson_allergies_2010,
	title = {Allergies, obesity, other risk factors and survival from pancreatic cancer},
	volume = {127},
	rights = {Copyright © 2010 {UICC}},
	issn = {1097-0215},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.25240/abstract},
	doi = {10.1002/ijc.25240},
	abstract = {Survival from pancreatic adenocarcinoma remains extremely poor, approximately 5\% at 5 years. Risk factors include smoking, high body mass index ({BMI}), family history of pancreatic cancer, and long-standing diabetes; in contrast, allergies are associated with reduced risk. Little is known about associations between these factors and survival. We analyzed overall survival in relation to risk factors for 475 incident cases who took part in a hospital based case–control study. Analyses were conducted separately for those who did (160) and did not (315) undergo tumor resection. Kaplan-Meier methods were used to describe survival according to smoking, {BMI}, family history, diabetes, and presence of allergies. Cox proportional hazards models were used to adjust for covariates. There was no association with survival based on smoking, family history, or history of diabetes in either group. Among patients with resection, those with allergies showed nonstatistically significant longer survival, a median of 33.1 months (95\% {CI}: 19.0–52.5) vs. 21.8 months (95\% {CI}: 18.0–33.1), p = 0.25. The adjusted hazard ratio ({HR}) was 0.72 (95\% {CI}: 0.43–1.23), p = 0.23. Among patients without resection, those with self-reported allergies survived significantly longer than those without allergies: 13.3 months (95\% {CI}: 10.6–16.9) compared to 10.4 months (95\% {CI}: 8.8–11.0), p = 0.04, with an adjusted {HR} of 0.68 (95\% {CI}: 0.49–0.95), p = 0.02. Obesity was nonsignificantly associated with poorer survival, particularly in the resected group ({HR} = 1.62, 95\% {CI}: 0.76–3.44). The mechanisms underlying the association between history of allergies and improved survival are unknown. These novel results need to be confirmed in other studies.},
	pages = {2412--2419},
	number = {10},
	journaltitle = {International Journal of Cancer},
	shortjournal = {Int. J. Cancer},
	author = {Olson, Sara H. and Chou, Joanne F. and Ludwig, Emmy and O'Reilly, Eileen and Allen, Peter J. and Jarnagin, William R. and Bayuga, Sharon and Simon, Jennifer and Gonen, Mithat and Reisacher, William R. and Kurtz, Robert C.},
	urldate = {2015-08-08},
	date = {2010-11-15},
	langid = {english},
	keywords = {allergies, {BMI}, pancreatic cancer, Survival},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Z8TWUDJH\\Olson et al. - 2010 - Allergies, obesity, other risk factors and surviva.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\X3NGEKC8\\full.html:text/html}
}

@article{choi_delayed_2004,
	title = {Delayed hemorrhage after pancreaticoduodenectomy},
	volume = {199},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15275871},
	abstract = {Postoperative hemorrhage, particularly delayed hemorrhage after pancreaticoduodenectomy, is a serious complication and one of the most common causes of mortality after pancreaticoduodenectomy.},
	pages = {186--91},
	number = {2},
	journaltitle = {J Am Coll Surg},
	author = {Choi, Seong Ho and Moon, Hyoun Jong and Heo, Jin Seok and Joh, Jae Won and Kim, Yong Il},
	date = {2004-08}
}

@article{adam_risk_2004,
	title = {Risk factors for complications after pancreatic head resection},
	volume = {187},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14769305},
	abstract = {{BACKGROUND}: Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period. {METHODS}: Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared. {RESULTS}: Mortality was 3\%. Overall and surgery-related complications occurred in 42\% and 28\%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [{OR}] 2.7), absence of preoperative biliary drainage ({OR} 1.9), and resection of other organs ({OR} 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period. {CONCLUSIONS}: Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.},
	pages = {201--8},
	number = {2},
	journaltitle = {Am J Surg},
	author = {Adam, Ulrich and Makowiec, Frank and Riediger, Hartwig and Schareck, Wolfgang D and Benz, Stefan and Hopt, Ulrich T},
	date = {2004-02}
}

@article{shaddock_pretreatment_1989,
	title = {Pretreatment with mixed-function oxidase inducers increases the sensitivity of the hepatocyte/{DNA} repair assay.},
	volume = {13},
	abstract = {A recent National Toxicology Program evaluation indicates that the rat hepatocyte/{DNA} repair assay has a high false-negative rate and that it is insensitive to some genotoxic hepatocarcinogens as well as other species and organ-specific carcinogens. In this study, we examined whether the sensitivity of the hepatocyte/{DNA} repair assay might be increased through animal pretreatment with various hepatic mixed-function oxidase inducers, i.e., Aroclor 1254, phenobarbital, and 3,3',4,4'-tetrachloroazobenzene ({TCAB}). The effects on unscheduled {DNA} synthesis ({UDS}), a measure of {DNA} damage and repair, were studied in cultures exposed to known and/or potential carcinogens that had been evaluated as negative or questionable or that produced conflicting results with hepatocytes isolated from uninduced animals. 4,4'-Oxydianiline, 1-nitropyrene, and {TCAB} produced concentration-dependent increases in {UDS} in hepatocytes from rats pretreated with Aroclor 1254. 4,4'-Oxydianiline and {TCAB} also induced a dose-dependent increase in {DNA} repair in hepatocytes from rats pretreated with phenobarbital, whereas 1-nitropyrene was negative. 4,4'-Methylenedianiline produced a marginal response, and 3,3',4,4'-tetrachloroazoxybenzene ({TCAOB}) was negative in Aroclor- and phenobarbital-induced hepatocytes; however, {TCAOB}, as well as {TCAB}, produced concentration-dependent increases in {UDS} in {TCAB}-induced hepatocytes. These data indicate that the limited sensitivity to chemical carcinogens displayed by the hepatocyte/{DNA} repair assay may be increased by using hepatocytes isolated from animals exposed to hepatic mixed-function oxidase inducers.},
	pages = {281--288},
	number = {4},
	journaltitle = {Environmental and molecular mutagenesis},
	shortjournal = {Environ Mol Mutagen},
	author = {Shaddock, J. G. and Heflich, R. H. and {McMillan}, D. C. and Hinson, J. A. and Casciano, D. A.},
	date = {1989},
	pmid = {2737181},
	keywords = {*Mutagenicity Tests, Animals, Aroclors/pharmacology, Autoradiography, Azo Compounds/pharmacology, Carcinogens, Cells, Cultured, Chlorobenzenes/pharmacology, {DNA} Repair/*drug effects, Enzyme Induction, Liver/cytology/*enzymology, Male, Mixed Function Oxygenases/biosynthesis/*metabolism, Mutagens, Phenobarbital/pharmacology, Rats, Rats, Inbred Strains}
}

@article{agusti_pulmonary_1989,
	title = {Pulmonary hemodynamics and gas exchange during exercise in liver cirrhosis},
	volume = {139},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2913894},
	abstract = {We have recently shown that ventilation-perfusion ({VA}/Q) mismatching at rest in cirrhosis is due to an abnormal pulmonary vascular tone. It has been suggested that in patients with cirrhosis, O2 transfer might become diffusion-limited during exercise. This study examined pulmonary hemodynamics and mechanisms modulating gas exchange during exercise (60 to 70\% {VO}2max) in six patients (41 +/- 5 yr, mean +/- {SEM}) with cirrhosis but with normal lung function tests. At rest, {QT} was high (8.4 +/- 0.5 L/min), pulmonary vascular resistance ({PVR}) was low (0.61 +/- 0.17 mm Hg/L/min), and there was mild to moderate {VA}/Q mismatching ({LogSD} Q, 0.79 +/- 0.09; normal range, 0.3 to 0.6). However, hyperventilation ({PaCO}2, 29 +/- 2 mm Hg) and high {QT} (thus, high {PVO}2, 41 +/- 2 mm Hg) contributed to the maintenance of {PaO}2 within normal values (99 +/- 7 mm Hg). Exercise {VO}2 (1,278 +/- 122 ml/min) was normal relative to work load, but, contrary to that in normal subjects, {QT} was higher and {PVR} did not fall. During exercise, {PaO}2 showed a trend to decrease (to 90 +/- 5 mm Hg) and {PaCO}2 to rise (to 35 +/- 2 mm Hg), but the differences failed to reach statistical significance (p = 0.07 each). {PVO}2 fell significantly with exercise (41 +/- 2 to 33 +/- 0.3 mm Hg, p less than 0.05), but neither {AaPO}2 (15 +/- 7 to 21 +/- 6 mm Hg) nor {VA}/Q inequality ({LogSD} Q, 0.82 +/- 0.11) changed. No systemic difference was noticed between predicted and measured {PaO}2 values, suggesting no O2 diffusion impairment during exercise.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {485--91},
	number = {2},
	journaltitle = {Am Rev Respir Dis},
	author = {Agusti, A G and Roca, J and Rodriguez-Roisin, R and Mastai, R and Wagner, P D and Bosch, J},
	date = {1989-02},
	note = {cited 54}
}

@article{crumley_evaluation_2006,
	title = {Evaluation of an inflammation-based prognostic score in patients with inoperable  gastro-oesophageal cancer.},
	volume = {94},
	doi = {10.1038/sj.bjc.6602998},
	abstract = {There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients with advanced cancer. The aim of the present study was to examine whether an inflammation-based prognostic score (Glasgow Prognostic score, {GPS}) was associated with survival, in patients with inoperable gastro-oesophageal cancer. Patients diagnosed with inoperable gastro-oesophageal carcinoma and who had measurement of albumin and},
	pages = {637--641},
	number = {5},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Crumley, A. B. C. and {McMillan}, D. C. and {McKernan}, M. and {McDonald}, A. C. and Stuart, R. C.},
	date = {2006-03-13},
	pmid = {16479253},
	pmcid = {PMC2361199},
	keywords = {*Inflammation, Aged, C-Reactive Protein/analysis, Esophageal Neoplasms/*immunology/*pathology, Female, Humans, Hypoalbuminemia, Male, Middle Aged, Neoplasm Staging/*methods, Predictive Value of Tests, Prognosis, Severity of Illness Index, Stomach Neoplasms/*immunology/*pathology, Survival Analysis}
}

@article{augenstein_bile_2010,
	title = {Bile cultures: a guide to infectious complications after pancreaticoduodenectomy},
	volume = {102},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20872951},
	abstract = {The aim of this study was to evaluate the utility of intraoperative bile cultures on the outcome of patients undergoing pancreaticoduodenectomy.},
	pages = {478--81},
	number = {5},
	journaltitle = {J Surg Oncol},
	author = {Augenstein, Vedra A and Reuter, Nathan P and Bower, Matthew R and {McMasters}, Kelly M and Scoggins, Charles R and Martin, Robert C G},
	date = {2010-10}
}

@article{qualls_parametric_2010,
	title = {Parametric Versus Nonparametric Statistical Tests: The Length of Stay Example: {PARAMETRIC} {VS}. {NONPARAMETRIC} {STATISTICAL} {TESTS}},
	volume = {17},
	issn = {10696563},
	url = {http://doi.wiley.com/10.1111/j.1553-2712.2010.00874.x},
	doi = {10.1111/j.1553-2712.2010.00874.x},
	shorttitle = {Parametric Versus Nonparametric Statistical Tests},
	pages = {1113--1121},
	number = {10},
	journaltitle = {Academic Emergency Medicine},
	author = {Qualls, Munirih and Pallin, Daniel J. and Schuur, Jeremiah D.},
	urldate = {2015-04-28},
	date = {2010-10},
	langid = {english},
	file = {Qualls et al. - 2010 - Parametric Versus Nonparametric Statistical Tests.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EHEEVRJ7\\Qualls et al. - 2010 - Parametric Versus Nonparametric Statistical Tests.pdf:application/pdf}
}

@article{fang_pre-operative_2012,
	title = {Pre-operative biliary drainage for obstructive jaundice},
	volume = {9},
	issn = {1469-493X},
	doi = {10.1002/14651858.CD005444.pub3},
	abstract = {{BACKGROUND}: Patients with obstructive jaundice have various pathophysiological changes that affect the liver, kidney, heart, and the immune system. There is considerable controversy as to whether temporary relief of biliary obstruction prior to major definitive surgery (pre-operative biliary drainage) is of any benefit to the patient.
{OBJECTIVES}: To assess the benefits and harms of pre-operative biliary drainage versus no pre-operative biliary drainage (direct surgery) in patients with obstructive jaundice (irrespective of a benign or malignant cause).
{SEARCH} {METHODS}: We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Clinical Trials ({CENTRAL}) in The Cochrane Library, {MEDLINE}, {EMBASE}, and Science Citation Index Expanded until February 2012.
{SELECTION} {CRITERIA}: We included all randomised clinical trials comparing biliary drainage followed by surgery versus direct surgery, performed for obstructive jaundice, irrespective of the sample size, language, and publication status.
{DATA} {COLLECTION} {AND} {ANALYSIS}: Two authors independently assessed trials for inclusion and extracted data. We calculated the risk ratio ({RR}), rate ratio ({RaR}), or mean difference ({MD}) with 95\% confidence intervals ({CI}) based on the available patient analyses. We assessed the risk of bias (systematic overestimation of benefit or systematic underestimation of harm) with components of the Cochrane risk of bias tool. We assessed the risk of play of chance (random errors) with trial sequential analysis.
{MAIN} {RESULTS}: We included six trials with 520 patients comparing pre-operative biliary drainage (265 patients) versus no pre-operative biliary drainage (255 patients). Four trials used percutaneous transhepatic biliary drainage and two trials used endoscopic sphincterotomy and stenting as the method of pre-operative biliary drainage. The risk of bias was high in all trials. The proportion of patients with malignant obstruction varied between 60\% and 100\%. There was no significant difference in mortality (40/265, weighted proportion 14.9\%) in the pre-operative biliary drainage group versus the direct surgery group (34/255, 13.3\%) ({RR} 1.12; 95\% {CI} 0.73 to 1.71; P = 0.60). The overall serious morbidity was higher in the pre-operative biliary drainage group (60 per 100 patients in the pre-operative biliary drainage group versus 26 per 100 patients in the direct surgery group) ({RaR} 1.66; 95\% {CI} 1.28 to 2.16; P = 0.0002). The proportion of patients who developed serious morbidity was significantly higher in the pre-operative biliary drainage group (75/102, 73.5\%) in the pre-operative biliary drainage group versus the direct surgery group (37/94, 37.4\%) (P {\textless} 0.001). Quality of life was not reported in any of the trials. There was no significant difference in the length of hospital stay (2 trials, 271 patients; {MD} 4.87 days; 95\% {CI} -1.28 to 11.02; P = 0.12) between the two groups. Trial sequential analysis showed that for mortality only a small proportion of the required information size had been obtained. There seemed to be no significant differences in the subgroup of trials assessing percutaneous compared to endoscopic drainage.
{AUTHORS}' {CONCLUSIONS}: There is currently not sufficient evidence to support or refute routine pre-operative biliary drainage for patients with obstructive jaundice. Pre-operative biliary drainage may increase the rate of serious adverse events. So, the safety of routine pre-operative biliary drainage has not been established. Pre-operative biliary drainage should not be used in patients undergoing surgery for obstructive jaundice outside randomised clinical trials.},
	pages = {CD005444},
	journaltitle = {The Cochrane Database of Systematic Reviews},
	shortjournal = {Cochrane Database Syst Rev},
	author = {Fang, Yuan and Gurusamy, Kurinchi Selvan and Wang, Qin and Davidson, Brian R. and Lin, He and Xie, Xiaodong and Wang, Chaohua},
	date = {2012},
	pmid = {22972086},
	pmcid = {PMC4164472},
	keywords = {Drainage, Humans, {JAUNDICE}, Obstructive, postoperative complications, Randomized Controlled Trials as Topic, Stents}
}

@article{diamond_playing_1986,
	title = {Playing doctor: application of game theory to medical decision-making},
	volume = {39},
	issn = {0021-9681},
	shorttitle = {Playing doctor},
	abstract = {Decision analysis is an explicit, quantitative and prescriptive means by which the physician can identify optimal clinical strategies under conditions of uncertainty. It is incomplete, however, since it dispenses clinical advice without regard for the fact that the patient--for whatever reason--might choose to reject that advice. Game theory provides a supplementary means to explicate optimal rational strategies in situations where the actual outcome depends on the choices of both the patient and the physician. To determine its potential clinical relevance, we used game theory to reassess a clinical problem which has been used as a textbook exemplar of decision analysis: Should patients with chronic liver failure undergo liver biopsy before being treated? Decision analysis prescribes a pure (deterministic) strategy: the physician should always perform a biopsy. In contrast, given the proper conditions, game theory mandates a mixed (probabilistic) strategy: the physician should (randomly) recommend biopsy to only some fraction of patients, and only some fraction of these should (randomly) accept this advice. Thus, whenever the patient is free to accept or reject the physician's advice, game theory provides a prescriptive decision-making model which is qualitatively and quantitatively different from decision analysis.},
	pages = {669--682},
	number = {9},
	journaltitle = {Journal of Chronic Diseases},
	shortjournal = {J Chronic Dis},
	author = {Diamond, G. A. and Rozanski, A. and Steuer, M.},
	date = {1986},
	pmid = {3734022},
	keywords = {Biopsy, Decision making, Economics, Medical, Game Theory, Humans, Liver Diseases, Mathematics, Models, Psychological, Patient Compliance, Probability, Problem Solving}
}

@article{mcmillan_preoperative_2013,
	title = {Preoperative indicators of the systemic inflammatory response in the treatment of patients with gastrointestinal cancer.},
	volume = {100},
	doi = {10.1002/bjs.9163},
	pages = {1260--1261},
	number = {10},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {{McMillan}, D. C. and Horgan, P. G.},
	date = {2013-09},
	pmid = {23939839},
	keywords = {Gastrointestinal Neoplasms/*surgery, Humans, Preoperative Care/*methods, Systemic Inflammatory Response Syndrome/*diagnosis}
}

@article{oettle_adjuvant_2007,
	title = {Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial},
	volume = {297},
	issn = {1538-3598},
	doi = {10.1001/jama.297.3.267},
	shorttitle = {Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer},
	abstract = {{CONTEXT}: The role of adjuvant therapy in resectable pancreatic cancer is still uncertain, and no recommended standard exists.
{OBJECTIVE}: To test the hypothesis that adjuvant chemotherapy with gemcitabine administered after complete resection of pancreatic cancer improves disease-free survival by 6 months or more.
{DESIGN}, {SETTING}, {AND} {PATIENTS}: Open, multicenter, randomized controlled phase 3 trial with stratification for resection, tumor, and node status. Conducted from July 1998 to December 2004 in the outpatient setting at 88 academic and community-based oncology centers in Germany and Austria. A total of 368 patients with gross complete (R0 or R1) resection of pancreatic cancer and no prior radiation or chemotherapy were enrolled into 2 groups.
{INTERVENTION}: Patients received adjuvant chemotherapy with 6 cycles of gemcitabine on days 1, 8, and 15 every 4 weeks (n = 179), or observation ([control] n = 175).
{MAIN} {OUTCOME} {MEASURES}: Primary end point was disease-free survival, and secondary end points were overall survival, toxicity, and quality of life. Survival analysis was based on all eligible patients (intention-to-treat).
{RESULTS}: More than 80\% of patients had R0 resection. The median number of chemotherapy cycles in the gemcitabine group was 6 (range, 0-6). Grade 3 or 4 toxicities rarely occurred with no difference in quality of life (by Spitzer index) between groups. During median follow-up of 53 months, 133 patients (74\%) in the gemcitabine group and 161 patients (92\%) in the control group developed recurrent disease. Median disease-free survival was 13.4 months in the gemcitabine group (95\% confidence interval, 11.4-15.3) and 6.9 months in the control group (95\% confidence interval, 6.1-7.8; P{\textless}.001, log-rank). Estimated disease-free survival at 3 and 5 years was 23.5\% and 16.5\% in the gemcitabine group, and 7.5\% and 5.5\% in the control group, respectively. Subgroup analyses showed that the effect of gemcitabine on disease-free survival was significant in patients with either R0 or R1 resection. There was no difference in overall survival between the gemcitabine group (median, 22.1 months; 95\% confidence interval, 18.4-25.8; estimated survival, 34\% at 3 years and 22.5\% at 5 years) and the control group (median, 20.2 months; 95\% confidence interval, 17-23.4; estimated survival, 20.5\% at 3 years and 11.5\% at 5 years; P = .06, log-rank).
{CONCLUSIONS}: Postoperative gemcitabine significantly delayed the development of recurrent disease after complete resection of pancreatic cancer compared with observation alone. These results support the use of gemcitabine as adjuvant chemotherapy in resectable carcinoma of the pancreas.
{TRIAL} {REGISTRATION}: isrctn.org Identifier: {ISRCTN}34802808.},
	pages = {267--277},
	number = {3},
	journaltitle = {{JAMA}},
	shortjournal = {{JAMA}},
	author = {Oettle, Helmut and Post, Stefan and Neuhaus, Peter and Gellert, Klaus and Langrehr, Jan and Ridwelski, Karsten and Schramm, Harald and Fahlke, Joerg and Zuelke, Carl and Burkart, Christof and Gutberlet, Klaus and Kettner, Erika and Schmalenberg, Harald and Weigang-Koehler, Karin and Bechstein, Wolf-Otto and Niedergethmann, Marco and Schmidt-Wolf, Ingo and Roll, Lars and Doerken, Bernd and Riess, Hanno},
	date = {2007-01-17},
	pmid = {17227978},
	keywords = {Adult, Aged, Aged, 80 and over, Antimetabolites, Antineoplastic, Chemotherapy, Adjuvant, Deoxycytidine, Disease-Free Survival, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Quality of Life}
}

@article{mcmillan_epidemiology_2007,
	title = {Epidemiology of colorectal liver metastases.},
	volume = {16},
	doi = {10.1016/j.suronc.2007.04.008},
	abstract = {In summary, the natural history of patients presenting with synchronous liver metastases has been well documented. However, the epidemiology and natural history of patients presenting with metachronous disease is scant. It is clear, therefore, that the accurate detection of occult liver metastases at the time of  presentation underpins further improvements in the selection of appropriate treatment for patients presenting with colorectal cancer. This will facilitate early referral for investigation and treatment of their liver metastases.},
	number = {1},
	journaltitle = {Surgical oncology},
	shortjournal = {Surg Oncol},
	author = {{McMillan}, Donald C. and {McArdle}, Colin S.},
	date = {2007-07},
	pmid = {17493802},
	keywords = {Colorectal Neoplasms/*epidemiology/pathology, Humans, Liver Neoplasms/*epidemiology/secondary/therapy}
}

@article{bromwich_systemic_2004,
	title = {The systemic inflammatory response, performance status and survival in patients undergoing alpha-interferon treatment for advanced renal cancer.},
	volume = {91},
	doi = {10.1038/sj.bjc.6602152},
	abstract = {The prognostic value of C-reactive protein, compared with {ECOG} performance status ({ECOG}-ps), in patients receiving alpha-interferon treatment for advanced renal cancer was assessed in 58 patients. In all, 55 patients died on follow-up. On multivariate analysis with {ECOG}-ps and C-reactive protein entered as covariates,  only C-reactive protein was a significant independent predictor of survival ({HR} 2.03, 95\% {CI} 1.09-3.80, P=0.026).},
	pages = {1236--1238},
	number = {7},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Bromwich, E. and {McMillan}, D. C. and Lamb, G. W. A. and Vasey, P. A. and Aitchison, M.},
	date = {2004-10-04},
	pmid = {15354220},
	pmcid = {PMC2409897},
	keywords = {Aged, Antineoplastic Agents/*therapeutic use, Carcinoma, Renal Cell/*drug therapy/*immunology/pathology, C-Reactive Protein/*analysis, Female, Health Status, Humans, Inflammation, Interferon-alpha/*therapeutic use, Kidney Neoplasms/*drug therapy/*immunology/pathology, Male, Middle Aged, Predictive Value of Tests, Prognosis, Survival Analysis, Treatment Outcome}
}

@article{preston_effect_1995,
	title = {Effect of ibuprofen on the acute-phase response and protein metabolism in patients with cancer and weight loss.},
	volume = {82},
	abstract = {The aim of this study was to determine whether administration of the non-steroidal anti-inflammatory agent ibuprofen might attenuate the acute-phase response in patients with colonic cancer. Cytokines and acute-phase proteins were measured before administration of ibuprofen and again 3 days later, when protein  synthesis was measured using 15N-glycine. In patients with cancer, ibuprofen caused a significant reduction in the plasma concentration of all five acute-phase proteins studied. Although interleukin 6 levels were raised, they did not change following administration of ibuprofen. Unlike the situation in patients with cancer who did not receive ibuprofen, whole-body protein kinetics were similar to those of control subjects in patients with cancer who received ibuprofen. Whether or not ibuprofen had been administered, non-export hepatic protein synthesis rates were significantly lower in patients with than in those without cancer. These results suggest that short-term administration of ibuprofen can attenuate accelerated whole-body protein kinetics and the acute-phase response in patients with advanced cancer.},
	pages = {229--234},
	number = {2},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Preston, T. and Fearon, K. C. and {McMillan}, D. C. and Winstanley, F. P. and Slater, C. and Shenkin, A. and Carter, D. C.},
	date = {1995-02},
	pmid = {7538412},
	keywords = {*Weight Loss, Acute-Phase Proteins/metabolism, Acute-Phase Reaction/*drug therapy, Adult, Aged, Colonic Neoplasms/*complications/metabolism, C-Reactive Protein/*metabolism, Female, Humans, Ibuprofen/*therapeutic use, Interleukin-1/metabolism, Interleukin-6/metabolism, Longitudinal Studies, Male, Middle Aged, Tumor Necrosis Factor-alpha/metabolism}
}

@article{janum_c-reactive_2011,
	title = {C-reactive protein level as a predictor of mortality in liver disease patients with bacteremia},
	volume = {46},
	issn = {0036-5521, 1502-7708},
	url = {http://www.tandfonline.com/doi/full/10.3109/00365521.2011.615855},
	doi = {10.3109/00365521.2011.615855},
	pages = {1478--1483},
	number = {12},
	journaltitle = {Scandinavian Journal of Gastroenterology},
	author = {Janum, Sine H. and Søvsø, Morten and Gradel, Kim O. and Schønheyder, Henrik C. and Nielsen, Henrik},
	urldate = {2015-08-21},
	date = {2011-12},
	langid = {english},
	file = {00365521%2E2011%2E615855.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RPEJN2DC\\00365521%2E2011%2E615855.pdf:application/pdf}
}

@article{batterham_modeling_1999,
	title = {Modeling the influence of body size on V(O2) peak: effects of model choice and body composition},
	volume = {87},
	issn = {8750-7587},
	shorttitle = {Modeling the influence of body size on V(O2) peak},
	abstract = {This study examined the bivariate relationship between peak oxygen uptake (V(O2) peak); l/min) and body size in adult men (n = 1,314, age 17-66 yr), using both "simple" and "full" iterative nonlinear allometric models. The simple model was described by V(O2) peak = M(b) (or {FFM}(b)) exp(c {SR}-{PA}) exp(a + d age) epsilon (where M is body mass in kg; {FFM} is fat-free mass in kg; {SR}-{PA} is self-reported physical activity; epsilon is a multiplicative error term; and exp indicates natural antilogarithms). The full model was described by V(O2) peak = M(b) (or {FFM}(b)) exp(c {SR}-{PA}) exp(a + d age) + e (epsilon), where e is a permitted Y-intercept term. The M exponent obtained from simple allometry was 0.65 [95\% confidence interval ({CI}), 0.59-0.71], suggestive of a curvilinear relationship constrained to pass through the origin. This "zero Y-intercept" assumption was examined via the full allometric model, which revealed an M exponent of 1.00 (95\% {CI}, 0.7-1.31), together with a positive Y-intercept term (e) of 1.13 (95\% {CI}, 0.54-1.73). The {FFM} exponents were not significantly different from unity in either the simple or full allometric models. It appears that the curvilinearity of the simple allometric model (using total M) is fictitious and is due to the inappropriate forcing of the regression line through the origin. Utilizing {FFM} as the body-size variable revealed a linear relationship between body size and V(O2) peak, irrespective of model choice. We conclude that the population mass exponent for V(O2) peak is close to unity.},
	pages = {1317--1325},
	number = {4},
	journaltitle = {Journal of Applied Physiology (Bethesda, Md.: 1985)},
	shortjournal = {J. Appl. Physiol.},
	author = {Batterham, A. M. and Vanderburgh, P. M. and Mahar, M. T. and Jackson, A. S.},
	date = {1999-10},
	pmid = {10517758},
	keywords = {Adolescent, Adult, Aged, Body Composition, Body Constitution, Humans, Male, Middle Aged, Models, Biological, Oxygen Consumption, Regression Analysis},
	file = {Batterham et al. - 1999 - Modeling the influence of body size on V(O2) peak.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PCPQU6Z3\\Batterham et al. - 1999 - Modeling the influence of body size on V(O2) peak.pdf:application/pdf}
}

@article{sargent_surgical_2010,
	title = {Surgical treatment concepts for patients with pancreatic cancer in Germany-results from a national survey conducted among members of the "Chirurgische Arbeitsgemeinschaft Onkologie" ({CAO}) and the "Arbeitsgemeinschaft Internistische Onkologie" ({AIO}) of the Germany Cancer Society ({DKG})},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20711737},
	abstract = {{BACKGROUND}: To date, only limited data are available regarding the routine surgical management of patients with exocrine pancreatic cancer ({PC}) in German community and university hospitals. {METHODS}: With the use of a standardized questionnaire, a national survey on surgical and oncological treatment concepts for {PC} in Germany was conducted on behalf of the Chirurgische Arbeitsgemeinschaft Onkologie and Arbeitsgemeinschaft Internistische Onkologie. The surgical part of that questionnaire contained 25 questions on criteria regarding resectability, surgical techniques, perioperative patient management, and palliative surgical procedures in advanced {PC}. Data were collected centrally and analyzed using the {SPSS}((R)) software. Additionally, predefined subgroup analyses, classifying the results by the professional site of the responding physician and the local annual number of treated patients, were carried out. {RESULTS}: One-hundred and two questionnaires on the surgical survey section were returned. For the majority of the survey respondents, arterial infiltration is the most important criterion for non-resectability of {PC} (common hepatic artery, 69.9\%; superior mesenteric artery, 85.3\%; celiac trunk, 86.3\%), whereas only 17.6\% would define non-resectability based on portal vein infiltration; 69.9\% consider extrapancreatic tumor manifestations as a criterion of surgical non-resectability. Of the survey participants, 53.9\% perform a biliary drainage in case of preoperative cholestasis, whereas 43.1\% reject this preoperative endoscopic-interventional approach. For cancers of the pancreatic head, 24.5\% of surgical units recommend a classical Kausch-Whipple procedure, 52.9\% prefer the pylorus-preserving partial pancreatoduodenectomy, and 20.6\% use both procedures; 74.5\% routinely perform a standard lymphadenectomy, whereas 16.7\% prefer an extended procedure. A radical pancreatic resection would be performed by 63.7\% of survey respondents also if a single liver metastasis would be found intraoperatively. {CONCLUSION}: Surgical treatment of {PC} in Germany is heterogeneous; future efforts to implement an evidence-based and standardized surgical management will be necessary.},
	journaltitle = {Langenbecks Arch Surg},
	author = {Sargent, Mirja and Boeck, Stefan and Heinemann, Volker and Jauch, Karl-Walter and Seufferlein, Thomas and Bruns, Christiane J},
	date = {2010-08}
}

@article{schwartz_radiosensitization_2010,
	title = {Radiosensitization and Stromal Imaging Response Correlates for the {HIF}-1 Inhibitor {PX}-478 Given with or without Chemotherapy in Pancreatic Cancer},
	volume = {9},
	issn = {1535-7163, 1538-8514},
	url = {http://mct.aacrjournals.org/cgi/doi/10.1158/1535-7163.MCT-09-0768},
	doi = {10.1158/1535-7163.MCT-09-0768},
	pages = {2057--2067},
	number = {7},
	journaltitle = {Molecular Cancer Therapeutics},
	author = {Schwartz, D. L. and Bankson, J. A. and Lemos, R. and Lai, S. Y. and Thittai, A. K. and He, Y. and Hostetter, G. and Demeure, M. J. and Von Hoff, D. D. and Powis, G.},
	urldate = {2014-01-27},
	date = {2010-06-29},
	file = {Schwartz et al. - 2010 - Radiosensitization and Stromal Imaging Response Co.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5N5F7UH2\\Schwartz et al. - 2010 - Radiosensitization and Stromal Imaging Response Co.pdf:application/pdf}
}

@article{horwich_relationship_2009,
	title = {The relationship between body mass index and cardiopulmonary exercise testing in chronic systolic heart failure},
	volume = {158},
	issn = {00028703},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0002870309005559},
	doi = {10.1016/j.ahj.2009.07.016},
	pages = {S31--S36},
	number = {4},
	journaltitle = {American Heart Journal},
	author = {Horwich, Tamara B. and Leifer, Eric S. and Brawner, Clinton A. and Fitz-Gerald, Meredith B. and Fonarow, Gregg C.},
	urldate = {2014-01-27},
	date = {2009-10},
	file = {Horwich et al. - 2009 - The relationship between body mass index and cardi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GFXND8WX\\Horwich et al. - 2009 - The relationship between body mass index and cardi.pdf:application/pdf}
}

@article{simmons_prognosis_2015,
	title = {Prognosis in advanced lung cancer - A prospective study examining key clinicopathological factors.},
	volume = {88},
	rights = {Copyright (c) 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.},
	doi = {10.1016/j.lungcan.2015.03.020},
	abstract = {{OBJECTIVES}: In patients with advanced incurable lung cancer deciding as to the most appropriate treatment (e.g. chemotherapy or supportive care only) is challenging. In such patients the {TNM} classification system has reached its ceiling therefore other factors are used to assess prognosis and as such, guide treatment. Performance status ({PS}), weight loss and inflammatory biomarkers (Glasgow Prognostic Score ({mGPS})) predict survival in advanced lung cancer however these have not been compared. This study compares key prognostic factors  in advanced lung cancer. {MATERIALS} {AND} {METHODS}: Patients with newly diagnosed advanced lung cancer were recruited and demographics, weight loss, other prognostic factors ({mGPS}, {PS}) were collected. Kaplan-Meier and Cox regression methods were used to compare these prognostic factors. {RESULTS}: 390 patients with advanced incurable lung cancer were recruited; 341 were male, median age was 66 years ({IQR} 59-73) and patients had stage {IV} non-small cell (n=288) (73.8\%) or extensive stage small cell lung cancer (n=102) (26.2\%). The median survival was 7.8 months. On multivariate analysis only performance status ({HR} 1.74 {CI} 1.50-2.02) and {mGPS} ({HR} 1.67, {CI} 1.40-2.00) predicted survival (p{\textless}0.001). Survival at 3 months ranged from 99\% ({ECOG} 0-1) to 74\% ({ECOG} 2) and using {mGPS}, from 99\% ({mGPS}0) to 71\% ({mGPS}2). In combination, survival ranged from 99\% ({mGPS} 0, {ECOG} 0-1) to 33\% ({mGPS}2, {ECOG} 3). {CONCLUSION}: Performance status and the {mGPS}  are superior prognostic factors in advanced lung cancer. In combination, these improved survival prediction compared with either alone.},
	pages = {304--309},
	number = {3},
	journaltitle = {Lung cancer (Amsterdam, Netherlands)},
	shortjournal = {Lung Cancer},
	author = {Simmons, Claribel P. and Koinis, Filippos and Fallon, Marie T. and Fearon, Kenneth C. and Bowden, Jo and Solheim, Tora S. and Gronberg, Bjorn Henning and {McMillan}, Donald C. and Gioulbasanis, Ioannis and Laird, Barry J.},
	date = {2015-06},
	pmid = {25870155}
}

@article{galvao_randomized_2009,
	title = {A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the {RADAR} trial},
	volume = {9},
	issn = {1471-2407},
	url = {http://www.biomedcentral.com/1471-2407/9/419},
	doi = {10.1186/1471-2407-9-419},
	pages = {419},
	number = {1},
	journaltitle = {{BMC} Cancer},
	author = {Galvão, Daniel A and Spry, Nigel and Taaffe, Dennis R and Denham, James and Joseph, David and Lamb, David S and Levin, Greg and Duchesne, Gillian and Newton, Robert U},
	urldate = {2015-04-28},
	date = {2009},
	langid = {english},
	file = {Galvão et al. - 2009 - A randomized controlled trial of an exercise inter.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZHH28ZZD\\Galvão et al. - 2009 - A randomized controlled trial of an exercise inter.pdf:application/pdf}
}

@article{spitz_preoperative_1997,
	title = {Preoperative and postoperative chemoradiation strategies in patients treated with pancreaticoduodenectomy for adenocarcinoma of the pancreas},
	volume = {15},
	issn = {0732-183X},
	abstract = {{PURPOSE}: The effects of preoperative versus postoperative fluorouracil (5-{FU})-based chemotherapy and irradiation on treatment toxicity, duration of treatment, tumor recurrence, and survival were compared in patients who underwent potentially curative therapy for adenocarcinoma of the pancreatic head during a 5-year period.
{METHODS}: From July 1990 to July 1995, 142 patients with localized adenocarcinoma of the pancreatic head deemed resectable on the basis of radiographic images were treated with curative intent using a multimodality approach involving either preoperative or postoperative chemoradiation. Patients with biopsy confirmation of adenocarcinoma and a low-density mass in the pancreatic head identified by computed tomography ({CT}) received preoperative chemoradiation. Patients without a mass on {CT} or in whom the preoperative biopsy was negative underwent pancreaticoduodenectomy with planned postoperative chemoradiation. Protocol-based preoperative chemoradiation consisted of external-beam irradiation at a dose of 50.4 Gy (standard fractionation; 1.8 Gy/d, 5 d/wk) or 30 Gy (rapid fractionation; 3 Gy/d, 5 d/wk) combined with continuous infusion 5-{FU} (300 mg/m2/d, 5 d/wk). Postoperative chemoradiation combined 50.4 Gy of external-beam irradiation (standard fractionation) with continuous-infusion 5-{FU}.
{RESULTS}: No patient who received preoperative chemoradiation experienced a delay in surgery because of chemoradiation toxicity, but six of 25 eligible patients (24\%) did not receive postoperative chemoradiation because of delayed recovery after pancreaticoduodenectomy. No significant differences in toxicities from chemoradiation were observed between groups. Patients treated with rapid-fractionation preoperative chemoradiation had a significantly (P {\textless} .01) shorter duration of treatment (median, 62.5 days) compared with patients who received postoperative chemoradiation (median, 98.5 days) or standard-fractionation preoperative chemoradiation (median, 91.0 days). At a median followup of 19 months, no significant differences in survival were observed between treatment groups. No patient who received preoperative chemoradiation and pancreaticoduodenectomy experienced a local recurrence; peritoneal (regional) recurrence occurred in 10\% of these patients. Local or regional recurrence occurred in 21\% of patients who received pancreaticoduodenectomy and postoperative chemoradiation.
{CONCLUSION}: Delivery of preoperative and postoperative chemoradiation in patients who underwent potentially curative pancreaticoduodenectomy for adenocarcinoma of the pancreatic head resulted in similar treatment toxicity, patterns of tumor recurrence, and survival. Rapid-fractionation preoperative chemoradiation ensured the delivery of all components of therapy to all eligible patients with a significantly shorter duration of treatment than with standard-fractionation chemoradiation given either before or after pancreaticoduodenectomy. Prolonged recovery after pancreaticoduodenectomy prevents the delivery of postoperative adjuvant chemoradiation in up to one fourth of eligible patients.},
	pages = {928--937},
	number = {3},
	journaltitle = {Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology},
	shortjournal = {J. Clin. Oncol.},
	author = {Spitz, F. R. and Abbruzzese, J. L. and Lee, J. E. and Pisters, P. W. and Lowy, A. M. and Fenoglio, C. J. and Cleary, K. R. and Janjan, N. A. and Goswitz, M. S. and Rich, T. A. and Evans, D. B.},
	date = {1997-03},
	pmid = {9060530},
	keywords = {Adenocarcinoma, Clinical Protocols, Combined Modality Therapy, Follow-Up Studies, Humans, Pancreatic Neoplasms, Pancreaticoduodenectomy, Prospective Studies, Survival Analysis}
}

@article{van_santvoort_conservative_2011,
	title = {A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome},
	volume = {141},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21741922},
	abstract = {Treatment of patients with necrotizing pancreatitis has become more conservative and less invasive, but there are few data from prospective studies to support the efficacy of this change. We performed a prospective multicenter study of treatment outcomes among patients with necrotizing pancreatitis.},
	pages = {1254--63},
	number = {4},
	journaltitle = {Gastroenterology},
	author = {van Santvoort, Hjalmar C and Bakker, Olaf J and Bollen, Thomas L and Besselink, Marc G and Ahmed Ali, Usama and Schrijver, A Marjolein and Boermeester, Marja A and van Goor, Harry and Dejong, Cornelis H and van Eijck, Casper H and van Ramshorst, Bert and Schaapherder, Alexander F and van der Harst, Erwin and Hofker, Sijbrand and Nieuwenhuijs, Vincent B and Brink, Menno A and Kruyt, Philip M and Manusama, Eric R and van der Schelling, George P and Karsten, Tom and Hesselink, Eric J and van Laarhoven, Cornelis J and Rosman, Camiel and Bosscha, Koop and de Wit, Ralph J and Houdijk, Alexander P and Cuesta, Miguel A and Wahab, Peter J and Gooszen, Hein G},
	date = {2011-10}
}

@article{mcardle_relationship_2004-1,
	title = {The relationship between T-lymphocyte subset infiltration and survival in patients with prostate cancer.},
	volume = {91},
	doi = {10.1038/sj.bjc.6601943},
	abstract = {The relationship between tumour stage, T-lymphocyte subset infiltration and survival was examined in patients with prostate cancer (n=80). On multivariate analysis {PSA} ({HR} 2.47, 95\% {CI} 1.27-4.83, P=0.008) and {CD}4+ T-lymphocyte count ({HR} 2.29, 95\% {CI} 1.25-4.22, P=0.008) had independent significance. Increased {CD}4+},
	pages = {541--543},
	number = {3},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McArdle}, P. A. and Canna, K. and {McMillan}, D. C. and {McNicol}, A.-M. and Campbell, R. and Underwood, M. A.},
	date = {2004-08-02},
	pmid = {15266325},
	pmcid = {PMC2409839},
	keywords = {Aged, {CD}4-Positive T-Lymphocytes/*physiology, Humans, Immunohistochemistry, Lymphocyte Subsets, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prospective Studies, Prostatectomy, Prostatic Neoplasms/*immunology/*pathology/surgery, Survival Analysis, T-Lymphocytes/*physiology}
}

@article{dias-santos_charlson_2015,
	title = {The Charlson age comorbidity index predicts early mortality after surgery for pancreatic cancer},
	volume = {157},
	issn = {0039-6060},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606014007934},
	doi = {10.1016/j.surg.2014.12.006},
	abstract = {Background
Although operative resection represents the only hope for cure in pancreatic cancer, it is associated with significant morbidity and mortality. Furthermore, in some patients disease progression occurs very early postoperatively and no tangible benefit is seen from the operation. Identification of preoperative predictors of death within the first year of surgery could help in the counseling of patients diagnosed with pancreatic cancer.
Methods
We studied retrospectively patients who underwent resection for pancreatic adenocarcinoma from 2002 to 2012. We calculated the age-adjusted Charlson Age Comorbidity Index ({CACI}) and used logistic regression models to determine predictors of mortality within 1 year of surgery. Kaplan–Meier curves and Cox proportional hazards models were developed to determine hazard ratios on survival.
Results
Surgery with curative intent was performed in 497 patients; 136 (27\%) died within the first year. A {CACI} score of \>4 was predictive of increased duration of stay (P \< .001), postoperative complications (P = .042), and mortality within 1 year of pancreatic resection (P \< .001). A {CACI} score of ≥6 increased 3-fold the odds of death within the first year.
Conclusion
{CACI} is useful to predict outcome after pancreatectomy for pancreatic cancer. Patients with a high {CACI} score have a \<50\% likelihood of being alive 1 year postoperatively. This information should be used when considering the appropriateness of pancreatic resection in patients with multiple comorbidities.},
	pages = {881--887},
	number = {5},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Dias-Santos, Daniela and Ferrone, Cristina R. and Zheng, Hui and Lillemoe, Keith D. and Fernández-del Castillo, Carlos},
	urldate = {2015-05-26},
	date = {2015-05},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\V48FDNXB\\Dias-Santos et al. - 2015 - The Charlson age comorbidity index predicts early .pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J2SZA5J2\\S0039606014007934.html:text/html}
}

@article{halm_is_2002,
	title = {Is volume related to outcome in health care? A systematic review and methodologic critique of the literature},
	volume = {137},
	issn = {0003-4819},
	shorttitle = {Is volume related to outcome in health care?},
	abstract = {Purpose: To systematically review the methodologic rigor of the research on volume and outcomes and to summarize the magnitude and significance of the association between them. Data Sources: The authors searched {MEDLINE} from January 1980 to December 2000 for English-language, population-based studies examining the independent relationship between hospital or physician volume and clinical outcomes. Bibliographies were reviewed to identify other articles of interest, and experts were contacted about missing or unpublished studies. Study Selection: Of 272 studies reviewed, 135 met inclusion criteria and covered 27 procedures and clinical conditions. Data Extraction: Two investigators independently reviewed each article, using a standard form to abstract information on key study characteristics and results. Data Synthesis: The methodologic rigor of the primary studies varied. Few studies used clinical data for risk adjustment or examined effects of hospital and physician volume simultaneously. Overall, 71\% of all studies of hospital volume and 69\% of studies of physician volume reported statistically significant associations between higher volume and better outcomes. The strongest associations were found for {AIDS} treatment and for surgery on pancreatic cancer, esophageal cancer, abdominal aortic aneurysms, and pediatric cardiac problems (a median of 3.3 to 13 excess deaths per 100 cases were attributed to low volume). Although statistically significant, the volume-outcome relationship for coronary artery bypass surgery, coronary angioplasty, carotid enclarterectomy, other cancer surgery, and orthopedic procedures was of much smaller magnitude. Hospital volume-outcome studies that performed risk adjustment by using clinical data were less likely to report significant associations than were studies that adjusted for risk by using administrative data. Conclusions: High volume is associated with better outcomes across a wide range of procedures and conditions, but the magnitude of the association varies greatly. The clinical and policy significance of these findings is complicated by the methodologic shortcomings of many studies. Differences in case mix and processes of care between high- and low-volume providers may explain part of the observed relationship between volume and outcome.},
	pages = {511--520},
	number = {6},
	journaltitle = {Annals of Internal Medicine},
	shortjournal = {Ann. Intern. Med.},
	author = {Halm, E. A. and Lee, C. and Chassin, M. R.},
	date = {2002-09-17},
	note = {{WOS}:000178069100006},
	keywords = {abdominal aortic-aneurysms, acquired-immunodeficiency-syndrome, acute myocardial-infarction, bypass graft-surgery, carotid endarterectomy, in-hospital mortality, new-york-state, percutaneous coronary interventions, short-term mortality, surgical-volume}
}

@article{mohammed_relationship_2013-1,
	title = {The relationship between lymphocyte subsets and clinico-pathological determinants of survival in patients with primary operable invasive ductal breast cancer.},
	volume = {109},
	doi = {10.1038/bjc.2013.493},
	abstract = {{BACKGROUND}: The importance of lymphocyte subtypes in determining outcome in primary operable ductal invasive breast cancer remains unclear. The aim of present study was to examine the relationship between tumour lymphocyte subsets infiltrate and standard clinico-pathological factors and survival in patients with primary operable invasive ductal breast cancer. {METHODS}: The analysis of the inflammatory cell infiltrate, including lymphocyte subtypes, was undertaken using immunohistochemical techniques and visual quantitative and semi-quantitative techniques in 338 patients with ductal breast cancer. {RESULTS}: The majority (91\%) of patients had high grade inflammatory cell infiltrate. The median follow-up of  the survivors was 164 months. During this period, 65 died of their cancer. On univariate analysis, tumour inflammatory cell infiltrate, macrophages infiltrate  (P{\textless}0.05), lymphocytic infiltrate (P{\textless}0.001) and {CD}8+ T-lymphocytic infiltrate (P{\textless}0.01) were associated with improved cancer-specific survival, whereas neutrophil (P{\textless}0.05) and {CD}138+ B-lymphocytic infiltrate (P{\textless}0.001) were associated with poorer cancer-specific survival. On multivariate analysis, tumour lymphocytic infiltrate (P{\textless}0.001), macrophage infiltrate (P{\textless}0.05), {CD}8+},
	pages = {1676--1684},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Mohammed, Z. M. A. and Going, J. J. and Edwards, J. and Elsberger, B. and {McMillan}, D. C.},
	date = {2013-09-17},
	pmid = {23982600},
	pmcid = {PMC3777002},
	keywords = {Breast Neoplasms/*immunology/metabolism/*pathology, Carcinoma, Ductal, Breast/*immunology/metabolism/*pathology, Female, Humans, Immunohistochemistry, Lymphocyte Subsets/*immunology/pathology, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Survival Analysis, Tissue Array Analysis}
}

@article{kubo_elevated_2013,
	title = {Elevated preoperative C-reactive protein levels are a risk factor for the development of postoperative infectious complications following elective colorectal surgery},
	volume = {398},
	issn = {1435-2443, 1435-2451},
	url = {http://link.springer.com/article/10.1007/s00423-013-1107-0},
	doi = {10.1007/s00423-013-1107-0},
	abstract = {Purpose The present study was designed to evaluate the relationship between the preoperative C-reactive protein levels and the incidence of postoperative infectious complications in patients undergoing colorectal surgery. Methods This study was a retrospective cohort study of a consecutive series of 464 patients who underwent elective colorectal resection between April 2010 and March 2012. We evaluated the patients’ preoperative conditions, including the preoperative C-reactive protein levels, surgical content, and incidence of postoperative infectious complications. Results Postoperative infectious complications occurred in 133 patients (28.7 \%). In the univariate analysis, male gender, rectal surgery, open surgery, elevated preoperative white blood cell counts, elevated preoperative C-reactive protein levels, extended operative times, large amounts of blood loss during surgery, and ostomy formation were found to be significantly associated with the incidence of postoperative infectious complications. In the multivariate analysis, elevated preoperative C-reactive protein levels ({OR} per mg/dl = 1.17, 95 \% {CI} = 1.02–1.37, P = 0.02) and large amounts of blood loss during surgery ({OR} per 100 g = 1.13, 95 \% {CI} = 1.06–1.23, P {\textless} 0.01) were found to be independently associated with the incidence of postoperative infectious complications. Conclusions This study provides evidence of an association between the preoperative C-reactive protein level and the incidence of postoperative infectious complications following colorectal surgery, which should be further confirmed in prospective and appropriately designed studies.},
	pages = {965--971},
	number = {7},
	journaltitle = {Langenbeck's Archives of Surgery},
	shortjournal = {Langenbecks Arch Surg},
	author = {Kubo, Toru and Ono, Satoshi and Ueno, Hideki and Shinto, Eiji and Yamamoto, Junji and Hase, Kazuo},
	urldate = {2015-08-20},
	date = {2013-08-29},
	langid = {english},
	keywords = {Abdominal Surgery, Blood loss, Cardiac Surgery, colorectal surgery, C-Reactive Protein, general surgery, Postoperative infectious complications, Thoracic Surgery, Traumatic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DGM4ZZPI\\Kubo et al. - 2013 - Elevated preoperative C-reactive protein levels ar.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Q5ZNX7HU\\10.html:text/html}
}

@article{munoz_hepatorenal_2008,
	title = {The Hepatorenal Syndrome},
	volume = {92},
	issn = {00257125},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0025712508000278},
	doi = {10.1016/j.mcna.2008.03.007},
	pages = {813--837},
	number = {4},
	journaltitle = {Medical Clinics of North America},
	author = {Munoz, Santiago J.},
	urldate = {2015-04-28},
	date = {2008-07},
	langid = {english},
	file = {Munoz - 2008 - The Hepatorenal Syndrome.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AVHVZQTG\\Munoz - 2008 - The Hepatorenal Syndrome.pdf:application/pdf}
}

@article{joglekar_sarcopenia_2015,
	title = {Sarcopenia is an independent predictor of complications following pancreatectomy for adenocarcinoma},
	volume = {111},
	issn = {1096-9098},
	doi = {10.1002/jso.23862},
	abstract = {{BACKGROUND} {AND} {OBJECTIVES}: Sarcopenia, which is subclinical loss of skeletal muscle mass, is commonly observed in patients with malignancy. The objective of this study is to determine the correlation between sarcopenia and operative complications following pancreatectomy for cancer.
{METHODS}: A retrospective review of a pancreatectomy database was performed. The Hounsfield Unit Average Calculation ({HUAC}) of the psoas muscle, a marker of muscle density and fatty infiltration, was measured from preoperative {CT} scans. Complications were graded and multivariate logistic regression analysis was performed.
{RESULTS}: One hundred eighteen patients met criteria for analysis; the overall morbidity rate was 78.8\% (n = 93). There were 31 (26.3\%) patients who met criteria for sarcopenia using the {HUAC}. When analyzed as a continuous variable, sarcopenia was an independent predictor of major grade {III} complications, length of stay, intensive care unit admission, delayed gastric emptying, and infectious, gastrointestinal, pulmonary, and cardiac complications.
{CONCLUSIONS}: These data suggest that sarcopenia as measured with the {HUAC}, a value that can be obtained from a preoperative {CT} scan, is a significant independent predictor of surgical outcome and can be used to improve patient selection and informed consent prior to pancreatectomy in patients with cancer.},
	pages = {771--775},
	number = {6},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J Surg Oncol},
	author = {Joglekar, Savita and Asghar, Aeen and Mott, Sarah L. and Johnson, Benjamin E. and Button, Anna M. and Clark, Eve and Mezhir, James J.},
	date = {2015-05},
	pmid = {25556324},
	pmcid = {PMC4406850},
	keywords = {Adenocarcinoma, Blood Transfusion, Female, Gastric Emptying, Humans, Intensive Care Units, Jejunostomy, length of stay, Male, Pancreatectomy, Pancreatic Neoplasms, postoperative complications, Retrospective Studies, Sarcopenia}
}

@article{bathe_diminished_2001,
	title = {Diminished benefit from resection of cancer of the head of the pancreas in patients of advanced age},
	volume = {77},
	issn = {0022-4790},
	abstract = {{BACKGROUND} {AND} {OBJECTIVES}: The incidence of pancreatic cancer is increasing, and an increasing proportion of these patients is older than 65 years. The benefits of resection in the geriatric population, in whom major comorbidity is more likely, are poorly defined. The authors sought to determine the relative benefits of resection of cancer of the head of the pancreas in different age groups, with particular emphasis on the geriatric population.
{METHODS}: Between 1983 and 1995, 273 patients presented to the University of Miami for evaluation of noncystic epithelial cancer of the head of the pancreas. Resection was performed in 104 patients, and these patients are the subject of this retrospective review. Mean length of follow-up for surviving patients was 37 +/- 24 months. Outcomes were compared in patients {\textless} 65 years old (group 1, n = 38), 65-74 years old (group 2, n = 47), and {\textgreater} 74 years old (group 3, n = 19).
{RESULTS}: Total pancreatectomy was performed in 12 patients and pancreaticoduodenectomy was performed in 92 patients. The overall complication rate was similar in all groups, but major morbidity was highest in group 3 (P = 0.05). Median survival for patients in group 2 was 25.1 months. Survival was significantly shorter in patients from groups 1 and 3 (median survivals 12.4 months and 11.4 months, respectively; P = 0.02). Following control for Hispanic ethnicity, which was also a significant prognostic factor on univariate analysis, only the oldest age group had a significantly shorter survival than the other two groups. Age {\textgreater} 74 years and Hispanic ethnicity remained significant after multivariate analysis.
{CONCLUSIONS}: Long-term survival after resection is truncated in older patients. This finding and the observation that the major complication rate is higher in the older subgroup emphasize the need to evaluate critically whether older patients should be submitted to radical resection.},
	pages = {115--122},
	number = {2},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J Surg Oncol},
	author = {Bathe, O. F. and Caldera, H. and Hamilton, K. L. and Franceschi, D. and Sleeman, D. and Livingstone, A. S. and Levi, J. U.},
	date = {2001-06},
	pmid = {11398165},
	keywords = {Aged, Age Factors, Humans, Multivariate Analysis, Neoplasm Staging, Pancreatectomy, Pancreatic Neoplasms, Retrospective Studies, Survival Analysis, Treatment Outcome}
}

@article{older_cardiopulmonary_1999,
	title = {Cardiopulmonary exercise testing as a screening test for perioperative management of major surgery in the elderly},
	volume = {116},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10453862},
	abstract = {{STUDY} {OBJECTIVE}: To develop an integrated strategy for the identification and subsequent management of high-risk patients in order to reduce both morbidity and mortality. {DESIGN}: Prospective consecutive series in which all patients underwent cardiopulmonary exercise ({CPX}) testing. {SETTING}: {CPX} laboratory and level 3 {ICU} and high-dependency unit ({HDU}) of a metropolitan teaching hospital. {PATIENTS}: Five hundred forty-eight patients {\textgreater}60 years of age (or younger with known cardiopulmonary disease) scheduled for major intra-abdominal surgery. {INTERVENTIONS}: The patients were assigned to one of three management strategies ({ICU}, {HDU}, or ward) based on the anaerobic threshold ({deltaT}) and {ECG} evidence of myocardial ischemia as determined by {CPX} testing that was performed as part of the presurgery evaluation, and by the expected oxygen demand stress of the surgical procedure. {RESULTS}: Overall mortality was 3.9\%. Forty-three percent of deaths were attributed to poor cardiopulmonary function, as detected preoperatively. There were no deaths related to cardiopulmonary complications in any patient deemed fit for major abdominal surgery and ward management, as determined by {CPX} testing. {CONCLUSIONS}: In elderly patients undergoing major intra-abdominal surgery, the {AT}, as determined by {CPX} testing, is an excellent predictor of mortality from cardiopulmonary causes in the postoperative period. Preoperative screening using {CPX} testing allowed the identification of high-risk patients and the appropriate selection of perioperative management.},
	pages = {355--62},
	number = {2},
	journaltitle = {Chest},
	author = {Older, P and Hall, A and Hader, R},
	date = {1999-08},
	file = {Older et al. - 1999 - Cardiopulmonary exercise testing as a screening te.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9KH33FK4\\Older et al. - 1999 - Cardiopulmonary exercise testing as a screening te.pdf:application/pdf}
}

@collection{sternberg_histology_1997-1,
	location = {Philadelphia},
	edition = {2. ed},
	title = {Histology for pathologists},
	isbn = {0-397-51718-1 0-397-51718-1},
	pagetotal = {1200},
	publisher = {Lippincott-Raven},
	editor = {Sternberg, Stephen S.},
	date = {1997},
	keywords = {Histologie, Histology, Histology, Pathological, Histopathologie, Pathology},
	file = {The Impact of Obesity on Surgical Outcome after PD.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QFRUD5WR\\The Impact of Obesity on Surgical Outcome after PD.pdf:application/pdf}
}

@article{makary_pancreaticoduodenectomy_2006,
	title = {Pancreaticoduodenectomy in the very elderly},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16504879},
	abstract = {It is estimated that by 2050, there will be a 300\% increase in the elderly population ({\textgreater} or =65 years) and a corresponding increase in elderly patients presenting for surgical evaluation. Surgical decision-making in this population can be difficult because outcomes in the elderly are poorly defined. We reviewed 2698 consecutive pancreaticoduodenectomies ({PDs}) at our institution over a 35-year period (April 1970 through March 2005), with the last 1000 resections being done in the last 4 years. Data collected included surgical indication, mortality (defined as 30-day or in-hospital mortality), complications, and survival. Patients were divided by age into three groups ({\textless}80, 80-89, and {\textgreater} or =90 years) and evaluated using multiple logistic regression. Two hundred seven patients {\textgreater} or =80 years old underwent a {PD} (7.7\% of 2698). Patients 80-89 years of age had a mortality rate of 4.1\% (8 of 197) and a complication rate of 52.8\% (99 of 197), whereas patients {\textless} or =79 years of age had a mortality of 1.7\% and a complication rate of 41.6\% (P {\textless} 0.05). There were no perioperative deaths among the 10 patients {\textgreater} or =90 years of age, and their complication rate was 50\% (5 of 10). One-year survival for patients 80-89 years of age was 59.1\%, and that for patients {\textgreater} or =90 years was 60\%. Age was not an independent risk factor for perioperative mortality and morbidity following {PD} after adjusting for preoperative comorbidities. We demonstrate that {PD} can be safely performed in patients over 80 years of age and conclude that age alone should not be a contraindication to pancreatic resection. The advent of improved surgical outcomes and an aging population will likely result in a significant increase in the number of {PDs} performed in the next few decades.},
	pages = {347--56},
	number = {3},
	journaltitle = {J Gastrointest Surg},
	author = {Makary, Martin A and Winter, Jordan M and Cameron, John L and Campbell, Kurtis A and Chang, David and Cunningham, Steven C and Riall, Taylor S and Yeo, Charles J},
	date = {2006-03}
}

@book{quetelet_treatise_1842,
	title = {A Treatise on Man and the Development of His Faculties},
	isbn = {978-1-108-06442-2},
	abstract = {The Belgian polymath Lambert Adolphe Jacques Quetelet (1796-1874) pioneered social statistics. Applying his training in mathematics to the physical and psychological dimensions of individuals, he identified the 'average man' as characterised by the mean values of measured variables that follow a normal distribution. He believed that comparing the features of individuals against this average would allow scientists to better explore the processes that determine normal and abnormal qualities. Quetelet's methods influenced many, among them Florence Nightingale, and his simple measure for classifying a person's weight, dividing it by the square of their height, is widely known as the body mass index. First published in French in 1835 and reissued here in the 1842 English translation, this is his most influential work and includes a new preface that succinctly states his aim to be 'the analysis of normal man through his actions and of intellectual man through his productions'.},
	pagetotal = {145},
	publisher = {Cambridge University Press},
	author = {Quetelet, Lambert Adolphe Jacques and Smibert, T.},
	date = {1842},
	langid = {english},
	keywords = {Philosophy / Mind \& Body}
}

@article{seres_increased_2006,
	title = {Increased exercise capacity after surgically induced weight loss in morbid obesity},
	volume = {14},
	issn = {1930-7381},
	doi = {10.1038/oby.2006.35},
	abstract = {{OBJECTIVE}: To investigate the effects of surgically induced weight loss on exercise capacity in patients with morbid obesity ({MO}).
{RESEARCH} {METHODS} {AND} {PROCEDURES}: A prospective 1-year follow-up study was carried out, with patients being their own controls. A symptom-limited cardiopulmonary exercise stress test was performed in 31 {MO} patients ({BMI} {\textgreater} 40 kg/m2) before and 1 year after undergoing bariatric surgery.
{RESULTS}: At 1 year after surgery, weight was reduced from 146 +/- 33 to 95 +/- 19 kg (p {\textless} 0.001), and {BMI} went from 51 +/- 4 to 33 +/- 6 kg/m2 (p {\textless} 0.001). After weight loss, obese patients performed each workload with lower oxygen consumption, heart rate, systolic arterial pressure, and ventilatory volume (p {\textless} 0.001). This reduced energy expenditure allowed them to increase the duration of their effort test from 13.8 +/- 3.8 to 21 +/- 4.2 minutes (p {\textless} 0.001). Upon finishing the exercise, {MO} patients before surgery were able to reach only 83\% of their age-predicted maximal heart rate, and their respiratory exchange ratio was 0.87 +/- 0.06. After weight loss, those values were 90\% and 1 +/- 0.08, respectively (p {\textless} 0.01). When we compared the peak O2 pulse corrected by fat free mass before and after surgery, no significant differences between the groups were found.
{DISCUSSION}: After surgically induced weight loss, {MO} patients markedly improved their exercise capacity. This is due to the fact that they were able to perform the external work with lower energy expenditure and also to increase cardiovascular stress, optimizing the use of cardiac reserve. There were no differences in cardiac function before and after surgery.},
	pages = {273--279},
	number = {2},
	journaltitle = {Obesity (Silver Spring, Md.)},
	shortjournal = {Obesity (Silver Spring)},
	author = {Serés, Luis and Lopez-Ayerbe, Jordi and Coll, Ramón and Rodriguez, Oriol and Vila, Juan and Formiguera, Xavier and Alastrue, Antonio and Rull, Miguel and Valle, Vicente},
	date = {2006-02},
	pmid = {16571853},
	keywords = {Adult, Bariatric Surgery, Chi-Square Distribution, Energy Metabolism, Exercise, Exercise Test, Female, Follow-Up Studies, Humans, Male, Obesity, Morbid, Oxygen Consumption, Prospective Studies, Weight Loss}
}

@article{yang_mechanisms_2010,
	title = {Mechanisms of {TNFalpha}-induced cardiac dysfunction in cholestatic bile duct-ligated mice: interaction between {TNFalpha} and endocannabinoids},
	volume = {53},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20626112},
	abstract = {Chronic liver disease is associated with endotoxemia, oxidative stress, increased endocannabinoids and decreased cardiac responsiveness. Endocannabinoids activate the tumor necrosis factor-alpha ({TNFalpha})-nuclear factor {kappaB} ({NFkappaB}) pathway. However, how they interact with each other remains obscure. We therefore aimed to clarify the relationship between the {TNFalpha}-{NFkappaB} pathway and endocannabinoids in the pathogenesis of cardiodepression of cholestatic bile duct ligated ({BDL}) mice.},
	pages = {298--306},
	number = {2},
	journaltitle = {J Hepatol},
	author = {Yang, Ying-Ying and Liu, Hongqun and Nam, Soon Woo and Kunos, George and Lee, Samuel S},
	date = {2010-08},
	file = {Yang et al. - 2010 - Mechanisms of TNFalpha-induced cardiac dysfunction.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\A476KNIG\\Yang et al. - 2010 - Mechanisms of TNFalpha-induced cardiac dysfunction.pdf:application/pdf}
}

@article{abraham_effects_1985,
	title = {The effects of hemorrhage on mitogen-induced lymphocyte proliferation},
	volume = {15},
	issn = {0092-6213},
	abstract = {Bacterial infection often occurs after trauma and hemorrhage and is believed to be a reflection of a compromised host defense system. In the present study, the effect of temporary loss of blood on lymphocyte proliferative capacity was investigated. Hemorrhage was induced in unanesthetized rats with chronically catheterized carotid arteries. Two hours after withdrawal of 30\% of total blood volume, phytohemagglutinin-induced lymphocyte proliferation was almost completely suppressed; proliferation remained depressed for at least 24 hrs. The degree of suppression in lymphocyte proliferation was found to be dependent on the duration of hemorrhage. Mitogen-induced proliferation of lymphocytes was significantly reduced as early as 30 min after hemorrhage and became more depressed at 2.0 hr after hemorrhage. This abnormality in host defense mechanisms may contribute to the increased incidence of sepsis present after trauma and hemorrhage.},
	pages = {141--149},
	number = {2},
	journaltitle = {Circulatory Shock},
	shortjournal = {Circ. Shock},
	author = {Abraham, E. and Chang, Y. H.},
	date = {1985},
	pmid = {3978766},
	keywords = {Animals, Hemorrhage, Lymphocyte Activation, Male, Phytohemagglutinins, Rats, Rats, Inbred Strains}
}

@article{smith_cardiopulmonary_2009,
	title = {Cardiopulmonary exercise testing as a risk assessment method in non cardio-pulmonary surgery: a systematic review},
	volume = {64},
	issn = {00032409, 13652044},
	url = {http://doi.wiley.com/10.1111/j.1365-2044.2009.05983.x},
	doi = {10.1111/j.1365-2044.2009.05983.x},
	shorttitle = {Cardiopulmonary exercise testing as a risk assessment method in non cardio-pulmonary surgery},
	pages = {883--893},
	number = {8},
	journaltitle = {Anaesthesia},
	author = {Smith, T. B. and Stonell, C. and Purkayastha, S. and Paraskevas, P.},
	urldate = {2014-01-27},
	date = {2009-08},
	file = {Smith et al. - 2009 - Cardiopulmonary exercise testing as a risk assessm.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\W8NBCWMK\\Smith et al. - 2009 - Cardiopulmonary exercise testing as a risk assessm.pdf:application/pdf}
}

@article{van_wyk_role_2015,
	title = {The role of tumour budding in predicting survival in patients with primary operable colorectal cancer: a systematic review.},
	volume = {41},
	rights = {Copyright (c) 2014 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2014.12.007},
	abstract = {Tumour budding reflects a detachment of tumour cells at the invasive front of carcinomas and is presumed to be an early step in the metastatic process. Tumour  budding has received some attention in colorectal cancer as it has been proposed  as an additional prognostic factor in colorectal cancer that may stratify patients into risk categories. The purpose of the review was to examine (1): The  different methods of detection using either routine stains (H\&E) or immunohistochemistry; (2): to compare studies that examined the different methods used to identify tumour budding; and (3) to examine the impact of tumour budding  on survival in primary operable colorectal cancer. Results from the present review suggest that tumour budding can be considered a promising and strong prognostic factor in colorectal cancer. However, the implementation of the assessment of tumour budding in routine pathological work will depend on a selected, internationally accepted scoring system and validation against other established prognostic factors in patients with colorectal cancer.},
	pages = {151--159},
	number = {2},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {van Wyk, H. C. and Park, James and Roxburgh, Campbell and Horgan, Paul and Foulis, Alan and {McMillan}, Donald C.},
	date = {2015-02},
	pmid = {25549950},
	keywords = {Colorectal Neoplasms/*mortality/*pathology/surgery, Humans, Immunohistochemistry, Neoplasm Grading, Predictive Value of Tests, Prognosis, Survival Analysis}
}

@article{canna_relationship_2008,
	title = {The relationship between tumour proliferative activity, the systemic inflammatory response and survival in patients undergoing curative resection for colorectal cancer.},
	volume = {10},
	doi = {10.1111/j.1463-1318.2007.01416.x},
	abstract = {{BACKGROUND}: The aim of the present study was to examine the relationship between  Ki-67, C-reactive protein and cancer-specific survival in patients undergoing resection for colorectal cancer. {METHOD}: One hundred and forty-seven patients undergoing potentially curative resection for colorectal cancer had preoperative},
	pages = {663--667},
	number = {7},
	journaltitle = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
	shortjournal = {Colorectal Dis},
	author = {Canna, K. and Hilmy, M. and {McMillan}, D. C. and Smith, G. W. and {McKee}, R. F. and {McArdle}, C. S. and {McNicol}, A.-M.},
	date = {2008-09},
	pmid = {18005189},
	keywords = {Aged, Chemotherapy, Adjuvant, Colorectal Neoplasms/*metabolism/*surgery, C-Reactive Protein/*analysis, Female, Follow-Up Studies, Humans, Ki-67 Antigen/*metabolism, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Survival Analysis}
}

@article{de_castro_possum_2009,
	title = {{POSSUM} predicts survival in patients with unresectable pancreatic cancer},
	volume = {26},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19169034},
	abstract = {{BACKGROUND}: The aim of this study was to evaluate the physiological and operative severity score for the enumeration of mortality and morbidity ({POSSUM}) for patients with unresectable pancreatic cancer and to analyze whether {POSSUM} can predict the long-term outcome in these patients. Such a scoring system could be useful to aid in the decision between surgical and endoscopic palliation. {METHODS}: Between January 1993 and December 2004, 241 patients were found to have unresectable pancreatic cancer during exploratory laparotomy and underwent a double bypass procedure consisting of a gastrojejunostomy and a hepaticojejunostomy. {RESULTS}: Overall, 64 of 240 patients (27\%) had one or more complications after bypass surgery and 4 patients (2\%) died. {POSSUM} predicted morbidity in 114 patients (47\%). The observed:predicted (O:P) ratio for morbidity was 0.56 and the model had a significant lack of fit (p {\textless} 0.001) using a goodness-of-fit analysis. The overall median survival was 7 months. The {POSSUM} scoring system was, however, an independent predictor of survival in multivariate analysis. {CONCLUSIONS}: Overall, {POSSUM} overpredicted morbidity but was an independent predictor of survival.},
	pages = {75--9},
	number = {1},
	journaltitle = {Dig Surg},
	author = {de Castro, S M M and Houwert, J T and Lagard, S M and Busch, O R C and van Gulik, T M and Gouma, D J},
	date = {2009}
}

@article{agostoni_exercise_2005,
	title = {Exercise capacity in patients with beta-thalassaemia intermedia},
	volume = {131},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16197461},
	abstract = {Thalassaemia intermedia patients can suffer fatigue and exercise capacity reduction, possibly because of anaemia, deconditioning and lack of exercise-induced haemoconcentration. We studied 21 beta-thalassaemia intermedia patients, 10 splenectomised (group A) and 11 not splenectomised (group B). Patients were evaluated by cardiopulmonary exercise test with blood sampling for haemoglobin and plasma protein measurements at rest and peak. During exercise, an isolated increase of haemoglobin suggested spleen contraction while a parallel increase of haemoglobin and proteins suggested fluid filtration through capillary wall. Groups were homogeneous for age and gender. Peak oxygen consumption ({VO}2) was 22.5 +/- 4.4 ml/min/kg (51 +/- 14\%) and 24.3 +/- 7.0 (53 +/- 12\%) in groups A and B respectively [not significant ({NS})]. At rest, haemoglobin was 8.8 g/dl in both groups. Exercise-induced increment was 0.4 +/- 0.2 and 1.0 +/- 0.4 g/dl (P {\textless} 0.001) for haemoglobin and 4.0 +/- 3.0 and 5.0 +/- 4.0 g/l ({NS}) for proteins, in groups A and B respectively. Anaemia was the major cause of peak {VO}2 reduction (1097 +/- 260 ml/min). However, anaemia did not explain the entire exercise capacity reduction, suggesting the presence of muscular deconditioning. Exercise capacity is reduced in beta-thalassaemia intermedia because of anaemia and muscular deconditioning. Spleen contraction does not significantly influence exercise capacity although exercise-induced haemoconcentration was greater in patients with spleen.},
	pages = {278--81},
	number = {2},
	journaltitle = {Br J Haematol},
	author = {Agostoni, Piergiuseppe and Cerino, Mario and Palermo, Pietro and Magini, Alessandra and Bianchi, Michele and Bussotti, Maurizio and Fiorelli, Gemino and Cappellini, Maria D},
	date = {2005-10}
}

@article{bomzon_systemic_1986,
	title = {Systemic hypotension and decreased pressor response in dogs with chronic bile duct ligation},
	volume = {6},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3732994},
	abstract = {Vascular instability as defined by systemic hypotension and unresponsiveness to endogenous or exogenous vasoactive substances is a feature of both patients and experimental animals with obstructive jaundice. In this study, we have attempted to dissect the possible mechanisms for these abnormalities using both in vivo and in vitro methods. In vivo cumulative pressor responses (Rmax) to intravenous and intraarterial infusions of norepinephrine and angiotensin {II} and to intravenous infusion of angiotensin I were studied pre- and postoperatively in chronic bile duct-ligated dogs and compared to sham-operated dogs. Preoperatively, the pressor responses to the cumulative infusion of six doses of vasoactive substances in the pre-sham operated and pre-chronic bile duct-ligated dogs were not significantly different. Postoperatively, in the sham-operated dogs, there was no significant change in systemic blood pressure at 1 and 3 weeks, and only in isolated instances were significantly different pressor responses found compared to the preoperative result. In chronic bile duct-ligated dogs, the mean systemic blood pressure fell significantly from 117.2 +/- 3.1 to 107.2 +/- 3.0 mm Hg (p less than 0.01) at 1 week and remained significantly lower at 3 weeks [109.7 +/- 2.6 mm Hg (p less than 0.05)]. The Rmax to intravenous, but not intraarterial norepinephrine, was significantly decreased. In contrast, the Rmax to both intravenous and intraarterial angiotensin {II} infusions were significantly depressed at both 1 and 3 weeks. Similarly, the response to intravenous angiotensin I was significantly depressed. Cardiac output rose moderately in two sham-operated dogs from an average of 3.1 to 3.5 liters per min by 3 weeks associated with a decrease of 14.8\% in peripheral vascular resistance.({ABSTRACT} {TRUNCATED} {AT} 250 {WORDS})},
	pages = {595--600},
	number = {4},
	journaltitle = {Hepatology},
	author = {Bomzon, A and Rosenberg, M and Gali, D and Binah, O and Mordechovitz, D and Better, O S and Greig, P D and Blendis, L M},
	date = {1986-08}
}

@article{maciejczyk_influence_2014,
	title = {The Influence of Increased Body Fat or Lean Body Mass on Aerobic Performance},
	volume = {9},
	issn = {1932-6203},
	url = {http://dx.plos.org/10.1371/journal.pone.0095797},
	doi = {10.1371/journal.pone.0095797},
	pages = {e95797},
	number = {4},
	journaltitle = {{PLoS} {ONE}},
	author = {Maciejczyk, Marcin and Więcek, Magdalena and Szymura, Jadwiga and Szyguła, Zbigniew and Wiecha, Szczepan and Cempla, Jerzy},
	editor = {Alemany, Marià},
	urldate = {2015-04-30},
	date = {2014-04-21},
	langid = {english},
	file = {Maciejczyk et al. - 2014 - The Influence of Increased Body Fat or Lean Body M.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\34Z54PWG\\Maciejczyk et al. - 2014 - The Influence of Increased Body Fat or Lean Body M.pdf:application/pdf}
}

@article{harten_effect_2008,
	title = {Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery: a randomised controlled pilot study ({ISRCTN} 11799696).},
	volume = {6},
	doi = {10.1016/j.ijsu.2008.03.002},
	abstract = {{BACKGROUND}: Emergency abdominal surgery carries a high risk of postoperative morbidity and mortality. Goal directed therapy has been advocated to improve outcome in high-risk surgery. The aim of the present pilot study was to examine the effect of goal directed therapy using fluid alone on postoperative renal function and organ failure score in patients undergoing emergency abdominal surgery. {METHODS}: This prospective randomised pilot study included patients over  the age of 50 undergoing emergency abdominal surgery. In the intervention group pulse pressure variation measurements were used to guide fluid boluses of 6\% Hydroxyethylstarch 130/0.4. The control group received standard care. Serum urea, creatinine and cystatin C levels were measured prior to and at the end of surgery and postoperatively on day 1, day 3 and day 5. {RESULTS}: Thirty patients were recruited. One patient died prior to surgery and was excluded from the analysis.  The intervention group received a median of 750 ml of hydroxyethylstarch. The peak values of postoperative urea were 6.9 (2.7-31.8) vs. 6.4 (3.5-11.5)mmol/l (p=0.425), creatinine 100 (60-300) vs. 85 (65-150) micromol/l (p=0.085) and cystatin C 1.09 (0.66-4.94) vs. 1.01 (0.33-2.29)mg/dl (p=0.352) in the control and intervention group, respectively. {CONCLUSIONS}: In the present pilot study replacing the identified fluid deficit was not associated with a change in renal  function. These results do not preclude that goal directed therapy using fluid alone may have an effect on renal function but they would suggest that the effect size of fluid optimisation alone on renal function is small.},
	number = {3},
	journaltitle = {International journal of surgery (London, England)},
	shortjournal = {Int J Surg},
	author = {Harten, J. and Crozier, J. E. M. and {McCreath}, B. and Hay, A. and {McMillan}, D. C. and {McArdle}, C. S. and Kinsella, J.},
	date = {2008-06},
	pmid = {18424200},
	keywords = {*Digestive System Surgical Procedures, *Emergencies, Acute Kidney Injury/*prevention \& control, Aged, Blood Pressure, Cardiac Output, Creatinine/blood, Cystatin C, Cystatins/blood, Female, Hemoglobins/analysis, Humans, Hydroxyethyl Starch Derivatives/*therapeutic use, Intraoperative Care, Kidney/physiology, Male, Middle Aged, Oxygen/blood, Pilot Projects, Plasma Substitutes/*therapeutic use, Urea/blood}
}

@article{roxburgh_cancer_2014,
	title = {Cancer and systemic inflammation: treat the tumour and treat the host},
	volume = {110},
	rights = {© 2014 Nature Publishing Group},
	issn = {0007-0920},
	url = {http://www.nature.com/bjc/journal/v110/n6/full/bjc201490a.html},
	doi = {10.1038/bjc.2014.90},
	shorttitle = {Cancer and systemic inflammation},
	abstract = {Determinants of cancer progression and survival are multifactorial and host responses are increasingly appreciated to have a major role. Indeed, the development and maintenance of a systemic inflammatory response has been consistently observed to confer poorer outcome, in both early and advanced stage disease. For patients, cancer-associated symptoms are of particular importance resulting in a marked impact on day-to-day quality of life and are also associated with poorer outcome. These symptoms are now recognised to cluster with one another with anorexia, weight loss and physical function forming a recognised cluster whereas fatigue, pain and depression forming another. Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer. Given the understanding of the above, there is now a need to intervene to moderate systemic inflammatory responses, where present. In this context the rationale for therapeutic intervention using nonselective anti-inflammatory agents is clear and compelling and likely to become a part of routine clinical practice in the near future. The published literature on therapeutic intervention using anti-inflammatory agents for cancer-associated symptoms was reviewed. There are important parallels with the development of useful treatments for the systemic inflammatory response in patients with rheumatological disease and cardiovascular disease.},
	pages = {1409--1412},
	number = {6},
	journaltitle = {British Journal of Cancer},
	shortjournal = {Br J Cancer},
	author = {Roxburgh, C. S. D. and {McMillan}, D. C.},
	urldate = {2015-05-18},
	date = {2014-03-18},
	langid = {english},
	keywords = {anti-inflammatory agents, appetite loss, cachexia, depression, fatigue, Humans, Inflammation/*pathology, Neoplasms/*pathology/*therapy, pain, physical function, Prognosis, Survival Analysis, systemic inflammation},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Z2FM7G98\\Roxburgh and McMillan - 2014 - Cancer and systemic inflammation treat the tumour.pdf:application/pdf}
}

@article{wente_postpancreatectomy_2007-1,
	title = {Postpancreatectomy hemorrhage ({PPH})–An International Study Group of Pancreatic Surgery ({ISGPS}) definition},
	volume = {142},
	issn = {00396060},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0039606007001055},
	doi = {10.1016/j.surg.2007.02.001},
	pages = {20--25},
	number = {1},
	journaltitle = {Surgery},
	author = {Wente, Moritz N. and Veit, Johannes A. and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J. and Izbicki, Jakob R. and Neoptolemos, John P. and Padbury, Robert T. and Sarr, Michael G. and Yeo, Charles J. and Büchler, Markus W.},
	urldate = {2014-01-27},
	date = {2007-07},
	file = {Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CI32P6WI\\Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:application/pdf;Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\F7KNCB9R\\Wente et al. - 2007 - Postpancreatectomy hemorrhage (PPH)–An Internation.pdf:application/pdf}
}

@article{fearon_albumin_1998,
	title = {Albumin synthesis rates are not decreased in hypoalbuminemic cachectic cancer patients with an ongoing acute-phase protein response.},
	volume = {227},
	abstract = {{OBJECTIVE}: To determine whether suppression of albumin synthesis contributes to the hypoalbuminemia observed in weight-losing cancer patients with evidence of an ongoing acute-phase protein response ({APPR}). {BACKGROUND} {DATA}: Proinflammatory cytokines such as tumor necrosis factor ({TNF}) and interleukin 6 ({IL}-6) are known  to downregulate albumin synthesis and increase acute-phase protein production in  isolated hepatocytes. However, whether albumin synthesis is suppressed in hypoalbuminemic cancer patients with evidence of an ongoing acute-phase response  is unknown. {METHODS}: Albumin synthesis rates were determined in six healthy controls and in six weight-losing pancreatic cancer patients with an ongoing {APPR} using a flooding dose technique with [2H5]-phenylalanine. The presence of an {APPR} was defined as a serum C-reactive protein concentration {\textgreater}10 mg/L. Serum cytokines ({TNF}, {IL}-6) and soluble {TNF} receptors ({sTNF}-R 55 and 75), along with serum cortisol and insulin, were also measured in both groups. {RESULTS}: Cancer patients had reduced serum albumin (median 32 [range, 23-36] vs. 42 g/L [40-45]; p {\textless} 0.01) and increased serum C-reactive protein concentrations (72 [23-126] vs. {\textless}5 mg/L; p {\textless} 0.01) when compared with controls. {TNF} was not detected in either group. {sTNF}-R 55 levels were significantly elevated in the cancer patients (3.8 [1.9-8.1] vs. 1.2 pg/{mL} [0.9-2.2]; p {\textless} 0.01). Circulating {IL}-6, insulin, and cortisol concentrations were not significantly different between the groups. The intravascular albumin mass was lower (88 [56-93] vs. 133 g [105-177]; p {\textless} 0.01),  but the intravascular albumin fractional synthetic rate was higher (13.9 [13.5-18.5] vs. 10.3\%/d [71-11.3]; p {\textless} 0.01) in the cancer patients compared with the controls. The total intravascular albumin synthetic rate was, however, similar between the two groups (12.7 [7.7-15.7] vs. 11.7 g/d [8.5-18.7]; p {NS}). {CONCLUSIONS}: In weight-losing pancreatic cancer patients with evidence of an ongoing {APPR}, hypoalbuminemia is not caused by a decreased rate of albumin synthesis.},
	pages = {249--254},
	number = {2},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Fearon, K. C. and Falconer, J. S. and Slater, C. and {McMillan}, D. C. and Ross, J. A. and Preston, T.},
	date = {1998-02},
	pmid = {9488524},
	pmcid = {PMC1191243},
	keywords = {Acute-Phase Proteins/*metabolism, Acute-Phase Reaction/complications/*metabolism/physiopathology, Aged, Albumins/*biosynthesis, Cachexia/complications/*metabolism/physiopathology, Cytokines/analysis, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms/complications/*metabolism/physiopathology, Plasma Volume, Serum Albumin/analysis}
}

@article{prentis_impaired_2013,
	title = {Impaired cardiopulmonary reserve in an elderly population is related to postoperative morbidity and length of hospital stay after radical cystectomy},
	volume = {112},
	rights = {© 2013 {BJU} International},
	issn = {1464-410X},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/bju.12219/abstract},
	doi = {10.1111/bju.12219},
	abstract = {Objective



* To determine the relationship of preoperatively measured cardiorespiratory function, to the development of postoperative complications and length of hospital stay ({LOS}) in a cohort of patients undergoing radical cystectomy ({RC}), as {RC} and conduit formation is curative but is associated with significant postoperative morbidity and mortality.



Patients and Methods



* Consecutive patients planned to have {RC} underwent cardiopulmonary exercise testing ({CPET}) to a standardised protocol.

* The results of the {CPET} were ‘blinded’ from the clinicians involved in the care of the patients.

* Patients were prospectively monitored for the primary outcome of postoperative complications, as defined by a validated classification (Clavien-Dindo).

* Secondary outcome included {LOS} and mortality.



Results



* In all, 82 patients underwent {CPET} before {RC}. Eight patients did not subsequently undergo {RC} and a further five did not exercise sufficiently to allow for appropriate determination of the cardiopulmonary variables of interest.

* There was a significant difference in {LOS} between those patients who had a major perioperative complication (Clavien score {\textgreater} 3) and those that did not (16 vs 30 days; P {\textless} 0.001; hazard ratio [{HR}] 3.6, 95\% confidence interval [{CI}] 2.1–6.3).

* The anaerobic threshold ({AT}) remained as the only significant independent predictor variable for the presence or absence of major postoperative complications (odds ratio 0.74, 95\% {CI} 0.57–0.97; P = 0.03).

* When the optimal predictive value of {AT} of 12 {mL}/min/kg was used as a fitness marker, there was a significant relationship between fitness and {LOS} (median {LOS}: ‘unfit’ 22 days vs ‘fit’ 16 days; {HR} 0.47, 95\% {CI} 0.28–0.80; P = 0.006)



Conclusion



* Impaired preoperative cardiopulmonary reserve was related to major morbidity, prolonged {LOS} and increased use of critical care resource after {RC}.

* This has important health and economic implications for risk assessment, rationalisation of postoperative resource and the potential for therapeutic preoperative intervention with exercise therapy.},
	pages = {E13--E19},
	number = {2},
	journaltitle = {{BJU} International},
	shortjournal = {{BJU} Int},
	author = {Prentis, James M. and Trenell, Michael I. and Vasdev, Nikhil and French, Rachel and Dines, Georgina and Thorpe, Andrew and Snowden, Christopher P.},
	urldate = {2015-05-05},
	date = {2013-07-01},
	langid = {english},
	keywords = {anaerobic threshold, Morbidity, outcome, Risk assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZMHW7GMR\\Prentis et al. - 2013 - Impaired cardiopulmonary reserve in an elderly pop.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7Q9KCF5I\\abstract.html:text/html}
}

@article{vickers_comorbidity_2012,
	title = {Comorbidity, age and overall survival in patients with advanced pancreatic cancer - results from {NCIC} {CTG} {PA}.3: a phase {III} trial of gemcitabine plus erlotinib or placebo},
	volume = {48},
	issn = {1879-0852},
	doi = {10.1016/j.ejca.2011.10.035},
	shorttitle = {Comorbidity, age and overall survival in patients with advanced pancreatic cancer - results from {NCIC} {CTG} {PA}.3},
	abstract = {{BACKGROUND}: The effect of comorbidity, age and performance status ({PS}) on treatment of advanced pancreatic cancer is poorly understood. We examined these factors as predictors of outcome in advanced pancreatic cancer patients treated with gemcitabine +/- erlotinib.
{PATIENTS} {AND} {METHODS}: Comorbidity was evaluated by two physicians using the Charlson Comorbidity Index ({CCI}) and correlated with clinical outcome data from the {NCIC} Clinical Trials Group ({NCIC} {CTG}) {PA}.3 clinical trial.
{RESULTS}: Five hundred and sixty-nine patients were included; 47\% were aged ≥ 65 years old, 36\% had comorbidity ({CCI}{\textgreater}0). In multivariate analysis, neither age (p=0.22) nor comorbidity (p=0.21) was associated with overall survival. The baseline presence of better {PS} and lower pain intensity scores was associated with better overall survival (p {\textless} 0.0001 and p=0.01, respectively). An improvement in survival with the addition of erlotinib therapy was seen in patients age {\textless} 65 (adjusted hazard ratio ({HR}) 0.73, p=0.01) or in the presence of comorbidity (adjusted {HR} 0.72, p=0.03). However, neither age nor {CCI} score was predictive of erlotinib benefit after test for interaction. Patients treated with gemcitabine plus erlotinib who were ≥ 65 years of age or those with comorbidity had a higher rate of infections ≥ grade 3.
{CONCLUSION}: Low baseline pain intensity and better {PS} were associated with improved overall survival, while age and comorbidity were not independent prognostic factors for patients treated with gemcitabine-based therapy.},
	pages = {1434--1442},
	number = {10},
	journaltitle = {European Journal of Cancer (Oxford, England: 1990)},
	shortjournal = {Eur. J. Cancer},
	author = {Vickers, M. M. and Powell, E. D. and Asmis, T. R. and Jonker, D. J. and Hilton, J. F. and O'Callaghan, C. J. and Tu, D. and Parulekar, W. and Moore, M. J.},
	date = {2012-07},
	pmid = {22119354},
	keywords = {Aged, Age Factors, Antimetabolites, Antineoplastic, Antineoplastic Combined Chemotherapy Protocols, Comorbidity, Deoxycytidine, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Metastasis, Outcome Assessment (Health Care), Pancreatic Neoplasms, Placebos, Proportional Hazards Models, Protein Kinase Inhibitors, Quinazolines, Risk}
}

@article{john_biochemical_2010,
	title = {Biochemical indicators of in-hospital complications following pancreatic surgery},
	volume = {95},
	issn = {0020-8868},
	abstract = {Early recognition of complications following pancreatic surgery could reduce morbidity and mortality. White cell counts ({WCCs}), platelets ({PLTs}), C-reactive protein ({CRP}) and albumin ({ALB}) are commonly used as guides in clinical decision making. However, the evidence to support their role as early indicators of complications is unclear. A retrospective cohort analysis of consecutive pancreatic surgical procedures between 2004 and 2008 was performed. Operative procedures, inflammatory markers--{WCCs}, {PLTs}, {CRP}, and {ALB}--preoperatively and on postoperative days ({PODs}) 1, 3, 5, 7, 9, 12, and 15, and clinical outcomes were recorded. {WCC} {\textgreater} 11 x 10(9)/L on {POD}5 was significantly associated with complications [odds ratio ({OR}), 2.60; P = 0.0067]. {ALB} {\textless} 28 g/L on {POD}7 was significantly associated with a postoperative complication ({OR}, 2.94; P = 0.0031). {WCC} {\textgreater} 12.2 x 10(9)/L and {ALB} {\textless} or = 28 g/L on {POD}7 were more likely to be associated with a complication ({OR}, 4.86; P = 0.0002). Postoperative {WCC} and {ALB} levels may be useful as aids to the early diagnosis of complications following pancreatic surgery.},
	pages = {215--220},
	number = {3},
	journaltitle = {International Surgery},
	shortjournal = {Int Surg},
	author = {John, Biku J. and Wijeyekoon, Sanjay and Warnaar, Nienke and Shasi, Prasoona and Rahman, Sakirullah H. and Davidson, B. R. and Fusai, G.},
	date = {2010-09},
	pmid = {21066999},
	keywords = {C-Reactive Protein, Humans, Leukocyte Count, Pancreatectomy, Pancreaticoduodenectomy, Platelet Count, postoperative complications, Retrospective Studies, {ROC} Curve, Serum Albumin, Splenectomy}
}

@article{maguire_longitudinal_2002,
	title = {A longitudinal study of leptin and appetite, resting energy expenditure and body  fat mass in weight-stable cancer patients.},
	volume = {20},
	abstract = {Leptin and its relationship with energy metabolism in male weight-stable patients with colorectal liver metastases (n=14) was assessed at baseline and after 6 weeks. At baseline, median leptin concentration was 5.9 microg/l and the median percentage fat mass was 32.1\%. Circulating leptin concentrations were correlated  with measured percentage fat mass at baseline (r(s)=0.519, P=0.040) and with the  changes after 6 weeks (r(s)=0.611, P=0.027) but not with insulin, cortisol,},
	pages = {174--177},
	number = {4},
	journaltitle = {Cytokine},
	shortjournal = {Cytokine},
	author = {Maguire, Roma and {McMillan}, Donald C. and Wallace, A. Michael and {McArdle}, Colin},
	date = {2002-11-24},
	pmid = {12543082},
	keywords = {*Appetite, *Body Composition, *Energy Metabolism, Adenocarcinoma/metabolism/*secondary, Adipose Tissue/*pathology, Adult, Aged, Body Weight, Colorectal Neoplasms/*metabolism, C-Reactive Protein/analysis, Humans, Hydrocortisone/blood, Insulin/blood, Leptin/*blood, Liver Neoplasms/metabolism/*secondary, Longitudinal Studies, Male, Middle Aged, Serum Albumin/analysis}
}

@article{junejo_cardiopulmonary_2014,
	title = {Cardiopulmonary Exercise Testing for Preoperative Risk Assessment before Pancreaticoduodenectomy for Cancer},
	volume = {21},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-014-3493-0},
	doi = {10.1245/s10434-014-3493-0},
	pages = {1929--1936},
	number = {6},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Junejo, M. A. and Mason, J. M. and Sheen, A. J. and Bryan, A. and Moore, J. and Foster, P. and Atkinson, D. and Parker, M. J. and Siriwardena, A. K.},
	urldate = {2015-05-05},
	date = {2014-01-30},
	langid = {english},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Junejo et al. - 2014 - Cardiopulmonary Exercise Testing for Preoperative .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MQVU54UR\\Junejo et al. - 2014 - Cardiopulmonary Exercise Testing for Preoperative .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\I5N5N2DM\\10.html:text/html}
}

@article{roxburgh_comparison_2009-1,
	title = {Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer.},
	volume = {249},
	doi = {10.1097/SLA.0b013e3181a3e738},
	abstract = {{OBJECTIVE}: To examine interrelationships between the local inflammatory response  (Klintrup and Jass scores) and the systemic inflammatory response (Glasgow prognostic score [{GPS}]), and compare their prognostic value in patients undergoing curative resection for colorectal cancer. {BACKGROUND}: Both localized peritumoral inflammatory cell infiltrate and the host systemic inflammatory response are known to have prognostic value in colorectal cancer. However, the interrelationships of biochemical and cellular components of the systemic inflammatory response and the local inflammatory response are poorly understood.  {METHODS}: Retrospective study of 287 patients who underwent surgery between 1997 and 2004. Data were collected from routine preoperative blood tests. Routine pathology specimens were scored according to Jass and Klintrup criteria for peritumoral infiltrate. {RESULTS}: Increased Dukes stage was associated with less peritumoral infiltrate (Jass criteria: P {\textless} 0.001, Klintrup criteria: P {\textless} 0.01). Increased modified {GPS} ({mGPS}) was associated with increased circulating white cell (P {\textless} 0.01) and neutrophil (P {\textless} 0.01) counts and low lymphocyte counts (P {\textless} 0.01). Increased circulating white cell count was associated with increased neutrophil count (P {\textless} 0.001) and low-grade peritumoral infiltrate (P {\textless} 0.05, Klintrup criteria). Jass and Klintrup criteria for peritumoral infiltrate were directly associated (P {\textless} 0.001). On univariate survival analysis of patients with node-negative disease (Dukes A and B), age (P {\textless} 0.01), {mGPS} (P {\textless} 0.01), neutrophil count (P {\textless} 0.05), and Klintrup criteria (P {\textless} 0.05) were associated with cancer-specific survival. On multivariate survival analysis in node-negative disease, the {mGPS} (hazard ratio: 2.61, 95\% {CI}: 1.27-5.35, P {\textless} 0.01) and Klintrup  criteria (hazard ratio: 6.31, 95\% {CI}: 1.40-28.44, P {\textless} 0.05) were independently associated with cancer-specific survival. {CONCLUSIONS}: The results of the present study suggest low peritumoral infiltrate (Klintrup criteria) and increased systemic inflammation ({mGPS} criteria) are linked through the cell-mediated immune system. Furthermore, both pathologic (Klintrup) and biochemical ({mGPS}) measures of the inflammatory response predict survival after colorectal cancer surgery.},
	pages = {788--793},
	number = {5},
	journaltitle = {Annals of surgery},
	shortjournal = {Ann Surg},
	author = {Roxburgh, Campbell S. D. and Salmond, Jonathan M. and Horgan, Paul G. and Oien, Karin A. and {McMillan}, Donald C.},
	date = {2009-05},
	pmid = {19387324},
	keywords = {Aged, Colorectal Neoplasms/*blood/immunology/*pathology/surgery, Female, Humans, Inflammation, Male, Middle Aged, Neoplasm Staging, Predictive Value of Tests, Prognosis, Retrospective Studies, Survival Analysis}
}

@article{scott_longitudinal_2001,
	title = {Longitudinal study of resting energy expenditure, body cell mass and the inflammatory response in male patients with non-small cell lung cancer.},
	volume = {32},
	abstract = {The aim of this study was to examine the inter-relationship between the inflammatory response and resting energy expenditure in patients with non-small cell lung cancer ({NSCLC}) before and after the onset of weight loss. Healthy subjects (n=7) and patients with {NSCLC} without weight loss (n=12) were studied. Resting energy expenditure adjusted for metabolically active tissue, as measured  by total body potassium, was approximately 15\% higher in the {NSCLC} group (P{\textless}0.01). Moreover, the resting energy expenditure, correlated with the magnitude of the inflammatory response (r=0.753, P{\textless}0.01). Six cancer patients subsequently  lost weight and the relationship between resting energy expenditure and the inflammatory response was maintained. These results highlight the impact of the inflammatory response on the increase in the resting energy expenditure which precedes the onset of weight loss in patients with {NSCLC}.},
	pages = {307--312},
	number = {3},
	journaltitle = {Lung cancer (Amsterdam, Netherlands)},
	shortjournal = {Lung Cancer},
	author = {Scott, H. R. and {McMillan}, D. C. and Watson, W. S. and Milroy, R. and {McArdle}, C. S.},
	date = {2001-06},
	pmid = {11390012},
	keywords = {*Energy Metabolism, *Inflammation, *Weight Loss, Adult, Aged, Body Mass Index, Carcinoma, Non-Small-Cell Lung/complications/*pathology, Case-Control Studies, C-Reactive Protein, Humans, Longitudinal Studies, Lung Neoplasms/complications/*pathology, Male, Middle Aged}
}

@article{teh_patient_2009,
	title = {Patient and hospital characteristics on the variance of perioperative outcomes for pancreatic resection in the United States: a plea for outcome-based and not volume-based referral guidelines},
	volume = {144},
	url = {http://archsurg.ama-assn.org/cgi/reprint/144/8/713.pdf},
	shorttitle = {Patient and hospital characteristics on the variance of perioperative outcomes for pancreatic resection in the United States},
	pages = {713},
	number = {8},
	journaltitle = {Archives of surgery},
	author = {Teh, Swee H. and Diggs, Brian S. and Deveney, Clifford W. and Sheppard, Brett C.},
	urldate = {2014-01-27},
	date = {2009},
	file = {Teh et al. - 2009 - Patient and hospital characteristics on the varian.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\HDUU739K\\Teh et al. - 2009 - Patient and hospital characteristics on the varian.pdf:application/pdf}
}

@article{ritland_improvement_1983,
	title = {Improvement of physical capacity after long-term training in patients with chronic active hepatitis},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6673079},
	abstract = {A training program was started in nine patients with chronic active hepatitis in clinical remission while receiving immunosuppressive therapy. The patients were examined before and after a training period of 4-5 weeks and 10-12 weeks, respectively. The calculated oxygen consumption increased by 19\% and 29\%, and the estimated work load capacity improved. No change occurred in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatases, gamma-glutamyl-transpeptidase, serum bilirubin, or prealbumin, whereas creatine kinase and lactate dehydrogenase increased significantly. The clinical condition did not worsen in any patient, and most of the patients felt that their physical performance capacity had improved. We conclude that long-term regular physical training is well tolerated by patients with chronic active hepatitis in clinical remission and that training leads to improvement in the oxygen consumption and the estimated work load capacity in such patients.},
	pages = {1083--7},
	number = {8},
	journaltitle = {Scand J Gastroenterol},
	author = {Ritland, S and Petlund, C F and Knudsen, T and Skrede, S},
	date = {1983-11}
}

@article{biancari_preoperative_2003,
	title = {Preoperative C-reactive protein and outcome after coronary artery bypass surgery},
	volume = {76},
	issn = {0003-4975},
	url = {http://www.sciencedirect.com/science/article/pii/S0003497503010671},
	doi = {10.1016/S0003-4975(03)01067-1},
	abstract = {Background
C-reactive protein ({CRP}) is a predictor of early and late outcome after coronary angioplasty, but there is scant data on its impact on the outcome after coronary artery bypass grafting ({CABG}).
Methods
The predictive value of preoperative {CRP} was evaluated in a series of 764 patients who underwent on-pump {CABG}.
Results
During the in-hospital stay, 13 patients (1.7\%) died, 45 (4.5\%) developed low cardiac output syndrome, and 28 (3.7\%) suffered minor or major cerebrovascular complications. Patients with a preoperative serum concentration of {CRP}≥1.0 mg/{dL} had a higher risk of overall postoperative death (5.3\% vs 1.1\%, p = 0.001), cardiac death (4.4\% vs 0.8\%, p = 0.002), low cardiac output syndrome (8.8\% vs 3.7\%, p = 0.01), and any cerebrovascular complication (4.4\% vs 3.5\%, p = 0.66). Preoperative serum concentration of {CRP}≥1.0 mg/{dL} was significantly more frequent among patients with history of myocardial infarction, diabetes, lower limb ischemia, low left ventricular ejection fraction, {NYHA} class {IV}, and in those undergoing urgent or emergency operation. At multivariate analysis, preoperative serum concentration of {CRP} ≥ 1.0 mg/{dL} (p = 0.01, O.R.: 6.97) and left ventricular ejection fraction (p = 0.01, O.R.: 0.95) were independent predictors of postoperative death. Postoperative mortality rate was 0.3\% among patients with preoperative {CRP} \< 1.0 mg/{dL} and an ejection fraction ≥50\%, whereas it was 21.4\% among those with a preoperative {CRP} ≥ 1.0 mg/{dL} and an ejection fraction less than 50\% (p \< 0.0001).
Conclusions
Preoperative serum concentration of {CRP} in patients undergoing on-pump coronary artery bypass surgery is an important determinant of postoperative outcome.},
	pages = {2007--2012},
	number = {6},
	journaltitle = {The Annals of Thoracic Surgery},
	shortjournal = {The Annals of Thoracic Surgery},
	author = {Biancari, Fausto and Lahtinen, Jarmo and Lepojärvi, Samuli and Rainio, Pekka and Salmela, Esa and Pokela, Risto and Lepojärvi, Martti and Satta, Jari and Juvonen, Tatu S},
	urldate = {2015-08-20},
	date = {2003-12},
	keywords = {17},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5BV3TBSF\\Biancari et al. - 2003 - Preoperative C-reactive protein and outcome after .pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VHFTF3AP\\S0003497503010671.html:text/html}
}

@article{for_research_easleortc_2012,
	title = {{EASL}–{EORTC} Clinical Practice Guidelines: management of hepatocellular carcinoma},
	volume = {56},
	shorttitle = {{EASL}–{EORTC} Clinical Practice Guidelines},
	pages = {908--943},
	number = {4},
	journaltitle = {Journal of Hepatology},
	author = {for Research, European Organisation and Liver, European Association for the Study of the},
	date = {2012},
	file = {for Research and Liver - 2012 - EASL–EORTC Clinical Practice Guidelines managemen.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CVV7BU25\\for Research and Liver - 2012 - EASL–EORTC Clinical Practice Guidelines managemen.pdf:application/pdf}
}

@article{mackay_c-reactive_2011-1,
	title = {C-reactive protein as a predictor of postoperative infective complications following elective colorectal resection},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20163424},
	abstract = {C-reactive protein ({CRP}) may be useful in predicting postoperative complications [1]. We investigated the sensitivity and specificity of postoperative {CRP} for infective complications after elective colorectal surgery.},
	pages = {583--7},
	number = {5},
	journaltitle = {Colorectal Dis},
	author = {{MacKay}, G J and Molloy, R G and O'Dwyer, P J},
	date = {2011-05},
	keywords = {Aged, Biological Markers, Colectomy, C-Reactive Protein, Female, Humans, Infection, Male, Middle Aged, postoperative complications, Predictive Value of Tests, Sensitivity and Specificity}
}

@article{lim_prognostic_2003,
	title = {Prognostic Factors Following Curative Resection for Pancreatic Adenocarcinoma},
	volume = {237},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513971/},
	abstract = {Objective
To analyze prognostic factors influencing pancreatic cancer survival following curative resection, using prospectively collected, population-based data.

Summary Background Data
Several studies have analyzed the determinants of long-term survival in postresection pancreatic cancer patients, but the majority of these have been single-institutional chart reviews yielding inconsistent results.

Methods
This retrospective cohort study examined 396 Medicare-eligible patients over age 65 who were diagnosed with nonmetastatic pancreatic adenocarcinoma and who underwent surgical resection with curative intent while residing in one of the 11 Survival, Epidemiology, and End Results ({SEER}) registries between January 1991 and December 1996. Linked Medicare data provided information on treatment and comorbidity, while linked census tract data supplied sociodemographic characteristics.

Results
Median survival for the overall study population was 17.6 months, with 1- and 3-year survival rates of 60.1\% and 34.3\%, respectively. Survival appears to be gradually improving over time, concomitant with a rise in the proportion of patients undergoing surgery in teaching centers. Prognostic variables significantly diminishing survival on univariate analysis included African American race, treatment not in a teaching hospital, lack of adjuvant chemoradiation therapy, as well as histopathologic factors that included tumor size larger than 2 cm in diameter, moderate to poor histologic grade, and positive lymph node metastases. Higher socioeconomic status was associated both with an increased likelihood of receiving adjuvant therapy and improved overall survival. Multivariate analyses indicated the strongest predictors of survival were adjuvant combined chemoradiotherapy, small tumors ({\textless}2 cm in diameter), negative lymph nodes, well-differentiated histology, undergoing surgery in a teaching hospital, and high socioeconomic status.

Conclusions
Although biologic characteristics remain important predictors of survival for patients with resected pancreatic cancer, the most powerful determinant is postoperative adjuvant chemoradiation therapy. An interesting finding that warrants further investigation is the effect of socioeconomic status on both the likelihood of receiving adjuvant treatment and subsequent survival, indicating a possible relationship between the quality of care delivered and outcomes.},
	pages = {74--85},
	number = {1},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Lim, Jonathan E. and Chien, Michael W. and Earle, Craig C.},
	urldate = {2015-05-26},
	date = {2003-01},
	pmid = {12496533},
	pmcid = {PMC1513971},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9QB4U6HB\\Lim et al. - 2003 - Prognostic Factors Following Curative Resection fo.pdf:application/pdf}
}

@article{sewnath_meta-analysis_2002,
	title = {A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice},
	volume = {236},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12131081},
	abstract = {To review the effectiveness of preoperative biliary drainage ({PBD}) in patients with obstructive jaundice resulting from tumors.},
	pages = {17--27},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Sewnath, Miguel E and Karsten, Thomas M and Prins, Martin H and Rauws, Erik J A and Obertop, Huug and Gouma, Dirk J},
	date = {2002-07}
}

@article{garcea_preoperative_2011,
	title = {Preoperative Neutrophil-to-Lymphocyte Ratio ({NLR}) is Associated with Reduced Disease-free Survival Following Curative Resection of Pancreatic Adenocarcinoma},
	volume = {35},
	issn = {0364-2313, 1432-2323},
	url = {http://link.springer.com/article/10.1007/s00268-011-0984-z},
	doi = {10.1007/s00268-011-0984-z},
	abstract = {Background Serological proinflammatory markers such as C-reactive protein ({CRP}), neutrophil-to-lymphocyte ratio ({NLR}), and platelet-to-lymphocyte ratio ({PLR}) have been associated with reduced survival for many different types of cancer. This study determined the prognostic value of the preoperative value of these markers in patients with resectable pancreatic adenocarcinoma. Methods Consecutive patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma were entered into our database from 2001 to the present day. {CRP}, {NLR}, and {PLR} at the time of presentation were recorded as well as overall and disease-free survival. Results Seventy-four patients were identified. Overall median survival was 35.0 months and median disease-free survival was 27.0 months. Follow-up ranged from 1 to 125.8 months. Preoperative {NLR} was significantly greater in those patients who developed recurrence in the follow-up period (4.5 vs. 3.1). {CRP} and {PLR} were not found to differ significantly between the two groups. Kaplan-Meier survival analysis of patients with {NLR} {\textgreater} 5 demonstrated a disease-free survival of 12 months compared with 52 months for those patients with {NLR} {\textless} 5 (p {\textless} 0.001). Conclusion Preoperative {NLR} offers important prognostic information regarding disease-free survival following curative resection of pancreatic ductal adenocarcinoma.},
	pages = {868--872},
	number = {4},
	journaltitle = {World Journal of Surgery},
	shortjournal = {World J Surg},
	author = {Garcea, G. and Ladwa, N. and Neal, C. P. and Metcalfe, M. S. and Dennison, A. R. and Berry, D. P.},
	urldate = {2015-05-18},
	date = {2011-02-11},
	langid = {english},
	keywords = {Abdominal Surgery, Cardiac Surgery, general surgery, surgery, Thoracic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D4W5SA6E\\Garcea et al. - 2011 - Preoperative Neutrophil-to-Lymphocyte Ratio (NLR) .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2N65ZJK5\\10.html:text/html}
}

@article{tang_cardiopulmonary_2012,
	title = {Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients},
	volume = {94},
	issn = {1478-7083},
	doi = {10.1308/003588412X13171221591493},
	pages = {373},
	number = {5},
	journaltitle = {Annals of the Royal College of Surgeons of England},
	shortjournal = {Ann R Coll Surg Engl},
	author = {Tang, T. Y. and Hayes, P. D. and Boyle, J. R.},
	date = {2012-07},
	pmid = {22943257},
	pmcid = {PMC3954403},
	keywords = {Aortic Aneurysm, Abdominal, endovascular procedures, Exercise Test, Female, Humans, Male, postoperative complications, preoperative care}
}

@article{proctor_relationship_2010,
	title = {The relationship between the presence and site of cancer, an inflammation-based prognostic score and biochemical parameters. Initial results of the Glasgow Inflammation Outcome Study.},
	volume = {103},
	doi = {10.1038/sj.bjc.6605855},
	abstract = {{BACKGROUND}: Cancer incidence is increasing in the United Kingdom, as well as on a global basis. Biochemical parameters, such as C-reactive protein and albumin (combined to form the modified Glasgow Prognostic Score, {mGPS}), alkaline phosphatase (Alk phos), gamma-glutamyl transferase ({GGT}) and serum calcium have been reported to be associated with cancer and non-cancer mortality. Therefore, to definitively examine the interrelationships between the above biochemical parameters, the {mGPS} and the presence of cancer, the Glasgow Inflammation Outcome Study was undertaken. The aim of this initial study was to examine the effect of  cancer on markers of systemic inflammation induced by the liver ({mGPS}) and on levels of routine biochemical parameters. {METHODS}: Patients (n=223 303) who had a single incidental sample taken for C-reactive protein, albumin, calcium and serum liver function tests where available, between 2000 and 2008 were studied. Those with a pathological diagnosis of cancer (n=22 715) were identified. The {mGPS} was  constructed and liver function tests classified in accordance with the local reference ranges. {RESULTS}: Patients with cancer had higher C-reactive protein and lower albumin levels (and thus a higher {mGPS}), higher adjusted calcium, Alk phos  and {GGT} levels, but lower aspartate transaminase ({AST}) and alanine transaminase ({ALT}) levels (all P{\textless}0.001). The strongest associations (Spearman's correlation {\textgreater}  or =0.3) in both the non-cancer and cancer groups were found between albumin,},
	pages = {870--876},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Proctor, M. J. and Talwar, D. and Balmar, S. M. and O'Reilly, D. S. J. and Foulis, A. K. and Horgan, P. G. and Morrison, D. S. and {McMillan}, D. C.},
	date = {2010-09-07},
	pmid = {20717110},
	pmcid = {PMC2966631},
	keywords = {Aged, Alkaline Phosphatase/blood, Cohort Studies, C-Reactive Protein/metabolism, Female, gamma-Glutamyltransferase/blood, Humans, Liver Function Tests, Male, Middle Aged, Neoplasms/blood/complications/*pathology, Prognosis, Serum Albumin/metabolism, Systemic Inflammatory Response Syndrome/blood/complications/*pathology}
}

@article{mokart_early_2002,
	title = {Early postoperative compensatory anti-inflammatory response syndrome is associated with septic complications after major surgical trauma in patients with cancer},
	volume = {89},
	rights = {© 2002 British Journal of Surgery Society Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2168.2002.02218.x/abstract},
	doi = {10.1046/j.1365-2168.2002.02218.x},
	abstract = {Background:
Patients who undergo major surgery for cancer are at high risk of postoperative infection. Postoperative immunosuppression may be due to dysregulation of cytokine production. The aim of this study was to investigate the association between changes in serum proinflammatory and anti-inflammatory cytokine concentrations and postoperative septic complications after major surgery.
Methods:
Serial blood samples were collected from 30 consecutive patients for determination of serum cytokine levels. Healthy volunteers were used as the control group.
Results:
Eleven patients developed no complications (group 1), 14 developed sepsis or severe sepsis (group 2), and five developed septic shock (group 3). On day 1 the patients in groups 2 and 3 had significantly higher levels of interleukin ({IL}) 6 than those in group 1. {IL}-6 levels remained high until day 5. Tumour necrosis factor ({TNF}), {IL}-1, interferon ({IFN}) γ and {IL}-12 levels were not affected by surgical trauma or by the occurrence of septic complications. After operation the circulating {IL}-1 receptor antagonist ({IL}-1ra) concentration was increased in all groups, but patients in group 3 had significantly higher levels of {IL}-1ra than those in group 1. {IL}-1ra levels correlated with {IL}-6 levels. The pattern of {IL}-10 levels was similar to that of {IL}-1ra levels.
Conclusion:
Serum concentrations of proinflammatory cytokines ({TNF}, {IL}-1, {IFN}-γ and {IL}-12) were not affected by operation or the occurrence of septic complications. The postoperative increase in {IL}-6 concentration was associated with septic morbidity, while raised {IL}-1ra concentration was associated with postoperative septic shock. © 2002 British Journal of Surgery Society Ltd},
	pages = {1450--1456},
	number = {11},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Mokart, D. and Capo, C. and Blache, J. L. and Delpero, J. R. and Houvenaeghel, G. and Martin, C. and Mege, J. L.},
	urldate = {2015-05-25},
	date = {2002-11-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9BCFKD8B\\Mokart et al. - 2002 - Early postoperative compensatory anti-inflammatory.pdf:application/pdf;Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3AX47WXN\\Mokart et al. - 2002 - Early postoperative compensatory anti-inflammatory.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NHQXHRSE\\abstract.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PG3ND9TA\\abstract.html:text/html}
}

@article{ramanathan_is_2013,
	title = {Is perioperative systemic inflammation the result of insufficient cortisol production in patients with colorectal cancer?},
	volume = {20},
	doi = {10.1245/s10434-013-2943-4},
	abstract = {{BACKGROUND}: Patients with colorectal cancer who have a raised systemic inflammatory response before surgery have been shown to have poorer long-term and short-term outcomes. The presence of an ongoing systemic inflammatory response in these patients may be due to impaired cortisol production. The aim of the present study was to examine the relationship between the perioperative systemic inflammatory response and endogenous cortisol production. {METHODS}: A prospective  study was performed to incorporate the assessment of adrenocortical function using synthetic adrenocorticotrophic hormone, a short Synacthen test, as part of  the preoperative assessment of patients undergoing resection for colorectal cancer. {RESULTS}: A total of 80 patients underwent short Synacthen testing. There  were no significant associations between the baseline, 30 min, or change (both relative and absolute) in cortisol and age (all p {\textgreater} 0.10), sex (all p {\textgreater} 0.10), site (all p {\textgreater} 0.10), {TNM} stage (all p {\textgreater} 0.10), modified Glasgow prognostic score  (all p {\textgreater} 0.10), {NLR} (all p {\textgreater} 0.10), white cell count (all p {\textgreater} 0.10) or postoperative C-reactive protein concentrations (all p {\textgreater} 0.10). {CONCLUSIONS}: Impaired cortisol production was uncommon in patients with potentially curable colorectal cancer. The presence of a perioperative systemic inflammatory response was not significantly associated with impaired cortisol production.},
	pages = {2172--2179},
	number = {7},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Ramanathan, Michelle L. and Roxburgh, Campbell S. D. and Guthrie, Graeme J. K. and Orange, Clare and Talwar, Dinesh and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2013-07},
	pmid = {23504123},
	keywords = {Aged, Age Factors, Colorectal Neoplasms/*blood/*pathology/surgery, C-Reactive Protein/metabolism, Female, Humans, Hydrocortisone/*blood/deficiency/metabolism, Leukocyte Count, Male, Middle Aged, Neoplasm Staging, Perioperative Period, Prospective Studies, Saliva/metabolism, Sex Factors, Systemic Inflammatory Response Syndrome/*blood/etiology}
}

@article{house_preoperative_2008,
	title = {Preoperative predictors for complications after pancreaticoduodenectomy: impact of {BMI} and body fat distribution},
	volume = {12},
	issn = {1091-255X},
	doi = {10.1007/s11605-007-0421-7},
	shorttitle = {Preoperative predictors for complications after pancreaticoduodenectomy},
	abstract = {{BACKGROUND}: The purpose of this study was to examine the preoperative patient and radiographic factors that are associated with operative morbidity after pancreaticoduodenectomy.
{MATERIAL} {AND} {METHODS}: Patient characteristics and preoperative radiographic findings and their association with postoperative complications after pancreaticoduodenectomy were analyzed for 356 patients with pancreatic adenocarcinoma who underwent resection between 2000 and 2005.
{RESULTS}: Postoperative complications developed in 135 patients (38\%). The most common complications were pancreatic fistula/abscess (15\%), wound infection (14\%), and delayed gastric emptying (4\%). On multivariate analysis, the only preoperative radiographic factors associated with having any postoperative complication were the absence of pancreatic atrophy and the extent of central obesity determined by the thickness of retrorenal visceral fat ({VF}). Complications occurred in 51\% of patients with {VF} {\textgreater} or = 2 cm, compared to 31\% of patients with {VF} {\textless} 2 cm, p {\textless} 0.001. Postoperatively, pancreatic fistula developed in 24\% of patients with {VF} {\textgreater} or = 2 cm and in only 10\% of patients with {VF} {\textless} 2 cm, p = 0.01. Wound infections occurred in 21\% of the patients with body mass index greater than or equal to 30 kg/m(2) compared to 12\% of the nonobese patients, p = 0.03.
{CONCLUSIONS}: Generalized obesity is associated with postoperative wound infections after pancreaticoduodenectomy. The degree of visceral fat on preoperative cross-sectional imaging is associated with significantly higher rates of overall complications and pancreatic fistula.},
	pages = {270--278},
	number = {2},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {House, Michael G. and Fong, Yuman and Arnaoutakis, Dean J. and Sharma, Rohit and Winston, Corinne B. and Protic, Mladjan and Gonen, Mithat and Olson, Sara H. and Kurtz, Robert C. and Brennan, Murray F. and Allen, Peter J.},
	date = {2008-02},
	pmid = {18060467},
	keywords = {Abdominal Fat, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Body Composition, Body Mass Index, Female, Humans, Male, Middle Aged, Multivariate Analysis, Pancreatic Fistula, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, Retrospective Studies, Risk Factors, Surgical Wound Infection},
	file = {House et al. - 2008 - Preoperative Predictors for Complications after Pa.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NX72D7T7\\House et al. - 2008 - Preoperative Predictors for Complications after Pa.pdf:application/pdf}
}

@misc{who_obesity:_2000,
	title = {Obesity: preventing and managing the global epidemic. Report of a {WHO} Consultation. {WHO} Technical Report Series 894.},
	publisher = {World Health Organisation, Geneva},
	author = {{WHO}},
	urldate = {2015-08-08},
	date = {2000}
}

@article{laporta_baez_c-reactive_2011,
	title = {C-reactive protein in the diagnosis of postoperative infection in pediatric patients: a prospective observational study of 103 patients},
	volume = {46},
	issn = {1531-5037},
	doi = {10.1016/j.jpedsurg.2011.03.014},
	shorttitle = {C-reactive protein in the diagnosis of postoperative infection in pediatric patients},
	abstract = {{BACKGROUND}: Surgical stress elicits a systemic inflammatory response syndrome that contributes to the development of septic complications. C-reactive protein ({CRP}) is an acute phase protein released in inflammatory states. To analyze the usefulness of {CRP} as a marker of infection in surgical pediatric patients, we analyzed its kinetics in these patients in comparison with usual markers, such temperature, leukocytes, or fibrinogen.
{METHODS}: One hundred three pediatric patients undergoing major surgery were enrolled consecutively in this observational study. C-reactive protein, leukocytes, neutrophils, platelets, fibrinogen, glycemia, and temperature were determined daily after surgery. Patients were classified as infected or not infected. Sensitivity, specificity, positive predictive value, negative predictive value, efficiency, precocity, positive likelihood ratio, and number of subjects to be treated were calculated.
{RESULTS}: Peak in {CRP} was detected at 48 ± 24 hours. C-reactive protein was higher in the infected group from the first day, with significant differences between groups from the second day. Best cutoff for detecting infection was increases in {CRP} of 11 mg/{dL} in 48 hours, with a sensitivity of 87\%, specificity of 89\%, precocity of 1.7 days (0.82-2.54), number of subjects to be treated of 1.7 (1.4-2.6), and positive likelihood ratio of 7.9. Application of other markers alone or in combination did not surpass the sensitivity, specificity, or precocity for increases in {CRP} of 11 mg/{dL} in 48 hours.
{CONCLUSIONS}: Increases of {CRP} constitute an easy and cheap prognostic alert system and may be used to establish strategies aimed to detect infection in surgical pediatric patients.},
	pages = {1726--1731},
	number = {9},
	journaltitle = {Journal of Pediatric Surgery},
	shortjournal = {J. Pediatr. Surg.},
	author = {Laporta Baez, Yolanda and Palomero Rodriguez, Miguel Angel and De Vicente Sánchez, Jesus Carlos and Sanabria Carretero, Pascual and Al Kassam Martínez, Daniel and Pérez Ferrer, Antonio and Muriel Villoria, Clemente and Gilsanz Rodríguez, Fernando},
	date = {2011-09},
	pmid = {21929981},
	keywords = {Biological Markers, Child, Preschool, C-Reactive Protein, Female, Humans, Infection, Male, postoperative complications, Prospective Studies}
}

@article{khan_does_2010,
	title = {Does body mass index/morbid obesity influence outcome in patients who undergo pancreatoduodenectomy for pancreatic adenocarcinoma?},
	volume = {14},
	issn = {1873-4626},
	doi = {10.1007/s11605-010-1285-9},
	abstract = {{INTRODUCTION}: The obesity epidemic coupled with epidemiologic evidence of the link between pancreatic cancer and obesity has raised the interest in the impact of body mass index ({BMI}) on outcomes for resected pancreatic cancer.
{METHODS}: All patients who underwent pancreatoduodenectomy ({PD}) for pancreatic adenocarcinoma from 1981 to 2007 were categorized into four groups according to their {BMI} ({\textless}25, 25 to {\textless}30, 30 to {\textless}35, and ≥35). Associations of these {BMI} groups with perioperative (operating time, blood loss, complications, in-hospital mortality), pathologic (tumor diameter, tumor stage, differentiation, lymph node status, R0 status) features and long-term patient outcome were evaluated using Kruskal-Wallis and chi-square tests, logistic regression, and Cox proportional hazards regression. A second set of analyses were performed by dichotomizing patients into morbidly obese ({BMI} ≥ 35) in comparison to the rest.
{RESULTS}: Of the 586 consecutive patients studied, there were 232 (39.6\%) with {BMI} {\textless}25, 232 (39.6\%) with {BMI} 25 to {\textless}30, 89 (15.2\%) with {BMI} 30 to {\textless}35, and 33 (5.6\%) with {BMI} ≥ 35. Operating time (P = 0.003) and intraoperative blood loss (P {\textless} 0.001) increased with {BMI}, although none of the remaining perioperative features differed significantly among the {BMI} groups. Similarly, there were no significant associations between {BMI} group and the pathological features studied, particularly lymph node status (P= 0.98). {BMI} was not associated with lymph node status even after adjusting for tumor diameter. All analyses were repeated for the morbidly obese. Cox regression did not demonstrate an impact of {BMI} or morbid obesity on overall or disease-free survival.
{CONCLUSIONS}: {BMI} (and morbid obesity) does not appear to influence long-term outcomes for patients undergoing {PD}. Surgeons should be vigilant of the greater risk of perioperative blood loss with increasing {BMI}.},
	pages = {1820--1825},
	number = {11},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Khan, Saboor and Sclabas, Guido and Reid-Lombardo, Kaye and Sarr, Michael G. and Nagorney, David and Kendrick, Michael L. and Que, Florencia G. and Donohue, John H. and Huebner, Marianne and Lohse, Christine and Farnell, Michael B.},
	date = {2010-11},
	pmid = {20676790},
	keywords = {Adenocarcinoma, Aged, Body Mass Index, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Obesity, Morbid, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, Proportional Hazards Models, Survival Rate, Treatment Outcome},
	file = {Khan et al. - 2010 - Does Body Mass IndexMorbid Obesity Influence Outc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\3TKHMMW6\\Khan et al. - 2010 - Does Body Mass IndexMorbid Obesity Influence Outc.pdf:application/pdf}
}

@article{seyama_current_2007,
	title = {Current surgical treatment for bile duct cancer},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17461441},
	abstract = {Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy ({PD}), plus extrahepatic bile duct resection and regional lymphadenectomy has recently been recognized as the standard curative treatment for hilar bile duct cancer. On the other hand, {PD} is the choice of treatment for middle and distal bile duct cancer. Major hepatectomy concomitant with {PD} (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage ({BD}) followed by portal vein embolization ({PVE}) enables major hepatectomy in patients with hilar bile duct cancer without mortality. {BD} should be performed considering the surgical procedure, especially, in patients with separated intrahepatic bile ducts caused by hilar bile duct cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar bile duct cancer with improved resectability, curability, and a 5-year survival rate of 40\%. A 5-year survival rate has ranged from 24\% to 39\% after {PD} for middle and distal bile duct cancer.},
	pages = {1505--15},
	number = {10},
	journaltitle = {World J Gastroenterol},
	author = {Seyama, Yasuji and Makuuchi, Masatoshi},
	date = {2007-03}
}

@article{lefebvre_role_2009,
	title = {Role of Bile Acids and Bile Acid Receptors in Metabolic Regulation},
	volume = {89},
	rights = {Copyright © 2009 the American Physiological Society},
	issn = {0031-9333, 1522-1210},
	url = {http://physrev.physiology.org/content/89/1/147},
	doi = {10.1152/physrev.00010.2008},
	abstract = {The incidence of the metabolic syndrome has taken epidemic proportions in the past decades, contributing to an increased risk of cardiovascular disease and diabetes. The metabolic syndrome can be defined as a cluster of cardiovascular disease risk factors including visceral obesity, insulin resistance, dyslipidemia, increased blood pressure, and hypercoagulability. The farnesoid X receptor ({FXR}) belongs to the superfamily of ligand-activated nuclear receptor transcription factors. {FXR} is activated by bile acids, and {FXR}-deficient ({FXR}−/−) mice display elevated serum levels of triglycerides and high-density lipoprotein cholesterol, demonstrating a critical role of {FXR} in lipid metabolism. In an opposite manner, activation of {FXR} by bile acids ({BAs}) or nonsteroidal synthetic {FXR} agonists lowers plasma triglycerides by a mechanism that may involve the repression of hepatic {SREBP}-1c expression and/or the modulation of glucose-induced lipogenic genes. A cross-talk between {BA} and glucose metabolism was recently identified, implicating both {FXR}-dependent and {FXR}-independent pathways. The first indication for a potential role of {FXR} in diabetes came from the observation that hepatic {FXR} expression is reduced in animal models of diabetes. While {FXR}−/− mice display both impaired glucose tolerance and decreased insulin sensitivity, activation of {FXR} improves hyperglycemia and dyslipidemia in vivo in diabetic mice. Finally, a recent report also indicates that {BA} may regulate energy expenditure in a {FXR}-independent manner in mice, via activation of the G protein-coupled receptor {TGR}5. Taken together, these findings suggest that modulation of {FXR} activity and {BA} metabolism may open new attractive pharmacological approaches for the treatment of the metabolic syndrome and type 2 diabetes.},
	pages = {147--191},
	number = {1},
	journaltitle = {Physiological Reviews},
	author = {Lefebvre, Philippe and Cariou, Bertrand and Lien, Fleur and Kuipers, Folkert and Staels, Bart},
	urldate = {2015-06-03},
	date = {2009-01-01},
	langid = {english},
	pmid = {19126757},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9MMIS89H\\147.html:text/html}
}

@article{zelenka_highly_2008-1,
	title = {Highly sensitive method for quantitative determination of bilirubin in biological fluids and tissues☆},
	volume = {867},
	issn = {15700232},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1570023208001669},
	doi = {10.1016/j.jchromb.2008.03.005},
	pages = {37--42},
	number = {1},
	journaltitle = {Journal of Chromatography B},
	author = {Zelenka, J and Lenicek, M and Muchova, L and Jirsa, M and Kudla, M and Balaz, P and Zadinova, M and Ostrow, J and Wong, R and Vitek, L},
	urldate = {2014-01-27},
	date = {2008-05-01},
	file = {Zelenka et al. - 2008 - Highly sensitive method for quantitative determina.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AKDI9SWR\\Zelenka et al. - 2008 - Highly sensitive method for quantitative determina.pdf:application/pdf}
}

@article{assimakopoulos_pathophysiology_2007,
	title = {Pathophysiology of increased intestinal permeability in obstructive jaundice},
	volume = {13},
	url = {http://www.researchgate.net/publication/5687397_Pathophysiology_of_increased_intestinal_permeability_in_obstructive_jaundice/file/79e415105055389a4f.pdf},
	pages = {6458},
	number = {48},
	journaltitle = {World Journal of Gastroenterology},
	author = {Assimakopoulos, Stelios F. and Scopa, Chrisoula D. and Vagianos, Constantine E.},
	urldate = {2014-01-27},
	date = {2007},
	file = {Assimakopoulos et al. - 2007 - Pathophysiology of increased intestinal permeabili.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TZBGFE5K\\Assimakopoulos et al. - 2007 - Pathophysiology of increased intestinal permeabili.pdf:application/pdf}
}

@article{epstein_analysis_1998,
	title = {Analysis of impaired exercise capacity in patients with cirrhosis},
	volume = {43},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9724156},
	abstract = {Exercise limitation in cirrhosis is typically attributed to a cirrhotic myopathy (without impaired oxygen utilization) and/or a cardiac chronotropic dysfunction. We performed symptom-limited cardiopulmonary exercise testing in 19 cirrhotics without confounding variables (cardiopulmonary disease, beta blockade, anemia, smoking). Twelve concurrently exercised patients without cirrhosis and with normal resting pulmonary function were controls. Oxygen consumption ({VO}2) at peak exercise, at anaerobic threshold ({VO}2-{AT}), work rate ({WR}), and heart rate ({HR}) were measured. Cirrhotics had significantly lower peak {WR} (73+/-4 vs 107+/-7\% predicted, p {\textless} 0.001), {VO}2 (72+/-4 vs 98+/-5\% predicted, P {\textless} 0.001), {VO}2-{AT} (53+/-4 vs 71+/-5\% predicted peak {VO}2, P {\textless} 0.01), {HR} (83+/-2 vs 91+/-2\% predicted, P {\textless} 0.01) and were more likely to have chronotropic dysfunction (peak {HR} {\textless} 85\% predicted). Six cirrhotics had normal aerobic capacity (peak {VO}2 {\textgreater} 80\% predicted), while 13 were abnormal. The abnormals had an earlier {AT} (46+/-2 vs 67+/-3\% predicted peak {VO}2, P {\textless} 0.05) but no difference in peak {HR} percent predicted was found. In conclusion, two thirds of cirrhotics, without confounding factors, have significantly reduced aerobic capacity. Cirrhotic myopathy (without impaired O2 utilization) and cardiac chronotropic dysfunction do not adequately account for the observed decrease in aerobic capacity.},
	pages = {1701--7},
	number = {8},
	journaltitle = {Dig Dis Sci},
	author = {Epstein, S K and Ciubotaru, R L and Zilberberg, M D and Kaplan, L M and Jacoby, C and Freeman, R and Kaplan, M M},
	date = {1998-08},
	file = {Epstein et al. - 1998 - Analysis of impaired exercise capacity in patients.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JJUGA6AX\\Epstein et al. - 1998 - Analysis of impaired exercise capacity in patients.pdf:application/pdf}
}

@article{west_effects_2014,
	title = {The effects of neoadjuvant chemoradiotherapy on physical fitness and morbidity in rectal cancer surgery patients},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798314003862},
	doi = {10.1016/j.ejso.2014.03.021},
	abstract = {{AbstractBackground}
Neoadjuvant chemoradiotherapy ({NACRT}) followed by surgery for resectable locally advanced rectal cancer improves outcome compared with surgery alone. Our primary hypothesis was that {NACRT} impairs objectively-measured physical fitness. We also wished to explore the relationship between fitness and postoperative outcome.
Method
In an observational study, we prospectively studied 27 consecutive patients, of whom 25 undertook cardiopulmonary exercise testing ({CPET}) 2 weeks before and 7 weeks after standardized {NACRT}, then underwent surgery. In-hospital post-operative morbidity and mortality were recorded. Patients were followed up to 1 year for mortality. Data was analysed blind to clinical details. Receiver-operating characteristic ({ROC}) analysis defined the predictive value of {CPET} for in-hospital morbidity at day 5.
Results
Oxygen uptake ( V ˙ O 2 in ml kg−1 min−1) at estimated lactate threshold ( θ ˆ L ) and at peak exercise ( V ˙ O 2 at peak in ml kg−1 min−1) both significantly decreased post-{NACRT}: V ˙ O 2 at θ ˆ L 12.1 (pre-{NACRT}) vs. 10.6 (post-{NACRT}), p \< 0.001 (95\%{CI} −1.7, −1.2); V ˙ O 2 at peak 18.1 vs. 16.7, p \< 0.001 (95\%{CI} −3.1, −1.0). Optimal V ˙ O 2 at θ ˆ L and peak pre-{NACRT} for predicting postoperative morbidity were 12.0 and 18.1 ( V ˙ O 2 at θ ˆ L – {AUC} = 0.71, 77\% sensitive and 75\% specific; V ˙ O 2 at peak – {AUC} = 0.75, 78\% sensitive and 76\% specific). Optimal V ˙ O 2 at θ ˆ L and peak post-{NACRT} for predicting postoperative morbidity were 10.7 and 16.7 ( V ˙ O 2 at θ ˆ L – {AUC} = 0.72, 77\% sensitive and 83\% specific; V ˙ O 2 at peak – {AUC} = 0.80, 85\% sensitive and 83\% specific).
Conclusion
{NACRT} before major rectal cancer surgery significantly decreased physical fitness as assessed by {CPET}.
Trials Registry Number
{NCT}01334593.},
	pages = {1421--1428},
	number = {11},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {West, M. A. and Loughney, L. and Barben, C. P. and Sripadam, R. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2014-11},
	keywords = {Cancer surgery, Cardiopulmonary exercise testing, Morbidity, Neoadjuvant chemoradiotherapy, Physical fitness, rectal cancer},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\24KIMW4W\\West et al. - 2014 - The effects of neoadjuvant chemoradiotherapy on ph.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P2KCN9NS\\S0748798314003862.html:text/html}
}

@article{dixon_factors_1983,
	title = {Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients},
	volume = {24},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6604001},
	pages = {845--52},
	number = {9},
	journaltitle = {Gut},
	author = {Dixon, J M and Armstrong, C P and Duffy, S W and Davies, G C},
	date = {1983-09},
	file = {Dixon et al. - 1983 - Factors affecting morbidity and mortality after su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DKIW6E2C\\Dixon et al. - 1983 - Factors affecting morbidity and mortality after su.pdf:application/pdf}
}

@thesis{tarrant_continuity_2006,
	title = {Continuity, trust and cooperation: a game theory perspective on the {GP}-patient interaction},
	url = {https://lra.le.ac.uk/handle/2381/847},
	shorttitle = {Continuity, trust and cooperation},
	institution = {University of Leicester},
	type = {phdthesis},
	author = {Tarrant, Carolyn Clare},
	urldate = {2015-06-06},
	date = {2006},
	file = {GT.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FKWDVH38\\GT.pdf:application/pdf}
}

@article{chang_debridement_1981,
	title = {Debridement pancreatectomy for pancreatic abscess},
	volume = {142},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7316030},
	abstract = {Experience with seven cases of pancreatic abscess is reviewed. All patients were treated with radical pancreatic debridement, large sump drainage with postoperative irrigation, gastrointestinal defunctionalization, antibiotic therapy and nutritional support. One patient died, for a mortality rate of 14 percent. We feel that this regimen will help maximize survival in patients with pancreatic abscess.},
	pages = {664--6},
	number = {6},
	journaltitle = {Am J Surg},
	author = {Chang, F C and Van Houden, C E},
	date = {1981-12}
}

@article{parks_prospective_1994,
	title = {Prospective study of postoperative renal function in obstructive jaundice and the effect of perioperative dopamine},
	volume = {81},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8173923},
	abstract = {A prospective study was undertaken to assess postoperative renal dysfunction in patients with obstructive jaundice and to determine the effectiveness of dopamine in reducing its incidence. A total of 23 patients undergoing surgical relief of obstructive jaundice (serum bilirubin level above 100 mumol l-1) were randomized into two groups. Those in the control group (n = 10) received 3 litres 5 per cent dextrose intravenously during the 24 h before surgery plus a bolus of intravenous frusemide 1 mg kg-1 at induction of anaesthesia. The second group (n = 13) received a similar fluid and frusemide regimen plus an infusion of dopamine 3 micrograms kg-1 min-1 starting at induction of anaesthesia and continuing for 48 h after surgery. Postoperative oliguria occurred in two of the ten patients in the control group and in three of the 13 given dopamine (P = 0.74). No patient developed acute renal failure. There was no significant difference in mean levels of serum bilirubin, urea and creatinine, creatinine clearance and 24-h urinary output, on the day before and on days 1-5 after operation, between the two groups. It is concluded that, with careful preoperative resuscitation and control of fluid and electrolyte balance, the incidence of postoperative renal dysfunction in patients with obstructive jaundice is not as high as in some previous studies and is unaltered by administration of perioperative low-dose dopamine.},
	pages = {437--9},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Parks, R W and Diamond, T and {McCrory}, D C and Johnston, G W and Rowlands, B J},
	date = {1994-03}
}

@article{tien_risk_2005,
	title = {Risk factors of massive bleeding related to pancreatic leak after pancreaticoduodenectomy},
	volume = {201},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16183493},
	abstract = {Most pancreatic leaks after pancreaticoduodenectomy were initially treated conservatively, and for the most part, they were self-limiting and closed spontaneously. But in a few patients, hemorrhage occurred 1 to 3weeks postoperatively and remained a fatal complication after pancreaticoduodenectomy.},
	pages = {554--9},
	number = {4},
	journaltitle = {J Am Coll Surg},
	author = {Tien, Yu-Wen and Lee, Po-Huang and Yang, Ching-Yao and Ho, Ming-Chih and Chiu, Yen-Feng},
	date = {2005-10}
}

@article{king_effect_1909,
	title = {Effect of the injection of bile on the circulation},
	volume = {11},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19867278},
	abstract = {1. We have confirmed previous work which shows that the injection of bile increases the tone of the vagus nerve, and that this action can be abolished after the administration of atropine. 2. We have found that the amount of bile salts in a lethal dose of pig's bile for dog's will, if inejcted alone, produce neither a fall in blood pressure nor a slowing in rate. 3. We have found that the amount of pigment in a lethal dose of the bile will, if injected alone, cause death with slowing of the heart and lowering of blood pressure. 4. We have found that the bile pigment in combination with calcium or sodium is less toxic than uncombined pigment. 5. We have found that in experimentally produced jaundice the calcium content of the blood is increased, while that of the liver, muscle and brain are decreased. 6. We are of the opinion that increase in calcium in the blood is a protective mechanism against the circulating pigments of obstructive jaundice.},
	pages = {673--85},
	number = {5},
	journaltitle = {J Exp Med},
	author = {King, J H and Stewart, H A},
	date = {1909-09},
	file = {King and Stewart - 1909 - Effect of the injection of bile on the circulation.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9XGG2NED\\King and Stewart - 1909 - Effect of the injection of bile on the circulation.pdf:application/pdf}
}

@article{forrest_prospective_2005,
	title = {A prospective longitudinal study of performance status, an inflammation-based score ({GPS}) and survival in patients with inoperable non-small-cell lung cancer.},
	volume = {92},
	doi = {10.1038/sj.bjc.6602591},
	abstract = {The value of an inflammation-based prognostic score (Glasgow Prognostic score, {GPS}) was compared with performance status ({ECOG}-ps) in a longitudinal study of patients (n=101) with inoperable non-small-cell lung cancer ({NSCLC}). At diagnosis, stratified for treatment, only the {GPS} ({HR} 2.32, 95\% {CI} 1.52-3.54, P{\textless}0.001) was a significant predictor of survival. In contrast, neither the {GPS} nor {ECOG}-ps measured at 3-6 months follow-up were significant predictors of residual survival. This study confirms the prognostic value of the {GPS}, at diagnosis, in patients with inoperable {NSCLC}. However, the role of the {GPS} and},
	pages = {1834--1836},
	number = {10},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Forrest, L. M. and {McMillan}, D. C. and {McArdle}, C. S. and Angerson, W. J. and Dagg, K. and Scott, H. R.},
	date = {2005-05-23},
	pmid = {15870712},
	pmcid = {PMC2361776},
	keywords = {Aged, Carcinoma, Non-Small-Cell Lung/*pathology, Female, Health Status, Humans, Inflammation/*classification, Lung Neoplasms/*pathology, Male, Middle Aged, Neoplasm Staging/*methods, Prognosis, Prospective Studies, Survival Analysis}
}

@article{forshaw_is_2008,
	title = {Is Cardiopulmonary Exercise Testing a Useful Test Before Esophagectomy?},
	volume = {85},
	issn = {00034975},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0003497507011563},
	doi = {10.1016/j.athoracsur.2007.05.062},
	pages = {294--299},
	number = {1},
	journaltitle = {The Annals of Thoracic Surgery},
	author = {Forshaw, Matthew J. and Strauss, Dirk C. and Davies, Andrew R. and Wilson, David and Lams, Boris and Pearce, Adrian and Botha, Abraham J. and Mason, Robert C.},
	urldate = {2015-04-28},
	date = {2008-01},
	langid = {english},
	file = {Forshaw et al. - 2008 - Is Cardiopulmonary Exercise Testing a Useful Test .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RSHDR4X9\\Forshaw et al. - 2008 - Is Cardiopulmonary Exercise Testing a Useful Test .pdf:application/pdf}
}

@article{richards_impact_2011-1,
	title = {The Impact of Perioperative Risk, Tumor Pathology and Surgical Complications on Disease Recurrence After Potentially Curative Resection of Colorectal Cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21572320},
	abstract = {{OBJECTIVE}:: The objective of the study was to identify determinants of disease recurrence after potentially curative resection of colorectal cancer. {SUMMARY} {BACKGROUND} {DATA}:: The identification of patients at increased risk of disease recurrence is currently based on pathological factors. Recently, there has been considerable interest in the potential impact of perioperative factors on long-term colorectal cancer outcome. Few studies have examined pre-, intra-, and postoperative variables in a single cohort. {METHODS}:: Four hundred and twenty-three patients with histologically confirmed colorectal cancer who underwent surgery with curative intent between 1997 and 2007 were included. Pre-, intra-, and postoperative variables were recorded. Logistic and Cox regression analyses were performed to identify predictors of surgical complications and disease recurrence, respectively. {RESULTS}:: The postoperative mortality rate was 4\% and the morbidity rate 34\%. The most important predictors of complications were smoking (odd ratio [{OR}] 1.32), {ASA} grade ({OR} 1.90) and {POSSUM} operative score ({OR} 1.32). During follow up (median 80 months), 35\% of patients developed disease recurrence. Predictors of recurrence, independent of tumor stage, were {POSSUM} physiology score (hazard ratio [{HR}] 1.31) and systemic inflammatory response ({HR} 1.31). {CONCLUSIONS}:: Preoperative risk factors, but not postoperative complications, are associated with early disease recurrence after potentially curative resection of colorectal cancer.},
	journaltitle = {Ann Surg},
	author = {Richards, Colin H and Platt, Jonathan J and Anderson, John H and {McKee}, Ruth F and Horgan, Paul G and {McMillan}, Donald C},
	date = {2011-05}
}

@article{neoptolemos_adjuvant_2001,
	title = {Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial},
	volume = {358},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11716884},
	abstract = {{BACKGROUND}: The role of adjuvant treatment in pancreatic cancer remains uncertain. The European Study Group for Pancreatic Cancer ({ESPAC}) assessed the roles of chemoradiotherapy and chemotherapy in a randomised study. {METHODS}: After resection, patients were randomly assigned to adjuvant chemoradiotherapy (20 Gy in ten daily fractions over 2 weeks with 500 mg/m(2) fluorouracil intravenously on days 1-3, repeated after 2 weeks) or chemotherapy (intravenous fluorouracil 425 mg/m(2) and folinic acid 20 mg/m(2) daily for 5 days, monthly for 6 months). Clinicians could randomise patients into a two-by-two factorial design (observation, chemoradiotherapy alone, chemotherapy alone, or both) or into one of the main treatment comparisons (chemoradiotherapy versus no chemoradiotherapy or chemotherapy versus no chemotherapy). The primary endpoint was death, and all analyses were by intention to treat. Findings 541 eligible patients with pancreatic ductal adenocarcinoma were randomised: 285 in the two-by-two factorial design (70 chemoradiotherapy, 74 chemotherapy, 72 both, 69 observation); a further 68 patients were randomly assigned chemoradiotherapy or no chemoradiotherapy and 188 chemotherapy or no chemotherapy. Median follow-up of the 227 (42\%) patients still alive was 10 months (range 0-62). Overall results showed no benefit for adjuvant chemoradiotherapy (median survival 15.5 months in 175 patients with chemoradiotherapy vs 16.1 months in 178 patients without; hazard ratio 1.18 [95\% {CI} 0.90-1.55], p=0.24). There was evidence of a survival benefit for adjuvant chemotherapy (median survival 19.7 months in 238 patients with chemotherapy vs 14.0 months in 235 patients without; hazard ratio 0.66 [0.52-0.83], p=0.0005). Interpretation This study showed no survival benefit for adjuvant chemoradiotherapy but revealed a potential benefit for adjuvant chemotherapy, justifying further randomised controlled trials of adjuvant chemotherapy in pancreatic cancer.},
	pages = {1576--85},
	number = {9293},
	journaltitle = {Lancet},
	author = {Neoptolemos, J P and Dunn, J A and Stocken, D D and Almond, J and Link, K and Beger, H and Bassi, C and Falconi, M and Pederzoli, P and Dervenis, C and Fernandez-Cruz, L and Lacaine, F and Pap, A and Spooner, D and Kerr, D J and Friess, H and Büchler, M W},
	date = {2001-11},
	file = {Neoptolemos et al. - 2001 - Adjuvant chemoradiotherapy and chemotherapy in res.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\REE6KG66\\Neoptolemos et al. - 2001 - Adjuvant chemoradiotherapy and chemotherapy in res.pdf:application/pdf}
}

@article{west_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise variables are associated with postoperative morbidity after major colonic surgery: a prospective blinded observational study},
	volume = {112},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/content/112/4/665},
	doi = {10.1093/bja/aet408},
	shorttitle = {Cardiopulmonary exercise variables are associated with postoperative morbidity after major colonic surgery},
	abstract = {Background Postoperative complications are associated with reduced fitness. Cardiopulmonary exercise testing ({CPET}) has been used in risk stratification. We investigated the relationship between preoperative {CPET} and in-hospital morbidity in major colonic surgery.
Methods We prospectively studied 198 patients undergoing major colonic surgery (excluding neoadjuvant cancer therapy), performing preoperative {CPET} (reported blind to clinical state), and recording morbidity (assessed blind to {CPET}), postoperative outcome, and length of stay.
Results Of 198 patients, 62 were excluded: 11 had emergency surgery, 25 had no surgery, 23 had incomplete data, and three were unable to perform {CPET}. One hundred and thirty-six (89 males, 47 females) were available for analysis. The median age was 71 [inter-quartile range ({IQR}) 62–77] yr. Sixty-five patients (48\%) had a complication at day 5 after operation. Measurements significantly lower in patients with complications than those without were O2 uptake (V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} ) at estimated lactate threshold (θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} ) [median 9.9 ({IQR} 8.3–12.7) vs 11.2 (9.5–14.2) ml kg−1 min−1, P{\textless}0.01], V˙O2\{{\textbackslash}rm\{{\textbackslash}dot {VO}\}\}\_\{{\textbackslash}rm 2\} at peak [15.2 (12.6–18.1) vs 17.2 (13.7–22.5) ml kg−1 min−1, P=0.01], and ventilatory equivalent for {CO}2 (V˙E{\textbackslash}dot V\_\{{\textbackslash}rm E\} /V˙{CO}2\{{\textbackslash}rm{\textbackslash}dot {VCO}\}\_\{{\textbackslash}rm 2\} ) at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} [31.3 (28.0–34.8) vs 33.9 (30.0–39.1), P{\textless}0.01]. A final multivariable logistic regression model contained V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} \{one-point change odds ratio ({OR}) 0.77 [95\% confidence interval ({CI}) 0.66–0.89], P{\textless}0.0005; two-point change {OR} 0.61 (0.46–0.81) and gender [{OR} 4.42 (1.78–9.88), P=0.001]\}, and was reasonably able to discriminate those with and without complications ({AUC} 0.71, {CI} 0.62–0.80, 68\% sensitivity, 65\% specificity).
Conclusions {CPET} variables are associated with postoperative morbidity. A multivariable model with V˙O2\{{\textbackslash}rm {\textbackslash}dot {VO}\}\_\{{\textbackslash}rm 2\} at θ{\textasciicircum}L{\textbackslash}hat {\textbackslash}theta \_\{{\textbackslash}rm L\} and gender discriminates those with complications after colonic surgery.},
	pages = {665--671},
	number = {4},
	journaltitle = {British Journal of Anaesthesia},
	shortjournal = {Br. J. Anaesth.},
	author = {West, M. A. and Lythgoe, D. and Barben, C. P. and Noble, L. and Kemp, G. J. and Jack, S. and Grocott, M. P. W.},
	urldate = {2015-05-05},
	date = {2014-04-01},
	langid = {english},
	pmid = {24322573},
	keywords = {anaerobic threshold, cardiopulmonary exercise test, colorectal surgery, Morbidity, postoperative complications},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\GU56PI6W\\665.html:text/html;West et al. - 2014 - Cardiopulmonary exercise variables are associated .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6BDRQSH3\\West et al. - 2014 - Cardiopulmonary exercise variables are associated .pdf:application/pdf}
}

@article{mcmillan_prospective_1995,
	title = {A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery.},
	volume = {170},
	abstract = {{BACKGROUND}: Approximately 70\% of patients who are going to develop tumor recurrence following curative colorectal surgery do so within 24 months of surgery. {PATIENTS} {AND} {METHODS}: The relationship was prospectively examined between an ongoing acute-phase response and subsequent clinical relapse in 36 colorectal cancer patients who had undergone a curative resection. Approximately  4 months after their operation, patients were grouped according to the presence (n = 15) or absence (n = 21) of an acute-phase response (C-reactive protein {\textgreater} 5 mg/L) and were followed-up for a minimum of 24 months. {RESULTS}: Age, tumor site,  and serum carcinoembryonic antigen concentrations were similar in both groups. There was a significantly higher recurrence rate in patients with an acute-phase  response (11 of 15) compared to those with no acute-phase response (2 of 21, P {\textless}  0.01). {CONCLUSIONS}: These results are consistent with the presence of an acute-phase response being an important predictive factor in the early stages of  tumor recurrence in patients who have had apparently curative colorectal surgery.},
	pages = {319--322},
	number = {4},
	journaltitle = {American journal of surgery},
	shortjournal = {Am J Surg},
	author = {{McMillan}, D. C. and Wotherspoon, H. A. and Fearon, K. C. and Sturgeon, C. and Cooke, T. G. and {McArdle}, C. S.},
	date = {1995-10},
	pmid = {7573721},
	keywords = {*Neoplasm Recurrence, Local/blood, Acute-Phase Reaction/*etiology, Adult, Aged, Aged, 80 and over, Carcinoembryonic Antigen/analysis, Colorectal Neoplasms/blood/pathology/*surgery, C-Reactive Protein/analysis, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Prospective Studies, Treatment Outcome}
}

@article{carli_optimizing_2005,
	title = {Optimizing functional exercise capacity in the elderly surgical population},
	volume = {8},
	issn = {1363-1950},
	abstract = {{PURPOSE} {OF} {REVIEW}: There are several studies on the effect of exercise post surgery (rehabilitation), but few studies have looked at augmenting functional capacity prior to surgical admission (prehabilitation). A programme of prehabilitation is proposed in order to enhance functional exercise capacity in elderly patients with the intent to minimize the postoperative morbidity and accelerate postsurgical recovery.
{RECENT} {FINDINGS}: Few studies have looked at exercise prehabilitation to improve functional capacity prior to surgical admission. Prehabilitation prior to orthopaedic surgery does not seem to improve quality of life or recovery. However, prehabilitation prior to abdominal or cardiac surgery, based on 275 elderly patients, results in fewer postoperative complications, shorter postoperative length of stay, improved quality of life, and reduced declines in functional disability compared to sedentary controls.
{SUMMARY}: A concentrated 3-month progressive exercise prehabilitation programme consisting of aerobic training at 45-65\% of maximal heart rate reserve (\%{HRR}) along with periodic high-intensity interval training ( approximately 90\% {HRR}) four times per week, 30-50 minutes per session, is recommended for improving cardiovascular functioning. A strength training programme of about 10 different exercises focused on large, multi-jointed muscle groups should also be implemented twice per week at a mean training intensity of 80\% of one-repetition maximum. Finally, a minimum of 140 g ( approximately 560 kcal) of carbohydrate ({CHO}) should be taken 3 h before training to increase liver and muscle glycogen stores and a minimum of about 200 kcal of mixed protein-{CHO} should be ingested within 30 min following training to enhance muscle hypertrophy.},
	pages = {23--32},
	number = {1},
	journaltitle = {Current Opinion in Clinical Nutrition and Metabolic Care},
	shortjournal = {Curr Opin Clin Nutr Metab Care},
	author = {Carli, Franco and Zavorsky, Gerald S.},
	date = {2005-01},
	pmid = {15585997},
	keywords = {Activities of Daily Living, Adaptation, Physiological, Aged, Aged, 80 and over, Exercise, Exercise Therapy, Humans, length of stay, Postoperative Period, preoperative care, Quality of Life}
}

@article{ausania_effects_2012,
	title = {Effects of low cardiopulmonary reserve on pancreatic leak following pancreaticoduodenectomy},
	volume = {99},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22828960},
	abstract = {Postoperative complications are increased in patients with reduced cardiopulmonary reserve undergoing major surgery. Pancreatic leak is an important contributor to postoperative complications and death following pancreaticoduodenectomy. The aim of this study was to determine whether reduced cardiopulmonary reserve was a risk factor for pancreatic leak.},
	pages = {1290--4},
	number = {9},
	journaltitle = {Br J Surg},
	author = {Ausania, F and Snowden, C P and Prentis, J M and Holmes, L R and Jaques, B C and White, S A and French, J J and Manas, D M and Charnley, R M},
	date = {2012-09},
	file = {Ausania et al. - 2012 - Effects of low cardiopulmonary reserve on pancreat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\U5HN8K57\\Ausania et al. - 2012 - Effects of low cardiopulmonary reserve on pancreat.pdf:application/pdf}
}

@article{keshavan_unconjugated_2004,
	title = {Unconjugated bilirubin induces apoptosis in colon cancer cells by triggering mitochondrial depolarization},
	volume = {112},
	issn = {0020-7136, 1097-0215},
	url = {http://doi.wiley.com/10.1002/ijc.20418},
	doi = {10.1002/ijc.20418},
	pages = {433--445},
	number = {3},
	journaltitle = {International Journal of Cancer},
	author = {Keshavan, Pavitra and Schwemberger, Sandy J. and Smith, Darcey L.H. and Babcock, George F. and Zucker, Stephen D.},
	urldate = {2014-01-27},
	date = {2004-11-10},
	file = {Keshavan et al. - 2004 - Unconjugated bilirubin induces apoptosis in colon .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\9K6PANWP\\Keshavan et al. - 2004 - Unconjugated bilirubin induces apoptosis in colon .pdf:application/pdf}
}

@article{wente_delayed_2007,
	title = {Delayed gastric emptying ({DGE}) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery ({ISGPS})},
	volume = {142},
	issn = {00396060},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0039606007003017},
	doi = {10.1016/j.surg.2007.05.005},
	shorttitle = {Delayed gastric emptying ({DGE}) after pancreatic surgery},
	pages = {761--768},
	number = {5},
	journaltitle = {Surgery},
	author = {Wente, Moritz N. and Bassi, Claudio and Dervenis, Christos and Fingerhut, Abe and Gouma, Dirk J. and Izbicki, Jakob R. and Neoptolemos, John P. and Padbury, Robert T. and Sarr, Michael G. and Traverso, L. William and Yeo, Charles J. and Büchler, Markus W.},
	urldate = {2014-01-27},
	date = {2007-11},
	file = {Wente et al. - 2007 - Delayed gastric emptying (DGE) after pancreatic su.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8HXV2985\\Wente et al. - 2007 - Delayed gastric emptying (DGE) after pancreatic su.pdf:application/pdf}
}

@article{fasol_influence_1992,
	title = {The influence of obesity on perioperative morbidity: retrospective study of 502 aortocoronary bypass operations},
	volume = {40},
	issn = {0171-6425},
	doi = {10.1055/s-2007-1020129},
	shorttitle = {The influence of obesity on perioperative morbidity},
	abstract = {The incidence of perioperative complications after coronary artery surgery was investigated by a retrospective study of all 502 patients undergoing coronary artery bypass graft ({CABG}) surgery in our Department between January 1st and December 31st of last year (1990). Furthermore, the influence of obesity on the early results of surgery was assessed and the effect of preoperative weight reduction on perioperative complication rates examined. Obese patients had a greater incidence of left-stem coronary artery stenosis (p less than 0.001), hyperlipidaemia (p less than 0.05), hypertension (p less than 0.05), diabetes mellitus (p less than 0.02), and were in general younger at the time of operation (57.9 +/- 8.4 vs. 60.8 +/- 8.5 years). There were no differences in the surgery performed and in operative mortality, but there were some in perioperative morbidity. Obese patients had higher rates of infection (p less than 0.02), sternal dehiscence (p less than 0.02), arrhythmias (p less than 0.02) and myocardial infarction (p less than 0.02). No significant differences were identified in obese patients with or without preoperative weight reduction, although there was a trend of better postoperative recovery and results in patients having undergone preoperative weight reduction. Analysis of our results demonstrated obesity to be an independent risk factor for perioperative complications, hospital morbidity, and length of hospitalization.},
	pages = {126--129},
	number = {3},
	journaltitle = {The Thoracic and Cardiovascular Surgeon},
	shortjournal = {Thorac Cardiovasc Surg},
	author = {Fasol, R. and Schindler, M. and Schumacher, B. and Schlaudraff, K. and Hannes, W. and Seitelberger, R. and Schlosser, V.},
	date = {1992-06},
	pmid = {1412377},
	keywords = {Aged, Coronary Artery Bypass, Coronary Disease, Humans, Middle Aged, Morbidity, Obesity, postoperative complications, preoperative care, Retrospective Studies, Weight Loss}
}

@article{mcmillan_longitudinal_1998,
	title = {Longitudinal study of body cell mass depletion and the inflammatory response in cancer patients.},
	volume = {31},
	doi = {10.1080/01635589809514687},
	abstract = {There is recent evidence that the inflammatory response may be important in the disproportionate loss of body cell mass in cancer patients. To examine this further, 18 male patients with lung or gastrointestinal cancer were studied over  a 12-week period. In addition to weight, anthropometry, C-reactive protein (marker of the inflammatory response), albumin, and total body potassium were measured at baseline and 12 weeks. When those patients who lost total body potassium were compared with those who had not, there was a significant increase  in the baseline and 12-week C-reactive protein concentrations (p {\textless} 0.05). The reduction in total body potassium was also associated with a reduction in triceps skinfold thickness (p {\textless} 0.05). There were significant correlations between the mean C-reactive protein concentration and the relative (r = -0.846, p {\textless} 0.001) and absolute (r = -0.806, p {\textless} 0.001) change in total body potassium over the follow-up period. This study demonstrates the association of a chronic inflammatory response with the rate of loss of body cell mass observed in cancer  patients.},
	pages = {101--105},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {{McMillan}, D. C. and Scott, H. R. and Watson, W. S. and Preston, T. and Milroy, R. and {McArdle}, C. S.},
	date = {1998},
	pmid = {9770720},
	keywords = {Aged, Albumins/*metabolism, Body Weight, C-Reactive Protein/*metabolism, Disease Progression, Gastrointestinal Neoplasms/*metabolism, Humans, Longitudinal Studies, Lung Neoplasms/*metabolism, Male, Middle Aged, Potassium/*metabolism}
}

@article{barber_modulation_2004,
	title = {Modulation of the liver export protein synthetic response to feeding by an n-3 fatty-acid-enriched nutritional supplement is associated with anabolism in cachectic cancer patients.},
	volume = {106},
	doi = {10.1042/CS20030301},
	abstract = {The acute-phase protein response is associated with accelerated weight loss and shortened survival in cancer. This may be due to hepatic protein synthesis increasing demand for amino acids. An n -3 fatty-acid-enriched nutritional supplement will moderate aspects of cachexia in cancer patients. The present study examined the effect of such a supplement on hepatic synthesis of albumin and fibrinogen. Albumin and fibrinogen synthesis were measured in the fed and fasting state in eight weight-losing patients with pancreatic cancer by an intravenous flooding dose technique. Tracer incorporation into proteins was measured by {GC}/{MS}. Patients were restudied after 3 weeks of oral supplement enriched with fish oil (providing 2510 {kJ}/day and 2 g of eicosapentaenoic acid/day). At baseline, all patients were losing weight (median, 2.4 kg/month). After 3 weeks of consumption of the fish-oil-enriched nutritional supplement, patients' weight stabilized (median change, +1 kg; P = 0.01). At baseline, albumin and fibrinogen synthesis rates were stimulated in the fed compared with the fasting state [14.2 compared with 11.3 g/day (29\% rise; P = 0.01) and 4.5 compared with 3.3 g/day (38\% rise; P = 0.01) respectively]. After 3 weeks of the  supplement, this stimulation in the fed state was no longer observed for albumin  and was reduced for fibrinogen [11.2 compared with 10.5 g/day (3\% rise; P = 0.21) and 3.7 compared with 2.9 g/day (17\% rise; P = 0.01) respectively]. After 3 weeks, the combined albumin plus fibrinogen synthetic rate tended to fall in the  fasting state (14.7 compared with 12.3 g/day; P = 0.09) and was significantly reduced in the fed state (18.7 compared with 14.6 g/day; P = 0.01). Modulation of hepatic export protein synthesis with feeding may have contributed to the net whole-body anabolism observed with administration of the n -3 fatty-acid-enriched oral supplement.},
	pages = {359--364},
	number = {4},
	journaltitle = {Clinical science (London, England : 1979)},
	shortjournal = {Clin Sci (Lond)},
	author = {Barber, Matthew D. and Preston, Tom and {McMillan}, Donald C. and Slater, Christine and Ross, James A. and Fearon, Kenneth C. H.},
	date = {2004-04},
	pmid = {14624668},
	keywords = {*Dietary Supplements, Aged, Albumins/biosynthesis, Cachexia/*diet therapy, Chi-Square Distribution, Fasting, Fatty Acids, Omega-3/*administration \& dosage, Female, Fibrinogen/biosynthesis, Humans, Liver/*metabolism, Male, Middle Aged, Nitrogen/metabolism, Pancreatic Neoplasms/*complications/diet therapy, Phenylalanine/diagnostic use, Statistics, Nonparametric}
}

@article{al_murri_evaluation_2007,
	title = {Evaluation of the relationship between the systemic inflammatory response and cancer-specific survival in patients with primary operable breast cancer.},
	volume = {96},
	doi = {10.1038/sj.bjc.6603682},
	abstract = {The relationship between the systemic inflammatory response (as evidenced by elevated C-reactive protein and lowered albumin concentrations), clinico-pathologic status and relapse-free, cancer-specific and overall survival  was examined in patients with invasive primary operable breast cancer (n=300). The median follow-up of the survivors was 46 months. During this period, 37 patients relapsed and 25 died of their cancer. On multivariate analysis, only tumour size (P{\textless}0.05), albumin (P{\textless}0.01) and systemic treatment (P{\textless}0.0001) were significant independent predictors of relapse-free, cancer-specific and overall survival. Lower serum albumin concentrations ({\textless}or=43 g l(-1)) were associated with deprivation (P{\textless}0.05), hormonal receptor negative tumours (P{\textless}0.01) and significantly poorer 3-year relapse-free (85 vs 93\%, P=0.001) cancer-specific (87 vs 97\%, P{\textless}0.0001) and overall survival (84 vs 94\%, P=0.001) rates. The results of the present study suggest that lower preoperative albumin concentrations, but not elevated C-reactive protein concentrations, predict relapse-free, cancer-specific and overall survival, independent of clinico-pathologic status and treatment in patients undergoing potentially curative surgery for primary operable breast cancer.},
	pages = {891--895},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Al Murri, A. M. and Wilson, C. and Lannigan, A. and Doughty, J. C. and Angerson, W. J. and {McArdle}, C. S. and {McMillan}, D. C.},
	date = {2007-03-26},
	pmid = {17375036},
	pmcid = {PMC2360103},
	keywords = {Adult, Breast Neoplasms/blood/*pathology/*surgery, Carcinoma, Ductal/pathology/surgery, C-Reactive Protein/metabolism, Disease-Free Survival, Female, Humans, Inflammation/blood/pathology, Leukocyte Count, Middle Aged, Neoplasm Staging, Serum Albumin/metabolism, Survival Rate}
}

@article{riall_resection_2011,
	title = {Resection Benefits Older Adults with Locoregional Pancreatic Cancer Despite Greater Short-Term Morbidity and Mortality},
	volume = {59},
	issn = {0002-8614},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156667/},
	doi = {10.1111/j.1532-5415.2011.03353.x},
	abstract = {{OBJECTIVES}
To evaluate time trends in surgical resection rates and operative mortality in older adults diagnosed with locoregional pancreatic cancer and to determine the effect of age on surgical resection rates and 2-year survival after surgical resection.

{DESIGN}
Retrospective cohort study using data from the Surveillance, Epidemiology, and End Results ({SEER}) and linked Medicare claims database (1992–2005).

{SETTING}
Secondary data analysis of population-based tumor registry and linked claims data.

{PARTICIPANTS}
Medicare beneficiaries aged 66 and older diagnosed with locoregional pancreatic cancer (N = 9,553), followed from date of diagnosis to time of death or censorship.

{MEASUREMENTS}
Percentage of participants undergoing surgical resection, 30-day operative mortality after resection, and 2-year survival according to age group.

{RESULTS}
Surgical resection rates increased significantly, from 20\% in 1992 to 29\% in 2005, whereas 30-day operative mortality rates decreased from 9\% to 5\%. After controlling for multiple factors, participants were less likely to be resected with older age. Resection was associated with lower hazard of death, regardless of age, with hazard ratios of 0.46, 0.51, 0.47, 0.43, and 0.35 for resected participants younger than 70, 70 to 74, 75 to 79, 80 to 84, and 85 and older respectively compared with unresected participants younger than 70 (P{\textless}.001).

{CONCLUSION}
With older age, fewer people with pancreatic cancer undergo surgical resection, even after controlling for comorbidity and other factors. This study demonstrated increased resection rates over time in all age groups, along with lower surgical mortality rates. Despite previous reports of greater morbidity and mortality after pancreatic resection in older adults, the benefit of resection does not diminish with older age in selected people.},
	pages = {647--654},
	number = {4},
	journaltitle = {Journal of the American Geriatrics Society},
	shortjournal = {J Am Geriatr Soc},
	author = {Riall, Taylor S. and Sheffield, Kristin M. and Kuo, Yong-Fang and Townsend, Courtney M. and Goodwin, James S.},
	urldate = {2015-05-26},
	date = {2011-04},
	pmid = {21453378},
	pmcid = {PMC3156667},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8E36QZZN\\Riall et al. - 2011 - Resection Benefits Older Adults with Locoregional .pdf:application/pdf}
}

@article{quasim_relationship_2004,
	title = {The relationship between leptin concentrations, the systemic inflammatory response and illness severity in surgical patients admitted to {ITU}.},
	volume = {23},
	doi = {10.1016/j.clnu.2003.07.002},
	abstract = {{BACKGROUND} \& {AIMS}: The relationship between circulation leptin concentrations, mediators of the systemic inflammatory response and illness severity in critically ill patients remains unclear. The aim of the present study was to examine these relationships in critically ill surgical patients admitted to the intensive therapy unit ({ITU}). {PATIENTS} {AND} {METHODS}: Patients (n = 38) who had undergone surgery and subsequently admitted to {ITU} were prospectively entered into a cross-sectional study. Circulating concentrations of leptin, cortisol, growth hormone, interleukin-6, C-reactive protein and albumin were measured. Sex  and age matched controls (n = 14) were also studied. {RESULTS}: On day 1, the critically ill group had lower {BMI} and leptin concentrations and a pronounced systemic inflammatory response compared with controls. There was a weak positive  correlation between leptin concentrations and {BMI} in the critically ill patients  (r = 0.42, P{\textless}0.10). In contrast, leptin was inversely correlated with C-reactive  protein (r = -0.59, P{\textless}0.05) but not with cortisol, growth hormone, interleukin-6, {APACHE} {II} or predicted mortality. Leptin concentrations did not alter with the day of admission to {ITU}. {CONCLUSIONS}: On {ITU} admission, leptin concentrations appeared to be low for {BMI}, related to the magnitude of the systemic inflammatory response but did not appear to be regulated by proposed mediators in critically ill surgical patients.},
	pages = {233--238},
	number = {2},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {Quasim, Tara and {McMillan}, Donald C. and Wallace, A. Michael and Kinsella, John},
	date = {2004-04},
	pmid = {15030963},
	keywords = {*Intensive Care Units, *Severity of Illness Index, Adult, Aged, Body Mass Index, Critical Illness, Female, Humans, Inflammation/*blood, Leptin/*blood, Male, Middle Aged, Postoperative Care, Respiration, Artificial}
}

@article{welsch_c-reactive_2007,
	title = {C-reactive protein as early predictor for infectious postoperative complications in rectal surgery},
	volume = {22},
	issn = {0179-1958, 1432-1262},
	url = {http://link.springer.com/article/10.1007/s00384-007-0354-3},
	doi = {10.1007/s00384-007-0354-3},
	abstract = {Background This study evaluated the role of the acute phase C-reactive protein ({CRP}) in the postoperative course of a large series of rectal resections on the basis of a prospective database. Main focus of this study was the early identification of complications. Materials and methods Three hundred eighty-three rectal resections with primary anastomosis for rectal cancer were screened for infectious postoperative complications. Forty-eight complicated cases were identified and matched with 48 patients with an uneventful postoperative course. Results In the postoperative setting, {CRP} peaked on postoperative day ({POD}) 2 with a median serum {CRP} of 140 mg/l and gradually declined thereafter in uncomplicated cases. In complicated cases, {CRP} elevation generally persisted after {POD} 2, whereas white blood cells and body temperature were within normal range in the early postoperative period. A cutoff {CRP} value of 140 mg/dl on {PODs} 3 and 4 resulted in predictive values of 85.7 and 90.5\% (adjusted to the prevalence: 37.6 and 50.3\%), sensitivities of 80.0 and 54.3\%, and specificities of 81.0 and 92.3\% for a complicated postoperative course (P {\textless} 0.001), respectively. Conclusion Persistent {CRP} elevation and elevation of serum {CRP} above 140 mg/dl on {PODs} 3–4 are predictive of infectious postoperative complications and should prompt intense clinical search for an inflammatory process, especially for an anastomotic leak if pneumonia and wound infection are unlikely or excluded.},
	pages = {1499--1507},
	number = {12},
	journaltitle = {International Journal of Colorectal Disease},
	shortjournal = {Int J Colorectal Dis},
	author = {Welsch, T. and Müller, S. A. and Ulrich, A. and Kischlat, A. and Hinz, U. and Kienle, P. and Büchler, M. W. and Schmidt, J. and Schmied, B. M.},
	urldate = {2015-05-23},
	date = {2007-07-17},
	langid = {english},
	keywords = {Anastomotic leak, C-Reactive Protein, Gastroenterology, Hepatology, Internal Medicine, postoperative complications, Proctology, Rectal surgery, surgery},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZMG6DPG6\\s00384-007-0354-3.html:text/html}
}

@article{colice_physiologic_2007,
	title = {Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: {ACCP} evidenced-based clinical practice guidelines},
	volume = {132},
	url = {http://journal.publications.chestnet.org/article.aspx?articleid=1211612},
	shorttitle = {Physiologic evaluation of the patient with lung cancer being considered for resectional surgery},
	pages = {161S--177S},
	number = {3},
	journaltitle = {{CHEST} Journal},
	author = {Colice, Gene L. and Shafazand, Shirin and Griffin, John P. and Keenan, Robert and Bolliger, Chris T.},
	urldate = {2015-06-05},
	date = {2007},
	file = {zcb10907000161.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KH58MBW9\\zcb10907000161.pdf:application/pdf}
}

@article{neoptolemos_adjuvant_2009,
	title = {Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the {ESPAC}-1 and -3(v1) trials},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19127260},
	abstract = {The {ESPAC}-1, {ESPAC}-1 plus, and early {ESPAC}-3(v1) results (458 randomized patients; 364 deaths) were used to estimate the effectiveness of adjuvant 5FU/{FA} vs resection alone for pancreatic cancer using meta-analysis. The pooled hazard ratio of 0.70 (95\% {CI}=0.55-0.88) P=0.003, and the median survival of 23.2 (95\% {CI}=20.1-26.5) months with 5FU/{FA} vs 16.8 (95\% {CI}=14.3-19.2) months with resection alone supports the use of adjuvant 5FU/{FA} in pancreatic cancer.},
	pages = {246--50},
	number = {2},
	journaltitle = {Br J Cancer},
	author = {Neoptolemos, J P and Stocken, D D and Tudur Smith, C and Bassi, C and Ghaneh, P and Owen, E and Moore, M and Padbury, R and Doi, R and Smith, D and Büchler, M W},
	date = {2009-01},
	file = {Neoptolemos et al. - 2009 - Adjuvant 5-fluorouracil and folinic acid vs observ.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2QCXDJ52\\Neoptolemos et al. - 2009 - Adjuvant 5-fluorouracil and folinic acid vs observ.pdf:application/pdf}
}

@article{barber_response_2004,
	title = {The response of leptin, interleukin-6 and fat oxidation to feeding in weight-losing patients with pancreatic cancer.},
	volume = {90},
	doi = {10.1038/sj.bjc.6601712},
	abstract = {At baseline, weight-losing pancreatic cancer patients (n=7) had lower leptin (P{\textless}0.05) but higher cortisol, interleukin-6, resting energy expenditure and fat oxidation than healthy subjects (n=6, P{\textless}0.05). Over a 4 h feeding period, the areas under the curve for glucose, cortisol and interleukin-6 were greater (P{\textless}0.05), but less for leptin in the cancer group (P{\textless}0.05). Therefore, it would appear that low leptin concentrations, increased fat oxidation and insulin resistance are associated with increased concentrations of cortisol and interleukin-6 in weight-losing patients with pancreatic cancer.},
	pages = {1129--1132},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Barber, M. D. and {McMillan}, D. C. and Wallace, A. M. and Ross, J. A. and Preston, T. and Fearon, K. C. H.},
	date = {2004-03-22},
	pmid = {15026790},
	pmcid = {PMC2409662},
	keywords = {*Diet, Blood Glucose, Energy Metabolism, Fats/metabolism, Female, Humans, Hydrocortisone/blood/pharmacology, Insulin Resistance, Interleukin-6/*blood/pharmacology, Leptin/*blood/pharmacology, Male, Middle Aged, Oxidation-Reduction, Pancreatic Neoplasms/*pathology, Weight Loss/*physiology}
}

@article{miwa_is_2007,
	title = {Is major hepatectomy with pancreatoduodenectomy justified for advanced biliary malignancy?},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17384903},
	abstract = {{BACKGROUND}/{PURPOSE}: Major hepatectomy with concomitant pancreatoduodenectomy (M-{HPD}) is usually indicated for the resection of diffuse bile duct cancer or advanced gallbladder cancer. This is the only procedure that can potentially cure such advanced cancers, so both a low mortality rate and long-term survival could potentially justify performing this procedure. {METHODS}: Between 1990 and 2005, the morbidity, mortality, and long-term survival of 26 patients with advanced biliary tract carcinoma 14 with diffuse bile duct cancer, 9 with advanced gallbladder cancer, and 3 with hilar bile duct cancer, who underwent hepatopancreatoduodectomy ({HPD}) were reviewed and analyzed. {RESULTS}: The overall morbidity and mortality rates were 30.8\% and 0\%, respectively. Postoperative infectious complications occurred in 6 patients (23.0\%). The 5-year survival rate of the 14 patients with diffuse bile duct cancer who underwent {HPD} was 51.9\%, while the 5-year survival rate in the 12 of these patients who underwent M-{HPD} was 61.4\%. Patients with diffuse bile duct cancer without residual tumor and those without lymph node metastasis had 5-year survival rates of 68.6\% and 80\%, respectively. Thirty-three percent (2 of 6) of the patients who underwent M-{HPD} for advanced gallbladder cancer survived for more than 5 years. {CONCLUSIONS}: Preoperative biliary drainage, portal embolization, complete external drainage of pancreatic juice, reduction of intraoperative bleeding, and prevention of bacterial colonization of bile may enable the incidence of mortality and hepatic failure to approach zero in patients who undergo {HPD}. Surgeons should strive for complete clearance of the tumor with a negative surgical margin to achieve long-term survival when performing M-{HPD}.},
	pages = {136--41},
	number = {2},
	journaltitle = {J Hepatobiliary Pancreat Surg},
	author = {Miwa, Shiro and Kobayashi, Akira and Akahane, Yasuhiko and Nakata, Takenari and Mihara, Motohiro and Kusama, Kei and Ogawa, Shinichiro and Soeda, Junpei and Miyagawa, Shinichi},
	date = {2007}
}

@article{kanoupakis_left_2001,
	title = {Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity},
	volume = {11},
	issn = {0960-8923},
	doi = {10.1381/09608920160556715},
	abstract = {{BACKGROUND}: It is well established that morbid obesity affects the respiratory system and the diastolic function of the heart. During exercise, cardiopulmonary reserve is exhausted because of augmented requirements, leading to a significant intolerance. A study was undertaken to investigate the influence of body weight loss on the characteristics of the left ventricle ({LV}) and on exercise capacity in obese patients before and 6 months, following vertical banded gastroplasty ({VBG}).
{METHODS}: 16 morbidly obese individuals ({BMI} {\textgreater} 40 kg/m2) scheduled for {VBG} were studied. A symptom-limited cardiopulmonary exercise test and a complete transthoracic echocardiogram were performed 1 day before operation and 6 months postoperatively (after the patients achieved a body weight loss of {\textgreater} 20\% of their pre-operative values).
{RESULTS}: Exercise duration increased significantly 6 months following surgery. The mean O2 consumption at peak exercise (peak {VO}2) and at the anaerobic threshold ({VO}2AT) was significantly higher after weight loss. 6 months after {VBG} the {LV} thickness decreased significantly. Regarding the diastolic indices, isovolumic relaxation time ({IVRT}) and early/late (E/A) velocity ratio, there was a significant improvement after weight loss. Simple linear regression analysis revealed that peak {VO}2 and {VO}2AT were significantly correlated with {IVRT} and E/A velocity ratio.
{CONCLUSIONS}: Weight loss after {VBG} improves the cardiac diastolic function and this is associated with an improvement in cardiopulmonary exercise performance. Left ventricular filling variables could be considered among the most important determinants of exercise intolerance in obese individuals.},
	pages = {552--558},
	number = {5},
	journaltitle = {Obesity Surgery},
	shortjournal = {Obes Surg},
	author = {Kanoupakis, E. and Michaloudis, D. and Fraidakis, O. and Parthenakis, F. and Vardas, P. and Melissas, J.},
	date = {2001-10},
	pmid = {11594094},
	keywords = {Adult, Body Mass Index, echocardiography, Exercise Tolerance, Female, Gastroplasty, Humans, Linear Models, Male, Obesity, Morbid, Oxygen Consumption, Pulmonary Gas Exchange, Ventricular Function, Left, Weight Loss}
}

@article{hall_cardiopulmonary_2009,
	title = {Cardiopulmonary exercise testing accurately predicts risk of major surgery including esophageal resection: letter 1},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19161817},
	pages = {670--1; author reply 671--2},
	number = {2},
	journaltitle = {Ann Thorac Surg},
	author = {Hall, A and Older, P},
	date = {2009-02},
	file = {Hall and Older - 2009 - Cardiopulmonary exercise testing accurately predic.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZSHD5D3F\\Hall and Older - 2009 - Cardiopulmonary exercise testing accurately predic.pdf:application/pdf}
}

@article{saltin_point:_2006,
	title = {Point: in health and in a normoxic environment, {VO}2 max is limited primarily by cardiac output and locomotor muscle blood flow},
	volume = {100},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16421282},
	pages = {744--5},
	number = {2},
	journaltitle = {J Appl Physiol},
	author = {Saltin, Bengt and Calbet, José A L},
	date = {2006-02}
}

@article{mullen_impact_2008,
	title = {Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery},
	volume = {15},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-008-9990-2},
	doi = {10.1245/s10434-008-9990-2},
	pages = {2164--2172},
	number = {8},
	journaltitle = {Annals of Surgical Oncology},
	author = {Mullen, John T. and Davenport, Daniel L. and Hutter, Matthew M. and Hosokawa, Patrick W. and Henderson, William G. and Khuri, Shukri F. and Moorman, Donald W.},
	urldate = {2015-04-28},
	date = {2008-08},
	langid = {english},
	file = {Mullen et al. - 2008 - Impact of Body Mass Index on Perioperative Outcome.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\E7EK9MUJ\\Mullen et al. - 2008 - Impact of Body Mass Index on Perioperative Outcome.pdf:application/pdf}
}

@article{ogorman_longitudinal_1999,
	title = {Longitudinal study of weight, appetite, performance status, and inflammation in advanced gastrointestinal cancer.},
	volume = {35},
	doi = {10.1207/S15327914NC352_5},
	abstract = {There is increasing evidence that, in most patients with advanced cancer, weight  loss is associated with an inflammatory response. To examine the temporal relationship between weight loss, appetite, performance status, and the inflammatory response, 50 patients with advanced gastrointestinal cancer with weight loss were observed for six weeks. Patients were grouped according to whether they had lost weight ({\textgreater} 3\%, n = 16), were weight stable ({\textless} 3\% change, n = 25), or gained weight ({\textgreater} 3\%, n = 9). At baseline, the group that subsequently lost weight had lower albumin and higher C-reactive protein concentrations (p {\textless} 0.05). On follow-up, there was an increase in C-reactive protein concentration and reductions in triceps skinfold thickness and Karnofsky performance status in  the weight-losing group (p {\textless} 0.05). In contrast, Karnofsky performance status was improved in the group that gained weight (p {\textless} 0.05). Over the six to eight weeks, there was a difference in the changes of triceps skinfold thickness (p {\textless} 0.05) and Karnofsky performance status (p {\textless} 0.01) between the two groups. These results suggest that loss or gain of {\textgreater} 2.5 kg over a six- to eight-week period is required to produce a significant alteration in performance status in weight-losing patients with gastrointestinal cancer. Moreover, the results suggest that the presence of an inflammatory response is associated with further  weight loss and the deterioration of performance status.},
	pages = {127--129},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {O'Gorman, P. and {McMillan}, D. C. and {McArdle}, C. S.},
	date = {1999},
	pmid = {10693165},
	keywords = {*Appetite, *Body Weight, *Inflammation, Adult, Aged, Colorectal Neoplasms/physiopathology, C-Reactive Protein/metabolism, Esophageal Neoplasms/physiopathology, Female, Gastrointestinal Neoplasms/*physiopathology, Humans, Karnofsky Performance Status, Longitudinal Studies, Male, Middle Aged, Pancreatic Neoplasms/physiopathology, Serum Albumin/metabolism, Skinfold Thickness, Stomach Neoplasms/physiopathology, Weight Gain, Weight Loss}
}

@article{clarke_use_2011,
	title = {Use of inflammatory markers to guide cancer treatment.},
	volume = {90},
	doi = {10.1038/clpt.2011.122},
	pages = {475--478},
	number = {3},
	journaltitle = {Clinical pharmacology and therapeutics},
	shortjournal = {Clin Pharmacol Ther},
	author = {Clarke, S. J. and Chua, W. and Moore, M. and Kao, S. and Phan, V. and Tan, C. and Charles, K. and {McMillan}, D. C.},
	date = {2011-09},
	pmid = {21775983},
	keywords = {Biological Markers/*blood, C-Reactive Protein/*analysis, Humans, Inflammation/*physiopathology, Neoplasms/blood/drug therapy/surgery/*therapy, Prognosis}
}

@article{richards_prognostic_2012,
	title = {Prognostic value of tumour necrosis and host inflammatory responses in colorectal cancer.},
	volume = {99},
	rights = {Copyright (c) 2011 British Journal of Surgery Society Ltd. Published by John Wiley \& Sons, Ltd.},
	doi = {10.1002/bjs.7755},
	abstract = {{BACKGROUND}: Tumour necrosis is a marker of poor prognosis in some tumours but the mechanism is unclear. This study examined the prognostic value of tumour necrosis and host inflammatory responses in colorectal cancer. {METHODS}: This was a retrospective study of patients undergoing potentially curative resection of colorectal cancer at a single surgical institution over a 10-year period. Patients who underwent preoperative radiotherapy were excluded. The systemic and  local inflammatory responses were assessed using the modified Glasgow Prognostic  Score and Klintrup-Makinen criteria respectively. Original tumour sections were retrieved and necrosis graded as absent, focal, moderate or extensive. Associations between necrosis and clinicopathological variables were examined, and multivariable survival analyses carried out. {RESULTS}: A total of 343 patients were included between 1997 and 2007. Tumour necrosis was graded as absent in 32 (9.3 per cent), focal in 166 (48.4 per cent), moderate in 101 (29.4 per cent) and extensive in 44 (12.8 per cent). There were significant associations between tumour necrosis and anaemia (P = 0.022), white cell count (P = 0.006), systemic inflammatory response (P {\textless} 0.001), local inflammatory cell infiltrate (P = 0.004), tumour node metastasis ({TNM}) stage (P = 0.015) and Petersen Index (P = 0.003). On univariable survival analysis, tumour necrosis was associated with cancer-specific survival (P {\textless} 0.001). On multivariable survival analysis, age (hazard ratio ({HR}) 1.29, 95 per cent confidence interval 1.00 to 1.66), systemic  inflammatory response ({HR} 1.74, 1.27 to 2.39), low-grade local inflammatory cell  infiltrate ({HR} 2.65, 1.52 to 4.63), {TNM} stage ({HR} 1.55, 1.02 to 2.35) and high-risk Petersen Index ({HR} 3.50, 2.21 to 5.55) were associated with reduced cancer-specific survival. {CONCLUSION}: The impact of tumour necrosis on colorectal cancer survival may be due to close associations with the host systemic and local inflammatory responses.},
	pages = {287--294},
	number = {2},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {Richards, C. H. and Roxburgh, C. S. D. and Anderson, J. H. and {McKee}, R. F. and Foulis, A. K. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2012-02},
	pmid = {22086662},
	keywords = {Adult, Aged, Colonic Neoplasms/mortality/*pathology/surgery, Colon/*pathology, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Necrosis/pathology, Prognosis, Rectal Neoplasms/mortality/*pathology/surgery, Rectum/*pathology, Retrospective Studies, Systemic Inflammatory Response Syndrome/mortality/*pathology}
}

@article{leung_vitamin_2008,
	title = {Vitamin antioxidants, lipid peroxidation, tumour stage, the systemic inflammatory response and survival in patients with colorectal cancer.},
	volume = {123},
	rights = {(c) 2008 Wiley-Liss, Inc.},
	doi = {10.1002/ijc.23811},
	abstract = {Both the tumour growth and progression and the systemic inflammatory response have the potential to increase oxidative stress. We therefore examined the relationship between lipid-soluble antioxidant vitamins, lipid peroxidation, the  systemic inflammatory response and survival in patients with primary operable (n  = 53) and advanced inoperable (n = 53) colorectal cancer. Compared with those patients with primary operable colorectal cancer, patients with unresectable liver disease had significantly lower median concentrations of alpha-tocopherol (p {\textless} 0.001), lutein (p {\textless} 0.001), lycopene (p {\textless} 0.001), alpha-carotene (p {\textless} 0.01)  and beta-carotene (p {\textless} 0.001) and higher malondialdehyde concentrations. An elevated systemic inflammatory response (Glasgow prognostic score, {mGPS}) was associated with a greater proportion of females (p {\textless} 0.05) and more advanced tumour stage (p {\textless} 0.05), lower circulating levels of retinol (p {\textless} 0.01), lutein (p {\textless} 0.01), lycopene (p {\textless} 0.01) and alpha- (p {\textless} 0.01) and beta-carotene but not {MDA} (p = 0.633). In the liver metastases group 41 patients died of their cancer and a further 1 patient died of intercurrent disease on follow-up. On univariate  survival analysis, {mGPS} (p {\textless} 0.01), retinol (p {\textless} 0.001), alpha-tocopherol (p {\textless} 0.05) and alpha-carotene (p {\textless} 0.05) were associated significantly with cancer-specific survival. On multivariate survival analysis of these significant  variables, only {mGPS} (p {\textless} 0.01) and retinol (p {\textless} 0.001) were independently associated with cancer-specific survival. The results of the present study showed that the systemic inflammatory response was associated with a reduction of lipid-soluble antioxidant vitamins, whereas advanced tumour stage was associated  with increased lipid peroxidation in patients with colorectal cancer. Of the antioxidant vitamins measured, only retinol was independently associated with cancer-specific survival.},
	pages = {2460--2464},
	number = {10},
	journaltitle = {International journal of cancer. Journal international du cancer},
	shortjournal = {Int J Cancer},
	author = {Leung, Elaine Y. L. and Crozier, Joseph E. M. and Talwar, Dinesh and O'Reilly, Denis St J. and {McKee}, Ruth F. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2008-11-15},
	pmid = {18729200},
	keywords = {Aged, Antioxidants/*metabolism, Colorectal Neoplasms/*metabolism/pathology, Female, Humans, Inflammation/*metabolism, Liver Neoplasms/secondary, Male, Middle Aged, Survival, Vitamins/*metabolism}
}

@article{odowd_elevated_2010,
	title = {Elevated preoperative C-reactive protein predicts poor cancer specific survival in patients undergoing resection for non-small cell lung cancer.},
	volume = {5},
	doi = {10.1097/JTO.0b013e3181da78f9},
	abstract = {{BACKGROUND}: Although only the minority of patients with non-small cell lung cancer ({NSCLC}) are suitable for surgical resection, it offers the best possibility of cure. The aim of this study was to examine the relationship between the clinicopathological status, the preoperative systemic inflammatory response, and survival in patients undergoing potentially curative resection for  {NSCLC}. {METHODS}: Data from 96 patients who underwent resection of {NSCLC} between 2000 and 2003 were collected retrospectively and that for 2004-2006 prospectively. {RESULTS}: All patients had Eastern cooperative oncology group performance status 0 or 1. No patient had T4, unresectable nodal or metastatic disease, and all macroscopic tumors were removed, with subsequent negative surgical margins. The majority of patients were older than 60 years (71\%), men (57\%), underwent a lobectomy (65\%), and had tumor, node, metastasis stage I disease (66\%). Of the markers of the systemic inflammatory response, white cell count, C-reactive protein, and albumin, only an elevated C-reactive protein ({\textgreater}10  mg/L) was associated with cancer-specific survival. On multivariate analysis, only tumor, node, metastasis stage (hazard ratio 1.88, 95\% confidence interval 1.34-2.63, p {\textless} 0.001) and preoperative C-reactive protein (hazard ratio 1.67, 95\% confidence interval 1.01-2.83, p {\textless} 0.05) retained independent significance. Those patients with a preoperative C-reactive protein concentration {\textgreater}10 mg/L had a median survival of 26.2 months compared with 75.9 months in those patients with a},
	pages = {988--992},
	number = {7},
	journaltitle = {Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer},
	shortjournal = {J Thorac Oncol},
	author = {O'Dowd, Caroline and {McRae}, Laura A. and {McMillan}, Donald C. and Kirk, Alan and Milroy, Robert},
	date = {2010-07},
	pmid = {20453690},
	keywords = {Adenocarcinoma/immunology/mortality/surgery, Adult, Aged, Carcinoma, Non-Small-Cell Lung/immunology/*mortality/*surgery, C-Reactive Protein/*metabolism, Female, Humans, Lung Neoplasms/immunology/*mortality/*surgery, Male, Middle Aged, Neoplasms, Squamous Cell/immunology/mortality/surgery, Prospective Studies, Retrospective Studies, Survival Rate, Treatment Outcome}
}

@article{castello_impact_2011,
	title = {Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery},
	volume = {21},
	issn = {1708-0428},
	doi = {10.1007/s11695-010-0319-4},
	abstract = {{BACKGROUND}: Obesity is a major public health concern on a global scale. Bariatric surgery is among the treatment options, resulting in significant and sustainable weight loss as well as amelioration of comorbidities. The purpose of this study was to evaluate whether a 12-week aerobic exercise program positively impacts heart rate variability ({HRV}) and functional capacity after gastric bypass surgery ({GBS}) in a female cohort.
{METHODS}: Of the 52 patients initially recruited, 21 were randomized to a training group ({TG}) or control group and successfully completed the study. Patients were tested on two occasions: 1 week before {GBS} and 4 months after {GBS}. Anthropometric variables, body composition, record of heart rate and R-R intervals, and 6-min walk test (6MWT) were assessed at both time points. The {TG} underwent an aerobic exercise training program on a treadmill (1-h session, totaling 36 sessions over 12 weeks).
{RESULTS}: The main findings from this study were: (1) only the {TG} demonstrated a significant increase (p {\textless} 0.05) in all indexes of heart rate variability ({HRV}) after 12 weeks of aerobic exercise training and (2) only the {TG} demonstrated a significant increase (p {\textless} 0.05) in 6MWT distance and decrease in diastolic blood pressure after aerobic exercise training.
{CONCLUSIONS}: We conclude that 12 weeks of aerobic exercise training improves cardiac autonomic modulation and functional capacity 4 months after {GBS}.},
	pages = {1739--1749},
	number = {11},
	journaltitle = {Obesity Surgery},
	shortjournal = {Obes Surg},
	author = {Castello, Viviane and Simões, Rodrigo Polaquini and Bassi, Daniela and Catai, Aparecida Maria and Arena, Ross and Borghi-Silva, Audrey},
	date = {2011-11},
	pmid = {21104041},
	keywords = {Adult, Exercise, Female, Gastric Bypass, Heart Rate, Humans, Middle Aged, Obesity, Morbid, Physical fitness, Prospective Studies, Time Factors, Young Adult}
}

@article{aggarwal_signal_2009,
	title = {Signal Transducer and Activator of Transcription-3, Inflammation, and Cancer: How Intimate Is the Relationship?},
	volume = {1171},
	issn = {00778923},
	url = {http://doi.wiley.com/10.1111/j.1749-6632.2009.04911.x},
	doi = {10.1111/j.1749-6632.2009.04911.x},
	shorttitle = {Signal Transducer and Activator of Transcription-3, Inflammation, and Cancer},
	pages = {59--76},
	number = {1},
	journaltitle = {Annals of the New York Academy of Sciences},
	author = {Aggarwal, Bharat B. and Kunnumakkara, Ajaikumar B. and Harikumar, Kuzhuvelil B. and Gupta, Shan R. and Tharakan, Sheeja T. and Koca, Cemile and Dey, Sanjit and Sung, Bokyung},
	urldate = {2015-04-28},
	date = {2009-08},
	langid = {english},
	file = {Aggarwal et al. - 2009 - Signal Transducer and Activator of Transcription-3.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7XN4EBDA\\Aggarwal et al. - 2009 - Signal Transducer and Activator of Transcription-3.pdf:application/pdf}
}

@article{alvaro-meca_impact_2012,
	title = {Impact of comorbidities and surgery on health related transitions in pancreatic cancer admissions: A multi state model},
	volume = {36},
	issn = {1877-7821},
	url = {http://www.sciencedirect.com/science/article/pii/S1877782111001998},
	doi = {10.1016/j.canep.2011.12.005},
	shorttitle = {Impact of comorbidities and surgery on health related transitions in pancreatic cancer admissions},
	abstract = {Aim
Pancreatic cancer is one of the least common tumors, nevertheless it is one of the most lethal. This lethality is mainly due to the fact that the vast majority of patients are diagnosed in an advanced stage. The objective of this work is investigate how different covariates affect the transition to death after a first admission due to pancreatic cancer.
Methods
We analyze the impact of different factors on health related transitions after a first hospital admission related to pancreatic cancer based on a multi state model.
Results
Transitions of interest include the transition to death (i.e. survival time), but also the time between a first admission and discharge or between discharge and readmission. We consider comorbidities, the type of admission, and especially the performance of pancreas surgery as covariates with a potential effect on the transition intensities.
Conclusion
The multi state model allows for a very detailed analysis since all covariate effects may change depending on the current state of the patient.},
	pages = {e142--e146},
	number = {2},
	journaltitle = {Cancer Epidemiology},
	shortjournal = {Cancer Epidemiology},
	author = {Álvaro-Meca, Alejandro and Kneib, Thomas and Prieto, Ruth Gil and de Miguel, Ángel Gil},
	urldate = {2015-05-26},
	date = {2012-04},
	keywords = {Hospital readmission, In hospital mortality, Multi state model, Pancreas cancer},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JFU3BZ7B\\Álvaro-Meca et al. - 2012 - Impact of comorbidities and surgery on health rela.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\D49WW8KA\\S1877782111001998.html:text/html}
}

@article{mcmillan_systemic_2009,
	title = {Systemic inflammation, nutritional status and survival in patients with cancer.},
	volume = {12},
	doi = {10.1097/MCO.0b013e32832a7902},
	abstract = {{PURPOSE} {OF} {REVIEW}: There is now good evidence in humans that a chronic systemic inflammatory response results in the cardinal features of cancer cachexia, principally the progressive loss of weight (in particular lean tissue). This review examines the role of recent simple objective systemic inflammation-based scores in predicting reduction of nutritional status and survival. {RECENT} {FINDINGS}: The most common measure of the systemic inflammatory response in cancer patients has been an elevated C-reactive protein concentration. This has now been included in recent definitions of cancer cachexia. There are also recent systemic inflammation-based scores, the Glasgow Prognostic Score, Neutrophil Lymphocyte Ratio and the Platelet Lymphocyte Ratio that have been shown to have prognostic value in cancer patients. These scores, in particular the Glasgow Prognostic Score, enable identification of patients who are, or likely, to develop cachexia, have a poor response to treatment and who are likely to have poor survival. {SUMMARY}: A chronic systemic inflammatory response is clearly implicated in the progressive nutritional and functional decline in the cancer patients and their subsequent poor outcome. Systemic inflammation-based prognostic scores not only identify patients at risk but also provide well defined therapeutic targets for future clinical trials targeting nutritional decline.},
	pages = {223--226},
	number = {3},
	journaltitle = {Current opinion in clinical nutrition and metabolic care},
	shortjournal = {Curr Opin Clin Nutr Metab Care},
	author = {{McMillan}, Donald C.},
	date = {2009-05},
	pmid = {19318937},
	keywords = {*Nutritional Status, Biological Markers/metabolism, Cachexia/etiology/*metabolism/mortality, C-Reactive Protein/metabolism, Humans, Inflammation/complications/*metabolism, Leukocytes/metabolism, Neoplasms/complications/*metabolism/mortality, Prognosis, Serum Albumin/metabolism}
}

@article{wrigley_inequalities_2003,
	title = {Inequalities in survival from colorectal cancer: a comparison of the impact of deprivation, treatment, and host factors on observed and cause specific survival},
	volume = {57},
	doi = {10.1136/jech.57.4.301},
	shorttitle = {Inequalities in survival from colorectal cancer},
	abstract = {Objective: To investigate whether socioeconomic deprivation is associated with cause specific and all cause survival for colorectal cancer and to what extent this is independent of significant prognostic factors. Design: Prospective cohort. Setting: The former Wessex Health Region, South West England. Participants: All patients resident in Wessex registered with a diagnosis of colorectal cancer over three years (n=5176). Survival analysis was carried out on those patients with compete data for all factors and a positive survival time (n=4419). Outcomes: Death from colorectal cancer and all cause over five year follow up from initial diagnosis. Main results: Deprivation was significantly associated with survival for both outcomes in univariate analysis; the unadjusted hazard ratio for dying from colorectal cancer (most deprived compared with most affluent) was 1.12 (95\% Cl 1.00 to 1.25) and for all cause was 1.18 (1.07 to 1.30). Significant prognostic factors for both outcomes were age, specialisation of surgeon, Dukes's stage, and emergency compared with elective surgery. Comorbidity and gender were only associated with all cause survival. After adjustment for prognostic factors, the effect of deprivation on both cause specific and all cause mortality was reduced, and it was non-significant for colorectal cancer. However, the most deprived group had consistently worse survival than the most affluent. Conclusions: Factors associated with survival with colorectal cancer depend on the outcome measure. Socioeconomic deprivation is adversely associated with survival in patients with colorectal cancer. This is strongest for non-colorectal cancer death, partly reflecting higher comorbidity, but it is there for colorectal cancer though not statistically significant. Conclusive evidence of the inequalities by socioeconomic status and underlying reasons needs to come from studies using individual based measures of socioeconomic status and more detail on treatment and host related factors.},
	pages = {301--309},
	number = {4},
	journaltitle = {Journal of Epidemiology and Community Health},
	author = {Wrigley, H. and Roderick, P. and George, S. and Smith, J. and Mullee, M. and Goddard, J.},
	date = {2003-04},
	note = {{WOS}:000181861000016}
}

@article{chang_combined_2012,
	title = {The Combined Effect of Individual and Neighborhood Socioeconomic Status on Cancer Survival Rates},
	volume = {7},
	issn = {1932-6203},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431308/},
	doi = {10.1371/journal.pone.0044325},
	abstract = {Background
This population-based study investigated the relationship between individual and neighborhood socioeconomic status ({SES}) and mortality rates for major cancers in Taiwan.

Methods
A population-based follow-up study was conducted with 20,488 cancer patients diagnosed in 2002. Each patient was traced to death or for 5 years. The individual income-related insurance payment amount was used as a proxy measure of individual {SES} for patients. Neighborhood {SES} was defined by income, and neighborhoods were grouped as living in advantaged or disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rates between the different {SES} groups after adjusting for possible confounding and risk factors.

Results
After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation and adjuvant therapy), and hospital characteristics (ownership and teaching level), colorectal cancer, and head and neck cancer patients under 65 years old with low individual {SES} in disadvantaged neighborhoods conferred a 1.5 to 2-fold higher risk of mortality, compared with patients with high individual {SES} in advantaged neighborhoods. A cross-level interaction effect was found in lung cancer and breast cancer. Lung cancer and breast cancer patients less than 65 years old with low {SES} in advantaged neighborhoods carried the highest risk of mortality. Prostate cancer patients aged 65 and above with low {SES} in disadvantaged neighborhoods incurred the highest risk of mortality. There was no association between {SES} and mortality for cervical cancer and pancreatic cancer.

Conclusions
Our findings indicate that cancer patients with low individual {SES} have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.},
	number = {8},
	journaltitle = {{PLoS} {ONE}},
	shortjournal = {{PLoS} One},
	author = {Chang, Chun-Ming and Su, Yu-Chieh and Lai, Ning-Sheng and Huang, Kuang-Yung and Chien, Sou-Hsin and Chang, Yu-Han and Lian, Wei-Cheng and Hsu, Ta-Wen and Lee, Ching-Chih},
	urldate = {2015-05-26},
	date = {2012-08-30},
	pmid = {22957007},
	pmcid = {PMC3431308},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\A6QJZMIK\\Chang et al. - 2012 - The Combined Effect of Individual and Neighborhood.pdf:application/pdf}
}

@article{misquita_applicability_2001,
	title = {Applicability of maximal oxygen consumption criteria in obese, postmenopausal women},
	volume = {10},
	issn = {1524-6094},
	doi = {10.1089/152460901753285787},
	abstract = {This study examines the applicability of using three standard criteria (age-predicted maximal heart rate [{HRmax}], respiratory exchange ratio [{RER}{\textgreater}1.10], and plateau in oxygen uptake [Vo(2)] for the measurement of maximal oxygen consumption (Vo(2)max) in postmenopausal women. One hundred eight postmenopausal (60 +/- 6 years), overweight and obese (body mass index [{BMI}] = 33 +/- 4 kg/m(2)), sedentary (Vo(2)max = 19 +/- 3 ml/kg/min) women underwent one exercise test (Bruce protocol), and 71 of these women underwent a second test (modified Balke protocol). On test 1, 69 (64\%) women achieved age-predicted {HRmax}, 61 (57\%) reached an {RER}{\textgreater}1.10, and 16 (15\%) achieved a plateau in Vo(2) ({\textless}2 ml/kg/min change). Women who reached age-predicted {HRmax} and reached an {RER} of at least 1.10 had a higher peak Vo(2) (p {\textless}0.01) than women who did not meet these criteria. There was no difference in the highest V02 obtained between women who did and did not achieve a plateau in Vo(2) during test 1 (p = 0.55). Resting {HR}, {HRmax}, and {RER} were similar between the two tests. On average, peak Vo(2) was higher on the second test (p {\textless}0.01). However, Vo(2)max was not different between exercise tests in women who achieved at least two of the three criteria on both tests (n = 24; test 1, 19.4 +/- 3.4; test 2: 19.8 +/- 3.7 ml/kg/min; p = {NS}). In addition, Vo(2)max was similar between the two exercise tests in 14 women who reached a plateau on the second test but did not reach a plateau on the first test (19.2 +/- 3.3 vs. 19.6 +/- 4.2 ml/kg/min; p = {NS}). We conclude that achievement of a plateau in Vo(2) is not a necessary criterion for a valid measurement of Vo(2)max in overweight and obese, sedentary, postmenopausal women.},
	pages = {879--885},
	number = {9},
	journaltitle = {Journal of women's health \& gender-based medicine},
	shortjournal = {J Womens Health Gend Based Med},
	author = {Misquita, N A and Davis, D C and Dobrovolny, C L and Ryan, A S and Dennis, K E and Nicklas, B J},
	date = {2001-11},
	pmid = {11747683},
	keywords = {Absorptiometry, Photon, Aged, Body Composition, Body Mass Index, Exercise Test, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Postmenopause, Respiration}
}

@article{meyer_c-reactive_1995,
	title = {The C-reactive protein for detection of early infections after lumbar microdiscectomy},
	volume = {136},
	issn = {0001-6268},
	abstract = {The tendency for short hospitalization after lumbar microdiscectomy implies the need for early confirmation or disapproval of serious postoperative infections such as spondylodiscitis or deep wound infections. The C-reactive protein ({CRP}) is a well-known screening parameter for monitoring postoperative infectious complications in other fields. Our objective was to establish the diagnostic significance of {CRP}-in comparison with {ESR} and {WBC}-for monitoring infectious complications after lumbar microdiscectomy. Over a 15 months period we studied prospectively a homogeneous group of N = 400 patients with lumbar disc herniations who were operated on a single level for the first time. {CRP}, {ESR} and {WBC} values were determined in all patients pre-operatively, and on postoperative days 1 and 5. Clinical and laboratory findings were correlated and the diagnostic significance of {CRP}, {ESR} and {WBC} calculated. N = 385 (96\%) patients had an uneventful postoperative course. N = 15 (4\%) patients developed infectious complications, of which N = 6 (1.5\%) were unrelated and N = 9 (2.5\%) related to surgery. Evaluation of the laboratory values showed: The {CRP} baseline is a very individual value of no prognostic relevance. A high postaggression peak is typical and essential as a reference value for only the future time course will disclose any infection. We found 0\% false negative and 4\% false positive results on day 5. The sensitivity for serial {CRP} testing was calculated as 100\% and specificity as 95.8\%. {ESR} (sensitivity: 78.1\%/specificity: 38.1\%) and {WBC} (sensitivity: 21.4\%/specificity: 76.8\%) both failed to reach such distinct diagnostic significance on day 5. The C-reactive protein has thus proved to be a reliable, simple and economical screening test for infectious complications after lumbar microdiscectomy, superior to classical laboratory parameters.},
	pages = {145--150},
	number = {3},
	journaltitle = {Acta Neurochirurgica},
	shortjournal = {Acta Neurochir (Wien)},
	author = {Meyer, B. and Schaller, K. and Rohde, V. and Hassler, W.},
	date = {1995},
	pmid = {8748845},
	keywords = {Adolescent, Adult, Blood Sedimentation, C-Reactive Protein, Diskectomy, Female, Humans, Intervertebral Disc Displacement, Leukocyte Count, Male, Microsurgery, Middle Aged, Predictive Value of Tests, prognosis, Reference Values, Sensitivity and Specificity, Surgical Wound Infection}
}

@article{roxburgh_relationship_2010,
	title = {Relationship Between Preoperative Comorbidity, Systemic Inflammatory Response, and Survival in Patients Undergoing Curative Resection for Colorectal Cancer},
	volume = {18},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-010-1410-8},
	doi = {10.1245/s10434-010-1410-8},
	abstract = {Background Besides tumor characteristics, colorectal cancer ({CRC}) outcomes are also determined by host factors, in particular the systemic inflammatory response. The basis of this relationship with survival is not known; however, systemic inflammation may reflect comorbidity. The present study examines relationships between host factors (including age, comorbidity, deprivation, and systemic inflammation) and survival in {CRC}. Methods A total of 302 patients underwent curative elective {CRC} resection between 1997 and 2005. Data was collected on patient comorbidity (Charlson Comorbidity Index [{CCI}], Lee Cardiac Risk Index [{LCRI}], National Institute on Aging and National Cancer Institute Comorbidity Index [{NIA}/{NCI}], and Adult Comorbidity Evaluation-27 [{ACE}-27]), systemic inflammatory response (Glasgow Prognostic Score [{mGPS}]), deprivation [Carstairs Deprivation Index], body mass index, and smoking status. Results For cancer-specific survival, age (P = 0.047), tumor, node, metastasis system stage (P {\textless} 0.001), high-risk Petersen Index (P {\textless} 0.001), {LCRI} (P = 0.021), and {mGPS} (P {\textless} 0.001) were independent factors by multivariate analysis. For overall survival, age (P {\textless} 0.001), tumor, node, metastasis system stage (P = 0.001), high-risk Petersen Index (P = 0.002), postoperative infective complications (P = 0.002), {ACE}-27 (P = 0.008), and {mGPS} (P {\textless} 0.001) were independent factors. Older age related to increasing comorbidity ({ACE}-27, {CCI}, {LCRI} [P {\textless} 0.005]) and increased {mGPS} (P {\textless} 0.005). Smoking and deprivation related to increasing comorbidity (P {\textless} 0.05). The {mGPS} was associated with high comorbidity burden assessed with {ACE}-27 (P = 0.065), {CCI} (P = 0.016), {LCRI} (P = 0.095), and {NIA}/{NCI} (P = 0.084). Conclusions Comorbidity does not fully explain the relationship between the {mGPS} and cancer-specific survival in {CRC} patients. Furthermore, comorbidity, in particular that measured by the {LCRI}, is an important independent indicator of cancer survival.},
	pages = {997--1005},
	number = {4},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Roxburgh, C. S. D. and Platt, J. J. and Leitch, E. F. and Kinsella, J. and Horgan, P. G. and {McMillan}, D. C.},
	urldate = {2015-05-26},
	date = {2010-11-02},
	langid = {english},
	keywords = {*Postoperative Complications, Aged, Colorectal Neoplasms/mortality/pathology/*surgery, Comorbidity, Female, Follow-Up Studies, Humans, Inflammation/mortality/pathology/*surgery, Male, Middle Aged, Neoplasm Recurrence, Local/mortality/pathology/*surgery, Neoplasm Staging, Oncology, Preoperative Period, Prospective Studies, surgery, Surgical Oncology, Survival Rate, Treatment Outcome},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BTW95MRG\\Roxburgh et al. - 2010 - Relationship Between Preoperative Comorbidity, Sys.pdf:application/pdf;Roxburgh et al. - 2011 - Relationship Between Preoperative Comorbidity, Sys.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Q3HMT8QD\\Roxburgh et al. - 2011 - Relationship Between Preoperative Comorbidity, Sys.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZHBCMIQK\\10.html:text/html}
}

@article{jacob_cardiac_1993,
	title = {Cardiac function and responsiveness to beta-adrenoceptor agonists in rats with obstructive jaundice},
	volume = {265},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8103636},
	abstract = {The function and role of the heart and the contribution of cardiac beta-adrenoceptors in the pathogenesis of circulatory failure in obstructive jaundice were studied in the 3-day bile duct-ligated ({BDL}) rat using three different techniques to measure cardiac function and beta-adrenoceptor activity, number, and affinity. The techniques were the pithed rat preparation, the isolated working heart preparation, and a competitive radioligand binding assay for beta-adrenoceptors. The results of these experiments were compared with those obtained in 3-day bile duct-manipulated (sham operated; {SO}) rats. Impaired indexes of basal cardiac contractility were observed in the {BDL} pithed rats and isolated working hearts. In these two preparations, responsiveness to norepinephrine and the beta-adrenoceptor agonists, isoproterenol and dobutamine, was unaffected by bile duct ligation. The affinity and number of cardiac beta-adrenoceptors in membranes from the hearts of {SO} and {BDL} rats were not significantly different from each other. These experiments have established for the first time that the 3-day {BDL} rat has a cardiac myopathy associated with intact responsiveness to beta-adrenoceptor agonists, a normal unchanged affinity and number of cardiac beta-adrenoceptors.},
	pages = {G314--20},
	number = {2},
	journaltitle = {Am J Physiol},
	author = {Jacob, G and Nassar, N and Hayam, G and Ben-Haim, S and Edoute, Y and Better, O S and Bomzon, A},
	date = {1993-08}
}

@article{dutta_persistent_2011,
	title = {Persistent elevation of C-reactive protein following esophagogastric cancer resection as a predictor of postoperative surgical site infectious complications.},
	volume = {35},
	doi = {10.1007/s00268-011-1002-1},
	abstract = {{BACKGROUND}: Infectious complications, particularly in the form of anastomotic leaks ({ALs}) or surgical site infections ({SSIs}), represent a serious morbidity after esophagogastric cancer resections. Therefore, early detection is of paramount importance. Although markers of the systemic inflammatory response, including C-reactive protein ({CRP}) and white cell count ({WCC}), have been used in  this regard, their relative predictive value is unclear. The aim of the present study was to examine serial postoperative {WCC}, albumin, and {CRP} and their diagnostic accuracy in case of infectious complications. {PATIENTS} {AND} {METHODS}: White cell count, albumin, and {CRP} were routinely measured postoperatively for 7  days in 136 consecutive patients who had undergone esophagogastric cancer resection. All postoperative complications were recorded. The diagnostic accuracy of the {WCC}, albumin, and {CRP} values were analyzed by receiver operating characteristics curve analysis with surgical site and remote infectious complications as outcome measures. {RESULTS}: Fifty-four (40\%) patients developed infectious complications, and 17 of them developed an {AL}. {CRP} was significantly higher from postoperative day ({POD}) 3 onward in those patients who developed an {AL}. On {POD} 3, a threshold reading of 180 mg/l was associated with development of  an {AL}, providing a sensitivity of 82\% and a specificity of 63\%. On {POD} 4, the same {CRP} threshold of 180 mg/l provided 71\% sensitivity and 83\% specificity. {CONCLUSIONS}: Postoperative {CRP} measurements on {PODs} 3 and 4 are clinically useful in predicting surgical site infectious complications, in particular an {AL}, after  resection for esophagogastric cancer.},
	pages = {1017--1025},
	number = {5},
	journaltitle = {World journal of surgery},
	shortjournal = {World J Surg},
	author = {Dutta, Sumanta and Fullarton, Grant M. and Forshaw, Matthew J. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-05},
	pmid = {21350898},
	keywords = {Abdominal Surgery, Aged, Anastomotic Leak, Cardiac Surgery, C-Reactive Protein/*analysis, Esophageal Neoplasms/*surgery, Female, general surgery, Humans, Leukocyte Count, Male, Middle Aged, {ROC} Curve, Sensitivity and Specificity, Serum Albumin/analysis, Stomach Neoplasms/*surgery, surgery, Surgical Wound Infection/*epidemiology, Thoracic Surgery, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DW4EU68Q\\Dutta et al. - 2011 - Persistent Elevation of C-Reactive Protein Followi.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H9H3BF6K\\10.html:text/html}
}

@article{roxburgh_role_2010,
	title = {Role of systemic inflammatory response in predicting survival in patients with primary operable cancer.},
	volume = {6},
	doi = {10.2217/fon.09.136},
	abstract = {Disease progression in cancer is dependent on the complex interaction between the tumor and the host inflammatory response. There is substantial evidence in advanced cancer that host factors, such as weight loss, poor performance status and the host systemic inflammatory response, are linked, and the latter is an important tumor-stage-independent predictor of outcome. Indeed, the systemic inflammatory response, as evidenced by an elevated level of C-reactive protein, is now included in the definition of cancer cachexia. This review examines the role of the systemic inflammatory response in predicting survival in patients with primary operable cancer. Approximately 80 studies have evaluated the role of the systemic inflammatory response using biochemical or hematological markers, such as elevated C-reactive protein levels, hypoalbuminemia or increased white cell, neutrophil and platelet counts. Combinations of such factors have been used to derive simple inflammation-based prognostic scores, such as the Glasgow Prognostic Score, the neutrophil:lymphocyte ratio and the platelet:lymphocyte ratio. This review demonstrates that there is now good evidence that preoperative measures of the systemic inflammatory response predict cancer survival, independent of tumor stage, in primary operable cancer. The evidence is particularly robust in colorectal (including liver metastases), gastro-esophageal and renal cancers. As described in this article, measurement of the systemic inflammatory response is simple, reliable and can be clinically incorporated into current staging algorithms. This will provide the clinician with a better prediction of outcome, and therefore better treatment allocation in patients with primary operable cancer. Furthermore, systemic inflammation-based markers and prognostic scores not only identify patients at risk, but also provide well-defined therapeutic targets for future clinical trials.},
	pages = {149--163},
	number = {1},
	journaltitle = {Future oncology (London, England)},
	shortjournal = {Future Oncol},
	author = {Roxburgh, Campbell S. D. and {McMillan}, Donald C.},
	date = {2010-01},
	pmid = {20021215},
	keywords = {Disease Progression, Humans, Inflammation/*physiopathology, Neoplasms/*immunology/*mortality, Prognosis, Tumor Markers, Biological/*analysis}
}

@article{watt_routine_2015,
	title = {Routine clinical markers of the magnitude of the systemic inflammatory response after elective operation: A systematic review},
	volume = {157},
	issn = {0039-6060},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606014005996},
	doi = {10.1016/j.surg.2014.09.009},
	shorttitle = {Routine clinical markers of the magnitude of the systemic inflammatory response after elective operation},
	abstract = {Background
Operative injury to the body from all procedures causes a stereotypical cascade of neuroendocrine, cytokine, myeloid, and acute phase responses. This response has been examined commonly by the use of cortisol, interleukin-6 ({IL}-6), white cell count, and C-reactive protein ({CRP}). We aimed to determine which markers of the systemic inflammatory response were useful in determining the magnitude of injury after elective operations.
Methods
A systematic review of the literature was performed using surgery, endocrine response, systemic inflammatory response, cortisol, {IL}-6, white cell count, and {CRP}. For each analyte the studies were grouped according to whether the operative injury was considered to be minor, moderate, or major and then by the operative procedure.
Results
A total of 164 studies were included involving 14,362 patients. The {IL}-6 and {CRP} responses clearly were associated with the magnitude of operative injury and the invasiveness of the operative procedure. For example, the peak {CRP} response increased from 52 mg/L with cholecystectomy to 123 mg/L with colorectal cancer resection, 145 mg/L with hip replacement, 163 mg/L after abdominal aortic aneurysm repair, and 189 mg/L after open cardiac surgery. There also appeared to be a difference between minimally invasive/laparoscopic and open procedures such as cholecystectomy (27 vs 80 mg/L), colorectal cancer resection (97 vs 133 mg/L), and aortic aneurysm repair (132 vs 180 mg/L).
Conclusion
Peak {IL}-6 and {CRP} concentrations consistently were associated with the magnitude of operative injury and operative procedure. These markers may be useful in the objective assessment of which components of Enhanced Recovery after Surgery are likely to improve patient outcome and to assess the possible impact of operative injury on immune function.},
	pages = {362--380},
	number = {2},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Watt, David G. and Horgan, Paul G. and {McMillan}, Donald C.},
	urldate = {2015-08-20},
	date = {2015-02},
	keywords = {Biological Markers/blood, C-Reactive Protein/metabolism, Elective Surgical Procedures/*adverse effects, Female, Humans, Hydrocortisone/blood, Interleukin-6/blood, Laparoscopy/adverse effects, Leukocyte Count, Male, Minimally Invasive Surgical Procedures/adverse effects, Postoperative Complications/*blood/*etiology, Systemic Inflammatory Response Syndrome/*blood/*etiology},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TD25TFJT\\Watt et al. - 2015 - Routine clinical markers of the magnitude of the s.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\F8WKE8AM\\S0039606014005996.html:text/html}
}

@article{leitch_comparison_2007,
	title = {Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer.},
	volume = {97},
	doi = {10.1038/sj.bjc.6604027},
	abstract = {There is increasing evidence that the presence of a systemic inflammatory response plays an important role in predicting survival in patients with colorectal cancer. However, it is not clear what components of the systemic inflammatory response best predict survival. The aim of the present study was to  compare the prognostic value of an inflammation-based prognostic score (modified  Glasgow Prognostic Score (Mgps) 0=C-reactive protein {\textless}10 mg l(-1), 1=C-reactive protein {\textgreater}10 mg l(-1), and 2=C-reactive protein {\textgreater}10 mg l(-1) and albumin{\textless}35 g l(-1)) with that of components of the white cell count (neutrophils, lymphocytes, monocytes and platelets using standard thresholds) in patients with colorectal cancer. Two patient groups were studied: 149 patients who underwent potentially curative resection for colorectal cancer and 84 patients who had synchronous unresectable liver metastases. In those patients who underwent potentially curative resection the minimum follow-up was 36 months and 20 patients died of their cancer. On multivariate survival analysis only {TNM} stage ({HR} 3.75, 95\% {CI} 1.54-9.17, P=0.004), monocyte count ({HR} 3.79, 95\% {CI} 1.29-11.12, P=0.015) and {mGPS} ({HR} 2.21, 95\% {CI} 1.11-4.41, P=0.024) were independently associated with cancer-specific survival. In patients with synchronous unresectable liver metastases the minimum follow-up was 6 months and 71 patients died of their cancer. On multivariate survival analysis only single liver metastasis {\textgreater}5 cm ({HR}  1.78, 95\% {CI} 0.99-3.21, P=0.054), extra-hepatic disease ({HR} 2.09, 95\% {CI} 1.05-4.17, P=0.036), chemotherapy treatment ({HR} 2.40, 95\% {CI} 1.82-3.17, P{\textless}0.001)  and {mGPS} ({HR} 1.44, 95\% {CI} 1.01-2.04, P=0.043) were independently associated with  cancer-specific survival. In summary, markers of the systemic inflammatory response are associated with poor outcome in patients with either primary operable or synchronous unresectable colorectal cancer. An acute-phase protein-based prognostic score, the {mGPS}, appears to be a superior predictor of survival compared with the cellular components of the systemic inflammatory response.},
	pages = {1266--1270},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Leitch, E. F. and Chakrabarti, M. and Crozier, J. E. M. and {McKee}, R. F. and Anderson, J. H. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2007-11-05},
	pmid = {17923866},
	pmcid = {PMC2360467},
	keywords = {Aged, Colorectal Neoplasms/*metabolism/mortality/therapy, Female, Humans, Inflammation Mediators/*metabolism, Leukocyte Count, Liver Neoplasms/metabolism/secondary, Male, Middle Aged, Neoplasm Staging, Prognosis, Survival Rate, Tumor Markers, Biological/*metabolism}
}

@article{lamb_relationship_2008,
	title = {The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer.},
	volume = {102},
	doi = {10.1111/j.1464-410X.2008.07666.x},
	abstract = {{OBJECTIVE}: To examine the relationship between the systemic inflammatory response (C-reactive protein, {CRP}), tumour interleukin-6 receptor and cyclooxygenase ({COX})-2 expression, tumour T-lymphocytic ({CD}4+, {CD}8+) infiltration and cancer survival in patients undergoing resection for renal cell carcinoma ({RCC}), as both the local and systemic inflammatory responses appear to predict the outcome in these patients. {PATIENTS} {AND} {METHODS}: The study included 60 patients undergoing nephrectomy for localized {RCC}. Pre-operative circulating {CRP} levels were measured and tumour interleukin-6 receptor and {COX}-2 expression, tumour {CD}4+ and {CD}8+ T lymphocytes were assessed using immunohistochemical analysis. {RESULTS}: The median follow-up was 78 months, with 14 patients relapsing from their disease and nine cancer-specific deaths. On univariate and multivariate survival analysis, tumour  stage and grade and {CRP} levels were identified as significant factors associated  with relapse-free and cancer-specific survival. There was a significant direct relationship between Fuhrman grade and {CD}4+ T-lymphocytic infiltrate (P {\textless} 0.05).  An increase in tumour expression of interleukin-6 receptor was weakly associated  with an increase in tumour {CD}8+ T-lymphocytic infiltration (P = 0.057). An increase in tumour {CD}4+ T-lymphocytic infiltration was associated with an increase in {CD}8+ T-lymphocytic infiltration (P {\textless} 0.01). {CONCLUSIONS}: The present  results suggest that tumour-based factors such as interleukin-6 receptor and},
	pages = {756--761},
	number = {6},
	journaltitle = {{BJU} international},
	shortjournal = {{BJU} Int},
	author = {Lamb, Gavin W. A. and {McArdle}, Peter A. and Ramsey, Sara and {McNichol}, Anne-Marie and Edwards, Joanne and Aitchison, Michael and {McMillan}, Donald C.},
	date = {2008-09},
	pmid = {18384626},
	keywords = {Aged, Carcinoma, Renal Cell/metabolism/*mortality/surgery, C-Reactive Protein/*metabolism, Cyclooxygenase 2/*metabolism, Female, Humans, Immunohistochemistry, Kidney Neoplasms/metabolism/*mortality/surgery, Lymphocytes, Tumor-Infiltrating/metabolism, Male, Middle Aged, Neoplasm Staging, Nephrectomy/methods, Prognosis, Receptors, Interleukin-6/*metabolism, Survival Analysis, Systemic Inflammatory Response Syndrome/metabolism/*mortality}
}

@article{wasserma.k_anaerobic_1973,
	title = {Anaerobic Threshold and Respiratory Gas-Exchange During Exercise},
	volume = {35},
	issn = {8750-7587},
	pages = {236--243},
	number = {2},
	journaltitle = {Journal of Applied Physiology},
	shortjournal = {J. Appl. Physiol.},
	author = {Wasserma.k and Whipp, Bj and Koyal, Sn and Beaver, Wl},
	date = {1973},
	note = {{WOS}:A1973Q489000011}
}

@article{cheung_are_2010,
	title = {Are patients of low socioeconomic status receiving suboptimal management for pancreatic adenocarcinoma?},
	volume = {116},
	issn = {0008-543X},
	doi = {10.1002/cncr.24758},
	abstract = {{BACKGROUND}: The objective of this study was to define the effects of socioeconomic status ({SES}) and other demographic variables on outcomes for patients with pancreatic adenocarcinoma.
{METHODS}: Florida cancer registry and inpatient hospital data were queried for pancreatic adenocarcinoma diagnosed from 1998 to 2002.
{RESULTS}: In total, 16,104 patients were identified. Low {SES} ({LSES}) patients were younger at diagnosis (P {\textless} .001) but presented with similar disease stage and tumor grade. {LSES} patients were less likely to receive surgical extirpation (16.5\% vs 19.8\%; P {\textless} .001), chemotherapy (30.7\% vs 36.4\%; P {\textless} .001), or radiotherapy (14.3\% vs 16.9\%; P = .003). Among surgical patients, 30-day mortality was significantly higher (5.1\% vs 3.7\%; P {\textless} .001) and overall median survival was significantly worse (5.0 months vs 6.2 months; P {\textless} .001) in the {LSES} cohorts. Although surgical patients who were treated at teaching facilities ({TF}) did significantly better; an increased 30-day surgical mortality (2.2\% vs 1.3\%; P {\textless} .001) and decreased median survival (5 months for poverty level {\textgreater}15\% vs 6.2 months for poverty level {\textless}5\%; P {\textless} .001) also were observed for patients of {LSES}. In a multivariate analysis that corrected for patient comorbidities, significant independent predictors of a poorer prognosis included {LSES} (hazard ratio [{HR}], 1.09); treatment at a non-{TF} ({HR}, 1.09); and failure to receive surgical extirpation ({HR}, 1.92), chemotherapy ({HR} 1.41), or radiation ({HR} 1.25).
{CONCLUSIONS}: Patients of {LSES} were less likely to receive surgical extirpation, chemotherapy, or radiation and had significantly higher perioperative and long-term mortality rates. A greater understanding of the barriers to providing optimal care and identifying means for improving successful delivery of therapies to the poor with pancreatic cancer are needed.},
	pages = {723--733},
	number = {3},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {Cheung, Michael C. and Yang, Relin and Byrne, Margaret M. and Solorzano, Carmen C. and Nakeeb, Attila and Koniaris, Leonidas G.},
	date = {2010-02-01},
	pmid = {19998350},
	keywords = {Adenocarcinoma, Adult, Aged, Comorbidity, Female, Florida, Healthcare Disparities, Humans, Male, Middle Aged, Pancreatic Neoplasms, poverty, Social Class}
}

@article{haupt_association_1997,
	title = {Association between preoperative acute phase response and postoperative complications},
	volume = {163},
	issn = {1102-4151},
	abstract = {{OBJECTIVE}: To find out if there is an association between the acute phase response preoperatively and the development of postoperative infective complications.
{DESIGN}: Prospective open study.
{SETTING}: Teaching hospital Germany.
{SUBJECTS}: 229 patients who were to undergo major abdominal operations.
{INTERVENTIONS}: Measurements of serum concentrations of interleukin 6 ({IL}-6), alpha-1-antitrypsin, C-reactive protein ({CRP}), albumin, and prealbumin.
{MAIN} {OUTCOME} {MEASURES}: Abnormal values of substances measured.
{RESULTS}: Serum concentrations of {IL}-6, alpha-1-antitrypsin and {CRP} were raised, and those of albumin and prealbumin were reduced in 5\% to 14\% of patients. 25 (11\%) developed major complications, of whom 9 (4\%) died. 9 Patients (4\%) had a severe systemic inflammatory response caused by infective complications that did not result from technical failure of the operative technique. Of these 9 patients, 7 (78\%) already had signs of an increased acute phase response before operation that was significantly different from the incidence among patients who recovered without complications (21/204. p {\textless} 0.001)
{CONCLUSION}: These data suggest that if there are signs of an acute phase response preoperatively the patient's response to operation and infection during the postoperative period may be adversely affected.},
	pages = {39--44},
	number = {1},
	journaltitle = {The European Journal of Surgery = Acta Chirurgica},
	shortjournal = {Eur J Surg},
	author = {Haupt, W. and Hohenberger, W. and Mueller, R. and Klein, P. and Christou, N. V.},
	date = {1997-01},
	pmid = {9116110},
	keywords = {Acute-Phase Reaction, alpha 1-Antitrypsin, C-Reactive Protein, Follow-Up Studies, Humans, Infection, Interleukin-6, postoperative complications, Prealbumin, Prospective Studies, Serum Albumin}
}

@article{donnelly_criteria_1990,
	title = {Criteria to verify attainment of maximal exercise tolerance test with obese females},
	volume = {10 Suppl 1},
	issn = {0168-8227},
	abstract = {This study compared criteria used to determine attainment of maximal {ETT} used with normal subjects to results shown by obese subjects. Results indicated that obese subjects do not show the values that normal subjects show for plateau in oxygen consumption, respiratory exchange ratio, predicted maximal heart rate, or perceived exertion. Generally, less than 60\% of the obese subjects met criteria for maximal {ETT}. These findings suggest that alternate criteria and/or alternate testing are needed to ascertain that {ETT} was maximal. Suggestions include longer treadmill stage times and the use of blood lactate.},
	pages = {S283--286},
	journaltitle = {Diabetes research and clinical practice},
	shortjournal = {Diabetes Res. Clin. Pract.},
	author = {Donnelly, J E and Jakicic, J and Roscoe, M and Jacobsen, D J and Israel, R G},
	date = {1990},
	pmid = {2286145},
	keywords = {Adult, Cardiovascular System, Exercise, Exercise Test, Female, Heart Rate, Humans, Middle Aged, Obesity, Oxygen Consumption, Pulmonary Gas Exchange}
}

@article{friedman_surgery_2010,
	title = {Surgery in the Patient with Liver Disease},
	volume = {121},
	issn = {0065-7778},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917124/},
	abstract = {Surgery is performed in patients with liver disease more frequently now than in the past, in part because of the long-term survival of patients with cirrhosis. Recent work has focused on estimating perioperative risk in patients with liver disease. Hemodynamic instability in the perioperative period can worsen liver function in patients with liver disease. Operative risk correlates with the severity of the underlying liver disease and the nature of the surgical procedure. Thorough preoperative evaluation is necessary prior to elective surgery. Surgery is contraindicated in patients with certain conditions, such as acute hepatitis, acute liver failure, and alcoholic hepatitis. Estimation of perioperative mortality is inexact because of the retrospective nature of and biased patient selection in available clinical studies. The Child-Pugh classification (Child-Turcotte-Pugh score) and particulary the Model for End-Stage Liver Disease ({MELD}) score provide reasonable estimations of perioperative mortality but do not replace the need for careful preoperative preparation and postoperative monitoring, as early detection of complications is essential for improving outcomes. Medical therapy for specific manifestations of hepatic disease, including ascites, encephalopathy, and renal dysfunction, should be optimized preoperatively or, if necessary, administered in the postoperative period.},
	pages = {192--205},
	journaltitle = {Transactions of the American Clinical and Climatological Association},
	shortjournal = {Trans Am Clin Climatol Assoc},
	author = {Friedman, Lawrence S.},
	urldate = {2015-06-03},
	date = {2010},
	pmid = {20697561},
	pmcid = {PMC2917124},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KJNJQEU2\\Friedman - 2010 - Surgery in the Patient with Liver Disease.pdf:application/pdf}
}

@article{padillo_improved_2001,
	title = {Improved cardiac function in patients with obstructive jaundice after internal biliary drainage: hemodynamic and hormonal assessment},
	volume = {234},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422089/},
	shorttitle = {Improved cardiac function in patients with obstructive jaundice after internal biliary drainage},
	pages = {652},
	number = {5},
	journaltitle = {Annals of surgery},
	author = {Padillo, Javier and Puente, Jesús and Gómez, Manuel and Dios, Francisco and Naranjo, Antonio and Vallejo, Juan A. and Miño, Gonzalo and Pera, Carlos and Sitges-Serra, Antonio},
	urldate = {2014-01-27},
	date = {2001},
	file = {Padillo et al. - 2001 - Improved cardiac function in patients with obstruc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UC4H38J9\\Padillo et al. - 2001 - Improved cardiac function in patients with obstruc.pdf:application/pdf}
}

@article{gerke_complications_2004,
	title = {Complications of pancreaticoduodenectomy after neoadjuvant chemoradiation in patients with and without preoperative biliary drainage},
	volume = {36},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15248382},
	abstract = {{BACKGROUND}: It has been suggested that preoperative biliary drainage increases the risk of infectious complications of pancreaticoduodenectomy. {AIMS}: The aim of this study was to assess complications related to biliary stents/drains and postoperative morbidity in patients undergoing neoadjuvant chemoradiotherapy for periampullary cancer. {PATIENTS}: One hundred and eighty-four patients with periampullary neoplasms were prospectively selected for neoadjuvant external beam radiation therapy and 5-fluorouracil-based chemotherapy between 1995 and 2002. {METHODS}: The data were retrospectively completed and analysed with respect to biliary drainage, efficacy and complications of endoscopic biliary stents and postoperative morbidity. Patients who had undergone a surgical biliary bypass were excluded. {RESULTS}: Data were completed in 168 patients. One hundred and nineteen patients were treated with endoscopic biliary stents, 18 patients had a percutaneous biliary drain and 31 patients did not require biliary drainage. Hospitalisation for stent-related complications was necessary in 15\% of the patients with endoscopic biliary stents. Seventy-two patients underwent pancreaticoduodenectomy. There was no significant difference in the rate of wound infections, intra-abdominal abscesses and overall complications between the groups with and without preoperative biliary drainage. {CONCLUSIONS}: Postoperative infectious complications are common in patients both with and without preoperative biliary drainage. A statistically significant difference in complication rates was not observed between these groups.},
	pages = {412--8},
	number = {6},
	journaltitle = {Dig Liver Dis},
	author = {Gerke, H and White, R and Byrne, M F and Stiffier, H and Mitchell, R M and Hurwitz, H I and Morse, M A and Branch, M S and Jowell, P S and Czito, B and Clary, B and Pappas, T N and Tyler, D S and Baillie, J},
	date = {2004-06}
}

@article{richards_relationships_2012-1,
	title = {The relationships between cellular components of the peritumoural inflammatory response, clinicopathological characteristics and survival in patients with primary operable colorectal cancer.},
	volume = {106},
	doi = {10.1038/bjc.2012.211},
	abstract = {{BACKGROUND}: The host inflammatory response is an important determinant of cancer  outcome. We examined different methods of assessing the local inflammatory response in colorectal tumours and explored relationships with both clinicopathological characteristics and survival. {METHODS}: Cohort study of patients (n=130) with primary operable colorectal cancer and mature follow-up. Local inflammatory response at the invasive margin was assessed with: (1) a semi-quantitative assessment of peritumoural inflammation using Klintrup-Makinen  (K-M) grading and (2) an assessment of individual immune cell infiltration (lymphocytes, plasma cells, neutrophils, macrophages and eosinophils). {RESULTS}: The peritumoural inflammatory response was K-M low grade in 48\% and high grade in 52\%. Inflammatory cells were primarily macrophages, lymphocytes and neutrophils with relatively few plasma cells or eosinophils. On univariate analysis, K-M grade, lymphocyte infiltration and plasma cell infiltration were associated with  cancer-specific survival. On multivariate analysis, only systemic inflammatory response, {TNM} (tumour, node and metastases) stage, venous invasion, tumour necrosis and K-M grade were independently associated with cancer-specific survival. There was no relationship between local infiltration of inflammatory cells and a systemic inflammatory response. However, high K-M grade, lymphocyte infiltration and plasma cell infiltration were associated with a number of favourable pathological characteristics, including an absence of venous invasion. {CONCLUSION}: Infiltration of inflammatory cells in the invasive margin of colorectal tumours is beneficial to survival. The adaptive immune response appears to have a prominent role in the prevention of tumour progression in patients with colorectal cancer.},
	pages = {2010--2015},
	number = {12},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Richards, C. H. and Flegg, K. M. and Roxburgh, C. S. D. and Going, J. J. and Mohammed, Z. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2012-06-05},
	pmid = {22596238},
	pmcid = {PMC3388572},
	keywords = {Colorectal Neoplasms/*immunology/mortality/pathology, Eosinophils/immunology, Female, Humans, Inflammation/*diagnosis, Leukocyte Count, Lymphocytes, Tumor-Infiltrating/*immunology, Macrophages/*immunology, Male, Neoplasm Invasiveness, Neutrophils/*immunology, Plasma Cells/immunology}
}

@article{mcmillan_inflammation-based_2008,
	title = {An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer.},
	volume = {67},
	doi = {10.1017/S0029665108007131},
	abstract = {Progressive involuntary weight loss, in particular the loss of lean tissue, is common in patients with advanced cancer and has long been recognised to result in a deterioration in performance status and quality of life, increased morbidity and mortality. The aetiology of such weight loss or cachexia is complex and involves both tumour and host responses. Thus, identification of patients who are or are likely to become cachectic has been problematic. In addition to a reduction in appetite and increased satiety leading to poor dietary intake, there is now increasing clinical evidence that the activation of a chronic ongoing systemic inflammatory response is one of the earliest and most important contributory factors to cachexia. Such findings help to explain the failure of simple nutritional programmes to reverse weight loss adequately in patients with  cancer. In the present paper the development of an inflammation-based score is described, which is derived from the acute-phase proteins C-reactive protein and  albumin and is termed the Glasgow prognostic score ({GPS}). Its value as a predictor of survival, independent of tumour stage, performance status and treatment (active or palliative), has been shown in a variety of advanced common  solid tumours. The nature of the relationship between the {GPS}, appetite, body composition, performance status and quality of life of the patient with advanced  cancer will be described. Recently, it has become evident that the systemic inflammatory response is also present in a smaller proportion of patients with primary operable cancer and is also predictive of disease progression and poor survival. The role of {GPS} in clinical decision making will be discussed.},
	pages = {257--262},
	number = {3},
	journaltitle = {The Proceedings of the Nutrition Society},
	shortjournal = {Proc Nutr Soc},
	author = {{McMillan}, Donald C.},
	date = {2008-08},
	pmid = {18452641},
	keywords = {Cachexia/*etiology/prevention \& control, C-Reactive Protein/analysis, Humans, Inflammation/*complications, Neoplasms/*immunology/*pathology/therapy, Neoplasm Staging/methods, Nutritional Physiological Phenomena/*physiology, Predictive Value of Tests, Prognosis, Serum Albumin/analysis, Severity of Illness Index}
}

@article{anblagan_measurement_2013,
	title = {Measurement of fetal fat in utero in normal and diabetic pregnancies using magnetic resonance imaging},
	volume = {42},
	rights = {Copyright © 2013 {ISUOG}. Published by John Wiley \& Sons Ltd.},
	issn = {1469-0705},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/uog.12382/abstract},
	doi = {10.1002/uog.12382},
	abstract = {Objectives

To assess the reliability of magnetic resonance imaging ({MRI}) to measure fetal fat volume in utero, and to study fetal growth in women with and without diabetes in view of the increased prevalence of macrosomia in the former.


Methods

We studied 26 pregnant women, 14 with pre-gestational diabetes and 12 non-diabetic controls. Fetal assessment took place at 24 weeks' gestation and again at 34 weeks by standard ultrasound biometry followed by {MRI} at 1.5 T. Fetal fat volume was determined from T1-weighted water-suppressed images using a semi-automated approach based on pixel intensity and taking into account partial volume effects. Fetal volume was also determined from the {MRI} images. Fetal weight was calculated using published fat and lean tissue densities.


Results

There was little fetal fat at 24 weeks' gestation, but at 34 weeks the fetal fat content was considerably higher in the women with diabetes, with a mean fat content of 1090 ± 417 cm3 compared with 541 ± 348 cm3 in the controls (P = 0.006). Measurements of fetal fat volume showed low intra- and interobserver variability at 34 weeks, with intraclass correlation coefficients consistently above 0.99. Birth-weight centile correlated with fetal fat volume (R2 = 0.496, P {\textless} 0.001), percentage of fetal fat (R2 = 0.362, P = 0.008) and calculated fetal weight (R2 = 0.492, P {\textless} 0.001) at 34 weeks.


Conclusions

{MRI} appears to be a promising tool for the determination of fetal fat, body composition and weight in utero during the third trimester of pregnancy. Copyright © 2013 {ISUOG}. Published by John Wiley \& Sons Ltd.},
	pages = {335--340},
	number = {3},
	journaltitle = {Ultrasound in Obstetrics \& Gynecology},
	shortjournal = {Ultrasound Obstet Gynecol},
	author = {Anblagan, D. and Deshpande, R. and Jones, N. W. and Costigan, C. and Bugg, G. and Raine-Fenning, N. and Gowland, P. A. and Mansell, P.},
	urldate = {2015-02-04},
	date = {2013},
	langid = {english},
	keywords = {Body Composition, diabetes, fat, fetus, magnetic resonance imaging, pregnancy},
	file = {Anblagan et al. - 2013 - Measurement of fetal fat in utero in normal and di.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6SCAMGDT\\Anblagan et al. - 2013 - Measurement of fetal fat in utero in normal and di.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UUH5WWWH\\abstract.html:text/html}
}

@article{_further_1987,
	title = {Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Gastrointestinal Tumor Study Group},
	volume = {59},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3567862},
	abstract = {The Gastrointestinal Tumor Study Group ({GITSG}) previously demonstrated a significant survival advantage for patients who receive adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Median survival in the group randomized to control was 10.9 months, compared with 21.0 months for those randomized to treatment. {GITSG} registered 30 additional patients, who received the adjuvant therapy to demonstrate that the results of the randomized trial could be replicated. Characteristics of registered patients were similar to those of patients in the randomized phase, with the exception of an improved performance status. The registered patients had median survival time of 18 months. Ten patients were alive at 18.9 to 42.4 months (median, 25.0.). Two-year actuarial survival was 46\% (95\% confidence interval [{CI}], 0.28, 0.65) compared with 43\% (95\% {CI}, 0.25, 0.63) for 21 patients randomized to treatment and 18\% (95\% {CI}, 0.08, 0.36) for 22 patients randomized to control. Based on the original study and the confirmatory findings, the combined use of radiation therapy and fluorouracil as adjuvant therapy after curative resection is effective and is preferred to no adjuvant therapy.},
	pages = {2006--10},
	number = {12},
	journaltitle = {Cancer},
	date = {1987-06}
}

@article{halmes_immunochemical_1996,
	title = {Immunochemical detection of protein adducts in mice treated with trichloroethylene.},
	volume = {9},
	doi = {10.1021/tx950171v},
	abstract = {Trichloroethylene has been shown to produce tumors in rodents and is a suspect human carcinogen. In addition, a number of case reports raise the possibility that trichloroethylene can induce an autoimmune disorder known as systemic sclerosis. To investigate whether covalent binding of reactive trichloroethylene  metabolites may be involved in the mechanisms underlying these toxic responses, we have developed a polyclonal antibody that can recognize trichloroethylene--protein adducts in tissues. The antibody was prepared by immunizing a rabbit with dichloroacetic anhydride-modified keyhole limpet hemocyanin. Enzyme-linked immunosorbent assay data indicated that the serum antibody recognized dichloroacetic anhydride-modified rabbit serum albumin, but not unmodified protein. In addition, N epsilon-dichloroacetyl-L-lysine was the most potent inhibitor of antibody binding to dichloroacetic anhydride-modified rabbit serum albumin, indicating that the antibody recognizes primarily dichloroacetylated lysine residues. Immunoblots revealed the presence of two major trichloroethylene adducts at 50 and 100 {kDa} in liver microsomal fractions from male B6C3/F1 mice treated with trichloroethylene. The formation of trichloroethylene adducts was both dose and time dependent. Furthermore, the},
	pages = {451--456},
	number = {2},
	journaltitle = {Chemical research in toxicology},
	shortjournal = {Chem Res Toxicol},
	author = {Halmes, N. C. and {McMillan}, D. C. and Oatis, J. E. Jr and Pumford, N. R.},
	date = {1996-03},
	pmid = {8839049},
	keywords = {Animals, Antibodies/chemistry, Antibody Specificity, Cytochrome P-450 {CYP}2E1/chemistry/immunology, Dichloroacetic Acid/immunology, Immunoblotting, Immunohistochemistry, Male, Mice, Mice, Inbred C57BL, Microsomes, Liver/immunology, Protein Binding, Serum Albumin/immunology/*metabolism, Trichloroethylene/administration \& dosage/*chemistry/immunology}
}

@article{bredella_comparison_2010,
	title = {Comparison of {DXA} and {CT} in the Assessment of Body Composition in Premenopausal Women With Obesity and Anorexia Nervosa},
	volume = {18},
	issn = {1930-7381},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607308/},
	doi = {10.1038/oby.2010.5},
	abstract = {Accurate methods for assessing body composition in subjects with obesity and anorexia nervosa ({AN}) are important for determination of metabolic and cardiovascular risk factors and to monitor therapeutic interventions. The purpose of our study was to assess the accuracy of dual-energy X-ray absorptiometry ({DXA}) for measuring abdominal and thigh fat, and thigh muscle mass in premenopausal women with obesity, {AN}, and normal weight compared to computed tomography ({CT}). In addition, we wanted to assess the impact of hydration on {DXA}-derived measures of body composition by using bioelectrical impedance analysis ({BIA}). We studied a total of 91 premenopausal women (34 obese, 39 with {AN}, and 18 lean controls). Our results demonstrate strong correlations between {DXA}- and {CT}-derived body composition measurements in {AN}, obese, and lean controls (r = 0.77–0.95, P {\textless} 0.0001). After controlling for total body water ({TBW}), the correlation coefficients were comparable. {DXA} trunk fat correlated with {CT} visceral fat (r = 0.51–0.70, P {\textless} 0.0001). {DXA} underestimated trunk and thigh fat and overestimated thigh muscle mass and this error increased with increasing weight. Our study showed that {DXA} is a useful method for assessing body composition in premenopausal women within the phenotypic spectrum ranging from obesity to {AN}. However, it is important to recognize that {DXA} may not accurately assess body composition in markedly obese women. The level of hydration does not significantly affect most {DXA} body composition measurements, with the exceptions of thigh fat.},
	pages = {2227--2233},
	number = {11},
	journaltitle = {Obesity (Silver Spring, Md.)},
	shortjournal = {Obesity (Silver Spring)},
	author = {Bredella, Miriam A. and Ghomi, Reza Hosseini and Thomas, Bijoy J. and Torriani, Martin and Brick, Danielle J. and Gerweck, Anu V. and Misra, Madhusmita and Klibanski, Anne and Miller, Karen K.},
	urldate = {2015-02-04},
	date = {2010-11},
	pmid = {20111013},
	pmcid = {PMC3607308},
	file = {Bredella et al. - 2010 - Comparison of DXA and CT in the Assessment of Body.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MXHUJGHZ\\Bredella et al. - 2010 - Comparison of DXA and CT in the Assessment of Body.pdf:application/pdf}
}

@article{cheng_nuclear_2011,
	title = {Nuclear Factor-κB–Dependent Epithelial to Mesenchymal Transition Induced by {HIF}-1α Activation in Pancreatic Cancer Cells under Hypoxic Conditions},
	volume = {6},
	issn = {1932-6203},
	url = {http://dx.plos.org/10.1371/journal.pone.0023752},
	doi = {10.1371/journal.pone.0023752},
	pages = {e23752},
	number = {8},
	journaltitle = {{PLoS} {ONE}},
	author = {Cheng, Zhuo-Xin and Sun, Bei and Wang, Shuang-Jia and Gao, Yue and Zhang, Ying-Mei and Zhou, Hao-Xin and Jia, Guang and Wang, Yong-Wei and Kong, Rui and Pan, Shang-Ha and Xue, Dong-Bo and Jiang, Hong-Chi and Bai, Xue-Wei},
	editor = {Batra, S. K.},
	urldate = {2014-01-27},
	date = {2011-08-22},
	file = {Cheng et al. - 2011 - Nuclear Factor-κB–Dependent Epithelial to Mesenchy.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VAMW7NT4\\Cheng et al. - 2011 - Nuclear Factor-κB–Dependent Epithelial to Mesenchy.pdf:application/pdf}
}

@article{beger_necrosectomy_1988,
	title = {Necrosectomy and postoperative local lavage in necrotizing pancreatitis},
	volume = {75},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3349326},
	abstract = {Necrosectomy with postoperative continuous local lavage was performed in a prospective study involving 95 patients with necrotizing pancreatitis. In the same period 567 patients with oedematous-interstitial pancreatitis were treated non-operatively with a hospital mortality rate of 0.7 per cent. In patients with necrotizing pancreatitis the median Ranson criteria score was 4.5 points; operation was required at a median of 7 days after the onset of symptoms because of non-response to conservative treatment. In all, 59 per cent of the patients (56 out of 95) developed extended intrapancreatic parenchymal necrosis, 70 per cent had ascites, and 66 per cent had intra- and extrapancreatic necrosis; 42 per cent of the patients had bacterial infection of the necrotic tissue. For lavage a median of 8 l/24 h of fluid were instilled postoperatively for 25 days (median). The lavage fluid showed high levels of immunoreactive trypsin, phospholipase A2, and endotoxin in the early postoperative period. Hospital mortality rate was 8.4 per cent. Necrosectomy and continuous postoperative lavage can achieve high survival rates in patients with necrotizing pancreatitis. Postoperative local lavage allows the continuous non-operative evacuation of biologically active compounds and devitalized tissue, and avoids damage to remaining vital exocrine and endocrine pancreatic tissue.},
	pages = {207--12},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Beger, H G and Büchler, M and Bittner, R and Block, S and Nevalainen, T and Roscher, R},
	date = {1988-03}
}

@article{older_preoperative_2000,
	title = {Preoperative cardiopulmonary risk assessment by cardiopulmonary exercise testing},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16599898},
	abstract = {{OBJECTIVE}: To review the strategies for identification and subsequent management of high-risk patients that have been proposed to reduce perioperative morbidity and mortality. {DATA} {SOURCES}: Articles and published reviews of studies on evaluation and management of patients to reduce perioperative morbidity and mortality. {SUMMARY} {OF} {REVIEW}: Many strategies have been devised to evaluate the perioperative risk in elderly patients, particularly those who are about to undergo major intra-abdominal surgery. An assessment of cardiac and pulmonary responses to exercise-induced stress (i.e. cardiopulmonary exercise testing) using a bicycle ergometer, metabolic cart (to measure oxygen uptake and carbon dioxide excretion) and a 12 lead electrocardiograph has been found to be a non.invasive test that is quick, cheap, easy to perform and requires no special preparation. It has advantages over any other preoperative test by defining operative risk and allowing logical triage according to objective risk assessment. It is able to objectively evaluate the extent of any cardiac failure (by assessing the anaerobic threshold), myocardial ischaemia, provides insight into stroke index, the presence of pulmonary artery hypertension and defines obstructive and restrictive lung disease and ventilation perfusion inequality better than conventional preoperative respiratory function tests. {CONCLUSIONS}: In patients who are about to undergo major intra-abdominal surgery, preoperative cardiopulmonary exercise testing is an excellent predictor of risk in the postoperative period. No other test is able to offer such a comprehensive preoperative risk evaluation for an operative patient.},
	pages = {198--208},
	number = {3},
	journaltitle = {Crit Care Resusc},
	author = {Older, P and Smith, R and Hall, A and French, C},
	date = {2000-09}
}

@article{naimark_continuous_1964,
	title = {Continuous measurement of ventilatory exchange ratio during exercise},
	volume = {19},
	rights = {Copyright © 1964 the American Physiological Society},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/19/4/644},
	abstract = {The ventilatory gas exchange ratio (R) has been measured continuously during exercise from end-tidal {CO}2 and N2 concentrations recorded with gas analyzers. Studies in normal subjects and patients with different working capacities indicate that the change in R at different levels of work lasting several minutes on an ergometer gives an excellent measure of the balance between oxygen supply and demand in the working muscles. The level of work at which R increases appreciably above its resting level corresponds to the level at which arterial lactate increases and plasma bicarbonate falls. The continuous measurement of R can be readily incorporated into work tests for the assessment of exercise performance in both normal subjects and patients with cardiovascular diseases.
blood bicarbonate; work test; anaerobic metabolism; physical fitness; blood lactate
Submitted on December 30, 1963},
	pages = {644--652},
	number = {4},
	journaltitle = {Journal of Applied Physiology},
	author = {Naimark, Arnold and Wasserman, Karlman and {McIlroy}, Malcolm B.},
	urldate = {2015-08-22},
	date = {1964-07-01},
	langid = {english},
	pmid = {14195574},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FGU6CPRV\\644.html:text/html}
}

@article{ramsey_longitudinal_2006,
	title = {The longitudinal relationship between circulating concentrations of C-reactive protein, interleukin-6 and interleukin-10 in patients undergoing resection for renal cancer.},
	volume = {95},
	doi = {10.1038/sj.bjc.6603387},
	abstract = {The systemic inflammatory response, as evidenced by elevated circulating concentrations of C-reactive protein, is a stage-independent prognostic factor in patients undergoing curative nephrectomy for localised renal cancer. However, it  is not clear whether the systemic inflammatory response arises from the tumour per se or as a result of an impaired immune cytokine response. The aim of the present study was to examine C-reactive protein, interleukin-6 and interleukin-10 concentrations before and following curative resection of renal cancer. Sixty-four patients with malignant renal disease and 12 with benign disease, undergoing resection were studied. Preoperatively, a blood sample was collected for routine laboratory analysis with a further sample stored before analysis of interleukin-6 and interleukin-10 using an enzyme-linked immunosorbent assay ({ELISA}) technique. The blood sampling procedure and analyses were repeated at approximately 3 months following resection. Circulating concentrations of both interleukin-6 and interleukin (P{\textless} or =0.01) were higher and a greater proportion  were elevated (P{\textless}0.05) in malignant compared with benign disease. The renal cancer patients were grouped according to whether they had evidence of a systemic inflammatory response. In the inflammatory group T stage was higher (P{\textless}0.01), both interleukin-6 and interleukin-10 concentrations were higher (P{\textless}0.001) and elevated (P{\textless}0.10) compared with the non-inflammatory group. Tumour volume was weakly correlated with C-reactive protein (r(2)=0.20, P=0.002), interleukin-6 (r(2)=0.20, P=0.002) and interleukin-10 (r(2)=0.24, P=0.001). Following nephrectomy the proportion of patients with elevated C-reactive protein, interleukin-6 and interleukin-10 concentrations did not alter significantly. An elevated preoperative C-reactive protein was associated with increased tumour stage, interleukin-6 and interleukin-10 concentrations. However, resection of the primary tumour did not appear to be associated with significant normalisation of  circulating concentrations of C-reactive protein, interleukin-6 or interleukin-10. Therefore, the presence of systemic inflammatory response is unlikely to be solely be determined by the tumour itself, but may be as a result  of an impaired immune cytokine response in patients with renal cancer.},
	pages = {1076--1080},
	number = {8},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Ramsey, S. and Lamb, G. W. A. and Aitchison, M. and {McMillan}, D. C.},
	date = {2006-10-23},
	pmid = {17003778},
	pmcid = {PMC2360708},
	keywords = {Analysis of Variance, C-Reactive Protein/*analysis, Enzyme-Linked Immunosorbent Assay, Female, Humans, Interleukin-6/*blood, Interleukin-10/*blood, Kaplan-Meier Estimate, Kidney Neoplasms/blood/*pathology/surgery, Male, Middle Aged, Neoplasm Staging, Nephrectomy, Time Factors}
}

@article{mohammed_breast_2012,
	title = {Breast cancer outcomes by steroid hormone receptor status assessed visually and by computer image analysis.},
	volume = {61},
	rights = {(c) 2012 Blackwell Publishing Ltd.},
	doi = {10.1111/j.1365-2559.2012.04244.x},
	abstract = {{AIMS}: To compare the assessment of steroid hormone receptor immunohistochemistry  by eye and by computer-aided image analysis, and to examine their relationships with survival in breast cancer. {METHODS} {AND} {RESULTS}: Allred scores and weighted histoscores for oestrogen receptor ({ER}) and progesterone receptor ({PR}) immunohistochemistry were determined by eye (visual histoscore) for 459 primary invasive ductal breast carcinomas in triplicate tissue microarrays. Histoscores were also determined by computerized image analysis (automated histoscore). {ER} and {PR} status determined by these different methods were compared with each other and in their ability to predict survival over at least 142 months of follow-up. Allred and visual histoscore were highly associated for {ER} and {PR} (both P {\textless} 0.001). By univariate analysis, Allred score and visual histoscore for {ER} and {PR}  were highly associated with recurrence-free and cancer-specific survival (both P  {\textless} 0.001) in patients with invasive ductal breast cancer overall, in those who received tamoxifen, and in those with recurrence on tamoxifen. Visual and automated histoscores were in excellent agreement for {ER} and {PR} (both P {\textless} 0.001), and were equally effective in predicting recurrence and survival for patients with invasive breast cancer who received tamoxifen. {CONCLUSIONS}: Automated histoscore appears to be a valid alternative to visual histoscore or Allred score for determining {ER} and {PR} status.},
	pages = {283--292},
	number = {2},
	journaltitle = {Histopathology},
	shortjournal = {Histopathology},
	author = {Mohammed, Zahra M. A. and Edwards, Joanne and Orange, Clare and Mallon, Elizabeth and Doughty, Julie C. and {McMillan}, Donald C. and Going, James J.},
	date = {2012-08},
	pmid = {22571413},
	keywords = {Adult, Aged, Antineoplastic Agents, Hormonal/therapeutic use, Breast Neoplasms/drug therapy/*metabolism/pathology, Carcinoma, Ductal, Breast/drug therapy/metabolism/pathology, Disease-Free Survival, Female, Humans, Image Processing, Computer-Assisted, Immunohistochemistry/*methods, Middle Aged, Receptors, Estrogen/*metabolism, Receptors, Progesterone/*metabolism, Recurrence, Tamoxifen/therapeutic use, Treatment Outcome}
}

@article{myers_obesity_2011,
	title = {The obesity paradox and weight loss},
	volume = {124},
	issn = {1555-7162},
	doi = {10.1016/j.amjmed.2011.04.018},
	abstract = {{BACKGROUND}: An "obesity paradox," in which overweight and obese individuals with established cardiovascular disease have a better prognosis than normal weight subjects, has been reported in a number of clinical cohorts, but little is known about the effects of weight loss on the obesity paradox and its association with health outcomes.
{METHODS}: Weight was determined in 3834 men at the time of a clinically referred exercise test and again during a clinical evaluation a mean of 7 years later. The associations among weight changes, baseline fitness, and other risk markers with cardiovascular and all-cause mortality were determined by Cox proportional hazards analysis.
{RESULTS}: During the follow-up period, 314 subjects died (72 of cardiovascular causes). In a multivariate analysis (including baseline weight, weight change, exercise capacity, and cardiovascular disease), weight gain was associated with lower mortality and weight loss was associated with higher mortality (4\% higher per pound lost per year, P{\textless}.001) compared with stable weight. For all-cause mortality, the relative risks for the no change, weight gain, and weight loss groups were 1.0 (referent), 0.64 (95\% confidence interval, 0.50-0.83), and 1.49 (95\% confidence interval, 1.17-1.89), respectively (P{\textless}.001). Those who died and exhibited weight loss had a significantly higher prevalence of deaths due to cancer and cardiovascular causes.
{CONCLUSION}: Weight loss was related to higher mortality and weight gain was related to lower mortality when compared with stable weight. The obesity paradox in our sample is explained in part by a combination of non-volitional weight loss related to occult disease and a protective effect of weight gain.},
	pages = {924--930},
	number = {10},
	journaltitle = {The American Journal of Medicine},
	shortjournal = {Am. J. Med.},
	author = {Myers, Jonathan and Lata, Kusum and Chowdhury, Shilpy and {McAuley}, Paul and Jain, Nikhil and Froelicher, Victor},
	date = {2011-10},
	pmid = {21798508},
	keywords = {Aged, Cardiovascular Diseases, Cause of Death, Cohort Studies, Exercise Test, Humans, Male, Middle Aged, Obesity, Risk Factors, Veterans, Weight Gain, Weight Loss}
}

@article{efishat_stage_2015,
	title = {Stage {III} pancreatic cancer and the role of irreversible electroporation},
	volume = {350},
	rights = {© {BMJ} Publishing Group Ltd 2015},
	issn = {1756-1833},
	url = {http://www.bmj.com/content/350/bmj.h521},
	doi = {10.1136/bmj.h521},
	abstract = {About a third of patients with pancreatic cancer present with locally advanced disease that is not amenable to resection. Because these patients have localized disease, conventional ablative therapies (thermal ablation and cryoablation) have the potential to be beneficial, but their use is inherently limited in the pancreas. These limitations could be overcome by irreversible electroporation—a novel, non-thermal ablative method that is gaining popularity for the treatment of many soft tissue tumors, including those of the pancreas. This review summarizes the status of this technique in the treatment of locally advanced pancreatic cancer. Most of the evidence on efficacy and safety is based on non-randomized prospective series, which show that irreversible electroporation may improve overall survival and pain control in locally advanced pancreatic cancer. As experience with this procedure increases, randomized controlled trials are needed to document its efficacy in locally advanced pancreatic cancer more precisely.},
	pages = {h521},
	journaltitle = {{BMJ}},
	author = {Efishat, Mohammad Al and Wolfgang, Christopher L. and Weiss, Matthew J.},
	urldate = {2015-04-29},
	date = {2015-03-18},
	langid = {english},
	pmid = {25787829},
	file = {Efishat et al. - 2015 - Stage III pancreatic cancer and the role of irreve.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\IHWVGEKW\\Efishat et al. - 2015 - Stage III pancreatic cancer and the role of irreve.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SZ55PTB5\\bmj.html:text/html}
}

@article{mcinnis_effect_1999,
	title = {Effect of Body Composition on Oxygen Uptake during Treadmill Exercise: Body Builders versus Weight-Matched Men},
	volume = {70},
	issn = {0270-1367, 2168-3824},
	url = {http://www.tandfonline.com/doi/abs/10.1080/02701367.1999.10608032},
	doi = {10.1080/02701367.1999.10608032},
	shorttitle = {Effect of Body Composition on Oxygen Uptake during Treadmill Exercise},
	pages = {150--156},
	number = {2},
	journaltitle = {Research Quarterly for Exercise and Sport},
	author = {{McInnis}, Kyle J. and Balady, Gary J.},
	urldate = {2015-04-30},
	date = {1999-06},
	langid = {english},
	file = {McInnis and Balady - 1999 - Effect of Body Composition on Oxygen Uptake during.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\25D5RDFK\\McInnis and Balady - 1999 - Effect of Body Composition on Oxygen Uptake during.pdf:application/pdf}
}

@article{_ats/accp_2003,
	title = {{ATS}/{ACCP} Statement on Cardiopulmonary Exercise Testing},
	volume = {167},
	issn = {1073-449X, 1535-4970},
	url = {http://www.atsjournals.org/doi/abs/10.1164/rccm.167.2.211},
	doi = {10.1164/rccm.167.2.211},
	pages = {211--277},
	number = {2},
	journaltitle = {American Journal of Respiratory and Critical Care Medicine},
	urldate = {2014-01-27},
	date = {2003-01-15},
	file = {2003 - ATSACCP Statement on Cardiopulmonary Exercise Tes.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CSVQ6NHV\\2003 - ATSACCP Statement on Cardiopulmonary Exercise Tes.pdf:application/pdf}
}

@article{ghoneim_serial_1982,
	title = {Serial C-reactive protein measurements in infective complications following cardiac operation: evaluation and use in monitoring response to therapy},
	volume = {34},
	issn = {0003-4975},
	shorttitle = {Serial C-reactive protein measurements in infective complications following cardiac operation},
	abstract = {Serum C-reactive protein ({CRP}) was studied serially in 100 patients who underwent cardiac operation and in another 17 patients in whom serious infections including prosthetic valve endocarditis developed in the early postoperative period. Eleven patients with late onset of prosthetic valve endocarditis and infective endocarditis were also investigated. The assay method used was radial immunodiffusion. Patients without postoperative infective complications showed a rapid increase in {CRP} levels, which reached a peak within 72 hours after operation followed by a progressive decline. The differences between the {CRP} levels in infected and uninfected patients were significant (p less than 0.01). Serial measurements were of prognostic value in evaluating the response to chemotherapy and in predicting the outcome of the disease.},
	pages = {166--175},
	number = {2},
	journaltitle = {The Annals of Thoracic Surgery},
	shortjournal = {Ann. Thorac. Surg.},
	author = {Ghoneim, A. T. and {McGoldrick}, J. and Ionescu, M. I.},
	date = {1982-08},
	pmid = {7103587},
	keywords = {Adult, Aged, Blood Sedimentation, Cardiac Surgical Procedures, C-Reactive Protein, Endocarditis, Bacterial, Female, Humans, Infection, Male, Middle Aged, postoperative complications, Postoperative Period, Time Factors}
}

@article{west_cardiopulmonary_2014-1,
	title = {Cardiopulmonary exercise testing for the prediction of morbidity risk after rectal cancer surgery},
	volume = {101},
	rights = {© 2014 {BJS} Society Ltd. Published by John Wiley \& Sons Ltd},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.9551/abstract},
	doi = {10.1002/bjs.9551},
	abstract = {Background

This study investigated the relationship between objectively measured physical fitness variables derived by cardiopulmonary exercise testing ({CPET}) and in-hospital morbidity after rectal cancer surgery.


Methods

Patients scheduled for rectal cancer surgery underwent preoperative {CPET} (reported blind to patient characteristics) with recording of morbidity (recorded blind to {CPET} variables). Non-parametric receiver operating characteristic ({ROC}) curves and logistic regression were used to assess the relationship between {CPET} variables and postoperative morbidity.


Results

Of 105 patients assessed, 95 (72 men) were included; ten patients had no surgery and were excluded (3 by choice, 7 owing to unresectable metastasis). Sixty-eight patients had received neoadjuvant treatment. {ROC} curve analysis of oxygen uptake (V˙o2) at estimated lactate threshold (θ{\textasciicircum}L) and peak V˙o2 gave an area under the {ROC} curve of 0·87 (95 per cent confidence interval 0·78 to 0·95; P {\textless} 0·001) and 0·85 (0·77 to 0·93; P {\textless} 0·001) respectively, indicating that they can help discriminate patients at risk of postoperative morbidity. The optimal cut-off points identified were 10·6 and 18·6 ml per kg per min for V˙o2 at θ{\textasciicircum}L and peak respectively.


Conclusion

{CPET} can help predict morbidity after rectal cancer surgery.},
	pages = {1166--1172},
	number = {9},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {West, M. A. and Parry, M. G. and Lythgoe, D. and Barben, C. P. and Kemp, G. J. and Grocott, M. P. W. and Jack, S.},
	urldate = {2015-05-05},
	date = {2014-08-01},
	langid = {english},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\T43QI2ZD\\abstract.html:text/html;West et al. - 2014 - Cardiopulmonary exercise testing for the predictio.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PTUJAWMI\\West et al. - 2014 - Cardiopulmonary exercise testing for the predictio.pdf:application/pdf}
}

@article{binah_obstructive_1985,
	title = {Obstructive jaundice blunts myocardial contractile response to isoprenaline in the dog: a clue to the susceptibility of jaundiced patients to shock?},
	volume = {69},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/4064577},
	abstract = {Patients with obstructive jaundice are susceptible to postoperative shock. To clarify the mechanism of this phenomenon, we compared the contractile response to isoprenaline of isolated ventricular preparations from three groups of dogs: (a) dogs with chronic bile-duct ligation ({CBDL}), (b) dogs with choledochocaval anastomosis ({CDCA}) and (c) sham-operated dogs ({SO}). Isolated ventricular muscles from {CBDL} and {CDCA} dogs showed a depressed contractile response to isoprenaline as compared with {SO} dogs. Mechanical performance was spared in the {CBDL} and {CDCA} dogs. There were no differences in the contractile responses of {SO} and {CBDL} dogs, either to ouabain or to changes in the rates of stimulation (force-frequency relationships). These data demonstrate that, in the dog, obstructive jaundice and/or cholaemia are associated with blunted contractile response to beta-adrenoreceptor stimulation in the face of intact basic mechanical performance. Similar inotropic refractoriness to beta-adrenoreceptor stimulation could contribute to the susceptibility to postoperative shock in patients with obstructive jaundice.},
	pages = {647--53},
	number = {6},
	journaltitle = {Clin Sci (Lond)},
	author = {Binah, O and Bomzon, A and Blendis, L M and Mordohovich, D and Better, O S},
	date = {1985-12}
}

@article{douglas_towards_2014,
	title = {Towards a simple objective framework for the investigation and treatment of cancer cachexia: the Glasgow Prognostic Score.},
	volume = {40},
	rights = {Copyright (c) 2013 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2013.11.007},
	abstract = {Progress in the treatment of progressive involuntary weight loss in patients with cancer (cancer cachexia) remains dismally slow. Cancer cachexia and its associated clinical symptoms, including weight loss, altered body composition, poor functional status, poor food intake, and poorer quality of life, have long been recognised as indicators of poorer prognosis in the patient with cancer. In  order to make some progress a starting point is to have general agreement on what constitutes cancer cachexia. In recent years a plethora of different definitions  and consensus statements have been proposed as a framework for investigation and  treatment of this debilitating and terminal condition. However, there are significant differences in the criteria used in these and all include poorly defined or subjective criteria and their prognostic value has not been established. The aim of the present review was to examine the hypothesis that a systemic inflammatory response accounts for most of the effect of cancer cachexia and its associated clinical symptoms on poor outcome in patients with cancer. Furthermore, to put forward the case for the Glasgow Prognostic Score to act a simple objective framework for the investigation and treatment of cancer cachexia.},
	pages = {685--691},
	number = {6},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {Douglas, Euan and {McMillan}, Donald C.},
	date = {2014-07},
	pmid = {24321611},
	keywords = {*Body Composition, *Weight Loss, Anorexia/complications, Biological Markers/blood, Cachexia/*diagnosis/etiology/*therapy, C-Reactive Protein/metabolism, Disease Progression, Energy Intake, Fatigue/etiology, Humans, Muscle Weakness/etiology, Neoplasms/*complications, Predictive Value of Tests, Prognosis, Quality of Life, Serum Albumin/metabolism, Severity of Illness Index, Systemic Inflammatory Response Syndrome/*blood/*complications}
}

@article{mccall_tumoral_2011,
	title = {Tumoral C-reactive protein and nuclear factor kappa-B expression are associated with clinical outcome in patients with prostate cancer.},
	volume = {10},
	doi = {10.3233/CBM-2012-0236},
	abstract = {Prostate cancer (Pca) is the most common form of cancer affecting men, despite recent advances in {PCa} treatments, one third of patients diagnosed each year succumb to this disease. The inflammatory response has been implicated in prostate cancer progression. The pro-inflammatory transcription factor, {NFkappaB}/p65 has been implicated in {PCa} progression. Few studies have examined the involvement of {NFkappaB} and inflammatory signalling in {PCa}.Immunohistochemistry was employed to investigate the expression of {NFkappaB}/p65, C-reactive protein and Ki67 in 61 clinical samples. Tumours expressing high levels of p65 (p=0.004), {CRP} (p=0.011) and Ki67 (p=0.0003) had a  shorter disease specific survival. Upon combining p65 and {CRP} status it was observed that those tumours with low expression of both proteins had a median survival of 11 years compared to 3.9 years for those with tumours with high expression of both (p=0.005). {CRP} expression was significantly higher in the 21 patients who died of their disease and on multivariate analysis {CRP} expression retained independent significance (p=0.005). This study suggests {CRP} and {NFkappaB} may function collectively to drive prostate cancer progression in a subset of patients. Tumoral {CRP} is a significant independent predictor of cancer specific survival. The relationship between tumour {CRP} and signalling pathways warrants further investigation in a larger cohort.},
	pages = {91--99},
	number = {2},
	journaltitle = {Cancer biomarkers : section A of Disease markers},
	shortjournal = {Cancer Biomark},
	author = {{McCall}, Pamela and Catlow, Jamie and {McArdle}, Peter A. and {McMillan}, Donald C. and Edwards, Joanne},
	date = {2011},
	pmid = {22430136},
	keywords = {Aged, C-Reactive Protein/analysis/*biosynthesis, Disease-Free Survival, Humans, Immunohistochemistry, Inflammation/metabolism/mortality/pathology, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, {NF}-kappa B/analysis/*biosynthesis, Prognosis, Proportional Hazards Models, Prostatic Neoplasms/metabolism/*mortality/pathology, Tumor Markers, Biological/*analysis}
}

@book{sarr_new_2013,
	location = {Department of Surgery, Mayo Clinic {GU} 10-01, 200 First Street Southwest, Rochester, {MN} 55905, {USA}. sarr.michael@mayo.edu},
	title = {The new revised classification of acute pancreatitis 2012},
	volume = {93},
	isbn = {1558-3171},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23632143},
	abstract = {This study aims to update the 1991 Atlanta Classification of acute pancreatitis, to standardize the reporting of and terminology of the disease and its complications. Important features of this classification have incorporated new insights into the disease learned over the last 20 years, including the recognition that acute pancreatitis and its complications involve a dynamic process involving two phases, early and late. The accurate and consistent description of acute pancreatitis will help to improve the stratification and reporting of new methods of care of acute pancreatitis across different practices, geographic areas, and countries.},
	pagetotal = {549-62},
	number = {3},
	author = {Sarr, Michael G and Banks, Peter A and Bollen, Thomas L and Dervenis, Christos and Gooszen, Hein G and Johnson, Colin D and Tsiotos, Gregory G and Vege, Santhi Swaroop},
	date = {2013-06}
}

@article{drury_citation_2009,
	title = {Citation of Retracted Articles: A Call for Vigilance},
	volume = {87},
	issn = {00034975},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S000349750801655X},
	doi = {10.1016/j.athoracsur.2008.07.108},
	shorttitle = {Citation of Retracted Articles},
	pages = {670},
	number = {2},
	journaltitle = {The Annals of Thoracic Surgery},
	author = {Drury, Nigel E. and Karamanou, Danai M.},
	urldate = {2014-01-27},
	date = {2009-02},
	file = {Drury and Karamanou - 2009 - Citation of Retracted Articles A Call for Vigilan.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\585PVZ46\\Drury and Karamanou - 2009 - Citation of Retracted Articles A Call for Vigilan.pdf:application/pdf}
}

@article{laird_systemic_2013,
	title = {The systemic inflammatory response and its relationship to pain and other symptoms in advanced cancer.},
	volume = {18},
	doi = {10.1634/theoncologist.2013-0120},
	abstract = {{INTRODUCTION}: Inflammation has been identified as a hallmark of cancer and may be necessary for tumorgenesis and maintenance of the cancer state. Inflammation-related symptoms are common in those with cancer; however, little is known about the relationship between symptoms and systemic inflammation in cancer. The aim of the present study was to examine the relationship between symptoms and systemic inflammation in a large cohort of patients with advanced cancer. {METHODS}: Data from an international cohort of patients with advanced cancer were analyzed. Symptoms and patient-related outcomes were recorded using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire--Core Questionnaire. Systemic inflammation was assessed using},
	pages = {1050--1055},
	number = {9},
	journaltitle = {The oncologist},
	shortjournal = {Oncologist},
	author = {Laird, Barry J. and {McMillan}, Donald C. and Fayers, Peter and Fearon, Kenneth and Kaasa, Stein and Fallon, Marie T. and Klepstad, Pal},
	date = {2013},
	pmid = {23966223},
	pmcid = {PMC3780637},
	keywords = {Cohort Studies, C-Reactive Protein/metabolism, Europe/epidemiology, Female, Humans, Inflammation/blood/*epidemiology/pathology, Male, Middle Aged, Neoplasms/blood/*epidemiology/pathology, Pain/blood/*epidemiology/etiology, Questionnaires}
}

@article{huddart_preoperative_2013,
	title = {Preoperative cardiopulmonary exercise testing in England – a national survey},
	volume = {2},
	issn = {2047-0525},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964325/},
	doi = {10.1186/2047-0525-2-4},
	abstract = {Background
Cardiopulmonary exercise testing ({CPET}) has become well established in the preoperative assessment of patients presenting for major surgery in the United Kingdom. There is evidence supporting its use in risk-stratifying patients prior to major high-risk surgical procedures., We set out to establish how {CPET} services in England have developed since the only survey on this subject was undertaken in 2008 (J Intensive Care Soc 2009, 10:275–278).

Methods
Availability of preoperative {CPET} and contact details were collected via a telephone survey and email invites to complete the online survey were sent to all contacts. The survey was live during March and April 2011.

Results
We received 123 (74\%) responses from the 166 emails that were sent out. In total, 32\% (53/166) of all adult anesthetic departments in England have access to preoperative {CPET} services and a further 4\% (6) were in the process of setting up services. The number of departments offering preoperative {CPET}, including those in the process of setting up services, has risen from 42 in 2008 to 59 in 2011, a rise of over 40\%. Only 61\% of the clinics are run by anesthetists and 39\% of clinics have trained cardiorespiratory technicians assisting in the performance of the test. Most of the clinics (55\%) rely solely on a bicycle ergometer. Vascular surgical patients are the largest group of patients tested, and the majority of tests are run to a symptom-limited maximum. We estimate that 15,000 tests are performed annually for preoperative assessment in England. Only 37\% of respondents were confident that the tests performed were being billed for.

Conclusions
{CPET} is increasing in popularity as a preoperative risk assessment tool. There remains a lack of consistency in the way tests are reported and utilized. The results highlight the extent and diversity of the use of preoperative {CPET} and the potential for further research into its use in unstudied patient groups.},
	pages = {4},
	journaltitle = {Perioperative Medicine},
	shortjournal = {Perioper Med (Lond)},
	author = {Huddart, Sam and Young, Emily L and Smith, Rebecca-Lea and Holt, Peter {JE} and Prabhu, Pradeep K},
	urldate = {2015-05-05},
	date = {2013-02-25},
	pmid = {24472647},
	pmcid = {PMC3964325},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7P2C48C7\\Huddart et al. - 2013 - Preoperative cardiopulmonary exercise testing in E.pdf:application/pdf}
}

@article{working_party_of_the_british_society_of_gastroenterology_uk_2005,
	title = {{UK} guidelines for the management of acute pancreatitis},
	volume = {54 Suppl 3},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15831893},
	pages = {iii1--9},
	journaltitle = {Gut},
	author = {Working Party of the British Society of Gastroenterology and Britain, Association of Surgeons of Great and Ireland and Britain, Pancreatic Society of Great and Ireland and Britain, Association of Upper {GI} Surgeons of Great and Ireland},
	date = {2005-05}
}

@article{barber_metabolic_2000,
	title = {Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement.},
	volume = {98},
	abstract = {Weight-losing patients with advanced cancer often fail to gain weight with conventional nutritional support. This suboptimal response might be explained, in part, by an increased metabolic response to feeding. It has been suggested that eicosapentaenoic acid ({EPA}) can modify beneficially the metabolic response to cancer. The aim of the present study was to examine the metabolic response to feeding in cancer and the effects of an {EPA}-enriched oral food supplement on this response. A total of 16 weight-losing, non-diabetic patients with unresectable pancreatic adenocarcinoma and six healthy, weight-stable controls were studied by indirect calorimetry in the fasting and fed states. Body composition was estimated by bioimpedence analysis. Cancer patients were then given a fish-oil-enriched nutritional supplement providing 2 g of {EPA} and 2550 {kJ} daily,  and underwent repeat metabolic study after 3 weeks of such supplementation. At baseline, resting energy expenditure whether expressed per kg body weight, lean body mass or body cell mass was significantly greater in the cancer patients compared with controls. Fat oxidation was significantly higher in the fasting state in cancer patients [median 1.26 g.kg(-1).min(-1) (interquartile range 0.95-1.38)] than in controls [0.76 g.kg(-1). min(-1) (0.62-0.92); P{\textless}0.05]. Over the 4 h feeding period, changes in insulin and glucose concentrations in cancer patients suggested relative glucose intolerance. In response to oral meal feeding, the percentage change in the area under the curve of energy expenditure  was significantly lower in the cancer patients [median 7.9\% (interquartile range  3.4-9.0)] than in controls [12.6\% (9.9-15.1); P{\textless}0.01]. After 3 weeks of the},
	pages = {389--399},
	number = {4},
	journaltitle = {Clinical science (London, England : 1979)},
	shortjournal = {Clin Sci (Lond)},
	author = {Barber, M. D. and {McMillan}, D. C. and Preston, T. and Ross, J. A. and Fearon, K. C.},
	date = {2000-04},
	pmid = {10731472},
	keywords = {*Food, Fortified, Aged, Blood Glucose/metabolism, Cachexia/etiology/metabolism/*therapy, Case-Control Studies, Eating/physiology, Energy Metabolism, Fasting/metabolism, Female, Fish Oils/*therapeutic use, Humans, Insulin/blood, Male, Middle Aged, Pancreatic Neoplasms/complications/*metabolism}
}

@article{barnett_pancreaticoduodenectomy:_2006,
	title = {Pancreaticoduodenectomy: does preoperative biliary drainage, method of pancreatic reconstruction or age influence perioperative outcome? A retrospective study of 104 consecutive cases},
	volume = {76},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16813619},
	abstract = {{BACKGROUND}: Whether preoperative biliary drainage ({PBD}) is beneficial in reducing complications after pancreaticoduodenectomy is controversial. There remains a reluctance to consider pancreaticoduodenectomy in older patients. The major source of morbidity and potential mortality after pancreaticoduodenectomy is pancreatic fistula, which is caused by difficulties associated with the pancreatic anastomosis. The purpose of this study was to examine the effect of {PBD}, patient age and method of pancreatico-enteric reconstruction on postoperative morbidity and mortality. {METHODS}: A total of 104 consecutive patients undergoing pancreaticoduodenectomy between November 1992 and November 2004 were identified from a prospectively collected database. Multiple preoperative and intraoperative variables were examined and their relationship to postoperative outcome was analysed. {RESULTS}: Postoperative mortality was {\textless}1\%. Forty-three patients (43\%) suffered a total of 85 complications. Median length of stay was 12.5 days (range, 1-88 days). The group undergoing {PBD} did not have higher rates of infectious complication (12 vs 19\%; P = 0.34) or overall complication (41 vs 42\%; P = 0.88) compared with the undrained group. Rate of anastomotic leak (18 vs 4\%; P = 0.045) and anaemia requiring transfusion (41 vs 9\%; P = 0.001) were significantly higher in the pancreaticojejunostomy group compared with the pancreaticogastrostomy group. Patients over the age of 70 years did not have higher rates of complication (44 vs 41\%, P = 0.5) or postoperative length of stay. {CONCLUSION}: Preoperative biliary drainage was not associated with increased postoperative complications. Pancreaticogastrostomy after pancreaticoduodenectomy is a safe and reliable method of reconstruction. Finally, pancreaticoduodenectomy can be carried out with acceptable rates of postoperative morbidity and mortality in selected patients over 70 years of age.},
	pages = {563--8},
	number = {7},
	journaltitle = {{ANZ} J Surg},
	author = {Barnett, Stephen A and Collier, Neil A},
	date = {2006-07}
}

@article{canna_evaluation_2004,
	title = {Evaluation of a cumulative prognostic score based on the systemic inflammatory response in patients undergoing potentially curative surgery for colorectal cancer.},
	volume = {90},
	doi = {10.1038/sj.bjc.6601757},
	abstract = {The value of combining Dukes' stage and C-reactive protein to form a cumulative prognostic score was assessed in 147 patients undergoing potentially curative resection for colorectal cancer. The cancer-specific survival rates at 3 years for patients with a cumulative prognostic score of 0, 1 and 2 were 100, 77 and 40\%, respectively ({HR} 4.76, 2.78-8.15, P{\textless}0.001).},
	pages = {1707--1709},
	number = {9},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Canna, K. and {McMillan}, D. C. and {McKee}, R. F. and {McNicol}, A.-M. and Horgan, P. G. and {McArdle}, C. S.},
	date = {2004-05-04},
	pmid = {15150596},
	pmcid = {PMC2409754},
	keywords = {Adult, Aged, Colorectal Neoplasms/*mortality/*surgery, C-Reactive Protein/*analysis, Female, Humans, Inflammation, Male, Middle Aged, Neoplasm Staging, Prognosis, Survival Analysis, Treatment Outcome, Tumor Markers, Biological/*analysis}
}

@article{von_haehling_ursodeoxycholic_2012-1,
	title = {Ursodeoxycholic Acid in Patients With Chronic Heart Failure},
	volume = {59},
	issn = {07351097},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S0735109711049849},
	doi = {10.1016/j.jacc.2011.10.880},
	pages = {585--592},
	number = {6},
	journaltitle = {Journal of the American College of Cardiology},
	author = {von Haehling, Stephan and Schefold, Joerg C. and Jankowska, Ewa A. and Springer, Jochen and Vazir, Ali and Kalra, Paul R. and Sandek, Anja and Fauler, Günter and Stojakovic, Tatjana and Trauner, Michael and Ponikowski, Piotr and Volk, Hans-Dieter and Doehner, Wolfram and Coats, Andrew J.S. and Poole-Wilson, Philip A. and Anker, Stefan D.},
	urldate = {2014-01-27},
	date = {2012-02},
	file = {von Haehling et al. - 2012 - Ursodeoxycholic Acid in Patients With Chronic Hear.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\W8TRJTSJ\\von Haehling et al. - 2012 - Ursodeoxycholic Acid in Patients With Chronic Hear.pdf:application/pdf}
}

@article{loftin_scaling_2001,
	title = {Scaling Vo2 Peak in Obese and Non-obese Girls},
	volume = {9},
	rights = {2001 North American Association for the Study of Obesity ({NAASO})},
	issn = {1550-8528},
	url = {http://onlinelibrary.wiley.com/doi/10.1038/oby.2001.36/abstract},
	doi = {10.1038/oby.2001.36},
	abstract = {Objective: The conventional ratio method (milliliters O2 per mass) typically is used to express Vo2 peak. The goal of the current study was to compare Vo2 peak of obese girls with normal-weight girls by ratio and allometric scaling methods. Research Methods and Procedures: We compared Vo2 peak by ratio and allometric methods in 46 obese and 47 normal-weight girls. Indirect calorimetry was used to measure Vo2 peak during either treadmill running or walking. Regression analysis was used to determine coefficients for mass and stature for each group with {ANOVA} used to compare data between groups. Results: The obese girls were taller and had higher values of body fatness (p ≤ 0.05). Absolute Vo2 peak (liters per minute) was similar between groups; however Vo2 peak relative to mass was 50\% lower (p ≤ 0.05) in the obese girls. When Vo2 peak (milliliters per minute per kilogram) and mass were correlated, r = −0.48 was found in the obese group. Allometric scaling of logarithmic transformed stature and mass reduced this to r = −0.002, thus eliminating the bias associated with the ratio method. Adjusting Vo2 peak allometrically scaled for mass, stature, and the combination of mass and stature reduced the difference between groups from 50\% (ratio method) to 10\% to 11\% (p ≤ 0.05) with higher values found in the normal-weight girls. Discussion: These results demonstrate the bias associated with the ratio method when comparing Vo2 peak in obese girls with Vo2 peak in normal-weight girls. Allometric scaling eliminated the bias and thus may reflect a truer comparative response.},
	pages = {290--296},
	number = {5},
	journaltitle = {Obesity Research},
	author = {Loftin, Mark and Sothern, Melinda and Trosclair, Laura and O'Hanlon, Ann and Miller, James and Udall, John},
	urldate = {2015-04-29},
	date = {2001-05-01},
	langid = {english},
	keywords = {absolute peak oxygen uptake, allometric scaling, normal-weight girls, overweight girls, peak oxygen uptake},
	file = {Loftin et al. - 2001 - Scaling Vo2 Peak in Obese and Non-obese Girls.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FW62EXGM\\Loftin et al. - 2001 - Scaling Vo2 Peak in Obese and Non-obese Girls.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J59CBS39\\abstract.html:text/html}
}

@article{meek_relationship_2010,
	title = {The relationship between the insulin-like growth factor-1 axis, weight loss, an inflammation-based score and survival in patients with inoperable non-small cell  lung cancer.},
	volume = {29},
	rights = {Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.clnu.2009.08.013},
	abstract = {{BACKGROUND} \& {AIMS}: The involvement of a systemic inflammatory response, as evidenced by the Glasgow Prognostic Score ({GPS}), is associated with weight loss and poor outcome in patients with non-small cell lung cancer. There is good evidence that nutritional and functional decline in patients with advanced malignant disease is associated with catabolic changes in metabolism. However, defects in anabolism may also contribute towards nutritional decline in patients  with cancer. The aim of the present study was to examine the relationship between},
	pages = {206--209},
	number = {2},
	journaltitle = {Clinical nutrition (Edinburgh, Scotland)},
	shortjournal = {Clin Nutr},
	author = {Meek, Claire L. and Wallace, A. Michael and Forrest, Lynn M. and {McMillan}, Donald C.},
	date = {2010-04},
	pmid = {19748165},
	keywords = {*Weight Loss, Aged, Body Mass Index, Carcinoma, Non-Small-Cell Lung/blood/metabolism/*mortality/pathology, Female, Hemoglobins/analysis, Humans, Insulin-Like Growth Factor Binding Protein 3, Insulin-Like Growth Factor Binding Proteins/blood, Insulin-Like Growth Factor I/*analysis, Leptin/blood, Leukocyte Count, Male, Middle Aged, Neoplasm Staging, Prognosis, Severity of Illness Index, Survival Analysis, Systemic Inflammatory Response Syndrome/blood/diagnosis/metabolism/*physiopathology}
}

@article{mccullough_cardiorespiratory_2006,
	title = {Cardiorespiratory Fitness and Short-term Complications After Bariatric Surgery},
	volume = {130},
	issn = {0012-3692},
	url = {http://journal.publications.chestnet.org/article.aspx?doi=10.1378/chest.130.2.517},
	doi = {10.1378/chest.130.2.517},
	pages = {517--525},
	number = {2},
	journaltitle = {Chest},
	author = {{McCullough}, P. A.},
	urldate = {2014-01-27},
	date = {2006-08-01},
	file = {McCullough - 2006 - Cardiorespiratory Fitness and Short-term Complicat.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UXWPTTAN\\McCullough - 2006 - Cardiorespiratory Fitness and Short-term Complicat.pdf:application/pdf}
}

@article{hothi_is_2015,
	title = {Is low V˙O2max/kg in obese heart failure patients indicative of cardiac dysfunction?},
	volume = {184},
	issn = {1874-1754},
	doi = {10.1016/j.ijcard.2015.02.018},
	abstract = {{PURPOSE}: Low peak O2 consumption (V˙O2max/kg) has been widely used as an indirect indicator of poor cardiac fitness, and often guides management of patients with severe heart failure ({HF}). We hypothesized that it should be as good an indicator of cardiac dysfunction in obese and non-obese {HF} patients.
{METHODS}: We compared the cardiopulmonary exercise performance and non-invasive hemodynamics of 152 obese ({BMI}{\textgreater}34kg.m(-2)) and 173 non-obese ({BMI}≤32) male {HF} patients in {NYHA} classes {II} and {III}, with reference to 101 healthy male controls. Their physical and cardiac functional reserves were measured during treadmill exercise testing with standard respiratory gas analyses and {CO}2 rebreathing to measure cardiac output non-invasively during peak exercise. Data are given as mean±{SD}.
{RESULTS}: Obese {HF} patients with {BMI} 40.9±7.5kg·m(-2) (age 56.1±14.0years, {NYHA} 2.5±0.5) exercised to acceptable cardiopulmonary limits (peak {RER}=1.07±0.12), and achieved a mean V˙O2max/kg of 18.6±5.2ml·kg(-1)·min(-1), significantly lower than in non-obese {HF} counterparts (19.9±5.6ml·kg(-1)·min(-1), P=0.02, age 55.8±10.6years, {BMI} 26.6±3.1, {NYHA} 2.4±0.5, peak {RER}=1.07±0.09), with both lower than controls (38.5±9.7ml·kg(-1)·min(-1), P{\textless}10(-6)). In contrast, the uncorrected V˙O2max was higher in obese (2.31±0.69ml·min(-1)) than non-obese {HF} patients (1.61±0.49ml·min(-1), P{\textless}10(-6)). When cardiac dysfunction was evaluated directly, peak cardiac power was significantly greater in obese than non-obese {HF} patients (4.11±1.21W vs 2.73±0.82W, P{\textless}10(-6)), with both lower than controls (5.42±1.04W, P{\textless}10(-6)).
{CONCLUSION}: These results demonstrate that V˙O2max/kg is not a generally reliable indicator of cardiac fitness in all patients. Instead, we found that despite having lower V˙O2max/kg, obese {HF} patients had stronger hearts capable of generating greater cardiac power than non-obese {HF} patients of equivalent clinical {HF} status.},
	pages = {755--762},
	journaltitle = {International Journal of Cardiology},
	shortjournal = {Int. J. Cardiol.},
	author = {Hothi, S. S. and Tan, D. K. and Partridge, G. and Tan, L. B.},
	date = {2015-02-17},
	pmid = {25827937}
}

@article{dellweg_cardiopulmonary_2008,
	title = {Cardiopulmonary exercise testing before and after blood donation},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18535983},
	abstract = {{BACKGROUND}: The link between haemoglobin and physical performance was established a long time ago and is the underlying principle of blood doping. Blood loss on the other hand decreases physical capacity. The aim of this study is to evaluate physical performance loss and underlying mechanisms following voluntary blood donation. {METHOD} {AND} {PATIENTS}: Eleven voluntary subjects (four female) completed a symptom-limiting cardio-pulmonary exercise test before and after blood donation (500 {mL} blood). {RESULTS}: The haemoglobin value decreased by 1.2 mg/{dL} (9\%, p {\textless} 0.001), maximal oxygen uptake by 9\% (p = 0.006), maximal work rate by 13\% (p = 0.001) and duration of exercise fell from 663 down to 607 seconds (p = 0.005). Anaerobic transition occurred at 81.2\% and 71.5\% of maximal oxygen uptake before and after blood donation, respectively (p = 0.001). Subjects who practise recreational endurance sports appear to be more effected by endurance loss. The haemoglobin value was the only significant predictor of maximal oxygen uptake in regression analysis (p {\textless} 0.001). {CONCLUSION}: Maximal physical performance is impaired after blood donation. Haemoglobin decline accounts for the decreased oxygen uptake. As a consequence thereof the anaerobic transition occurs earlier. Subjects not engaged in regular sports activity did not experience a decline in their capacity. Inclusion of the haemoglobin value into equations predicting maximal oxygen uptake could improve prediction precision.},
	pages = {372--7},
	number = {6},
	journaltitle = {Pneumologie},
	author = {Dellweg, D and Siemon, K and Mahler, F and Appelhans, P and Klauke, M and Köhler, D},
	date = {2008-06}
}

@article{sano_one_2006,
	title = {One hundred two consecutive hepatobiliary resections for perihilar cholangiocarcinoma with zero mortality},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16858186},
	abstract = {{OBJECTIVE}: To analyze the short-term surgical outcome of hepatobiliary resections for perihilar cholangiocarcinoma in the last 5 years. {SUMMARY} {BACKGROUND} {DATA}: Hepatobiliary resection for perihilar cholangiocarcinoma remains a technically demanding procedure, calling for a high level of expertise in biliary and hepatic surgery, and is still associated with significant morbidity or mortality. {METHODS}: Between 2000 and 2004, we surgically treated 102 consecutive patients with perihilar cholangiocarcinoma with a management strategy consisting of preoperative biliary drainage, portal vein embolization (for right-sided and extended left-sided resections), and major hepatobiliary resection. The data on all of the patients were analyzed retrospectively to identify the factors that might significantly affect the postoperative mortality and morbidity. {RESULTS}: There were no cases of in-hospital mortality or postoperative liver failure. Major complications were encountered in 7 patients (6.9\%), and the overall morbidity rate was 50\%. Reoperation was required in 2 patients (2\%). The overall median length of postoperative hospital stay was 26 days (range, 13-119 days). Univariate analysis in relation to the postoperative morbidity showed significant differences in the preoperative occurrence of segmental cholangitis or cholecystitis (P = 0.015), the severity of postoperative hyperbilirubinemia (P {\textless} 0.001), and the total amount of fresh frozen plasma administered (P = 0.002). Multivariate analysis revealed a single independent significant predictive factor for postoperative morbidity, namely, preoperative cholangitis or cholecystitis (odds ratio, 9.08; 95\% confidence interval, 1.05-78.56, P = 0.045). {CONCLUSIONS}: Our experience indicates that hepatobiliary resections for perihilar cholangiocarcinoma can be conducted safely, without a single case of postoperative liver failure or mortality. Occurrence of preoperative cholangitis or cholecystitis is a significant indicator for morbidity of major hepatobiliary resection.},
	pages = {240--7},
	number = {2},
	journaltitle = {Ann Surg},
	author = {Sano, Tsuyoshi and Shimada, Kazuaki and Sakamoto, Yoshihiro and Yamamoto, Junji and Yamasaki, Susumu and Kosuge, Tomoo},
	date = {2006-08}
}

@article{barakat_supervised_2014,
	title = {Supervised exercise program improves aerobic fitness in patients awaiting abdominal aortic aneurysm repair},
	volume = {28},
	issn = {1615-5947},
	doi = {10.1016/j.avsg.2013.09.001},
	abstract = {{BACKGROUND}: Aerobic fitness is an important predictor of postoperative outcome in major surgery. In this study, we assess the effects of a period of preoperative exercise on aerobic fitness as measured by cardiopulmonary exercise testing ({CPET}) in patients scheduled for abdominal aortic aneurysm ({AAA}) repair.
{METHODS}: As part of a randomized trial, the first patients recruited in the intervention group were enrolled in a supervised exercise program of six week duration. Treadmill {CPET} parameters were measured before and after exercise preoperatively for these patients. These parameters were as follows: peak oxygen uptake ({VO}2 peak), anaerobic threshold ({AT}), and ventilator equivalents for oxygen and carbon dioxide ({VE}/{VO}2 and {VE}/{VCO}2, respectively). Total exercise time and the time at which {AT} was achieved were also recorded. A comparison between pre- and postexercise parameters was made to detect for a possible improvement in aerobic fitness.
{RESULTS}: Twenty patients with {AAA} (17 men; mean age: 74.9 ± 5.9 years) were included in this study. Thirty-five percent of patients had a history of ischemic heart disease, 25\% of obstructive airway disease, and 15\% of cerebral vascular events. Seventy percent were previous smokers, and 15\% were current smokers. Fifty-five percent of patients were taking aspirin and 75\% were undergoing statin therapy. The median (interquartile range) {VO}2 peak at baseline was 18.2 (15.4-19.9) {mL}/kg/min, and after exercise was 19.9 (17.1-21.1; P = 0.048). Median {AT} at baseline was 12.2 (10.5-14.9), and 14.4 (12.3-15.4) after exercise (P = 0.023). Time of exercise tolerated also improved from a median of 379 to 604 sec (P = 0.001). No significant changes were seen in {VE}/{VO}2, {VE}/{VCO}2, or the time at which {AT} was achieved.
{CONCLUSION}: This study shows that cardiopulmonary aerobic fitness improves after a period of supervised exercise in patients scheduled for {AAA} repair. This is justification for a randomized trial to assess whether this affects morbidity and mortality after {AAA} repair.},
	pages = {74--79},
	number = {1},
	journaltitle = {Annals of Vascular Surgery},
	shortjournal = {Ann Vasc Surg},
	author = {Barakat, Hashem M. and Shahin, Yousef and Barnes, Rachel and Gohil, Risha and Souroullas, Panos and Khan, Junaid and {McCollum}, Peter T. and Chetter, Ian C.},
	date = {2014-01},
	pmid = {24332259},
	keywords = {Aged, Aged, 80 and over, anaerobic threshold, Aortic Aneurysm, Abdominal, Elective Surgical Procedures, endovascular procedures, England, Exercise Test, Exercise Therapy, Female, Humans, Male, Oxygen Consumption, Physical fitness, Risk Factors, Time Factors, Treatment Outcome, Vascular Surgical Procedures, Waiting Lists}
}

@article{campione_oxygen_2010,
	title = {Oxygen pulse as a predictor of cardiopulmonary events in lung resection},
	volume = {18},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20304849},
	abstract = {Traditional algorithms suggest a stepwise approach to the functional evaluation of candidates for lung resection. A cardiopulmonary exercise test is incorporated as a supplementary test for patients with borderline pulmonary predicted values, and sometimes as a first screening test for cardiac risk evaluation. To assess the predictive weight of exercise tests in noncardiac thoracic surgery, we retrospectively analyzed 99 patients (80 males) aged 67.8 +/-8.1 years who underwent lung resection after a cardiopulmonary exercise test. During basal spirometry, the mean predicted forced expiratory volume in the first second was 69.9\% +/-18.6\%, and predicted carbon monoxide diffusing capacity was 71.6\% +/-20.5\%. Peak oxygen consumption was 11.1 +/-3.2 {mL}.kg(-1).min(-1), oxygen pulse was 9 +/-2.8 {mL}.beat(-1), and minute ventilation/{CO}(2) output was 45.2 +/- 7.7. Mean hospital stay was 10.4 days, and intensive care unit stay was 0.3 days. Postoperative complications occurred in 20 (20\%) patients. On multivariate analysis, body mass index, a high level of exercise achieved during the cardiopulmonary exercise test, lower heart rate at peak exercise, and oxygen pulse correlated significantly with better postoperative outcome. Cardiopulmonary exercise tests are helpful for stratifying patients undergoing thoracic surgery. Perioperative complications seem to be strongly related to left ventricular function and physical performance.},
	pages = {147--52},
	number = {2},
	journaltitle = {Asian Cardiovasc Thorac Ann},
	author = {Campione, Andrea and Terzi, Alberto and Bobbio, Marco and Rosso, Gian Luca and Scardovi, Angela Beatrice and Feola, Mauro},
	date = {2010-02}
}

@article{mcmillan_clinical_2010,
	title = {A clinical risk score to predict 3-, 5- and 10-year survival in patients undergoing surgery for Dukes B colorectal cancer.},
	volume = {103},
	doi = {10.1038/sj.bjc.6605864},
	abstract = {{BACKGROUND}: The prognosis of patients with Dukes stage B colorectal cancer is unpredictable and there is continuing interest in simply and reliably identifying patients at high risk of developing recurrence and dying of their disease. The aim of this study was to devise a clinical risk score to predict 3-, 5- and},
	pages = {970--974},
	number = {7},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and {McArdle}, C. S. and Morrison, D. S.},
	date = {2010-09-28},
	pmid = {20808311},
	pmcid = {PMC2965872},
	keywords = {Aged, Age Factors, Anastomosis, Surgical/adverse effects, Colorectal Neoplasms/*mortality/pathology/surgery, Female, Health Status Indicators, Humans, Male, Prognosis, Risk Factors, Survival Rate}
}

@article{evans_sarcopenia_1993,
	title = {Sarcopenia and Age-Related Changes in Body Composition and Functional Capacity},
	volume = {123},
	issn = {0022-3166, 1541-6100},
	url = {http://jn.nutrition.org/content/123/2_Suppl/465},
	pages = {465--468},
	number = {2},
	journaltitle = {The Journal of Nutrition},
	shortjournal = {J. Nutr.},
	author = {Evans, William J. and Campbell, Wayne W.},
	urldate = {2015-08-22},
	date = {1993-02-01},
	langid = {english},
	pmid = {8429405},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PRFKN94V\\Evans and Campbell - 1993 - Sarcopenia and Age-Related Changes in Body Composi.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EPGREGVH\\465.html:text/html}
}

@article{kanai_mechanism_1991,
	title = {Mechanism of adaptive increase of respiratory enzymes in rat liver mitochondria during obstructive jaundice},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1953810},
	abstract = {In order to elucidate the response of mitochondria to obstructive jaundice, we have examined the effects of common bile duct ligation on rat liver mitochondria. Although oxidative phosphorylation, especially respiratory control, of mitochondria was disturbed after the ligation, specific enzymic activities and subunit contents of the respiratory enzymes in mitochondria were significantly increased one week after the ligation. The immunostain for ubiquinol-cytochrome c oxidoreductase confirmed the increase in the subunit amounts in hepatocytes. This increase was associated with the increase in specific contents of {DNA} in mitochondria. These results suggest that mitochondrial biosynthesis is stimulated during obstructive jaundice.},
	pages = {1165--73},
	number = {6},
	journaltitle = {Biochem Int},
	author = {Kanai, M and Tanaka, M and Nimura, Y and Nagino, M and Katoh, T and Ozawa, T},
	date = {1991-04}
}

@article{prentis_importance_2009,
	title = {The importance of cardiopulmonary exercise testing in the prediction of surgical risk: letter 2},
	volume = {87},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19161819},
	pages = {671; author reply 671--2},
	number = {2},
	journaltitle = {Ann Thorac Surg},
	author = {Prentis, James M and Randles, Derek and Snowden, Chris},
	date = {2009-02}
}

@article{berg_adipose_2005,
	title = {Adipose Tissue, Inflammation, and Cardiovascular Disease},
	volume = {96},
	issn = {0009-7330, 1524-4571},
	url = {http://circres.ahajournals.org/content/96/9/939},
	doi = {10.1161/01.RES.0000163635.62927.34},
	abstract = {Mounting evidence highlights the role of adipose tissue in the development of a systemic inflammatory state that contributes to obesity-associated vasculopathy and cardiovascular risk. Circulating mediators of inflammation participate in the mechanisms of vascular insult and atheromatous change, and many of these inflammatory proteins are secreted directly from adipocytes and adipose tissue–derived macrophages. Several factors linking obesity with an increased cardiovascular risk have been identified. The adipocyte-specific secretory protein adiponectin is a particularly promising candidate in this context. Its levels are decreased in obesity. Adiponectin may mediate some of its demonstrated cardioprotective effects through its anti-inflammatory properties. In addition to decreased expression of beneficial adipokines, secretion of a host of inflammatory factors from visceral adipose tissue may contribute to the increased cardiovascular risk associated with obesity. The cardioprotective effects of many of the most popular drug regimens corroborate these conclusions, demonstrating that along with improvements in other therapeutic end points, they mediate improvements in systemic inflammation. In some cases, these improvements are attributable to direct suppression of inflammatory signaling in adipocytes. The targeted suppression of various proinflammatory cascades in adipocytes specifically represents an exciting new therapeutic opportunity for the cardiovascular disease area.},
	pages = {939--949},
	number = {9},
	journaltitle = {Circulation Research},
	shortjournal = {Circulation Research},
	author = {Berg, Anders H. and Scherer, Philipp E.},
	urldate = {2015-08-21},
	date = {2005-05-13},
	langid = {english},
	pmid = {15890981},
	keywords = {adipocyte, Inflammation, secretion},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MMVA5FRX\\Berg and Scherer - 2005 - Adipose Tissue, Inflammation, and Cardiovascular D.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\Q9MEQNVK\\939.html:text/html}
}

@article{hightower_pilot_2010,
	title = {A pilot study evaluating predictors of postoperative outcomes after major abdominal surgery: physiological capacity compared with the {ASA} physical status classification system},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20190255},
	abstract = {{BACKGROUND}: /st{\textgreater} This pilot study compared the risk predictive value of preoperative physiological capacity ({PC}: defined by gas exchange measured during cardiopulmonary exercise testing) with the {ASA} physical status classification in the same patients (n=32) undergoing major abdominal cancer surgery. {METHODS}: /st{\textgreater} Uni- and multivariate logistic regression models were fitted to measurements of {PC} and {ASA} rank data determining their predictive value for postoperative morbidity. Receiver operating characteristic ({ROC}) curves were used to discriminate between the predictive abilities, exploring trade-offs between sensitivity and specificity. {RESULTS}: /st{\textgreater} Individual statistically significant predictors of postoperative morbidity included the {ASA} rank [P=0.038, area under the curve ({AUC})=0.688, sensitivity=0.630, specificity=0.750] and three newly identified measures of {PC}: {PAT} (\% predicted anaerobic threshold achieved, {\textless}75\% vs {\textgreater}/=75\%), {DeltaHR}1 (heart rate response from rest to the anaerobic threshold), and {HR}3 (heart rate at the anaerobic threshold). A two-variable model of {PC} measurements ({DeltaHR}1+{PAT}) was also shown to be statistically significant in the prediction of postoperative morbidity (P=0.023, {AUC}=0.826, sensitivity=0.813, specificity=0.688). {CONCLUSIONS}: /st{\textgreater} Three newly identified {PC} measures and the {ASA} rank were significantly associated with postoperative morbidity; none showed a statistically greater association compared with the others. {PC} appeared to improve predictive sensitivity. The potential for new unidentified measures of {PC} to predict postoperative outcomes remains unexplored.},
	journaltitle = {Br J Anaesth},
	author = {Hightower, C E and Riedel, B J and Feig, B W and Morris, G S and Ensor, J E Jr and Woodruff, V D and Daley-Norman, M D and Sun, X G},
	date = {2010-02},
	file = {Hightower et al. - 2010 - A pilot study evaluating predictors of postoperati.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DW86UVWC\\Hightower et al. - 2010 - A pilot study evaluating predictors of postoperati.pdf:application/pdf}
}

@article{challand_randomized_2011,
	title = {Randomized controlled trial of intraoperative goal-directed fluid therapy in aerobically fit and unfit patients having major colorectal surgery},
	volume = {108},
	issn = {0007-0912, 1471-6771},
	url = {http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aer273},
	doi = {10.1093/bja/aer273},
	pages = {53--62},
	number = {1},
	journaltitle = {British Journal of Anaesthesia},
	author = {Challand, C. and Struthers, R. and Sneyd, J. R. and Erasmus, P. D. and Mellor, N. and Hosie, K. B. and Minto, G.},
	urldate = {2014-01-27},
	date = {2011-08-26},
	file = {Challand et al. - 2011 - Randomized controlled trial of intraoperative goal.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8NH287QJ\\Challand et al. - 2011 - Randomized controlled trial of intraoperative goal.pdf:application/pdf}
}

@book{cancerresearchuk_cancer_2014,
	title = {Cancer Stats report - Pancreatic Cancer, Cancer Research {UK}.},
	url = {http://www.cancerresearchuk.org/cancer-info/cancerstats/types/pancreas/},
	abstract = {How common is pancreatic cancer? Pancreatic cancer is the tenth most common cancer in the {UK}. Around 8,100 people were diagnosed with pancreatic cancer in 2008 in the {UK}, that’s around 22 people every day. Pancreatic cancer is the eleventh most common cancer in men, with around 4,000 new cases diagnosed in 2008 in the {UK}. Around 4,100 women were diagnosed with pancreatic cancer in the {UK} in 2008, making it the eighth most common cancer in women. More than 8 in 10 cases of pancreatic cancer occur in people aged 60 and over. Pancreatic cancer rates for men declined slightly between the late 1970s and mid-1990s, and since then have remained stable. Pancreatic cancer rates for women declined between the late 1980s and late 1990s, but since then have gradually increased. Worldwide, around 279,000 people were diagnosed with pancreatic cancer in 2008. How many people survive pancreatic cancer? Overall, pancreatic cancer has a poor prognosis. By the time someone has symptoms, goes to their doctor and is diagnosed, the disease is very often quite advanced. The one-year survival rate for pancreatic cancer has more than doubled since the 1970s, however the rate is still low with only around 16-17\% of patients surviving their disease. Younger pancreatic cancer patients have better survival rates than older patients. Around 3\% of pancreatic cancer patients survive the disease for five years or more. How many people die from pancreatic cancer? Pancreatic cancer is the fifth most common cause of cancer death in the {UK}. About 8,000 people in the {UK} died from pancreatic cancer in 2009 in the {UK}, that's around 22 people every day. Worldwide, around 266,000 people died from pancreatic cancer in 2008. Read more in depth {UK} pancreatic cancer mortality statistics. What causes pancreatic cancer? More than 1 in 4 pancreatic cancers in the {UK} are caused by smoking. People with type I or {II} diabetes have roughly twice the risk of developing pancreatic cancer. Chronic pancreatitis (inflammation of the pancreas) is associated with increased risk of pancreatic cancer. Obesity increases the risk of pancreatic cancer. Eating processed meat may increase risk of pancreatic cancer. People with a family history of pancreatic cancer have a higher risk of developing the disease},
	author = {{CancerResearchUK}},
	urldate = {2015-05-17},
	date = {2014}
}

@article{janz_longitudinal_1998,
	title = {Longitudinal analysis of scaling {VO}2 for differences in body size during puberty: the Muscatine Study.},
	volume = {30},
	url = {http://europepmc.org/abstract/med/9741614},
	shorttitle = {Longitudinal analysis of scaling {VO}2 for differences in body size during puberty},
	pages = {1436--1444},
	number = {9},
	journaltitle = {Medicine and science in sports and exercise},
	author = {Janz, {KATHLEEN} F. and Burns, {TRUDY} L. and Witt, {JOHN} D. and Mahoney, {LARRY} T.},
	urldate = {2015-04-30},
	date = {1998},
	file = {Janz et al. - 1998 - Longitudinal analysis of scaling VO2 for differenc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QKEIXP5P\\Janz et al. - 1998 - Longitudinal analysis of scaling VO2 for differenc.pdf:application/pdf}
}

@article{roxburgh_role_2012,
	title = {The role of the in situ local inflammatory response in predicting recurrence and  survival in patients with primary operable colorectal cancer.},
	volume = {38},
	rights = {Copyright (c) 2011 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2011.09.001},
	abstract = {Colorectal cancer progression and survival is dependent on complex interactions between the tumour and the host. The pronounced local inflammatory response in and around the tumour is thought to represent the in situ host anti-tumour immune response. Since early reports, 40 years ago, there has been a continuing interest in establishing the cellular composition of immune cell infiltrates and their relationship with survival in colorectal cancer. In this review, we comprehensively examine the evidence for the local inflammatory cell reaction/in  situ immune response in predicting outcome in primary operable colorectal cancer  and make recommendations as to how such information may be incorporated into routine clinical assessment. Generally, an increasing number/density of immune cells in and around the tumour is associated with improved outcome in over 100 studies. Whilst the prognostic value of a generalized lymphocytic infiltrate or non-specific peritumoural inflammatory response is strongly related to survival based on 40 different studies, it is also apparent that most individual immune cell types relate to recurrence and cancer specific survival. The evidence is particularly robust for tumour infiltrating T lymphocytes and their subsets ({CD}3+, {CD}8+, {CD}45RO+, {FOXP}3+) in addition to tumour associated macrophages, dendritic cells and neutrophils. Taken together, the evidence suggests both adaptive and innate anti-tumour immune responses play key roles in determining cancer progression. In order to establish routine clinical utility there is a need to rationalise this prognostic information, published over a 40 years period, into a standardized assessment of tumour inflammatory cell infiltrate. Such standardization may also guide development of novel therapeutic interventions.},
	pages = {451--466},
	number = {5},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {Roxburgh, C. S. D. and {McMillan}, D. C.},
	date = {2012-08},
	pmid = {21945823},
	keywords = {Antigens, {CD}3/immunology, Antigens, {CD}45/immunology, {CD}4-Positive T-Lymphocytes/immunology, {CD}8-Positive T-Lymphocytes/immunology, Colorectal Neoplasms/genetics/*immunology/mortality/*surgery, Dendritic Cells/immunology, Disease Progression, Forkhead Transcription Factors/metabolism, Humans, Lymphocytes, Tumor-Infiltrating/*immunology/pathology, Macrophages/immunology/pathology, Microsatellite Instability, Neutrophils/immunology/pathology, Predictive Value of Tests}
}

@article{mcmillan_impact_2009,
	title = {The impact of young age on cancer-specific and non-cancer-related survival after  surgery for colorectal cancer: 10-year follow-up.},
	volume = {101},
	doi = {10.1038/sj.bjc.6605222},
	abstract = {{BACKGROUND}: It has been reported that although young patients present with more advanced disease, when adjusted for stage, cancer-specific survival is not different after surgery for colorectal cancer. However, few studies have examined non-cancer survival in young patients and 10-year survival has rarely been reported. Moreover, the largest study included patients of old age as a comparator. The aim of this study was to compare cancer-specific and non-cancer-related survival at 10 years in a young age cohort and a middle age cohort in patients undergoing surgery for colorectal cancer. {METHODS}: Two thousand and seventy seven patients who underwent surgery for colorectal cancer between 1991 and 1994 in 11 hospitals in Scotland were included in the study. Ten-year cancer-specific and non-cancer-related survival and the hazard ratios ({HR}) were calculated according to age groups ({\textless}45/45-54/55-64/65-74 years). {RESULTS}: On follow-up, 1066 patients died of their cancer and 369 died of non-cancer-related causes. At 10 years, overall survival was 32\%, cancer-specific was 45\%, and non-cancer-related survival was 72\%. On multivariate analysis of all factors, sex ({HR} 0.77, 95\% {CI} 0.68-0.88, P{\textless}0.001), mode of presentation ({HR} 1.64, 95\% {CI} 1.44-1.87, P{\textless}0.01), Dukes' stage ({HR} 2.69, 95\% {CI} 2.49-2.90, P{\textless}0.001), and specialisation ({HR} 1.24, 95\% {CI} 1.04-1.44, P{\textless}0.01) were independently associated  with cancer-specific survival. On multivariate analysis of all factors, age ({HR} 2.46, 2.04-2.97, P{\textless}0.001), sex ({HR} 0.56, 0.45-0.70, P{\textless}0.001), and deprivation ({HR} 1.16, 1.10-1.24, P{\textless}0.001) were independently associated with non-cancer-related survival. {CONCLUSION}: The results of this study confirm that young age does not have a negative impact on cancer-specific survival. Moreover, they show that, with 10-year follow-up, young age does not have a negative impact on non-cancer-related survival.},
	pages = {557--560},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C. and {McArdle}, C. S.},
	date = {2009-08-18},
	pmid = {19672260},
	pmcid = {PMC2736824},
	keywords = {Adult, Age Factors, Colorectal Neoplasms/*mortality/pathology/*surgery, Digestive System Surgical Procedures, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prognosis}
}

@article{horvath_safety_2010,
	title = {Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study},
	volume = {145},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20855750},
	abstract = {The feasibility of video-assisted retroperitoneal debridement ({VARD}) for infected pancreatic walled-off necrosis is established. We provide prospective data on the safety and efficacy of {VARD}.},
	pages = {817--25},
	number = {9},
	journaltitle = {Arch Surg},
	author = {Horvath, Karen and Freeny, Patrick and Escallon, Jaime and Heagerty, Patrick and Comstock, Bryan and Glickerman, David J and Bulger, Eileen and Sinanan, Mika and Langdale, Lorrie and Kolokythas, Orpheus and Andrews, R Torrance},
	date = {2010-09}
}

@article{mourtzakis_practical_2008,
	title = {A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18923576},
	abstract = {Human body composition is important in numerous cancer research domains. Our objective was to evaluate clinically accessible methods to achieve practical and precise measures of body composition in cancer patients. Dual-energy X-ray absorptiometry ({DXA})-based analysis of fat and fat-free mass was performed in 50 cancer patients and compared with bioelectrical impedance analysis ({BIA}) and with regional computed tomography ({CT}) images available in the patients' medical records. {BIA} overestimated or underestimated fat-free mass substantially compared with {DXA} as the method of reference (up to 9.3 kg difference). Significant changes in fat-free mass over time detected with {DXA} in a subset of 21 patients (+2.2 +/- 3.2\%/100 days, p = 0.003), was beyond the limits of detection of {BIA}. Regional analysis of fat and fat-free tissue at the 3rd lumbar vertebra with either {DXA} or {CT} strongly predicted whole-body fat and fat-free mass (r = 0.86-0.94; p {\textless} 0.001). {CT} images provided detail on specific muscles, adipose tissues and organs, not provided by {DXA} or {BIA}. {CT} presents great practical significance due to the prevalence of these images in patient diagnosis and follow-up, thus marrying clinical accessibility with high precision to quantify specific tissues and to predict whole-body composition.},
	pages = {997--1006},
	number = {5},
	journaltitle = {Appl Physiol Nutr Metab},
	author = {Mourtzakis, Marina and Prado, Carla M M and Lieffers, Jessica R and Reiman, Tony and {McCargar}, Linda J and Baracos, Vickie E},
	date = {2008-10}
}

@article{assimakopoulos_bile_2009,
	title = {Bile duct ligation in rats: a reliable model of hepatorenal syndrome?},
	volume = {15},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19115478},
	abstract = {The two most widely used experimental models of advanced liver disease are the administration of carbon tetrachloride, and common bile duct ligation ({BDL}), however, neither has been systematically evaluated as a model of hepatorenal syndrome ({HRS}). The {BDL} model in rats, studied at diverse time points, induced a progressive renal dysfunction without structural changes in the kidney. The authors concluded that {BDL} is a good model for further studies of {HRS} and its treatment. However, the renal impairment observed at the acute phase of the {BDL} model is based on a different pathophysiology than that of {HRS}. Specifically, in acute obstructive jaundice, cholemia predominates over parenchymal liver disease (reversible at this stage without portal hypertension or cirrhosis) and independently induces negative inotropic and chronotropic effects on the heart, impaired sympathetic vasoconstriction response and profound natriuresis and diuresis that might lead to volume depletion. In addition, systemic endotoxemia contributes to the prerenal etiology of renal impairment and promotes direct nephrotoxicity and acute tubular necrosis. On the other hand, the renal failure observed in the chronic {BDL} model (with development of biliary cirrhosis, portal hypertension and ascites) shares pathophysiological similarities with {HRS}, but the accordance of the chronic {BDL} model to the diagnostic criteria of {HRS} (e.g. absence of spontaneous bacterial peritonitis, no renal function improvement after plasma volume expansion) should have been confirmed. In conclusion, we think that the {BDL} model is not suitable for the study of the natural history of {HRS}, but the chronic {BDL} model might be valid for the study of established {HRS} and its potential therapies.},
	pages = {121--3},
	number = {1},
	journaltitle = {World J Gastroenterol},
	author = {Assimakopoulos, Stelios F and Vagianos, Constantine E},
	date = {2009-01}
}

@article{mcmillan_favism:_2001,
	title = {Favism: effect of divicine on rat erythrocyte sulfhydryl status, hexose monophosphate shunt activity, morphology, and membrane skeletal proteins.},
	volume = {62},
	abstract = {Favism is an acute anemic crisis that can occur in susceptible individuals who ingest fava beans. The fava bean pyrimidine aglycone divicine has been identified as a hemotoxic constituent; however, its mechanism of toxicity remains unknown. We have shown recently that divicine can induce a favic-like response in rats and that divicine is directly toxic to rat red cells. In the present study, we have examined the effect of hemotoxic concentrations of divicine on rat erythrocyte sulfhydryl status, hexose monophosphate ({HMP}) shunt activity, morphology, and membrane skeletal proteins. In vitro exposure of rat red cells to divicine markedly stimulated {HMP} shunt activity and resulted in depletion of reduced glutathione with concomitant formation of glutathione-protein mixed-disulfides. Examination of divicine-treated red cells by scanning electron microscopy revealed transformation of the cells to an extreme echinocytic morphology.},
	pages = {353--359},
	number = {2},
	journaltitle = {Toxicological sciences : an official journal of the Society of Toxicology},
	shortjournal = {Toxicol Sci},
	author = {{McMillan}, D. C. and Bolchoz, L. J. and Jollow, D. J.},
	date = {2001-08},
	pmid = {11452148},
	keywords = {*Pentose Phosphate Pathway, Animals, Electrophoresis, Polyacrylamide Gel, Erythrocytes/*drug effects/metabolism/ultrastructure, Favism/*chemically induced, Male, Membrane Proteins/*drug effects, Microscopy, Electron, Scanning, Pyrimidinones/*toxicity, Rats, Rats, Sprague-Dawley, Sulfhydryl Compounds/*blood}
}

@article{ortega-deballon_c-reactive_2010,
	title = {C-reactive protein is an early predictor of septic complications after elective colorectal surgery},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20049435},
	abstract = {Nowadays, most patients who undergo colorectal surgery are discharged early. An early predictor of septic complications could avoid readmissions and decrease morbidity. {CRP} could be a good predictor allowing a safe discharge.},
	pages = {808--14},
	number = {4},
	journaltitle = {World J Surg},
	author = {Ortega-Deballon, Pablo and Radais, François and Facy, Olivier and d'Athis, Philippe and Masson, David and Charles, Pierre E and Cheynel, Nicolas and Favre, Jean-Pierre and Rat, Patrick},
	date = {2010-04}
}

@article{gouma_rates_2000,
	title = {Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume},
	volume = {232},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11088073},
	abstract = {To perform a two-part study of pancreaticoduodenectomy in the Netherlands, focusing on the effects of risk factors on outcomes in a single high-volume hospital and the effect of hospital volume on outcomes.},
	pages = {786--95},
	number = {6},
	journaltitle = {Ann Surg},
	author = {Gouma, D J and van Geenen, R C and van Gulik, T M and de Haan, R J and de Wit, L T and Busch, O R and Obertop, H},
	date = {2000-12}
}

@article{antinori_[effect_2003,
	title = {[Effect of preoperative biliary drainage on the immediate and long-term results after duodeno-cephalo-pancreatectomy for peri-ampullar neoplasia]},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12903532},
	abstract = {Pancreaticoduodenectomy has a primary role in the treatment of patients with periampullary carcinoma. Several series have reported encouraging operative mortality and survival after resection. Controversies exist regarding the impact of preoperative biliary drainage on immediate and long-term results.},
	pages = {9--10},
	number = {4},
	journaltitle = {Tumori},
	author = {Antinori, A and Crucitti, A and Antonacci, V and Giustacchini, P and Magistrelli, P},
	date = {2003-08}
}

@article{al-shaiba_relationship_2004,
	title = {The relationship between hypoalbuminaemia, tumour volume and the systemic inflammatory response in patients with colorectal liver metastases.},
	volume = {91},
	doi = {10.1038/sj.bjc.6601886},
	abstract = {The relationship between hypoalbuminaemia, tumour volume and C-reactive protein was examined in patients with colorectal liver metastases (n=57). On multiple regression analysis, albumin concentrations were independently associated with},
	pages = {205--207},
	number = {2},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Al-Shaiba, R. and {McMillan}, D. C. and Angerson, W. J. and Leen, E. and {McArdle}, C. S. and Horgan, P.},
	date = {2004-07-19},
	pmid = {15213726},
	pmcid = {PMC2409827},
	keywords = {Aged, Aged, 80 and over, Alanine Transaminase/blood, Alkaline Phosphatase/blood, Aspartate Aminotransferases/blood, Colorectal Neoplasms/enzymology/*pathology, C-Reactive Protein/analysis, Female, Humans, Hypoalbuminemia/*etiology, Inflammation/etiology, Liver Function Tests, Liver Neoplasms/enzymology/*secondary, Male, Middle Aged, Serum Albumin/analysis}
}

@article{gouma_stent_2007,
	title = {Stent versus surgery},
	volume = {9},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18345286},
	abstract = {Following the introduction of percutaneous and endoscopic biliary drainage there has been an ongoing debate about the indications and outcomes of endoscopic versus surgical drainage in a variety of bilio-pancreatic disorders. The evidence-based literature concerning four different areas of pancreatobiliary diseases have been reviewed. Preoperative endoscopic biliary drainage in patients with obstructive jaundice should not be used routinely but only in selected patients. For patients with biliary leakage and bile duct strictures after a laparoscopic cholecystectomy, endoscopic stent therapy might be first choice and surgery should be used for failures of endoscopic treatment. Surgery is the treatment of choice after transection of the bile duct (the major bile duct injuries). The majority of patients with obstructive jaundice due to advanced pancreatic cancer will undergo endoscopic drainage but for relatively fit patients with a prognosis of more than 6 months, surgical drainage or even palliative resection might be considered. For patients with persistent pain due to chronic pancreatitis surgical drainage combined with limited pancreatic head resection might be first choice for pain relief. Most importantly, the management of patients with these pancreatobiliary diseases should be performed by a multidisciplinary {HPB} approach and teamwork consisting of gastroenterologists, radiologists and surgeons.},
	pages = {408--13},
	number = {6},
	journaltitle = {{HPB} (Oxford)},
	author = {Gouma, Dirk J},
	date = {2007}
}

@article{velanovich_relationship_2009,
	title = {Relationship of postoperative complications from preoperative biliary stents after pancreaticoduodenectomy. A new cohort analysis and meta-analysis of modern studies},
	volume = {10},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19129611},
	abstract = {{CONTEXT}: Debate still continues as to the effects of preoperative biliary stents on postoperative complications after pancreaticoduodenectomy. Some studies have documented increased wound infection rates, while others have not. The importance of this issue rests on whether these postoperative complications are detrimental enough to not recommend preoperative chemoradiation in the treatment of pancreatic cancer. {OBJECTIVE}: This study is in two parts: 1) a retrospective review of patients who underwent pancreaticoduodenectomy at Henry Ford Hospital; and 2) a meta-analysis of published studies on the effects of preoperative biliary stents. {METHODS}: In the retrospective portion, all patients who underwent pancreaticoduodenectomy from January 1st, 1997 through December 31st, 2006 were included in the study. {MAIN} {OUTCOME} {MEASURES}: Data gathered included gender, age, pathologic diagnosis, use of preoperative biliary stent (either {ERCP} or {PTC}), all postoperative complications, and in-hospital mortality. In the meta-analysis portion, all studies published from 1990 with either a randomized or quasi-randomized allocation of patients were included. Endpoints analysis were peri-operative mortality, wound infection rate, intra-abdominal abscess rate, and overall morbidity rate. {RESULTS}: In the retrospective portion, 181 patients were studied, with 123 (68.0\%) of these having preoperative biliary stents. Patients with and without stents had no significant difference in wound infection rate (19.5\% vs. 17.2\%, respectively), intra-abdominal abscess rate (16.3\% vs. 22.4\%), any postoperative complication (50.4\% vs. 51.7\%) and in-hospital death (2.4\% vs. 1.7\%). Fifteen studies were included in the meta-analysis. There was variation in both the definitions of complications as well as the incidence of all postoperative endpoints among the studies. For peri-operative mortality and wound infection rate, the relative difference favored the no stent group by 0.5\% (95\% confidence interval: -0.4\% to 1.4\%) and 5.8\% (95\% confidence interval: 3.6\% to 8.0\%), respectively. For intra-abdominal abscess and overall morbidity rate, the relative difference favored the stent group by 2.0\% (95\% confidence interval: -0.3\% to 4.3\%) and 0.06\% (95\% confidence interval -3.8\% to 3.9\%), respectively. {CONCLUSION}: Although the use of a preoperative biliary stent increases the postoperative wound infection rate by about 5\%, there is no overwhelming evidence that it either promotes or protects from the other complications. As there was variation in the definitions used in these studies, a more uniformed system of complication reporting is required.},
	pages = {24--9},
	number = {1},
	journaltitle = {{JOP}},
	author = {Velanovich, Vic and Kheibek, Tariq and Khan, Muhammad},
	date = {2009}
}

@article{mcmillan_effect_1995,
	title = {Effect of extended ibuprofen administration on the acute phase protein response in colorectal cancer patients.},
	volume = {21},
	abstract = {The regulation of acute phase protein production and the relationship of the acute phase protein response to tumour growth was examined in colorectal cancer patients (n = 9). Ibuprofen (1200 mg/d) was administered for 8-11 days. Following ibuprofen administration there were reductions in circulating concentrations of},
	pages = {531--534},
	number = {5},
	journaltitle = {European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology},
	shortjournal = {Eur J Surg Oncol},
	author = {{McMillan}, D. C. and Leen, E. and Smith, J. and Sturgeon, C. and Preston, T. and Cooke, T. G. and {McArdle}, C. S.},
	date = {1995-10},
	pmid = {7589600},
	keywords = {Acute-Phase Proteins/*drug effects, Adult, Aged, Carcinoembryonic Antigen/blood, Colorectal Neoplasms/*drug therapy/*metabolism, C-Reactive Protein/metabolism, Female, Humans, Hydrocortisone/blood, Ibuprofen/administration \& dosage/*pharmacology, Insulin/blood, Interleukin-6/blood, Leukocyte Count, Male, Middle Aged, Platelet Count, Serum Albumin/metabolism}
}

@article{kawai_early_2006,
	title = {Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for 104 consecutive patients},
	volume = {244},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16794381},
	abstract = {The aim of this study was designed to determine whether the period of drain insertion influences the incidence of postoperative complications.},
	pages = {1--7},
	number = {1},
	journaltitle = {Ann Surg},
	author = {Kawai, Manabu and Tani, Masaji and Terasawa, Hiroshi and Ina, Shinomi and Hirono, Seiko and Nishioka, Ryohei and Miyazawa, Motoki and Uchiyama, Kazuhisa and Yamaue, Hiroki},
	date = {2006-07}
}

@article{epstein_response_1998,
	title = {Response to symptom-limited exercise in patients with the hepatopulmonary syndrome},
	volume = {114},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9743159},
	abstract = {To study the response to symptom-limited exercise in patients with the hepatopulmonary syndrome ({HPS}).},
	pages = {736--41},
	number = {3},
	journaltitle = {Chest},
	author = {Epstein, S K and Zilberberg, M D and Jacoby, C and Ciubotaru, R L and Kaplan, L M},
	date = {1998-09},
	file = {Epstein et al. - 1998 - Response to symptom-limited exercise in patients w.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\4F7VVSFM\\Epstein et al. - 1998 - Response to symptom-limited exercise in patients w.pdf:application/pdf}
}

@article{cheng_pancreatic_2010,
	title = {Pancreatic Cancer Cells Expressing Hypoxia-Inducible Factor-1α Tend to Be Adjacent to Intratumoral Blood Vessels},
	volume = {45},
	issn = {1421-9921, 0014-312X},
	url = {http://www.karger.com/doi/10.1159/000319876},
	doi = {10.1159/000319876},
	pages = {134--137},
	number = {3},
	journaltitle = {European Surgical Research},
	author = {Cheng, B.-Q. and Segersvärd, R. and Permert, J. and Wang, F.},
	urldate = {2014-01-27},
	date = {2010},
	file = {Cheng et al. - 2010 - Pancreatic Cancer Cells Expressing Hypoxia-Inducib.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\2MCJBH6V\\Cheng et al. - 2010 - Pancreatic Cancer Cells Expressing Hypoxia-Inducib.pdf:application/pdf}
}

@article{ramanathan_impact_2015,
	title = {The impact of open versus laparoscopic resection for colon cancer on C-reactive protein concentrations as a predictor of postoperative infective complications.},
	volume = {22},
	doi = {10.1245/s10434-014-4065-z},
	abstract = {{BACKGROUND}: There is increasing evidence that C-reactive protein is a useful negative predictor of infective complications and anastomotic leak following surgery for colorectal cancer. In particular, C-reactive protein concentrations on postoperative days 3 and 4 have been proposed to be of clinical utility since  they aid safe and early discharge of selected patients following colorectal surgery. However, it is not clear whether such thresholds are also applicable in  laparoscopic surgery. The aim of the present study was to compare the value of daily C-reactive protein concentrations in the prediction of postoperative infective complications in patients undergoing open versus laparoscopic resection for colon cancer. {METHODS}: Patients with histologically proven colon cancer who were considered to have undergone potentially curative resection in one of two university teaching hospitals in Glasgow were included in the study (n = 344). Patient characteristics were collected in a prospective surgical database. All resections were elective cases and were performed using either open (n = 191) or  laparoscopic surgery (n = 153). Daily blood samples to measure C-reactive protein concentrations perioperatively were taken routinely. Patients were assessed for postoperative infective and non-infective complications. {RESULTS}: The majority of patients were aged 65 years or older (75\%), male (52\%), had left-sided tumors (54\%), node negative disease (77\%), and did not undergo neoadjuvant treatment (94\%). Patients undergoing open and laparoscopic resection were similar in terms  of age, sex, tumor site, {TNM} stage, comorbidity, and infective complications. In  contrast, preoperative and postoperative days 1-3 C-reactive protein concentrations were lower following laparoscopic compared with open resection in  the whole cohort (n = 344; all p {\textless} 0.001) and in those who did not develop infective complications (n = 251; all p {\textless} 0.001). The median length of hospital stay was shorter in the laparoscopic resection (p {\textless} 0.001). During follow-up, 127 (37\%) patients developed a postoperative complication, 93 (73\%) of which were infective complications. In those who developed an infective complication, there  was no significant difference in the C-reactive protein concentrations between open and laparoscopic resections on postoperative days 1-4. C-reactive protein thresholds predictive of infective complications were the same on postoperative days 3 (180 mg/l) and 4 (140 mg/l) following both open and laparoscopic resection for colon cancer. {CONCLUSIONS}: The results of the present study show that although the magnitude of the systemic inflammatory response, as evidenced by},
	pages = {938--943},
	number = {3},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Ramanathan, Michelle L. and {MacKay}, Graham and Platt, Jonathan and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2015-03},
	pmid = {25201503}
}

@article{tan_sarcopenia_2009,
	title = {Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer},
	volume = {15},
	issn = {1078-0432},
	doi = {10.1158/1078-0432.CCR-09-1525},
	abstract = {{PURPOSE}: The average weight-losing pancreatic cancer patient undergoing palliative therapy is frequently overweight rather than underweight, and this can confound conventional measures used for risk stratification. The aim of this study was to evaluate if weight and body composition, specifically sarcopenia, assessed from diagnostic computed tomography ({CT}) scans, is of prognostic value in patients with pancreatic cancer. The nature and extent of tissue loss over subsequent months was also evaluated.
{EXPERIMENTAL} {DESIGN}: A total of 111 patients entering a palliative therapy program, who had {CT} images and had undergone nutritional screening, were studied. In patients for whom follow-up scans were available (n = 44), longitudinal changes in body composition were studied at a mean of 230 +/- 62 and 95 +/- 60 days prior to demise.
{RESULTS}: Sixty-two patients (55.9\%) were sarcopenic, 44 (39.6\%) were overweight/obese, and 18 (16.2\%) were both. Age {\textgreater} or =59 years (hazard ratio, 1.71; 95\% confidence interval, 1.10-2.66; P = 0.018), and overweight/obese sarcopenia (hazard ratio, 2.07; 95\% confidence interval, 1.23-3.50; P = 0.006) were identified as independent predictors of survival on multivariate analysis. Longitudinal analysis revealed that total fat-free mass index decreased from 15.5 +/- 2.5 kg/m(2) to 14.5 +/- 2.0 kg/m2 (P = 0.002), and total fat mass index decreased from 7.5 +/- 2.0kg/m2 to 6.0 +/- 1.5kg/m2 (P {\textless} 0.0001) over 135 days.
{CONCLUSIONS}: Sarcopenia in overweight/obese patients with advanced pancreatic cancer is an occult condition but can be identified using {CT} scans. This condition is an independent adverse prognostic indicator that should be considered for stratification of patients' entering clinical trials, systemic therapy, or support care programs.},
	pages = {6973--6979},
	number = {22},
	journaltitle = {Clinical Cancer Research: An Official Journal of the American Association for Cancer Research},
	shortjournal = {Clin. Cancer Res.},
	author = {Tan, Benjamin H. L. and Birdsell, Laura A. and Martin, Lisa and Baracos, Vickie E. and Fearon, Kenneth C. H.},
	date = {2009-11-15},
	pmid = {19887488},
	keywords = {Aged, Body Composition, Body Weight, {CT} scans, Female, Humans, Male, Middle Aged, Obesity, Overweight, pancreatic cancer, Pancreatic Neoplasms, prognosis, Risk, Sarcopenia, Tomography, X-Ray Computed, Treatment Outcome},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ERAK7RZ4\\Tan et al. - 2009 - Sarcopenia in an Overweight or Obese Patient Is an.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P4PNJUV3\\6973.html:text/html}
}

@article{van_heek_hospital_2005,
	title = {Hospital volume and mortality after pancreatic resection - A systematic review and an evaluation of intervention in The Netherlands},
	volume = {242},
	issn = {0003-4932},
	doi = {10.1097/01.sla.0000188462.00249.36},
	abstract = {Objectives: To evaluate the best available evidence on volume-outcome effect of pancreatic surgery by a systematic review of the existing data and to determine the impact of the ongoing plea for centralization in The Netherlands. Summary Background Data: Centralization of pancreatic resection ({PR}) is still under debate. The reported impact of hospital volume on the mortality rate after {PR} varies. Since 1994, there has been a continuous plea for centralization of {PR} in The Netherlands, based on repetitive analysis of the volume-outcome effect. Methods: A systematic search for studies comparing hospital mortality rates after {PR} between high- and low-volume hospitals was used. Studies were reviewed independently for design features, inclusion and exclusion criteria, cutoff values for high and low volume. and outcome. Primary outcome measure was hospital or 30-day mortality. Data were obtained from the Dutch nationwide registry on the outcome of {PR} from 1994 to 2004. Hospitals were divided into 4 volume categories based on the number of {PRs} performed per year. Interventions and their effect on mortality rates and centralization were analyzed. Results: Twelve observational studies with a total of 19,688 patients were included. The studies were too heterogeneous to allow a meta-analysis; therefore, a qualitative analysis was performed. The relative risk of dying in a high-volume hospital compared with a low-volume hospital was between 0.07 and 0.76, and was inversely proportional to the volume cutoff values arbitrarily defined. In 5 evaluations within a decade, hospital mortality rates were between 13.8\% and 16.5\% in hospitals with less than 5 {PRs} per year, whereas hospital mortality rates were between 0\% and 3.5\% in hospitals with more than 24 {PRs} per year. Despite the repetitive plea for centralization. no effect was seen. During 2001, 2002, and 2003, 454 of 792 (57.3\%) patients underwent surgery in hospitals with a volume of less than 10 {PRs} per year, compared with 280 of 428 (65.4\%) patients between 1994 and 1996. Conclusions: The data on hospital volume and mortality after {PR} are too heterogeneous to perform a meta-analysis, but a systematic review shows convincing evidence of an inverse relation between hospital volume and mortality and enforces the plea for centralization. The 10-year lasting plea for centralization among the surgical community did not result in a reduction of the mortality rate after {PR} or change in the referral pattern in The Netherlands.},
	pages = {781--790},
	number = {6},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {van Heek, N. T. and Kuhlmann, K. F. D. and Scholten, R. J. and de Castro, S. M. M. and Busch, O. R. C. and van Gulik, T. M. and Obertop, H. and Gouma, D. J.},
	date = {2005-12},
	note = {{WOS}:000233521500005},
	keywords = {Adenocarcinoma, cancer-surgery, high-risk surgery, operative mortality, Pancreaticoduodenectomy, prognostic-factors, rates, regionalization, surgical volume, united-states}
}

@online{_pdfpages_????,
	title = {pdfpages - How to include multiple pages in latex - {TeX} - {LaTeX} Stack Exchange},
	url = {http://tex.stackexchange.com/questions/91440/how-to-include-multiple-pages-in-latex},
	urldate = {2015-05-17},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QQJUKUQ7\\how-to-include-multiple-pages-in-latex.html:text/html}
}

@article{michalski_systematic_2007,
	title = {Systematic review and meta-analysis of standard and extended lymphadenectomy in pancreaticoduodenectomy for pancreatic cancer},
	volume = {94},
	issn = {0007-1323},
	doi = {10.1002/bjs.5716},
	abstract = {{BACKGROUND}: Although some retrospective studies of extended radical lymphadenectomy for pancreatic cancer have suggested a survival advantage, this is controversial.
{METHODS}: A literature search identified randomized controlled trials comparing extended with standard lymphadenectomy in pancreatic cancer surgery. Overall survival was analysed using hazard ratios and standard errors. Pooled estimates of overall treatment effects were calculated using a random effects model (odds ratio and 95 per cent confidence interval).
{RESULTS}: Of four randomized trials identified for systematic review, three were included in a meta-analysis of survival. The log hazard ratios (standard errors) for survival for the three trials were 0.36 (0.22), - 0.15 (0.17) and - 0.21 (0.15); the weighted mean log hazard ratio for survival overall was 0.93 (95 per cent confidence interval 0.77 to 1.13), revealing no significant differences between the standard and extended procedure (P = 0.480). Morbidity and mortality rates were also comparable, with a trend towards higher rates of delayed gastric emptying for extended lymphadenectomy. The number of resected lymph nodes was significantly higher in the extended lymphadenectomy groups (P {\textless} 0.001).
{CONCLUSION}: The extended procedure does not benefit overall survival, and there may even be a trend towards increased morbidity. Therefore extended lymphadenectomy should be performed only within adequately powered controlled trials, if at all.},
	pages = {265--273},
	number = {3},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Michalski, C. W. and Kleeff, J. and Wente, M. N. and Diener, M. K. and Büchler, M. W. and Friess, H.},
	date = {2007-03},
	pmid = {17318801},
	keywords = {Humans, Lymphatic Metastasis, Lymph Node Excision, Pancreatic Neoplasms, Pancreaticoduodenectomy, Randomized Controlled Trials as Topic, Survival Rate, Treatment Outcome}
}

@article{beaver_new_1986,
	title = {A new method for detecting anaerobic threshold by gas exchange},
	volume = {60},
	rights = {Copyright © 1986 the American Physiological Society},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/60/6/2020},
	abstract = {Excess {CO}2 is generated when lactate is increased during exercise because its [H+] is buffered primarily by {HCO}-3 (22 ml for each meq of lactic acid). We developed a method to detect the anaerobic threshold ({AT}), using computerized regression analysis of the slopes of the {CO}2 uptake ({VCO}2) vs. O2 uptake ({VO}2) plot, which detects the beginning of the excess {CO}2 output generated from the buffering of [H+], termed the V-slope method. From incremental exercise tests on 10 subjects, the point of excess {CO}2 output ({AT}) predicted closely the lactate and {HCO}-3 thresholds. The mean gas exchange {AT} was found to correspond to a small increment of lactate above the mathematically defined lactate threshold [0.50 +/- 0.34 ({SD}) meq/l] and not to differ significantly from the estimated {HCO}-3 threshold. The mean {VO}2 at {AT} computed by the V-slope analysis did not differ significantly from the mean value determined by a panel of six experienced reviewers using traditional visual methods, but the {AT} could be more reliably determined by the V-slope method. The respiratory compensation point, detected separately by examining the minute ventilation vs. {VCO}2 plot, was consistently higher than the {AT} (2.51 +/- 0.42 vs. 1.83 +/- 0.30 l/min of {VO}2). This method for determining the {AT} has significant advantages over others that depend on regular breathing pattern and respiratory chemosensitivity.},
	pages = {2020--2027},
	number = {6},
	journaltitle = {Journal of Applied Physiology},
	author = {Beaver, W. L. and Wasserman, K. and Whipp, B. J.},
	urldate = {2015-08-22},
	date = {1986-06-01},
	langid = {english},
	pmid = {3087938},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BBFPNST7\\Beaver et al. - 1986 - A new method for detecting anaerobic threshold by .pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\I35Q3WEZ\\2020.full.html:text/html}
}

@article{riemann_pancreas:_2010,
	title = {Pancreas: preoperative biliary drainage for pancreatic cancer},
	volume = {7},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20523350},
	pages = {308--9},
	number = {6},
	journaltitle = {Nat Rev Gastroenterol Hepatol},
	author = {Riemann, Jürgen F and Eickhoff, Axel},
	date = {2010-06}
}

@article{wasserman_detecting_1964,
	title = {{DETECTING} {THE} {THRESHOLD} {OF} {ANAEROBIC} {METABOLISM} {IN} {CARDIAC} {PATIENTS} {DURING} {EXERCISE}},
	volume = {14},
	issn = {0002-9149},
	pages = {844--852},
	journaltitle = {The American Journal of Cardiology},
	shortjournal = {Am. J. Cardiol.},
	author = {Wasserman, K. and Mcilroy, M. B.},
	date = {1964-12},
	pmid = {14232808},
	keywords = {Acromegaly, Bicarbonates, Carbon Dioxide, Exercise Test, Heart Rate, Metabolism, Mitral Valve Insufficiency, Mitral Valve Stenosis, Nitrogen, physical exertion, Respiratory Function Tests}
}

@article{ingle_prognostic_2008,
	title = {Prognostic value and diagnostic potential of cardiopulmonary exercise testing in patients with chronic heart failure},
	volume = {10},
	issn = {13889842},
	url = {http://doi.wiley.com/10.1016/j.ejheart.2007.12.011},
	doi = {10.1016/j.ejheart.2007.12.011},
	pages = {112--118},
	number = {2},
	journaltitle = {European Journal of Heart Failure},
	author = {Ingle, Lee},
	urldate = {2015-04-28},
	date = {2008-02},
	langid = {english},
	file = {Ingle - 2008 - Prognostic value and diagnostic potential of cardi.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\5S2FF3X7\\Ingle - 2008 - Prognostic value and diagnostic potential of cardi.pdf:application/pdf}
}

@article{buskirk_maximal_1957,
	title = {Maximal Oxygen Intake and Its Relation to Body Composition, With Special Reference to Chronic Physical Activity and Obesity},
	volume = {11},
	rights = {Copyright © 1957 the American Physiological Society},
	issn = {8750-7587, 1522-1601},
	url = {http://jap.physiology.org/content/11/1/72},
	abstract = {The maximal oxygen intake (Max Vo2) was determined in 46 healthy male students and 13 soldiers along with the weight of body fat as estimated by immersion densitometry. In 41 the active tissue and cell mass were estimated from measurements of blood volume, thiocyanate space and antipyrine space. The correlation coefficients between Max Vo2 and a) fat-free body weight, b) active tissue, c) body weight and d) cell mass were found to be 0.85, 0.91, 0.63 and 0.45, respectively. Max Vo2 was related to blood volume and red cell volume by correlation coefficients of 0.78 and 0.69 which was shown to be dependent on relationship between fat-free weight and blood volume (r = 0.76). It was shown that students who participated in athletics had a significantly larger Max Vo2 per kilogram of fat-free body weight than the sedentary group. The largest values occurred in cross-country runners. The sedentary students who did not take part in athletics were divided into three groups according to their body composition, i.e. more than 25\% fat, 10–25\% fat and less than 10\% fat. It was shown that there was no difference in Max Vo2 per kilogram of fat-free weight in the three groups. It is concluded that when Vo2 is used to examine the capacity to perform exhausting work the values should be expressed as Vo2 per kilogram of body weight; that when the test is used to examine the performance of the respiratory-cardiovascular system, the values should be expressed as Vo2 per kilogram of fat-free weight. It is also concluded that physical conditioning affects the maximum Vo2 independently of the mass of active tissue and that obesity per se has no effect on the maximal performance of the respiratory-cardiovascular system in young men.

Submitted on December 28, 1956},
	pages = {72--78},
	number = {1},
	journaltitle = {Journal of Applied Physiology},
	author = {Buskirk, Elsworth and Taylor, Henry Longstreet},
	urldate = {2015-04-30},
	date = {1957-07-01},
	langid = {english},
	pmid = {13462921},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7QMIJP69\\72.html:text/html}
}

@article{ballinger_persistent_1998,
	title = {Persistent systemic inflammatory response after stent insertion in patients with malignant bile duct obstruction},
	volume = {42},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9616320},
	abstract = {{BACKGROUND}: Surgery in patients with malignant bile duct obstruction is associated with high postoperative morbidity and mortality. Tumour necrosis factor alpha ({TNF}-alpha) plays a key role in the pathogenesis of these complications. {AIMS}: To determine the effect of biliary drainage on plasma concentrations of {TNF}-alpha, its soluble circulating receptors ({sTNFr}), and other proinflammatory cytokines. {METHODS}: Plasma concentrations of {TNF}-alpha, {sTNFr}-P75, interleukin 6 ({IL}-6), and {IL}-1 alpha were measured in 25 patients with malignant bile duct obstruction before and after endoscopic stent insertion. {RESULTS}: Mean serum bilirubin was 157 mumol/l before stent insertion and 35.2 mumol/l one week post stent insertion. There was complete relief of jaundice in 77\% of patients by four weeks. Plasma concentrations of {TNF}-alpha and {IL}-1 alpha were below the detection limit of the assays in all samples. Median plasma {sTNFr}-P75 in the cancer patients was 960 ng/l (range 400-6600), before stent insertion and remained unchanged at one and four weeks after stenting. Plasma {sTNFr}-P75 in cancer patients was significantly higher (p {\textless} 0.01) than in healthy controls (250 (200-650) ng/l). Before stent insertion, plasma {IL}-6 concentrations were detectable (above 5 ng/l) in 17 (68\%) patients. After relief of biliary obstruction {IL}-6 levels fell from a prestent median of 13.2 to less than 5 ng/l at one week after stent insertion. Plasma concentrations of {IL}-6 were undetectable in 76\% of patients at this time. {CONCLUSION}: Activation of the {TNF}/{sTNFr} complex is unchanged after biliary drainage in patients with malignant bile duct obstruction. This may explain why preoperative drainage does not influence the high morbidity and mortality associated with surgery in these patients.},
	pages = {555--9},
	number = {4},
	journaltitle = {Gut},
	author = {Ballinger, A B and Woolley, J A and Ahmed, M and Mulcahy, H and Alstead, E M and Landon, J and Clark, M L and Farthing, M J},
	date = {1998-04}
}

@article{woeste_increased_2010,
	title = {Increased serum levels of C-reactive protein precede anastomotic leakage in colorectal surgery},
	volume = {34},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19953248},
	abstract = {Anastomotic leakage ({AL}) is a severe complication following colorectal surgery. C-reactive protein ({CRP}) is considered to be an indicator of postoperative complications.},
	pages = {140--6},
	number = {1},
	journaltitle = {World J Surg},
	author = {Woeste, Guido and Müller, Christine and Bechstein, Wolf O and Wullstein, Christoph},
	date = {2010-01},
	keywords = {Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Biological Markers, colorectal surgery, C-Reactive Protein, Female, Hospital Mortality, Humans, Male, Middle Aged, postoperative complications, Predictive Value of Tests, Retrospective Studies, Statistics, Nonparametric}
}

@article{mcardle_male_2003,
	title = {Male gender adversely affects survival following surgery for colorectal cancer.},
	volume = {90},
	rights = {Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley \&  Sons, Ltd.},
	doi = {10.1002/bjs.4098},
	abstract = {{BACKGROUND}: Previous studies have suggested that survival following surgery for colorectal cancer is better in women than men. However, the findings were inconsistent and few studies adjusted for case-mix. The aim of the present study  was to establish whether there were gender differences in survival following surgery for colorectal cancer after adjusting for case-mix. {METHODS}: Some 3200 patients who underwent resection for colorectal cancer between 1991 and 1994 in 11 hospitals in Scotland were included in the study. Five-year survival rates, and the corresponding hazard ratios, adjusted for age, mode of presentation, site of tumour, the nature of surgery and Dukes stage, were calculated for men and women. {RESULTS}: Overall survival at 5 years was higher in women than men, in those with colonic tumours, those who underwent elective surgery and those who underwent apparently curative resection (all P {\textless} 0.001). Cancer-specific survival at 5 years was also higher in women (P = 0.008) and those who underwent elective  surgery (P {\textless} 0.001). The adjusted hazard ratios, for women relative to men following curative resection, were 0.76 (95 per cent confidence interval (c.i.) 0.68 to 0.85) (P {\textless} 0.001) for overall survival and 0.84 (95 per cent c.i. 0.73 to 0.98) (P = 0.021) for cancer-specific survival. {CONCLUSION}: Following apparently  curative resection for colorectal cancer and after adjusting for case-mix, there  was an excess of both cancer-related and intercurrent deaths in men.},
	pages = {711--715},
	number = {6},
	journaltitle = {The British journal of surgery},
	shortjournal = {Br J Surg},
	author = {{McArdle}, C. S. and {McMillan}, D. C. and Hole, D. J.},
	date = {2003-06},
	pmid = {12808619},
	keywords = {Adult, Aged, Chi-Square Distribution, Colorectal Neoplasms/mortality/*surgery, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Sex Factors, Survival Analysis}
}

@article{clayton_cardiopulmonary_2011,
	title = {Cardiopulmonary exercise testing and length of stay in patients undergoing major surgery},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21480842},
	pages = {393--4},
	number = {5},
	journaltitle = {Anaesthesia},
	author = {Clayton, R A and Bannard-Smith, J P and Washington, S J and Wisely, N and Columb, M and Rees, L},
	date = {2011-05},
	note = {No association with {LOS}}
}

@article{struthers_assessing_2008,
	title = {Assessing fitness for surgery: a comparison of questionnaire, incremental shuttle walk, and cardiopulmonary exercise testing in general surgical patients},
	volume = {101},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18953057},
	abstract = {{BACKGROUND}: Morbidity and mortality are higher in patients with poor preoperative cardiorespiratory reserve. This study aimed to ascertain fitness and therefore risk in elective patients, comparing three measures: Duke Activity Status Index ({DASI}) questionnaire, incremental shuttle walk test ({ISWT}), and cycle cardiopulmonary exercise testing ({CPET}). We looked for correlation between the measures and for thresholds on the questionnaire or shuttle test which could identify fit patients and render {CPET} unnecessary. {METHODS}: A prospective cohort trial of 50 patients having intra-abdominal surgery. Each performed {DASI}, {ISWT}, and {CPET} during a single visit to the hospital. {RESULTS}: There was a significant correlation between measured oxygen consumption and both {ISWT} and {DASI}. Receiver operator curve showed both the shuttle walk test and the {DASI} are sensitive and specific predictors of {VO}(2)peak {\textgreater}15 ml O(2) kg(-1) min(-1) and anaerobic threshold ({AT}) {\textgreater}11 ml O(2) kg(-1) min(-1). Thirty-two patients would be considered lower risk, having achieved both {VO}(2)peak and {AT} cut-offs. Setting an {ISWT} threshold of 360 m identified 13 of the lower risk patients [positive predictive value ({PPV}) 1.0, negative predictive value ({NPV}) 0.49]. Setting a {DASI} threshold score of 46 identified nine lower risk patients ({PPV} 1.0, {NPV} 0.44). {CONCLUSIONS}: We found a significant correlation between the tests. However, many patients with poor questionnaire scores or shuttle walks had satisfactory {CPET} results. Hence, the ability of either simple test to determine risk in a heterogeneous surgical population is poor. {CPET} provides an objective measurement of cardiopulmonary fitness; however, evidence for this information improving patient outcome is limited and requires further research.},
	pages = {774--80},
	number = {6},
	journaltitle = {Br J Anaesth},
	author = {Struthers, R and Erasmus, P and Holmes, K and Warman, P and Collingwood, A and Sneyd, J R},
	date = {2008-12},
	file = {Struthers et al. - 2008 - Assessing fitness for surgery a comparison of que.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\64FMXBEU\\Struthers et al. - 2008 - Assessing fitness for surgery a comparison of que.pdf:application/pdf}
}

@article{gullo_early_2001,
	title = {Do early symptoms of pancreatic cancer exist that can allow an earlier diagnosis?},
	volume = {22},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11249079},
	abstract = {Diagnosis of pancreatic cancer is made late, and prognosis remains extremely poor. This study was carried out to investigate whether symptoms exist before pain or jaundice that could suggest pancreatic cancer and favor earlier diagnosis. The study involved 305 patients with confirmed pancreatic cancer and 305 controls. All subjects were interviewed personally at least twice about their clinical history; pancreatic cancer patients were asked about any disturbances before abdominal pain or jaundice. Of the 305 pancreatic cancer patients, 151 (49.5\%) had some prior disturbances, 108 (35.4\%) 6 months or less before pain or jaundice and 43 (14.1\%) more than 6 months before. Among the latter, 14 (4.6\% of all patients) had had anorexia and/or early satiety and/or asthenia (7-20 months before pain or jaundice), 11 (3.6\%) had disgust for coffee and/or smoking and/or wine (7-20 months before), 14 (4.6\%) had diabetes (7-24 months before), and four (1.3\%) had acute pancreatitis (8-26 months before). Among the controls, the only reports of these symptoms were two (0.7\%) cases of asthenia (4 and 6 years earlier), 22 (7.2\%) cases of diabetes (of which only two [0.7\%] were diagnosed 7-24 months before the interview), and one (0.33\%) case of acute pancreatitis (10 years earlier). Apart from acute pancreatitis, all the other differences between patients and controls were statistically significant. In approximately 15\% of patients, disturbances existed more than 6 months before pain or jaundice, which, although not specific, could raise suspicion of the possibility of pancreatic cancer. These disturbances could represent the one current opportunity for an earlier diagnosis in a significant minority of pancreatic cancer patients.},
	pages = {210--3},
	number = {2},
	journaltitle = {Pancreas},
	author = {Gullo, L and Tomassetti, P and Migliori, M and Casadei, R and Marrano, D},
	date = {2001-03}
}

@article{mcmillan_performance_2002,
	title = {Performance status of male and female advanced cancer patients is independently predicted by mid-upper arm circumference measurement.},
	volume = {42},
	doi = {10.1207/S15327914NC422_7},
	abstract = {In the advanced cancer patient, performance status has considerable prognostic power. Karnofsky performance status, together with variables reported to influence its score, was measured in advanced gastrointestinal cancer patients (n = 148). For male and female patients, age, body mass index, weight loss, triceps  skinfold thickness, mid-upper arm circumference, albumin, C-reactive protein, and tumor type and stage were regressed against Karnofsky performance status. On multiple regression analysis, only mid-upper arm circumference and log10},
	pages = {191--193},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {{McMillan}, Donald C. and Forrest, Lynn M. and O'Gorman, Patricia and Angerson, Wilson J. and {McArdle}, Colin S.},
	date = {2002},
	pmid = {12416259},
	keywords = {*Anthropometry, Aged, Arm/*anatomy \& histology, C-Reactive Protein/analysis, Female, Gastrointestinal Neoplasms/*etiology/metabolism, Humans, Male, Middle Aged, Regression Analysis, Weight Loss}
}

@article{kahl_[endoscopic_2003,
	title = {[Endoscopic biliary drainage in patients with pancreatic cancer]},
	volume = {128},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12813640},
	abstract = {Obstructive jaundice is a common clinical sign in patients with pancreatic cancer. 52\% of all patients with a potentially resectable pancreatic cancer suffer from painless obstructive jaundice. There are no prospective studies showing a beneficial effect of preoperative drainage in patients with resectable pancreatic cancer. Morbidity (53\%) and mortality (15\%) in patients without preoperative biliary drainage are not significantly different from those who had endoscopic drainage preoperatively (morbidity 41\%; mortality 15\%). However, there are some logistic reasons for preoperative drainage, especially if surgery is delayed. In cases of nonresectable pancreatic cancer endoscopic drainage for palliation of obstructive jaundice is the method of choice. The decision between metallic and plastic stents for palliation is based on expected survival time and quality of life. Implantation of metal stents is the method of choice in patients with life expectancy exceeding six months. Scheduled three months exchange of plastic stents is recommended to avoid complications. After a six months interval about 70\% of patients with scheduled exchange are without symptoms, compared to about 40\% of patients who had exchange of plastic stents on demand. Scheduled three months exchange of plastic stents leeds to a patency rate of plastic stents comparable to those of metallic stents.},
	pages = {406--10},
	number = {5},
	journaltitle = {Zentralbl Chir},
	author = {Kahl, S and Zimmermann, S and Pross, M and Schulz, H-U and Malfertheiner, P},
	date = {2003-05}
}

@article{matsuda_preoperative_2009,
	title = {Preoperative Plasma Adiponectin Level Is a Risk Factor for Postoperative Infection Following Colorectal Cancer Surgery},
	volume = {157},
	issn = {0022-4804},
	url = {http://www.journalofsurgicalresearch.com/article/S002248040800588X/abstract},
	doi = {10.1016/j.jss.2008.09.007},
	abstract = {Background
Adiponectin is produced exclusively by adipose tissues. It is associated with visceral adiposity and various metabolic disorders, and acts as an anti-inflammatory protein that inhibits nuclear factor-κB activation. The purpose of this study is to clarify the association between the preoperative plasma adiponectin levels and the development of postoperative infection following colorectal cancer surgery.
Methods
Peripheral blood samples were collected from 41 colorectal cancer patients before surgery and on postoperative days ({PODs}) 1, 3, 5, and 7. Plasma adiponectin, leptin, and serum C-reactive protein ({CRP}) levels were measured and the white blood cells ({WBCs}) were counted. Subcutaneous and visceral fat volumes were quantified by preoperative {CT} scans. The patients were divided into a group with postoperative infections and an uninfected group.
Results
In both groups, the postoperative plasma adiponectin levels decreased transiently and then gradually recovered. However, the infected group had significantly lower adiponectin levels throughout the perioperative period than the uninfected group. Logistic regression analysis revealed that preoperative adiponectin level was an independent risk factor for postoperative infection.
Conclusions
Preoperative adiponectin levels may be useful for anticipating the development of postoperative infection following colorectal cancer surgery.},
	pages = {227--234},
	number = {2},
	journaltitle = {Journal of Surgical Research},
	author = {Matsuda, Akihisa and Matsutani, Takeshi and Sasajima, Koji and Furukawa, Kiyonori and Tajiri, Takashi and Tamura, Kazuhiro and Kogo, Hiroshi},
	urldate = {2015-08-20},
	date = {2009-12-01},
	pmid = {19394964},
	keywords = {Adiponectin, Colorectal cancer, Leptin, postoperative infection},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\78MDU6RX\\abstract.html:text/html}
}

@article{kawasaki_surgical_2001,
	title = {Surgical stress induces endotoxin hyporesponsiveness and an early decrease of monocyte {mCD}14 and {HLA}-{DR} expression during surgery},
	volume = {92},
	issn = {0003-2999},
	abstract = {It is generally accepted that major surgery is associated with severe alterations of the host-defense mechanisms. We investigated the effect of surgical stress on the immune system. Specifically, we studied the relationship between perioperative lipopolysaccharide ({LPS}) hyporesponsiveness and monocyte human leukocyte antigen-{DR} ({HLA}-{DR}) and {CD}14 expression during the perioperative period in 20 patients who underwent partial gastrectomy. This study demonstrated that surgical stress rapidly depressed monocyte {mCD}14 and {HLA}-{DR} expression in comparison with preanesthesia levels. Monocyte {mCD}14 expression recovered to preoperative levels on the first postoperative day, and monocyte {HLA}-{DR} expression recovered by the seventh postoperative day. Consistent with our previous study, {LPS}-induced tumor necrosis factor ({TNF})-alpha production ex vivo was significantly suppressed from the beginning of the operation. On the contrary, the plasma interleukin-10 concentration started to increase after the surgical incision was made. {LPS} hyporesponsiveness was least at the end of the operation and returned to preoperative levels on the first postoperative day. In conclusion, the present study demonstrated that {LPS} responsiveness, plasma interleukin-10 concentration, and monocytes {mCD}14 and {HLA}-{DR} expression altered from the early period of surgery. These alterations may be related to the impairment of the immune system during the perioperative period.
{IMPLICATIONS}: Recent studies demonstrate that surgical stress induces immune dysfunction. We found that surgical stress rapidly decreased monocyte {mCD}14 and human leukocyte antigen-{DR} expression, and endotoxin responsiveness. These findings suggest that early changes of the immune system caused by surgical stress contribute to postoperative complications such as sepsis and multiple organ failure.},
	pages = {1322--1326},
	number = {5},
	journaltitle = {Anesthesia and Analgesia},
	shortjournal = {Anesth. Analg.},
	author = {Kawasaki, T. and Ogata, M. and Kawasaki, C. and Tomihisa, T. and Okamoto, K. and Shigematsu, A.},
	date = {2001-05},
	pmid = {11323370},
	keywords = {Antigens, {CD}14, Gastrectomy, {HLA}-{DR} Antigens, Humans, Immune Tolerance, Interleukin-10, In Vitro Techniques, Lipopolysaccharides, Monocytes, Stress, Physiological, Surgical Procedures, Operative, Tumor Necrosis Factor-alpha}
}

@article{jack_effect_2014,
	title = {The effect of neoadjuvant chemotherapy on physical fitness and survival in patients undergoing oesophagogastric cancer surgery},
	volume = {40},
	issn = {0748-7983},
	url = {http://www.sciencedirect.com/science/article/pii/S0748798314003643},
	doi = {10.1016/j.ejso.2014.03.010},
	abstract = {{AbstractBackground}
Neoadjuvant chemotherapy ({NAC}) followed by surgery for resectable oesophageal or gastric cancer improves outcome when compared with surgery alone. However {NAC} has adverse effects. We assess here whether {NAC} adversely affects physical fitness and whether such an effect is associated with impaired survival following surgery.
Methods
We prospectively studied 116 patients with oesophageal or gastric cancer to assess the effect of {NAC} on physical fitness, of whom 89 underwent cardiopulmonary exercise testing ({CPET}) before {NAC} and proceeded to surgery. 39 patients were tested after all cycles of {NAC} but prior to surgery. Physical fitness was assessed by measuring oxygen uptake ( V ˙ O 2 in ml kg−1 min−1) at the estimated lactate threshold ( θ ˆ L ) and at peak exercise ( V ˙ O 2 peak in ml kg−1 min−1).
Results
V ˙ O 2 at θ ˆ L and at peak were significantly lower after {NAC} compared to pre-{NAC} values: V ˙ O 2 at θ ˆ L 14.5 ± 3.8 (baseline) vs. 12.3 ± 3.0 (post-{NAC}) ml kg−1 min−1; p ≤ 0.001; V ˙ O 2 peak 20.8 ± 6.0 vs. 18.3 ± 5.1 ml kg−1 min−1; p ≤ 0.001; absolute V ˙ O 2 (ml min−1) at θ ˆ L and peak were also lower post-{NAC}; p ≤ 0.001. Decreased baseline V ˙ O 2 at θ ˆ L and peak were associated with increased one year mortality in patients who completed a full course of {NAC} and had surgery; p = 0.014.
Conclusion
{NAC} before cancer surgery significantly reduced physical fitness in the overall cohort. Lower baseline fitness was associated with reduced one-year-survival in patients completing {NAC} and surgery, but not in patients who did not complete {NAC}. It is possible that in some patients the harms of {NAC} may outweigh the benefits.

Trials Registry Number: {NCT}01335555.},
	pages = {1313--1320},
	number = {10},
	journaltitle = {European Journal of Surgical Oncology ({EJSO})},
	shortjournal = {European Journal of Surgical Oncology ({EJSO})},
	author = {Jack, S. and West, M. A. and Raw, D. and Marwood, S. and Ambler, G. and Cope, T. M. and Shrotri, M. and Sturgess, R. P. and Calverley, P. M. A. and Ottensmeier, C. H. and Grocott, M. P. W.},
	urldate = {2015-05-05},
	date = {2014-10},
	keywords = {Cancer surgery, Cardiopulmonary exercise testing, Neoadjuvant chemotherapy, Oesphagogastric, Physical fitness, Survival},
	file = {ScienceDirect Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\H9HSZFES\\Jack et al. - 2014 - The effect of neoadjuvant chemotherapy on physical.pdf:application/pdf;ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EKRKEXA3\\S0748798314003643.html:text/html}
}

@article{proctor_inflammation-based_2011,
	title = {An inflammation-based prognostic score ({mGPS}) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study.},
	volume = {104},
	doi = {10.1038/sj.bjc.6606087},
	abstract = {{INTRODUCTION}: A selective combination of C-reactive protein and albumin (termed the modified Glasgow Prognostic Score, {mGPS}) has been shown to have prognostic value, independent of tumour stage, in lung, gastrointestinal and renal cancers.  It is also of interest that liver function tests such as bilirubin, alkaline phosphatase and gamma-glutamyl transferase, as well as serum calcium, have also been reported to predict cancer survival. The aim of the present study was to examine the relationship between an inflammation-based prognostic score ({mGPS}), biochemical parameters, tumour site and survival in a large cohort of patients with cancer. {METHODS}: Patients (n=21,669) who had an incidental blood sample taken between 2000 and 2006 for C-reactive protein, albumin and calcium (and liver function tests where available) and a diagnosis of cancer were identified.  Of this group 9608 patients who had an ongoing malignant process were studied (sampled within 2 years before diagnosis). Also a subgroup of 5397 sampled at the time of diagnosis (sampled within 2 months prior to diagnosis) were examined. Cancers were grouped by tumour site in accordance with International Classification of Diseases 10 ({ICD} 10). {RESULTS}: On follow up, there were 6005 (63\%) deaths of which 5122 (53\%) were cancer deaths. The median time from blood sampling to diagnosis was 1.4 months. Increasing age, male gender and increasing  deprivation was associated with a reduced 5-year overall and cancer-specific survival (all P{\textless}0.001). An elevated {mGPS}, adjusted calcium, bilirubin, alkaline phosphatase, aspartate transaminase, alanine transaminase and gamma-glutamyl transferase were associated with a reduced 5-year overall and cancer-specific survival (independent of age, sex and deprivation in all patients sampled), as well as within the time of diagnosis subgroup (all P{\textless}0.001). An increasing {mGPS} was predictive of a reduced cancer-specific survival in all cancers (all P{\textless}0.001). {CONCLUSION}: The results of the present study indicate that the {mGPS} is  a powerful prognostic factor when compared with other biochemical parameters and  independent of tumour site in patients with cancer.},
	pages = {726--734},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Proctor, M. J. and Morrison, D. S. and Talwar, D. and Balmer, S. M. and O'Reilly, D. S. J. and Foulis, A. K. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2011-02-15},
	pmid = {21266974},
	pmcid = {PMC3049591},
	keywords = {Adult, Aged, Cohort Studies, Female, Follow-Up Studies, Humans, Inflammation/*blood/diagnosis/etiology/pathology, Male, Middle Aged, Neoplasms/complications/*diagnosis/*mortality/pathology, Neoplasm Staging/methods, Outcome Assessment (Health Care), Prognosis, Research Design, Survival Analysis}
}

@article{neoptolemos_adjuvant_2010,
	title = {Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial},
	volume = {304},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20823433},
	abstract = {{CONTEXT}: Adjuvant fluorouracil has been shown to be of benefit for patients with resected pancreatic cancer. Gemcitabine is known to be the most effective agent in advanced disease as well as an effective agent in patients with resected pancreatic cancer. {OBJECTIVE}: To determine whether fluorouracil or gemcitabine is superior in terms of overall survival as adjuvant treatment following resection of pancreatic cancer. {DESIGN}, {SETTING}, {AND} {PATIENTS}: The European Study Group for Pancreatic Cancer ({ESPAC})-3 trial, an open-label, phase 3, randomized controlled trial conducted in 159 pancreatic cancer centers in Europe, Australasia, Japan, and Canada. Included in {ESPAC}-3 version 2 were 1088 patients with pancreatic ductal adenocarcinoma who had undergone cancer resection; patients were randomized between July 2000 and January 2007 and underwent at least 2 years of follow-up. {INTERVENTIONS}: Patients received either fluorouracil plus folinic acid (folinic acid, 20 mg/m(2), intravenous bolus injection, followed by fluorouracil, 425 mg/m(2) intravenous bolus injection given 1-5 days every 28 days) (n = 551) or gemcitabine (1000 mg/m(2) intravenous infusion once a week for 3 of every 4 weeks) (n = 537) for 6 months. {MAIN} {OUTCOME} {MEASURES}: Primary outcome measure was overall survival; secondary measures were toxicity, progression-free survival, and quality of life. {RESULTS}: Final analysis was carried out on an intention-to-treat basis after a median of 34.2 (interquartile range, 27.1-43.4) months' follow-up after 753 deaths (69\%). Median survival was 23.0 (95\% confidence interval [{CI}], 21.1-25.0) months for patients treated with fluorouracil plus folinic acid and 23.6 (95\% {CI}, 21.4-26.4) months for those treated with gemcitabine (chi(1)(2) = 0.7; P = .39; hazard ratio, 0.94 [95\% {CI}, 0.81-1.08]). Seventy-seven patients (14\%) receiving fluorouracil plus folinic acid had 97 treatment-related serious adverse events, compared with 40 patients (7.5\%) receiving gemcitabine, who had 52 events (P {\textless} .001). There were no significant differences in either progression-free survival or global quality-of-life scores between the treatment groups. {CONCLUSION}: Compared with the use of fluorouracil plus folinic acid, gemcitabine did not result in improved overall survival in patients with completely resected pancreatic cancer. {TRIAL} {REGISTRATION}: clinicaltrials.gov Identifier: {NCT}00058201.},
	pages = {1073--81},
	number = {10},
	journaltitle = {{JAMA}},
	author = {Neoptolemos, John P and Stocken, Deborah D and Bassi, Claudio and Ghaneh, Paula and Cunningham, David and Goldstein, David and Padbury, Robert and Moore, Malcolm J and Gallinger, Steven and Mariette, Christophe and Wente, Moritz N and Izbicki, Jakob R and Friess, Helmut and Lerch, Markus M and Dervenis, Christos and Oláh, Attila and Butturini, Giovanni and Doi, Ryuichiro and Lind, Pehr A and Smith, David and Valle, Juan W and Palmer, Daniel H and Buckels, John A and Thompson, Joyce and {McKay}, Colin J and Rawcliffe, Charlotte L and Büchler, Markus W},
	date = {2010-09},
	file = {Neoptolemos et al. - 2010 - Adjuvant chemotherapy with fluorouracil plus folin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8SGDET8E\\Neoptolemos et al. - 2010 - Adjuvant chemotherapy with fluorouracil plus folin.pdf:application/pdf}
}

@article{conway_plasma_2015,
	title = {Plasma vitamin D concentration and survival in colorectal cancer: potential confounding by the systemic inflammatory response.},
	volume = {33},
	doi = {10.1200/JCO.2014.59.2386},
	number = {2},
	journaltitle = {Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
	shortjournal = {J Clin Oncol},
	author = {Conway, Fiona J. S. and {McMillan}, Donald C.},
	date = {2015-01-10},
	pmid = {25488961},
	keywords = {Colorectal Neoplasms/*blood/*mortality, Female, Humans, Male, Vitamin D/*analogs \& derivatives}
}

@article{platt_c-reactive_2012,
	title = {C-reactive Protein as a Predictor of Postoperative Infective Complications after Curative Resection in Patients with Colorectal Cancer},
	volume = {19},
	issn = {1068-9265, 1534-4681},
	url = {http://link.springer.com/article/10.1245/s10434-012-2498-9},
	doi = {10.1245/s10434-012-2498-9},
	abstract = {Background Infective complications particularly in the form of surgical site infections including anastomotic leak represent a serious morbidity after colorectal cancer surgery. Systemic inflammation markers, including C-reactive protein ({CRP}) and white cell count, have been reported to provide early detection. However, their relative predictive value is unclear. The aim of the present study was to examine the diagnostic accuracy of serial postoperative {WCC}, albumin and {CRP} in detecting infective complications. Methods White cell count, albumin and {CRP} were measured postoperatively for 7 days in 454 consecutive patients undergoing surgery for colorectal cancer. All postoperative complications were recorded. The diagnostic accuracy of the white cell count, albumin and {CRP} values were analyzed by receiver operating characteristics curve analysis with surgical site infective complications as outcome measures. Results One hundred four patients (23 \%) developed infective complications, and 26 of them developed an anastomotic leak. {CRP} was most sensitive to the development of an infective complication, surgical site or at a remote site. On postoperative day 3 {CRP} the area under the receiver operating characteristic curve was 0.80 (p {\textless} 0.001) and the optimal cutoff value was 170 mg/L. This threshold was also associated with an increase in the length of hospital stay (p {\textless} 0.001), 30 day mortality (p {\textless} 0.05) and 12 month mortality (p {\textless} 0.10). Conclusions Postoperative {CRP} measurement on day 3 postoperatively is clinically useful in predicting surgical site infective complications, including an anastomotic leak, in patients undergoing surgery for colorectal cancer.},
	pages = {4168--4177},
	number = {13},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Platt, Jonathan J. and Ramanathan, Michelle L. and Crosbie, Robin A. and Anderson, John H. and {McKee}, Ruth F. and Horgan, Paul G. and {McMillan}, Donald C.},
	urldate = {2015-08-20},
	date = {2012-07-18},
	langid = {english},
	keywords = {Oncology, surgery, Surgical Oncology},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EJUIR26A\\Platt et al. - 2012 - C-reactive Protein as a Predictor of Postoperative.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\S42KJEI7\\10.html:text/html}
}

@article{bradshaw_formation_1997,
	title = {Formation of free radicals and protein mixed disulfides in rat red cells exposed  to dapsone hydroxylamine.},
	volume = {22},
	abstract = {The hemolytic activity of dapsone is well known to reside in its N-hydroxylamine  metabolites. Addition of dapsone hydroxylamine ({DDS}-{NOH}) to red cell suspensions  causes damage such that when reintroduced into the circulation of isologous rats, the injured cells are rapidly removed by the spleen. Hemolytic activity is associated with the extensive formation of disulfide-linked hemoglobin adducts on red cell membrane skeletal proteins. To determine if free radicals could be involved in this process, rat red cells were incubated with {DDS}-{NOH} in the presence of the spin trap, 5,5'-dimethyl-1-pyrroline-N-oxide ({DMPO}) and subjected to {EPR} analysis. Addition of {DDS}-{NOH} (25-50 {microM}) to a red cell suspension gave rise to a four-line (1:2:2:1) {EPR} spectrum with coupling constants identical to those of a {DMPO}-hydroxyl radical adduct ({DMPO}-{OH}) standard. No other radicals were detected; however, preincubation of red cells with cysteamine caused the},
	pages = {1183--1193},
	number = {7},
	journaltitle = {Free radical biology \& medicine},
	shortjournal = {Free Radic Biol Med},
	author = {Bradshaw, T. P. and {McMillan}, D. C. and Crouch, R. K. and Jollow, D. J.},
	date = {1997},
	pmid = {9098092},
	keywords = {Animals, Cyclic N-Oxides/metabolism, Cysteamine/metabolism/pharmacology, Dapsone/*analogs \& derivatives/pharmacology, Disulfides/*metabolism, Electron Spin Resonance Spectroscopy, Erythrocytes/drug effects/*metabolism, Free Radicals/metabolism, Glutathione/metabolism, Hemoglobins/metabolism, Hemolysis/*drug effects, Hydroxylation, Hydroxyl Radical/metabolism, Male, Rats, Rats, Sprague-Dawley, Reactive Oxygen Species/metabolism, Salicylates/metabolism, Spin Labels}
}

@article{dunne_cardiopulmonary_2014,
	title = {Cardiopulmonary exercise testing before liver surgery},
	volume = {110},
	rights = {© 2014 Wiley Periodicals, Inc.},
	issn = {1096-9098},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/jso.23670/abstract},
	doi = {10.1002/jso.23670},
	abstract = {Background

Cardiopulmonary exercise testing ({CPET}) assessed “poorer” fitness correlates with poorer outcomes in blinded studies. Whether this correlation will persist when {CPET} is utilized to stratify care as part of a multi-modal enhanced recovery after surgery ({ERAS}) program is unclear. This study examined whether {CPET} variables were associated with postoperative morbidity in patients undergoing hepatectomy within an {ERAS} program.


Objectives and Methods

Data were prospectively collected on patients undergoing elective hepatectomy between October 2009 and April 2011. The relationships between {CPET} derived variables; postoperative complications and length of stay were investigated.


Results

Of 267 patients undergoing surgery, 197 had undergone standard cycle ergometer {CPET}. The relative oxygen uptake [{VO}2 (ml kg−1 min−1)] and ventilatory equivalent of {CO}2 ({VE}/{VCO}2) at the anaerobic threshold ({AT}) were not associated with complications or length of stay. Greater absolute oxygen uptake at {AT} [{VO}2 at {AT} (L min−1)] was associated with early hospital discharge [{OR} 2.16 (95\% {CI} 1.18–3.96), P = 0.013] on multivariable analysis.


Conclusions

When {CPET} is used to delineate perioperative management a low relative oxygen uptake [{VO}2 (ml kg−1 min−1)] at the {AT} does not place patients at significantly higher risk of postoperative complications. This suggests {CPET} assessed “poor” fitness should not be used as a barrier to surgical intervention. J. Surg. Oncol. 2014; 110:439–444. © 2014 Wiley Periodicals, Inc.},
	pages = {439--444},
	number = {4},
	journaltitle = {Journal of Surgical Oncology},
	shortjournal = {J. Surg. Oncol.},
	author = {Dunne, Declan F.J. and Jones, Robert P. and Lythgoe, Daniel T. and Pilkington, Francis J. and Palmer, Daniel H. and Malik, Hassan Z. and Poston, Graeme J. and Lacasia, Carmen and Jack, Sandy and Fenwick, Stephen W.},
	urldate = {2015-05-05},
	date = {2014-09-01},
	langid = {english},
	keywords = {Cardiopulmonary exercise testing, {ERAS}, exercise testing, hepatectomy, preopertive assessment},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TZMVPKKE\\Dunne et al. - 2014 - Cardiopulmonary exercise testing before liver surg.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\KCFPKN8T\\abstract.html:text/html}
}

@article{proctor_comparison_2011,
	title = {A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study.},
	volume = {47},
	rights = {Copyright (c) 2011 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ejca.2011.03.028},
	abstract = {{INTRODUCTION}: Components of the systemic inflammatory response, combined to form  inflammation-based prognostic scores (modified Glasgow Prognostic Score ({mGPS}), Neutrophil Lymphocyte Ratio ({NLR}), Platelet Lymphocyte Ratio ({PLR}), Prognostic Index ({PI}), Prognostic Nutritional Index ({PNI})) have been associated with cancer  specific survival. The aim of the present study was to compare the prognostic value of these scores. {METHODS}: Patients (n=27,031) who had an incidental blood sample taken between 2000 and 2007 for C-reactive protein, albumin, white cell, neutrophil, lymphocyte and platelet counts, as well as a diagnosis of cancer (Scottish Cancer Registry) were identified. Of this group 8759 patients who had been sampled within two years following their cancer diagnosis were studied. {RESULTS}: On follow up, there were 5163 deaths of which 4417 (86\%) were cancer deaths. The median time from blood sampling to diagnosis was 1.7 months. An elevated {mGPS}, {NLR}, {PLR}, {PI} and {PNI} were predictive of a reduced cancer specific  survival independent of age, sex and deprivation and tumour site (all p{\textless}0.001). The area under the receiver operator curves was greatest for {mGPS} and {PI}. Specifically, in colorectal cancer, an elevated {mGPS} and {PI} were predictive of a  reduced cancer specific survival independent of age, sex, deprivation and tumour  stage (both p{\textless}0.001). {CONCLUSION}: The results of the present study show that systemic inflammation-based scores, in particular the {mGPS} and {PI}, have prognostic value in cancer independent of tumour site. Based on the present results and the existing validation literature, the {mGPS} should be included in the routine assessment of all patients with cancer.},
	pages = {2633--2641},
	number = {17},
	journaltitle = {European journal of cancer (Oxford, England : 1990)},
	shortjournal = {Eur J Cancer},
	author = {Proctor, Michael J. and Morrison, David S. and Talwar, Dinesh and Balmer, Steven M. and Fletcher, Colin D. and O'Reilly, Denis St J. and Foulis, Alan K. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2011-11},
	pmid = {21724383},
	keywords = {Aged, Aged, 80 and over, Cohort Studies, C-Reactive Protein/analysis, Female, Humans, Inflammation/*blood, Leukocyte Count, Male, Middle Aged, Neoplasms/*blood/mortality/pathology, Neoplasm Staging/methods, Nutrition Assessment, Platelet Count, Prognosis, Survival Analysis, Tumor Markers, Biological/analysis}
}

@article{murakami_soft_2008,
	title = {A soft pancreatic remnant is associated with increased drain fluid pancreatic amylase and serum {CRP} levels following pancreatoduodenectomy},
	volume = {12},
	issn = {1091-255X},
	doi = {10.1007/s11605-007-0340-7},
	abstract = {The aim of this prospective study was to clarify differences in postoperative changes of serum or drainage fluid pancreatic amylase levels and serum C-reactive protein ({CRP}) levels between patients with a soft pancreatic texture and those with a hard pancreatic texture undergoing pancreatoduodenectomy ({PD}) with pancreaticogastrostomy. A total of 61 consecutive patients with resectable periampullary tumors undergoing {PD} were recruited. This population was divided into 27 patients with a hard pancreatic texture and 34 patients with a soft pancreatic texture. Drainage fluid total amylase or pancreatic amylase levels, serum total amylase or pancreatic amylase levels, and serum {CRP} levels were measured postoperatively. Clinicopathological data were also compared between two groups. Postoperative complications more frequently occurred in patients with a soft pancreatic texture compared with those with a hard pancreatic texture (P=0.029). Serum or drainage fluid pancreatic amylase levels and serum {CRP} levels of patients with a soft pancreatic texture were significantly higher than those of patients with a hard pancreatic texture after {PD} on postoperative days 1 and 2 (P{\textless}0.05). A soft pancreatic texture was identified as an only independent predictive factor of increased drainage fluid pancreatic amylase levels (P=0.006) and serum {CRP} levels (P=0.047). A soft pancreatic texture is closely associated with increased drainage fluid pancreatic amylase and serum {CRP} levels after {PD}. More careful post-{PD} management is needed for patients with a soft pancreatic texture.},
	pages = {51--56},
	number = {1},
	journaltitle = {Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract},
	shortjournal = {J. Gastrointest. Surg.},
	author = {Murakami, Yoshiaki and Uemura, Kenichiro and Hayasidani, Yasuo and Sudo, Takeshi and Hashimoto, Yasushi and Nakagawa, Naoya and Ohge, Hiroki and Sueda, Taijiro},
	date = {2008-01},
	pmid = {17955317},
	keywords = {Aged, Amylases, Anastomosis, Surgical, Biological Markers, Carcinoma, C-Reactive Protein, Drainage, Female, Follow-Up Studies, Humans, Male, pancreas, Pancreatic Neoplasms, Pancreaticoduodenectomy, postoperative complications, Prospective Studies, Reoperation, Stomach, Treatment Outcome}
}

@article{mcmillan_abc_2006,
	title = {{ABC} of obesity. Obesity and cancer.},
	volume = {333},
	doi = {10.1136/bmj.39042.565035.BE1},
	pages = {1109--1111},
	number = {7578},
	journaltitle = {{BMJ} (Clinical research ed.)},
	shortjournal = {{BMJ}},
	author = {{McMillan}, Donald C. and Sattar, Naveed and {McArdle}, Colin S.},
	date = {2006-11-25},
	pmid = {17124223},
	pmcid = {PMC1661751},
	keywords = {European Union, Exercise, Humans, Incidence, Life Style, Neoplasms/*etiology/mortality, Obesity/*complications/mortality, Risk Factors}
}

@article{young_systematic_2012,
	title = {A Systematic Review of the Role of Cardiopulmonary Exercise Testing in Vascular Surgery},
	volume = {44},
	issn = {1078-5884},
	url = {http://www.ejves.com/article/S1078588412002341/abstract},
	doi = {10.1016/j.ejvs.2012.03.022},
	abstract = {Objective
To perform a systematic review of cardiopulmonary exercise testing ({CPET}) in the pre-operative evaluation of patients with abdominal aortic aneurysm or peripheral vascular disease requiring surgery.
Methods
Review methods and reporting were according to the {PRISMA} guidelines. Studies were eligible if they reported {CPET}-derived physiological parameters in patients undergoing abdominal aortic aneurysm repair or lower extremity arterial bypass. Data were extracted regarding patient populations and correlation between {CPET} and surgical outcomes including mortality, morbidity, critical care bed usage and length of hospital stay.
Results
The searches identified 1301 articles. Although 53 abstracts referred to the index vascular procedures, only seven articles met inclusion criteria. There were no data from randomised controlled trials. Data from prospective studies did not comprehensively correlate {CPET} and surgical outcomes in patients with abdominal aortic aneurysms. There were no studies reporting {CPET} in patients undergoing lower extremity arterial bypass. Major limitations included small sample sizes, lack of blinding, and an absence of reporting standards.
Conclusion
The paucity of robust data precludes routine adoption of {CPET} in risk stratifying patients undergoing major vascular surgery. The use of {CPET} should be restricted to clinical trials and experimental registries, reporting to consensus-defined standards.},
	pages = {64--71},
	number = {1},
	journaltitle = {European Journal of Vascular and Endovascular Surgery},
	author = {Young, E. L. and Karthikesalingam, A. and Huddart, S. and Pearse, R. M. and Hinchliffe, R. J. and Loftus, I. M. and Thompson, M. M. and Holt, P. J. E.},
	urldate = {2015-06-04},
	date = {2012-07-01},
	keywords = {{CPET}, exercise testing, Vascular Surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NQ3DMFHU\\Young et al. - 2012 - A Systematic Review of the Role of Cardiopulmonary.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\K94BEZQV\\abstract.html:text/html}
}

@article{bailey_endotoxin_1976,
	title = {Endotoxin, bile salts and renal function in obstructive jaundice},
	volume = {63},
	rights = {Copyright © 1976 British Journal of Surgery Society Ltd.},
	issn = {1365-2168},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.1800631011/abstract},
	doi = {10.1002/bjs.1800631011},
	abstract = {It is generally agreed that there is an increased incidence of postoperative renal failure in patients with obstructive jaundice. The proposition that this may be due to endotoxin, and that the endotoxin may be absorbed from the patient's own bowel flora, has been investigated. The study was conducted in patients and in animals. Twenty-four patients with obstructive jaundice were studied. Sixteen had endotoxin in the portal blood at operation and 13 of these had peripheral endotoxaemia at the time of operation or developed it during the 72 hours following operation. Only 3 of the patients had a proved possible site of infective origin for the endotoxaemia, the remainder absorbing the endotoxin from their own gastro-intestinal organisms. Portal endotoxaemia occurred when the serum bilirubin was 8·5 mg/100 ml or greater. There was a highly significant decrease in mean endogenous creatinine clearance postoperatively in patients with endotoxaemia, and expression of this as a percentage postoperative fall compared with preoperative levels enhanced the significance. Jaundiced patients without endotoxaemia had no significant fall in endogenous creatinine clearance. Matched non-jaundiced control patients did not develop portal or peripheral endotoxaemia, and there was no significant fall in postoperative creatinine clearance. Experiments using animals showed that the absence of bile salts in the intestinal tract in obstructive jaundice allows endotoxin to be absorbed, and that this absorption can be preuented by the oral administration of bile salts. The therapeutic implications in patients are discussed.},
	pages = {774--778},
	number = {10},
	journaltitle = {British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Bailey, M. E.},
	urldate = {2015-06-03},
	date = {1976-10-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RRXMNURT\\Bailey - 1976 - Endotoxin, bile salts and renal function in obstru.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\K57BA2RA\\abstract.html:text/html}
}

@article{uhl_iap_2002,
	title = {{IAP} Guidelines for the Surgical Management of Acute Pancreatitis},
	volume = {2},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12435871},
	abstract = {During 2002 the International Association of Pancreatology developed evidenced-based guidelines on the surgical management of acute pancreatitis. There were 11 guidelines, 10 of which were recommendations grade B and one (the second) grade A. (1) Mild acute pancreatitis is not an indication for pancreatic surgery. (2) The use of prophylactic broad-spectrum antibiotics reduces infection rates in computed tomography-proven necrotizing pancreatitis but may not improve survival. (3) Fine-needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome. (4) Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for intervention including surgery and radiological drainage. (5) Patients with sterile pancreatic necrosis (with negative fine-needle aspiration for bacteriology) should be managed conservatively and only undergo intervention in selected cases. (6) Early surgery within 14 days after onset of the disease is not recommended in patients with necrotizing pancreatitis unless there are specific indications. (7) Surgical and other forms of interventional management should favor an organ-preserving approach, which involves debridement or necrosectomy combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate. (8) Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis. (9) In mild gallstone-associated acute pancreatitis, cholecystectomy should be performed as soon as the patient has recovered and ideally during the same hospital admission. (10) In severe gallstone-associated acute pancreatitis, cholecystectomy should be delayed until there is sufficient resolution of the inflammatory response and clinical recovery. (11) Endoscopic sphincterotomy is an alternative to cholecystectomy in those who are not fit to undergo surgery in order to lower the risk of recurrence of gallstone-associated acute pancreatitis. There is however a theoretical risk of introducing infection into sterile pancreatic necrosis. These guidelines should now form the basis for audit studies in order to determine the quality of patient care delivery.},
	pages = {565--73},
	number = {6},
	journaltitle = {Pancreatology},
	author = {Uhl, Waldemar and Warshaw, Andrew and Imrie, Clement and Bassi, Claudio and {McKay}, Colin J and Lankisch, Paul G and Carter, Ross and Di Magno, Eugene and Banks, Peter A and Whitcomb, David C and Dervenis, Christos and Ulrich, Charles D and Satake, Kat and Ghaneh, Paula and Hartwig, Werner and Werner, Jens and {McEntee}, Gerry and Neoptolemos, John P and Büchler, Markus W},
	date = {2002}
}

@article{boyd_effect_2012,
	title = {The effect of depression on stage at diagnosis, treatment, and survival in pancreatic adenocarcinoma},
	volume = {152},
	issn = {0039-6060},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465163/},
	doi = {10.1016/j.surg.2012.06.010},
	abstract = {Background
Depression has been associated with delayed presentation, inadequate treatment, and poor survival in patients with cancer.

Methods
Using Surveillance, Epidemiology and End Results and Medicare linked data (1992–2005), we identified patients with pancreatic adenocarcinoma (N = 23,745). International Classification of Diseases, 9th edition, Clinical Modification codes were used to evaluate depression during the 3 to 27 months before the diagnosis of cancer. The effect of depression on receipt of therapy and survival was evaluated in univariate and multivariate models.

Results
Of patients with pancreatic cancer in our study, 7.9\% had a diagnosis of depression (N = 1,868). Depression was associated with increased age, female sex, white race, single or widowed status, and advanced stage disease (P {\textless} .0001). In an adjusted model, patients with locoregional disease and depression had 37\% lower odds of undergoing surgical resection (odds ratio, 0.63; 95\% confidence interval, 0.52–0.76). In patients with locoregional disease, depression was associated with lower 2-year survival (hazard ratio, 1.20; 95\% confidence interval, 1.09–1.32). After adjusting for surgical resection, this association was attenuated (hazard ratio, 1.14; 95\% confidence interval, 1.04–1.26). In patients who underwent surgical resection, depression was a significant predictor of survival (hazard ratio, 1.34; 95\% confidence interval, 1.04–1.73). Patients with distant disease and depression had 21\% lower odds of receiving chemotherapy (odds ratio, 0.79; 95\% confidence interval, 0.70–0.90). After adjusting for chemotherapy for distant disease, depression was no longer a significant predictor of survival (hazard ratio, 1.03; 95\% confidence interval, 0.97–1.09).

Conclusion
The decreased survival associated with depression appears to be mediated by a lower likelihood of appropriate treatment in depressed patients. Accurate recognition and treatment of pancreatic cancer patients with depression may improve treatment rates and survival.},
	pages = {403--413},
	number = {3},
	journaltitle = {Surgery},
	shortjournal = {Surgery},
	author = {Boyd, Casey A. and Benarroch-Gampel, Jaime and Sheffield, Kristin M. and Han, Yimei and Kuo, Yong-Fang and Riall, Taylor S.},
	urldate = {2015-05-26},
	date = {2012-09},
	pmid = {22938900},
	pmcid = {PMC3465163},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7ICE34G7\\Boyd et al. - 2012 - The effect of depression on stage at diagnosis, tr.pdf:application/pdf}
}

@article{buter_dynamic_2002,
	title = {Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis},
	volume = {89},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11872053},
	abstract = {All patients with organ dysfunction are currently classified as having severe acute pancreatitis. The aim of this study was to characterize the systemic inflammatory response syndrome ({SIRS}) and early organ dysfunction in patients with acute pancreatitis and the relationship with overall mortality.},
	pages = {298--302},
	number = {3},
	journaltitle = {Br J Surg},
	author = {Buter, A and Imrie, C W and Carter, C R and Evans, S and {McKay}, C J},
	date = {2002-03}
}

@article{gergely_does_1986,
	title = {Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?},
	volume = {204},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/3094468},
	pages = {614--5},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Gergely, M},
	date = {1986-11}
}

@article{mesner_hyperbilirubinemia_2008,
	title = {Hyperbilirubinemia Diminishes Respiratory Drive in a Rat Pup Model},
	volume = {64},
	issn = {0031-3998, 1530-0447},
	url = {http://www.nature.com/doifinder/10.1203/PDR.0b013e31817d9c0c},
	doi = {10.1203/PDR.0b013e31817d9c0c},
	pages = {270--274},
	number = {3},
	journaltitle = {Pediatric Research},
	author = {Mesner, Oded and Miller, Martha J and Iben, Sabine C and Prabha, Kc and Mayer, Catherine A and Haxhiu, Musa A and Martin, Richard J},
	urldate = {2014-01-27},
	date = {2008-09},
	file = {Mesner et al. - 2008 - Hyperbilirubinemia Diminishes Respiratory Drive in.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VG6CVU2I\\Mesner et al. - 2008 - Hyperbilirubinemia Diminishes Respiratory Drive in.pdf:application/pdf}
}

@article{mcmillan_systemic_2013,
	title = {The systemic inflammation-based Glasgow Prognostic Score: a decade of experience  in patients with cancer.},
	volume = {39},
	rights = {Copyright (c) 2012 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2012.08.003},
	abstract = {Since the initial work, a decade ago that the combination of C-reactive protein and albumin, the Glasgow Prognostic Score ({GPS}), had independent prognostic value in patients with cancer, there have been more than 60 studies ({\textgreater}30,000 patients)  that have examined and validated the use of the {GPS} or the modified {GPS} ({mGPS}) in a variety of cancer scenarios. The present review provides a concise overview of  these studies and comments on the current and future clinical utility of this simple objective systemic inflammation-based score. The {GPS}/{mGPS} had independent  prognostic value in (a) unselected cohorts (4 studies, {\textgreater}19,400 patients) (b) operable disease (28 studies, {\textgreater}8,000 patients) (c) chemo/radiotherapy (11 studies, {\textgreater}1500 patients) (d) inoperable disease (11 studies, {\textgreater}2,000 patients). Association studies (15 studies, {\textgreater}2,000 patients) pointed to an increased {GPS}/{mGPS} being associated with increased weight and muscle loss, poor performance status, increased comorbidity, increased pro-inflammatory and angiogenic cytokines and complications on treatment. These studies have originated from 13 different countries, in particular the {UK} and Japan. A chronic systemic inflammatory response, as evidenced by the {GPS}/{mGPS}, is clearly implicated in the prognosis of patients with cancer in a variety of clinical scenarios. The {GPS}/{mGPS} is the most extensively validated of the systemic inflammation-based prognostic scores and therefore may be used in the routine clinical assessment of patients with cancer. It not only identifies patients at risk but also provides a well defined therapeutic target for future clinical trials. It remains to be determined whether the {GPS} has prognostic value in other disease states.},
	pages = {534--540},
	number = {5},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {{McMillan}, Donald C.},
	date = {2013-08},
	pmid = {22995477},
	keywords = {Health Status Indicators, Humans, Inflammation/diagnosis/*pathology, Neoplasms/diagnosis/*pathology, Prognosis}
}

@article{scott-conner_pathophysiology_1994,
	title = {The Pathophysiology of Biliary Obstruction and Its Effect on Phagocytic and Immune Function},
	volume = {57},
	issn = {0022-4804},
	url = {http://www.sciencedirect.com/science/article/pii/S0022480484711516},
	doi = {10.1006/jsre.1994.1151},
	pages = {316--336},
	number = {2},
	journaltitle = {Journal of Surgical Research},
	shortjournal = {Journal of Surgical Research},
	author = {Scott-Conner, Carol E. H. and Grogan, James B.},
	urldate = {2015-08-21},
	date = {1994-08},
	file = {ScienceDirect Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DPU6Z2V9\\S0022480484711516.html:text/html;Scott-Conner and Grogan - 1994 - The Pathophysiology of Biliary Obstruction and Its.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WC83R67R\\Scott-Conner and Grogan - 1994 - The Pathophysiology of Biliary Obstruction and Its.pdf:application/pdf}
}

@article{chang_restricted_1996,
	title = {Restricted redox oscillation in oxidative phosphorylation in jaundiced rat liver mitochondria and its relation to calcium ion},
	volume = {66},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9024818},
	abstract = {High morbidity and mortality in surgical management for patients with obstructive jaundice was greatly attributed to the metabolic derangements in jaundiced liver mitochondria. Isolated liver mitochondria from jaundiced rat, produced by common bile duct ligation, were used to study the relationship among {NADH} level, oxygen consumption, and extramitochondrial calcium concentration. Alterations in {NADH} percentage and oxygen consumption were accomplished by incubating mitochondria with different substrates and monitoring oxygen consumption and {NAD}(P)H fluorescence simultaneously. In jaundiced liver mitochondria with glutamate + malate as substrate, respiration increased after the addition of exogenous Ca2+ at concentrations of 1 x 10(-7), 5 x 10(-7), and 1 x 10(-6) M. The maximal effect occurred at 5 x 10(-7) M. With different {NADH}-related substrates, the {NAD}(P)H fluorescence measurements (X axis) correlated linearly with state 3 respiration (Y axis), the slopes of the correlation curves being 2.27 and 0.79 in control and jaundiced mitochondria, respectively. After the addition of 5 x 10(-7) M Ca2+, the respirations of both control and jaundiced mitochondria increased and the slope for jaundiced mitochondria rose to 1.67. The matrix free Ca2+ concentration in jaundiced mitochondria, measured by fluo-3 loading, was higher than that in controls (162.1 +/- 16.7 {nM}, vs 129.7 +/- 12.6 {nM}, P {\textless} 0.01), while the matrix free/total Ca2+ ratio decreased from 34.9 +/- 6.0 (x10(-6)) to 27.2 +/- 4.4 (x10(-6), 9- {\textless} 0.05. The amplitude of the change in {NAD}(P)H fluorescence was reduced in jaundiced rat liver mitochondria and this correlated with the depression of respiration. A decrease in free/total Ca2+ ratio may be closely related to mitochondrial respiratory impairment in jaundice.},
	pages = {91--9},
	number = {2},
	journaltitle = {J Surg Res},
	author = {Chang, Y J and Iwata, S and Terada, Y and Ozawa, K},
	date = {1996-12}
}

@article{haupt_reduced_1998,
	title = {Reduced {TNFalpha} and {IL}-6 production in patients who mount a preoperative acute phase response},
	volume = {383},
	issn = {1435-2443},
	abstract = {{BACKGROUND}/{AIMS}: In some patients postoperative infective complications are related to a reduced resistance to the operative trauma and the perioperative microbiological challenge. To investigate preoperative alterations in the immune responses in patients who had mounted an acute-phase response before the operation, we measured the capacity of tumor necrosis factor alpha and interleukin-6 production in whole blood.
{PATIENTS}/{METHODS}: Serum concentrations of C-reactive protein, alpha1-antitrypsin, albumin, and prealbumin were measured in 89 patients submitted for major abdominal surgery on their admission to hospital.
{RESULTS}: In 23 patients (26\%) we found concentrations of at least one, and in 16 patients (18\%) of two or more of these variables beyond the reference range. Patients who mounted an acute-phase response released 37\% less {TNFalpha} (1339 vs. 848 pg/ml) and 31\% less {IL}-6 (24293 vs. 16900 pg/ml) when whole blood was stimulated with lipopolysaccharide 0.5 microg/ml.
{CONCLUSION}: Patients who mount an acute-phase response before operation may thus have a downregulated immune response at the level of proinflammatory cytokines. This is likely to alter their resistance to invasive micro-organisms in the perioperative period.},
	pages = {71--74},
	number = {1},
	journaltitle = {Langenbeck's Archives of Surgery / Deutsche Gesellschaft Für Chirurgie},
	shortjournal = {Langenbecks Arch Surg},
	author = {Haupt, W. and Zirngibl, H. and Klein, P. and Riese, J. and Hohenberger, W.},
	date = {1998-03},
	pmid = {9627174},
	keywords = {Acute-Phase Reaction, Adult, Aged, alpha 1-Antitrypsin, C-Reactive Protein, Diagnostic Tests, Routine, Digestive System Diseases, Digestive System Neoplasms, Female, Humans, Immune Tolerance, Interleukin-6, Male, Middle Aged, Prealbumin, Reference Values, Risk Factors, Serum Albumin, Surgical Wound Infection, Tumor Necrosis Factor-alpha}
}

@article{peskova_[preoperative_2004,
	title = {[Preoperative biliary drainage in the pancreatic head carcinoma]},
	volume = {83},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15736394},
	abstract = {Hemipancreatoduodenectomy has remained afflicted with high postoperative morbidity rates. Preoperative icterus is considered a significant risk factor. Therefore, a preoperative biliary drainage has been considered a standard preoperative procedure. This study aims to assess the preoperative drainage of the biliary tract significance with respect to the postoperative complications rates. {SUBJECTS} {AND} {METHODOLOGY}: This retrospective study includes 304 patients after completed hemipancreatoduodenectomies, who were operated in the 1st Surgical Clinic of the 1st Medical Faculty of the Charles University and the General Faculty Hospital in Prague between January 1990 and December 2002. In this trial group, 144 patients had underwent preoperative drainage of the biliary ducts and 160 patients underwent surgical procedures without the preoperative drainage. {RESULTS}: In the trial group, no significant difference in the gender rates, the history of the risk factors, the surgical procedure duration, the perioperative blood loss and the disease stage was detected. The patient trial group with the preoperative drainage of the biliary ducts completed was statistically significantly older (p = 0.05), had higher serum bilirubin levels recorded (118, respectively 81, p = 0.01), had more complications recorded postoperatively (42.4\%, respectively 25\%; p = 0.05), and more infectious complications (29\%, respectively 13\%; p = 0.05) when compared with the trial group without the preoperative drainage completed. Upon comparison of the both groups, we have not detected any statistically significant differences regarding the time interval between the diagnosis and the surgical procedure, the hospitalization duration or the mortality rates. {CONCLUSION}: The operated who had had the internal drainage of the biliary ducts conduted preoperatively, suffered from more complications in total as well as from more infectious complications, compared with the patients without the drainage. On the other hand, the patients who had had the preoperative drainage completed were older and had had higher preoperative bilirubin levels. With respect to the above results we strongly advise the patients with the pancreatic head carcinoma to early consult a hepatobiliary surgeon. As far as the examination algorithm is concerned, we strongly recommend using not only the spiral {CT}, but also non-invasive methods of examination (the {MRI} and the {MRI} cholangiography).},
	pages = {624--8},
	number = {12},
	journaltitle = {Rozhl Chir},
	author = {Pesková, M and Gürlich, R},
	date = {2004-12}
}

@article{hsu_early_2012,
	title = {Early Mortality Risk Score: Identification of Poor Outcomes Following Upfront Surgery for Resectable Pancreatic Cancer},
	volume = {16},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/article/10.1007/s11605-011-1811-4},
	doi = {10.1007/s11605-011-1811-4},
	shorttitle = {Early Mortality Risk Score},
	abstract = {Background Identifying pancreatic cancer patients at high risk of early mortality following pancreaticoduodenectomy ({PD}) is important for treatment decisions in a multidisciplinary setting. This study examines the preoperative predictors of early mortality following {PD} and combines these variables into an early mortality risk score ({EMRS}). Methods Medical records of patients who underwent {PD} for pancreatic adenocarcinoma at the Johns Hopkins Hospital between 30 August 1993 and 28 February 2005 were reviewed. Cox proportional hazards analysis was performed to identify predictors of early mortality, defined as death at 9 and 12 months. {EMRS} was constructed from univariate associated risk factors (age {\textgreater}75 years, tumor size ≥3cm, poor differentiation, co-morbid diseases) with each factor assigned 1 point (range of 0-4). {EMRS} was evaluated as an independent predictor of death at 9 and 12 months. Results On univariate analysis, risk factors for death at 9 months included age ≥75 years ({RR}, 1.6; p = .009), comorbid disease ({RR}, 1.5; p = 0.020), tumor ≥3 cm ({RR}, 1.4; P = 0.050), and poor differentiation ({RR}, 2.1; P {\textless} 0.001). {EMRS} was associated with early mortality among those who did (p = 0.038) and did not receive adjuvant treatment (p {\textless} 0.001). A modified {EMRS} without tumor differentiation was also associated with early mortality (p {\textless} 0.001). Results persisted when reanalyzed using death at 12 months. Conclusions {EMRS} may identify patients at risk of early mortality following {PD} who may be candidates for alternatively sequenced treatment protocols. Prospective validation of this {EMRS} is needed.},
	pages = {753--761},
	number = {4},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Hsu, Charles C. and Wolfgang, Christopher L. and Laheru, Daniel A. and Pawlik, Timothy M. and Swartz, Michael J. and Winter, Jordan M. and Robinson, Raymond and Edil, Barish H. and Narang, Amol K. and Choti, Michael A. and Hruban, Ralph H. and Cameron, John L. and Schulick, Richard D. and Herman, Joseph M.},
	urldate = {2015-05-26},
	date = {2012-02-07},
	langid = {english},
	keywords = {Early mortality, Gastroenterology, Pancreatic adenocarcinoma, Resectable, Risk score, surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QF8AKIF7\\Hsu et al. - 2012 - Early Mortality Risk Score Identification of Poor.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WKB8X7IM\\10.html:text/html}
}

@article{tjeertes_obesity_2015,
	title = {Obesity – a risk factor for postoperative complications in general surgery?},
	volume = {15},
	issn = {1471-2253},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520073/},
	doi = {10.1186/s12871-015-0096-7},
	abstract = {Background
Obesity is generally believed to be a risk factor for the development of postoperative complications. Although being obese is associated with medical hazards, recent literature shows no convincing data to support this assumption. Moreover a paradox between body mass index and survival is described. This study was designed to determine influence of body mass index on postoperative complications and long-term survival after surgery.

Methods
A single-centre prospective analysis of postoperative complications in 4293 patients undergoing general surgery was conducted, with a median follow-up time of 6.3 years. We analyzed the impact of bodyweight on postoperative morbidity and mortality, using univariate and multivariate regression models.

Results
The obese had more concomitant diseases, increased risk of wound infection, greater intraoperative blood loss and a longer operation time. Being underweight was associated with a higher risk of complications, although not significant in adjusted analysis. Multivariate regression analysis demonstrated that underweight patients had worse outcome ({HR} 2.1; 95 \% {CI} 1.4-3.0), whereas being overweight ({HR} 0.6; 95 \% {CI} 0.5–0.8) or obese ({HR} 0.7; 95 \% {CI} 0.6–0.9) was associated with improved survival.

Conclusion
Obesity alone is a significant risk factor for wound infection, more surgical blood loss and a longer operation time. Being obese is associated with improved long-term survival, validating the obesity paradox. We also found that complication and mortality rates are significantly worse for underweight patients. Our findings suggest that a tendency to regard obesity as a major risk factor in general surgery is not justified. It is the underweight patient who is most at risk of major postoperative complications, including long-term mortality.

Electronic supplementary material
The online version of this article (doi:10.1186/s12871-015-0096-7) contains supplementary material, which is available to authorized users.},
	journaltitle = {{BMC} Anesthesiology},
	shortjournal = {{BMC} Anesthesiol},
	author = {Tjeertes, Elke E.K.M. and Hoeks, Sanne S.E. and Beks, Sabine S.B.J.C. and Valentijn, Tabita T.M. and Hoofwijk, Anton A.G.M. and Stolker, Robert Jan R.J.},
	urldate = {2015-08-04},
	date = {2015-07-31},
	pmid = {null},
	pmcid = {PMC4520073},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\WI5ADSQC\\Tjeertes et al. - 2015 - Obesity – a risk factor for postoperative complica.pdf:application/pdf}
}

@article{goldstein_obesity_2009,
	title = {Obesity and survival among patients with pancreatic cancer},
	volume = {302},
	issn = {1538-3598},
	doi = {10.1001/jama.2009.1510},
	pages = {1752; author reply 1752--1753},
	number = {16},
	journaltitle = {{JAMA}},
	shortjournal = {{JAMA}},
	author = {Goldstein, Mark R. and Mascitelli, Luca and Pezzetta, Francesca},
	date = {2009-10-28},
	pmid = {19861663},
	keywords = {Humans, Hydroxymethylglutaryl-{CoA} Reductase Inhibitors, Hypoglycemic Agents, Obesity, Pancreatic Neoplasms, Risk Factors}
}

@article{furukawa_negative_2015,
	title = {Negative Impact of Preoperative Endoscopic Biliary Drainage on Prognosis of Pancreatic Ductal Adenocarcinoma After Pancreaticoduodenectomy},
	volume = {35},
	issn = {1791-7530},
	abstract = {{BACKGROUND}/{AIM}: Patients with obstructive jaundice due to cancer of the pancreatic head often undergo preoperative endoscopic biliary drainage ({EBD}). The aim of the study was to evaluate the long-term impact of preoperative {EBD} following pancreaticoduodenectomy ({PD}) for pancreatic ductal adenocarcinoma.
{PATIENTS} {AND} {METHODS}: We studied 106 patients who underwent {PD} for pancreatic ductal adenocarcinoma between May 2000 and November 2013 at the Jikei University Hospital. We retrospectively examined perioperative findings as predictors of prognosis and the relationship between preoperative {EBD} and recurrence rate as well as overall survival.
{RESULTS}: In univariate analysis, significant factors associated with poor disease-free survival consisted of the presence of {EBD} (p=0.0213), poor tumor differentiation (p=0.0023) and tumor-node-metastasis ({TNM}) classification {IV} (p=0.0027), while significant factors associated with poor overall survival consisted of the presence of {EBD} (p=0.0047), poor tumor differentiation (p{\textless}0.0001), {TNM} classification {IV} (p=0.0031) and microscopic or macroscopic residual tumor (p=0.0184). In multivariate analysis, poor tumor differentiation (p=0.0033) and {TNM} classification {IV} (p=0.0020) were independent factors for poor disease-free survival, while the presence of {EBD} (p=0.0435), poor tumor differentiation (p=0.0009), {TNM} classification {IV} (p=0.0447) and microscopic or macroscopic residual tumor (p=0.0184) were independent factors for poor overall survival.
{CONCLUSION}: Preoperative {EBD} may have a negative impact on prognosis after {PD} for pancreatic ductal adenocarcinoma.},
	pages = {5079--5083},
	number = {9},
	journaltitle = {Anticancer Research},
	shortjournal = {Anticancer Res.},
	author = {Furukawa, Kenei and Shiba, Hiroaki and Shirai, Yoshihiro and Horiuchi, Takashi and Iwase, Ryota and Haruki, Koichiro and Fujiwara, Yuki and Misawa, Takeyuki and Yanaga, Katsuhiko},
	date = {2015-09},
	pmid = {26254410}
}

@article{taggart_resting_1991,
	title = {Resting and total energy expenditure in patients with ischemic heart disease.},
	volume = {7},
	abstract = {Total energy expenditure ({TEE}) was measured by doubly labeled water in 13 preoperative patients undergoing elective coronary artery surgery and compared to resting energy expenditure ({REE}) measured by indirect calorimetry ({IC}) calculated from the Harris-Benedict ({HB}) formula or from formulas based on midarm circumference and arm muscle circumference. Mean {REE} measured by {IC} and calculated from the {HB}, midarm circumference, arm muscle circumference formulas were 62, 75, 62, and 69\%, respectively, of {TEE} measured by doubly labeled water.  {REE} measured by {IC} correlated significantly with that predicted by the {HB} (p = 0.006) but not the anthropometric formulas. The relationship between {REE} derived  from anthropometric predictive formulas and {REE} measured by {IC} is altered in ischemic heart disease.},
	pages = {271--274},
	number = {4},
	journaltitle = {Nutrition (Burbank, Los Angeles County, Calif.)},
	shortjournal = {Nutrition},
	author = {Taggart, D. P. and {McMillan}, D. C. and Preston, T. and Richardson, R. and Shenkin, A. and Burns, H. J. and Wheatley, D. J.},
	date = {1991-08},
	pmid = {1802217},
	keywords = {*Energy Metabolism, Adult, Anthropometry, Arm, Body Water/metabolism, Calorimetry, Indirect, Coronary Disease/*metabolism/surgery, Deuterium/diagnostic use, Humans, Middle Aged, Muscles, Oxygen Isotopes}
}

@article{saleh_preoperative_2002,
	title = {Preoperative endoscopic stent placement before pancreaticoduodenectomy: a meta-analysis of the effect on morbidity and mortality},
	volume = {56},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/12297769},
	abstract = {{BACKGROUND}: Pancreaticoduodenectomy is the only potentially curative treatment for peripapillary pancreatic tumors. However, postoperative morbidity and mortality are high, and different approaches have been tried to improve results, such as preoperative biliary drainage in patients with jaundice. This meta-analysis investigated the effect on postoperative outcome of preoperative biliary drainage by endoscopic biliary stent placement in patients who are jaundiced and who have peripapillary pancreatic tumors. {METHODS}: A Medline search for the period 1985 to 2001 was performed. Eight retrospective studies and 2 prospective randomized controlled trials were included. Selection criteria for the primary analysis were as follows: patients with peripapillary pancreatic cancer, endoscopic stent placement versus no stent, radical surgery, and assessment of postoperative morbidity and mortality. A secondary analysis included both radical and palliative surgery. {RESULTS}: In the primary analysis, 337 patients underwent preoperative endoscopic biliary stent placement, and 412 patients had no endoscopic biliary stent placement (controls). The overall odds ratio for postoperative complications (stent vs. no stent) is estimated as 0.79: 95\% {CI} [0.36, 1.73] and the estimated odds ratio for postoperative mortality is 0.81: 95\% {CI} [0.33, 1.99]. In the secondary analysis, 1008 patients underwent preoperative {EBS} versus 720 control patients. The odds ratio for postoperative complications in this analysis was 0.93: 95\% {CI} [0.65, 1.33] and for postoperative mortality is 1.12: 95\% {CI} [0.62, 2.01]. {CONCLUSION}: No evidence was found of either a positive or adverse effect of preoperative endoscopic biliary stent placement on the outcome of surgery in patients with pancreatic cancer.},
	pages = {529--34},
	number = {4},
	journaltitle = {Gastrointest Endosc},
	author = {Saleh, Martha M A and Nørregaard, Peter and Jørgensen, Henrik L and Andersen, Per K and Matzen, Peter},
	date = {2002-10}
}

@book{_nih_2002,
	title = {{NIH} state-of-the-science statement on endoscopic retrograde cholangiopancreatography ({ERCP}) for diagnosis and therapy},
	volume = {19},
	isbn = {1553-0957},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/14768653},
	abstract = {{OBJECTIVE}: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding the use of endoscopic retrograde cholangiopancreatography ({ERCP}) for diagnosis and therapy. {PARTICIPANTS}: A non-Federal, non-advocate, 13-member panel representing the fields of gastroenterology, hepatology, clinical epidemiology, oncology, biostatistics, surgery, health services research, radiology, internal medicine, and the public. In addition, experts in these same fields presented data to the panel and to a conference audience of approximately 300. {EVIDENCE}: Presentations by experts; a systematic review of the medical literature provided by the Agency for Healthcare Research and Quality; and an extensive bibliography of {ERCP} research papers, prepared by the National Library of Medicine. Scientific evidence was given precedence over clinical anecdotal experience. {CONFERENCE} {PROCESS}: Answering predefined questions, the panel drafted a statement based on the scientific evidence presented in open forum and the scientific literature. The draft statement was read in its entirety on the final day of the conference and circulated to the experts and the audience for comment. The panel then met in executive session to consider these comments and released a revised statement at the end of the conference. The statement was made available on the World Wide Web at http://consensus.nih.gov immediately after the conference. This statement is an independent report of the panel and is not a policy statement of the {NIH} or the Federal Government. {CONCLUSIONS}: In the diagnosis of choledocholithiasis, magnetic resonance cholangiopancreatography ({MRCP}), endoscopic ultrasound ({EUS}), and {ERCP} have comparable sensitivity and specificity. Patients undergoing cholecystectomy do not require {ERCP} preoperatively if there is low probability of having choledocholithiasis. Laparoscopic common bile duct exploration and postoperative {ERCP} are both safe and reliable in clearing common bile duct stones. {ERCP} with endoscopic sphincterotomy ({ES}) and stone removal is a valuable therapeutic modality in choledocholithiasis with jaundice, dilated common bile duct, acute pancreatitis, or cholangitis. In patients with pancreatic or biliary cancer, the principal advantage of {ERCP} is palliation of biliary obstruction when surgery is not elected. In patients who have pancreatic or biliary cancer and who are surgical candidates, there is no established role for preoperative biliary drainage by {ERCP}. Tissue sampling for patients with pancreatic or biliary cancer not undergoing surgery may be achieved by {ERCP}, but this is not always diagnostic. {ERCP} is the best means to diagnose ampullary cancers. {ERCP} has no role in the diagnosis of acute pancreatitis except when biliary pancreatitis is suspected. In patients with severe biliary pancreatitis, early intervention with {ERCP} reduces morbidity and mortality compared with delayed {ERCP}. {ERCP} with appropriate therapy is beneficial in selected patients who have either recurrent pancreatitis or pancreatic pseudocysts. Patients with type I sphincter of Oddi dysfunction ({SOD}) respond to endoscopic sphincterotomy ({ES}). Patients with type {II} {SOD} should not undergo diagnostic {ERCP} alone. If sphincter of Oddi manometer pressures are {\textgreater}40 {mmHg}, {ES} is beneficial in some patients. Avoidance of unnecessary {ERCP} is the best way to reduce the number of complications. {ERCP} should be avoided if there is a low likelihood of biliary stone or stricture, especially in women with recurrent pain, a normal bilirubin, and no other objective sign of biliary disease. Endoscopists performing {ERCP} should have appropriate training and expertise before performing advanced procedures. With newer diagnostic imaging technologies emerging, {ERCP} is evolving into a predominantly therapeutic procedure.},
	pagetotal = {1-26},
	number = {1},
	date = {2002-01}
}

@article{warschkow_safe_2012,
	title = {Safe and early discharge after colorectal surgery due to C-reactive protein: a diagnostic meta-analysis of 1832 patients},
	volume = {256},
	issn = {1528-1140},
	doi = {10.1097/SLA.0b013e31825b60f0},
	shorttitle = {Safe and early discharge after colorectal surgery due to C-reactive protein},
	abstract = {{OBJECTIVE}: To assess the predictive value of C-reactive protein ({CRP}) level for postoperative infectious complications after colorectal surgery.
{BACKGROUND}: Postoperative infectious complications after colorectal surgery are frequent and associated with relevant short- and long-term sequelae. Therefore, the identification of a diagnostic tool for early recognition of postoperative infectious complications is of cardinal importance.
{METHODS}: A meta-analysis was performed for diagnostic studies evaluating {CRP} as a predictor for postoperative infectious complications on days 1 to 5 after colorectal surgery.
{RESULTS}: Six studies including a total of 1832 patients were identified. The best performance of {CRP} to predict postoperative infectious complications was on postoperative day 4, on which the mean {CRP} cutoff value was 135 mg/L ({SD}: 10 mg/L), the pooled sensitivity 68\% (95\% {CI}: 57\%-79\%), the specificity 83\% (95\% {CI}: 77\%-90\%) and the negative predictive value 89\% (95\% {CI}: 87\%-92\%). The pooled area under the receiver operating characteristic curve was 0.81 (95\% {CI}: 0.73-0.89).
{CONCLUSIONS}: This diagnostic meta-analysis of 1832 patients--the first in the literature--provides compelling evidence that C-reactive protein on postoperative day 4 has a high negative predictive value for infectious complications of 89\%. Therefore, {CRP} measurement allows safe and early discharge of selected patients after colorectal surgery.},
	pages = {245--250},
	number = {2},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {Warschkow, Rene and Beutner, Ulrich and Steffen, Thomas and Müller, Sascha A. and Schmied, Bruno M. and Güller, Ulrich and Tarantino, Ignazio},
	date = {2012-08},
	pmid = {22735714},
	keywords = {C-Reactive Protein, Digestive System Surgical Procedures, Humans, length of stay, postoperative complications, prognosis, {ROC} Curve, Sensitivity and Specificity}
}

@article{mcardle_systemic_2010-1,
	title = {Systemic inflammatory response and survival in patients with localised prostate cancer: 10-year follow-up.},
	volume = {85},
	doi = {10.1159/000320242},
	number = {4},
	journaltitle = {Urologia internationalis},
	shortjournal = {Urol Int},
	author = {{McArdle}, Peter A. and Qayyum, Tahir and {McMillan}, Donald C.},
	date = {2010},
	pmid = {21071914},
	keywords = {C-Reactive Protein/analysis, Humans, Inflammation Mediators/blood, Male, Neoplasm Invasiveness, Prostatic Neoplasms/immunology/*mortality/pathology/surgery, Research Design, Survival Analysis, Systemic Inflammatory Response Syndrome/immunology/*mortality, Time Factors, Treatment Outcome, Up-Regulation}
}

@article{weinstein_influence_2007,
	title = {Influence of preoperative exercise capacity on length of stay after thoracic cancer surgery},
	volume = {84},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17588411},
	abstract = {{BACKGROUND}: Stress testing is frequently used to assess cardiac risk before thoracic surgery. However, the relationship between treadmill exercise capacity and length of stay ({LOS}) has not been investigated. We hypothesized that exercise capacity, a strong predictor of long-term prognosis, can also predict {LOS} after thoracic cancer surgery. {METHODS}: Accordingly, 191 consecutive patients who had exercise stress testing before major thoracic cancer surgery were retrospectively grouped by poor ({\textless}4 metabolic equivalents [{METs}], n = 31), fair (4 to 7 {METs}, n = 107), good (7 to 10 {METs}, n = 30), and excellent ({\textgreater}10 {METs}, n = 23) exercise capacity. The relationship between exercise capacity and {LOS} was then determined. {RESULTS}: Average {LOS} was inversely related to exercise capacity, with a nearly twofold increase in {LOS} between the excellent and poor exercise groups (4.8 versus 9.2 days). This relationship remained significant even after controlling for operation type, history of dyspnea, sex, and smoking history in analysis of covariance. Prolonged hospital stay (10 days or more) was strongly predicted by exercise capacity. Failure to exceed 4 {METs} was associated with a high risk of prolonged stay (9 of 31, 39\%), whereas none of the 23 patients who exceeded 10 {METs} had a prolonged stay. {CONCLUSIONS}: Treadmill exercise capacity has independent predictive value for {LOS} and risk of prolonged stay after thoracic cancer surgery. These findings have important implications for risk assessment and cost, suggesting that preoperative programs designed to improve exercise capacity may favorably influence {LOS} and associated costs.},
	pages = {197--202},
	number = {1},
	journaltitle = {Ann Thorac Surg},
	author = {Weinstein, Howard and Bates, Andrew T and Spaltro, Barbara E and Thaler, Howard T and Steingart, Richard M},
	date = {2007-07}
}

@article{beger_operative_1991,
	title = {Operative management of necrotizing pancreatitis–necrosectomy and continuous closed postoperative lavage of the lesser sac},
	volume = {38},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1855769},
	abstract = {In patients with severe acute pancreatitis, the most important diagnostic goal is differentiation between the interstitial-edematous and the necrotizing type of acute pancreatitis. Surgical management in patients with proven necrotizing pancreatitis is indicated in patients who develop surgical acute abdomen, sepsis, shock syndrome, multisystemic organ failure syndrome, persistent or progressive despite maximum intensive care. The most appropriate procedure for surgical management of pancreatic necrosis is the careful removal of necrosis and preservation of vital pancreatic tissue. Necrosectomy supplemented by postoperative closed continuous lavage of the lesser sac is a procedure that offers the advantages of debridement of devitalized tissue only, and the non-surgical removal of necrotic tissue and bacterially and biologically active compounds. In comparison with a reoperation protocol, necrosectomy and continuous lavage reduce the reoperation rate as well as the need for tracheostomy. In a prospectively treated series of patients suffering from necrotizing pancreatitis, hospital mortality was 8.4\% and the reoperation rate 27\%. Any tissue becoming necrotic in the postoperative course of disease is rinsed with lavage fluid, thus obviating the need for repeated surgical reoperation in most patients. Local lavage is achieved by the insertion of two, in some cases five, large double-lumen tubus and the use of 8 liters (median) of lavage fluid per day.},
	pages = {129--33},
	number = {2},
	journaltitle = {Hepatogastroenterology},
	author = {Beger, H G},
	date = {1991-04}
}

@article{neal_preoperative_2011,
	title = {Preoperative systemic inflammation and infectious complications after resection of colorectal liver metastases},
	volume = {146},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21502458},
	abstract = {Postoperative complications are associated with a poor long-term prognosis after resection of colorectal liver metastases via an undetermined mechanism. The preoperative systemic inflammatory response, itself a predictor of poor survival, was recently shown to independently predict postoperative infectious complications after primary colorectal cancer resection.},
	pages = {471--8},
	number = {4},
	journaltitle = {Arch Surg},
	author = {Neal, Christopher P and Mann, Christopher D and Garcea, Giuseppe and Briggs, Christopher D and Dennison, Ashley R and Berry, David P},
	date = {2011-04},
	file = {Neal et al. - 2011 - Preoperative systemic inflammation and infectious .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\59CDD6VN\\Neal et al. - 2011 - Preoperative systemic inflammation and infectious .pdf:application/pdf}
}

@article{jones_peak_2010,
	title = {Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20597134},
	abstract = {{BACKGROUND}:: Identifying strong markers of prognosis is critical to optimize treatment and survival outcomes in patients with nonsmall cell lung cancer ({NSCLC}). The authors investigated the prognostic significance of preoperative cardiorespiratory fitness (peak oxygen consumption [{VO}(2peak)]) among operable candidates with {NSCLC}. {METHODS}:: By using a prospective design, 398 patients with potentially resectable {NSCLC} enrolled in Cancer and Leukemia Group B 9238 were recruited between 1993 and 1998. Participants performed a cardiopulmonary exercise test to assess {VO}(2peak) and were observed until death or June 2008. Cox proportional models were used to estimate the risk of all-cause mortality according to cardiorespiratory fitness category defined by {VO}(2peak) tertiles ({\textless}0.96 of 0.96-1.29/{\textgreater}1.29 L/min(-1)) with adjustment for age, sex, and performance status. {RESULTS}:: Median follow-up was 30.8 months; 294 deaths were reported during this period. Compared with patients achieving a {VO}(2peak) {\textless}0.96 L/min(-1), the adjusted hazard ratio ({HR}) for all-cause mortality was 0.64 (95\% confidence interval [{CI}], 0.46-0.88) for a {VO}(2peak) of 0.96 to 1.29 L/min(-1), and 0.56 (95\% {CI}, 0.39-0.80) for a {VO}(2peak) of {\textgreater}1.29 L/min(-1) (P(trend) = .0037). The corresponding {HRs} for resected patients were 0.66 (95\% {CI}, 0.46-0.95) and 0.59 (95\% {CI}, 0.40-0.89) relative to the lowest {VO}(2peak) category (P(trend) = .0247), respectively. For nonresected patients, the {HRs} were 0.78 (95\% {CI}, 0.34-1.79) and 0.39 (95\% {CI}, 0.16-0.94) relative to the lowest category (P(trend) = .0278). {CONCLUSIONS}:: {VO}(2peak) is a strong independent predictor of survival in {NSCLC} that may complement traditional markers of prognosis to improve risk stratification and prognostication. Cancer 2010. (c) 2010 American Cancer Society.},
	journaltitle = {Cancer},
	author = {Jones, Lee W and Watson, Dorothy and Herndon, James E 2nd and Eves, Neil D and Haithcock, Benjamin E and Loewen, Gregory and Kohman, Leslie},
	date = {2010-07}
}

@article{castellanos_management_2013,
	title = {Management of infected pancreatic necrosis using retroperitoneal necrosectomy with flexible endoscope: 10 years of experience},
	volume = {27},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22806520},
	abstract = {This study was designed to provide our experience in the management of infected and drained pancreatic necrosis using the retroperitoneal approach.},
	pages = {443--53},
	number = {2},
	journaltitle = {Surg Endosc},
	author = {Castellanos, Gregorio and Piñero, Antonio and Doig, Laura A and Serrano, Andrés and Fuster, Matilde and Bixquert, Vicente},
	date = {2013-02}
}

@article{older_preoperative_1993,
	title = {Preoperative evaluation of cardiac failure and ischemia in elderly patients by cardiopulmonary exercise testing},
	volume = {104},
	url = {C:\Users\vishnuvcb\Documents\Research\LiteratureØlder1993_w9w0vg.pdf},
	doi = {http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8365279},
	abstract = {Major surgery in the elderly continues to have a high mortality rate. Preoperative myocardial ischemia is a known risk factor. Cardiac failure is also a risk factor, but is difficult to quantify objectively. One hundred eighty-seven elderly surgical patients were evaluated for cardiac failure by cardiopulmonary exercise testing ({CPX}). The overall mortality in these patients was 7.5 percent. If three deaths secondary to surgical causes are excluded, mortality was 5.9 percent. There were 55 patients in whom the anaerobic threshold ({AT}) was less than 11 ml/min/kg; of these, 10 died, a mortality rate of 18 percent. There were 132 patients with an {AT} of greater than 11 ml/min/kg and of these, 1 patient died, giving a mortality rate of 0.8 percent (p {\textless} 0.001). A low {AT} associated with preoperative ischemia resulted in the death of 8 of 19 patients, a mortality rate of 42 percent. When the ischemia was associated with the higher {AT}, then 1 patient out of 25 died, a mortality rate of 4 percent (p {\textless} 0.01). Both preoperative ischemia and preoperative cardiac failure are independent risk factors for perioperative mortality in the elderly.},
	pages = {701--4},
	number = {3},
	journaltitle = {Chest},
	author = {Older, P and Smith, R and Courtney, P and Hone, R},
	date = {1993-09},
	file = {Older et al. - 1993 - Preoperative evaluation of cardiac failure and isc.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AIESIVN4\\Older et al. - 1993 - Preoperative evaluation of cardiac failure and isc.pdf:application/pdf}
}

@article{bramhall_treatment_1995,
	title = {Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study},
	volume = {82},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7881926},
	abstract = {The trends in treatment and outcome of 13,560 patients with pancreatic cancer, and in incidence of the disease, in the West Midlands health region were determined between 1957 and 1986 using data from the West Midlands Region Cancer Registry. Patients were divided into those diagnosed in the first 20 years (1957-1976, n = 7888) and the most recent 10 years (1977-1986, n = 5672). The disease was more common in men and the incidence increased up to 1970 after which it levelled off. In the 1977-1986 period a lower proportion of patients had laparotomy alone (825 (14.5 per cent) versus 1552 (19.7 per cent)), a similar proportion had bypass surgery (2010 (35.4 per cent) versus 2760 (35.0 per cent)), while a greater proportion had supportive care (2710 (47.8 per cent) versus 3368 (42.7 per cent)) but the resection rates were the same (145 (2.6 per cent) versus 208 (2.6 per cent)). The 30-day mortality rates between the two periods improved for resection (40 (27.6 per cent) versus 94 (45.2 per cent)), bypass surgery (436 (21.7 percent) versus 691 (25.0 per cent)) and laparotomy (372 (45.1 per cent) versus 873 (56.3 per cent)). The 12-month survival rate for bypass did not significantly differ during the study (14.9 per cent versus 12.4 per cent) but there was a significant improvement in the 5-year survival for resection (9.7 per cent versus 2.6 per cent, P {\textless} 0.015). The resection rates were low and 30-day mortality rates for surgery were high compared with those of other published series.},
	pages = {111--5},
	number = {1},
	journaltitle = {Br J Surg},
	author = {Bramhall, S R and Allum, W H and Jones, A G and Allwood, A and Cummins, C and Neoptolemos, J P},
	date = {1995-01}
}

@article{don_poor_2004,
	title = {{POOR} {NUTRITIONAL} {STATUS} {AND} {INFLAMMATION}: Serum Albumin: Relationship to Inflammation and Nutrition},
	volume = {17},
	issn = {1525-139X},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/j.0894-0959.2004.17603.x/abstract},
	doi = {10.1111/j.0894-0959.2004.17603.x},
	shorttitle = {{POOR} {NUTRITIONAL} {STATUS} {AND} {INFLAMMATION}},
	abstract = {Hypoalbuminemia is the result of the combined effects of inflammation and inadequate protein and caloric intake in patients with chronic disease such as chronic renal failure. Inflammation and malnutrition both reduce albumin concentration by decreasing its rate of synthesis, while inflammation alone is associated with a greater fractional catabolic rate ({FCR}) and, when extreme, increased transfer of albumin out of the vascular compartment. A vicious cascade of events ensues in which inflammation induces anorexia and reduces the effective use of dietary protein and energy intake and augments catabolism of the key somatic protein, albumin. Hypoalbuminemia is a powerful predictor of mortality in patients with chronic renal failure, and the major cause of death in this population is due to cardiovascular events. Inflammation is associated with vascular disease and likely causes injury to the vascular endothelium, and hypoalbuminemia as two separate expressions of the inflammatory process. Albumin has a myriad of important physiologic effects that are essential for normal health. However, simply administering albumin to critically ill patients with hypoalbuminemia has not been shown to improve survival or reduce morbidity. Thus the inference from these clinical studies suggests that the cause of hypoalbuminemia, rather than low albumin levels specifically, is responsible for morbidity and mortality.},
	pages = {432--437},
	number = {6},
	journaltitle = {Seminars in Dialysis},
	author = {Don, Burl R. and Kaysen, George},
	urldate = {2015-08-21},
	date = {2004-11-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\RBWNVNI3\\Don and Kaysen - 2004 - POOR NUTRITIONAL STATUS AND INFLAMMATION Serum Al.pdf:application/pdf;Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P4CNMTMI\\Don and Kaysen - 2004 - POOR NUTRITIONAL STATUS AND INFLAMMATION Serum Al.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\7SNBGQH5\\abstract.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MSSSCZ6A\\abstract.html:text/html;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\A8WBJMX7\\abstract.html:text/html}
}

@article{mcmillan_evaluation_1988,
	title = {Evaluation of propanil and its N-oxidized derivatives for genotoxicity in the Salmonella typhimurium reversion, Chinese hamster ovary/hypoxanthine guanine phosphoribosyl transferase, and rat hepatocyte/{DNA} repair assays.},
	volume = {11},
	abstract = {Since the herbicide propanil (3,4-dichloropropionanilide) is an aromatic amide and many other aromatic amides are genotoxic via N-hydroxy (N-{OH}) metabolites,},
	pages = {429--439},
	number = {3},
	journaltitle = {Fundamental and applied toxicology : official journal of the Society of Toxicology},
	shortjournal = {Fundam Appl Toxicol},
	author = {{McMillan}, D. C. and Shaddock, J. G. and Heflich, R. H. and Casciano, D. A. and Hinson, J. A.},
	date = {1988-10},
	pmid = {3065118},
	keywords = {*Mutagens, Anilides/*toxicity, Animals, Cricetinae, Cricetulus, {DNA}/metabolism, {DNA} Repair/*drug effects, Female, Hypoxanthine Phosphoribosyltransferase/*genetics, Liver/cytology/enzymology/*metabolism, L-Lactate Dehydrogenase/metabolism, Male, Mutagenicity Tests, Oxidation-Reduction, Propanil/analogs \& derivatives/*toxicity, Rats, Rats, Inbred Strains, Salmonella typhimurium/drug effects/genetics}
}

@article{tsujinaka_visceral_2008,
	title = {Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer:},
	volume = {51},
	issn = {0012-3706},
	url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003453-200851120-00003},
	doi = {10.1007/s10350-008-9395-0},
	shorttitle = {Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer},
	pages = {1757--1767},
	number = {12},
	journaltitle = {Diseases of the Colon \& Rectum},
	author = {Tsujinaka, Shingo and Konishi, Fumio and Kawamura, Yutaka J. and Saito, Masaaki and Tajima, Naoshi and Tanaka, Osamu and Lefor, Alan T.},
	urldate = {2015-04-28},
	date = {2008-12},
	langid = {english},
	file = {Tsujinaka et al. - 2008 - Visceral Obesity Predicts Surgical Outcomes after .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\R8RCBXFB\\Tsujinaka et al. - 2008 - Visceral Obesity Predicts Surgical Outcomes after .pdf:application/pdf}
}

@article{mcmillan_cancer_2013,
	title = {Cancer and systemic inflammation: stage the tumour and stage the host.},
	volume = {109},
	doi = {10.1038/bjc.2013.418},
	number = {3},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {{McMillan}, D. C.},
	date = {2013-08-06},
	pmid = {23921279},
	pmcid = {PMC3738113},
	keywords = {*Inflammation, Carcinoma, Renal Cell/*mortality, Female, Humans, Kidney Neoplasms/*mortality, Male}
}

@article{lamb_relationship_2006,
	title = {The relationship between the preoperative systemic inflammatory response and cancer-specific survival in patients undergoing potentially curative resection for renal clear cell cancer.},
	volume = {94},
	doi = {10.1038/sj.bjc.6603034},
	abstract = {The relationship between tumour stage, grade (Fuhrman), performance status ({ECOG}), a combined score ({UCLA} Integrated Staging System, {UISS}), systemic inflammatory response (elevated C-reactive protein concentration), and cancer-specific survival was examined in patients undergoing potentially curative resection for renal clear cell cancer (n=100). On univariate survival analysis, sex (P=0.050), tumour stage (P=0.001), Fuhrman grade (P{\textless}0.001), {UISS} (P{\textless}0.001),},
	pages = {781--784},
	number = {6},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Lamb, G. W. A. and {McMillan}, D. C. and Ramsey, S. and Aitchison, M.},
	date = {2006-03-27},
	pmid = {16523196},
	pmcid = {PMC3216422},
	keywords = {Carcinoma, Renal Cell/*immunology/pathology/*surgery, C-Reactive Protein/*analysis, Female, Humans, Inflammation, Kidney Neoplasms/*immunology/pathology/*surgery, Male, Middle Aged, Neoplasm Staging, Predictive Value of Tests, Prognosis, Retrospective Studies, Survival Analysis}
}

@article{crumley_interrelationships_2011,
	title = {Interrelationships between tumor proliferative activity, leucocyte and macrophage infiltration, systemic inflammatory response, and survival in patients selected for potentially curative resection for gastroesophageal cancer.},
	volume = {18},
	doi = {10.1245/s10434-011-1658-7},
	abstract = {{BACKGROUND}: A number of accepted criteria, including pathological tumor, node, metastasis system stage, lymph node metastasis, and tumor differentiation, predict survival in patients undergoing surgery for gastroesophageal cancer. We examined the interrelationships between standard clinicopathological factors, systemic and local inflammatory responses, tumor proliferative activity, and survival. {METHODS}: The interrelationships between the systemic inflammatory response (Glasgow prognostic score, {mGPS}), standard clinicopathological factors,  local inflammatory response (Klintrup criteria, macrophage infiltration), and tumor proliferative activity (Ki-67) were examined by immunohistochemistry in 100 patients (44 esophageal [19 squamous, 25 adenocarcinoma], 19 junctional, and 37 gastric cancers) selected for potentially curative resection. {RESULTS}: The minimum follow-up was 59 months. On multivariate survival analysis, lymph node ratio (hazard ratio [{HR}] 1.63, 95\% confidence interval [{CI}] 1.11-2.40, P {\textless} 0.05), tumor differentiation ({HR} 2.63, 95\% {CI} 1.45-4.77, P = 0.001), {mGPS} ({HR} 3.91, 95\%  {CI} 1.96-8.11, P {\textless} 0.001), Klintrup score ({HR} 3.47, 95\% {CI} 1.14-10.55, P {\textless} 0.05),  and Ki-67 ({HR} 0.67, 95\% {CI} 0.47-0.96, P {\textless} 0.05) were independently associated with cancer-specific survival. A higher lymph node ratio was associated with poor tumor differentiation (P {\textless} 0.05), low-grade Klintrup criteria (P {\textless} 0.005), and low tumor proliferative activity (P {\textless} 0.05). {CONCLUSION}: Tumor proliferation rate and local and systemic inflammatory responses are important predictors of survival, albeit in a heterogeneous cohort of patients including esophageal, junctional, and gastric cancers. These scores may be combined with accepted tumor-based factors to improve prediction of outcome.},
	pages = {2604--2612},
	number = {9},
	journaltitle = {Annals of surgical oncology},
	shortjournal = {Ann Surg Oncol},
	author = {Crumley, Andrew B. C. and Going, James J. and Hilmy, Mustafa and Dutta, Sumanta and Tannahill, Claire and {McKernan}, Margaret and Edwards, Joanne and Stuart, Robert C. and {McMillan}, Donald C.},
	date = {2011-09},
	pmid = {21409484},
	keywords = {*Cell Proliferation, Adenocarcinoma/immunology/mortality/pathology, Aged, Carcinoma, Squamous Cell/immunology/mortality/pathology, Cell Differentiation, Esophageal Neoplasms/immunology/mortality/*pathology, Female, Follow-Up Studies, Humans, Immunoenzyme Techniques, Leukocytes/immunology/*pathology, Lymph Nodes/immunology/*pathology, Macrophages/*immunology/*pathology, Male, Prognosis, Stomach Neoplasms/immunology/mortality/*pathology, Survival Rate}
}

@article{ernster_bilirubin_1956,
	title = {Bilirubin, an uncoupler of oxidative phosphorylation in isolated mitochondria},
	volume = {178},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/13387703},
	doi = {BILIRUBIN/effects;LIVER/metabolism},
	pages = {1335--7},
	number = {4546},
	journaltitle = {Nature},
	author = {{ERNSTER}, L and {ZETTERSTROM}, R},
	date = {1956-12}
}

@article{barber_effect_2001,
	title = {Effect of a fish oil-enriched nutritional supplement on metabolic mediators in patients with pancreatic cancer cachexia.},
	volume = {40},
	doi = {10.1207/S15327914NC402_7},
	abstract = {Weight loss in advanced cancer patients is refractory to conventional nutritional support. This may be due to metabolic changes mediated by proinflammatory cytokines, hormones, and tumor-derived products. We previously showed that a nutritional supplement enriched with fish oil will reverse weight loss in patients with pancreatic cancer cachexia. The present study examines the effect of this supplement on a number of mediators thought to play a role in cancer cachexia. Twenty weight-losing patients with pancreatic cancer were asked to consume a nutritional supplement providing 600 kcal and 2 g of eicosapentaenoic acid per day. At baseline and after 3 wk, patients were weighed and samples were  collected to measure serum concentrations of interleukin ({IL})-6 and its soluble receptor tumor necrosis factor receptors I and {II}, cortisol, insulin, and leptin, peripheral blood mononuclear cell production of {IL}-1 beta, {IL}-6, and tumor necrosis factor, and urinary excretion of proteolysis inducing factor. After 3 wk of consumption of the fish oil-enriched nutritional supplement, there was a significant fall in production of {IL}-6 (from median 16.5 to 13.7 ng/ml, P = 0.015), a rise in serum insulin concentration (from 3.3 to 5.0 {mU}/l, P = 0.0064), a fall in the cortisol-to-insulin ratio (P = 0.0084), and a fall in the proportion of patients excreting proteolysis inducing factor (from 88\% to 40\%, P  = 0.008). These changes occurred in association with weight gain (median 1 kg, P  = 0.024). Various mediators of catabolism in cachexia are modulated by administration of a fish oil-enriched nutritional supplement in pancreatic cancer patients. This may account for the reversal of weight loss in patients consuming  this supplement.},
	pages = {118--124},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {Barber, M. D. and Fearon, K. C. and Tisdale, M. J. and {McMillan}, D. C. and Ross, J. A.},
	date = {2001},
	pmid = {11962246},
	keywords = {Adolescent, Adult, Aged, Blood Proteins/urine, Cachexia/etiology/*metabolism/*therapy, Dietary Supplements, Eicosapentaenoic Acid/administration \& dosage, Energy Intake, Female, Fish Oils/*administration \& dosage, Humans, Hydrocortisone/blood, Insulin/blood, Interleukin-6/biosynthesis/blood, Leukocytes, Mononuclear/metabolism, Lipopolysaccharides/pharmacology, Male, Middle Aged, Neoplasm Staging, Pancreatic Neoplasms/*complications/pathology, Proteoglycans}
}

@article{andalib_influence_2013,
	title = {Influence of postoperative infectious complications on long-term survival of lung cancer patients: a population-based cohort study},
	volume = {8},
	issn = {1556-1380},
	doi = {10.1097/JTO.0b013e3182862e7e},
	shorttitle = {Influence of postoperative infectious complications on long-term survival of lung cancer patients},
	abstract = {{INTRODUCTION}: Surgery is essential to any curative plan for lung cancer, but is associated with a high complication rate. We sought to determine the impact of complications on long-term survival after a curative surgery for lung cancer, independent of the effect on early postoperative mortality.
{METHODS}: We studied a population-based cohort of patients with lung cancer who underwent curative-intent surgery in the province of Quebec, Canada, from 2000 to 2005. Kaplan-Meier survival analysis was used to compare unadjusted overall survival ({OS}) beyond postoperative day 90 for patients with and without complications. Cox regression was used to determine the prognostic impact of 30-day postoperative complications on the {OS} after adjusting for several confounders.
{RESULTS}: The overall 30-day postoperative complication rate was 58.2\% among 4033 eligible patients. A major infectious complication (pneumonia, empyema, or mediastinitis) occurred in 378 patients. The 5-year {OS} was lower for those with any postoperative complication (62.8\%) than those without (73.8\%; p {\textless} 0.001). Those with major infectious complications had the lowest {OS} (56.3\%; p {\textless} 0.001). Postoperative complication was an independent prognostic factor after adjusting for several patient and treatment factors (hazard ratio = 1.37; 95\% confidence interval, 1.21-1.54). Adjusted hazard ratio for major infectious complications was 1.67 (95\% confidence interval, 1.39-2.01).
{CONCLUSIONS}: Postoperative complications, particularly of a major infectious type, are strong negative predictors of long-term survival in lung cancer patients. The strong association between major infectious complications and survival may also open the door to investigational therapies targeting bacterial antigens in the perioperative period in patients who undergo lung cancer surgery.},
	pages = {554--561},
	number = {5},
	journaltitle = {Journal of Thoracic Oncology: Official Publication of the International Association for the Study of Lung Cancer},
	shortjournal = {J Thorac Oncol},
	author = {Andalib, Amin and Ramana-Kumar, Agnihotram V. and Bartlett, Gillian and Franco, Eduardo L. and Ferri, Lorenzo E.},
	date = {2013-05},
	pmid = {23459402},
	keywords = {Aged, Empyema, Female, Humans, Infection, Kaplan-Meier Estimate, Lung Neoplasms, Male, Mediastinitis, Middle Aged, Pneumonia, postoperative complications, Proportional Hazards Models, Quebec, Retrospective Studies}
}

@article{copeland_possum_2002,
	title = {The {POSSUM} system of surgical audit},
	volume = {137},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/11772209},
	pages = {15--9},
	number = {1},
	journaltitle = {Arch Surg},
	author = {Copeland, Graham Paul},
	date = {2002-01}
}

@article{martinez-rodenas_circulating_1998,
	title = {Circulating bile is the main factor responsible for atrial natriuretic peptide release in experimental obstructive jaundice},
	volume = {85},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9607527},
	abstract = {{BACKGROUND}: Biliary obstruction in the rabbit causes increased release of atrial natriuretic peptide ({ANP}). Circulating bile, raised biliary pressure or absence of bile in the duodenum may be implicated in this hepatocardiac syndrome. {METHODS}: An experimental model was developed to elucidate the mechanism linking obstructive jaundice and increased plasma {ANP}. Hepatic and renal function, biliary tree pressure and {ANP} plasma concentrations were investigated in conscious rabbits 4 and 24 h after common bile duct ligation, biliovenous shunting or external drainage via a biliary fistula. {RESULTS}: Bilirubin concentration increased after bile duct ligation and creation of a biliovenous shunt. Plasma creatinine increased abruptly in rabbits with a biliovenous shunt. At 4 h, the {ANP} increase in animals with a biliovenous shunt was ninefold that observed after bile duct obstruction while no change was noted after external biliary diversion (mean 350 versus 45 versus 9 fmol/l; P {\textless} 0.01). Relief of biliary tree obstruction was associated with a return of {ANP} levels towards basal normal values. {CONCLUSION}: Raised plasma {ANP} in obstructive jaundice is not the result of an increased biliary pressure per se or absence of bile in the proximal duodenum but of the passage of bile components to the circulation.},
	pages = {480--4},
	number = {4},
	journaltitle = {Br J Surg},
	author = {Martínez-Ródenas, F and Pereira, J A and Jiménez, W and Gubern, J M and Sitges-Serra, A},
	date = {1998-04},
	file = {Martínez-Ródenas et al. - 1998 - Circulating bile is the main factor responsible fo.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\JQHCGB3I\\Martínez-Ródenas et al. - 1998 - Circulating bile is the main factor responsible fo.pdf:application/pdf}
}

@article{cheema_novel_2011,
	title = {Novel approaches to perioperative assessment and intervention may improve long-term outcomes after colorectal cancer resection in older adults},
	volume = {253},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21183846},
	abstract = {Colorectal cancer ({CRC}) is common among older adults and surgical resection with curative intent is the primary treatment of {CRC}. Despite the changing demographics of {CRC} patients and increasing prevalence of multiple comorbidities, surgery is increasingly performed in this complex aging population. Clinically important short-term outcomes have improved for this population, but little is known about long-term outcomes. We review the literature to evaluate trends in {CRC} surgery in the geriatric population and the outcomes of surgical treatment. We explore the specific gaps in understanding longitudinal patient-centered outcomes of {CRC} treatment. We then propose adaptations from the geriatrics literature to better predict both short and long-term outcomes after {CRC} surgery. Interventions, such as prehabilitation, coupled with comprehensive geriatric assessment may be important future strategies for identifying vulnerable older patients, ameliorating the modifiable causes of vulnerability, and improving patient-centered longitudinal outcomes. Further research is needed to determine relevant aspects of geriatric assessments, identify effective intervention strategies, and demonstrate their validity in improving outcomes for at-risk older adults.},
	pages = {867--74},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Cheema, Faisal N and Abraham, Neena S and Berger, David H and Albo, Daniel and Taffet, George E and Naik, Aanand D},
	date = {2011-05},
	file = {Cheema et al. - 2011 - Novel approaches to perioperative assessment and i.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\8NIEC77Q\\Cheema et al. - 2011 - Novel approaches to perioperative assessment and i.pdf:application/pdf}
}

@article{kimmings_endotoxin_2000,
	title = {Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage},
	volume = {46},
	issn = {, 1468-3288},
	url = {http://gut.bmj.com/content/46/5/725},
	doi = {10.1136/gut.46.5.725},
	abstract = {{BACKGROUND} Obstructive jaundice is associated with postoperative complications related to increased endotoxaemia and the inflammatory response. In animals obstructive jaundice is associated with endotoxaemia and cytokine induction, which are reversed by internal biliary drainage.
{AIMS} To study endotoxaemia and the subsequent inflammatory response in obstructive jaundiced patients and after endoscopic biliary drainage.
{METHODS} In 15 patients with malignant distal obstructive jaundice, inflammatory and bacteriological parameters were assessed before endoscopic stent placement and after three weeks endoscopic drainage.
{RESULTS} Drainage reduced bilirubin from 252.5 to 45.1 μmol/l. At baseline low level endotoxaemia was detected (4.3 pg/ml) which was not affected after drainage (4.5 pg/ml). Serum interleukin 8 ({IL}-8) and endotoxin binding proteins were increased in jaundice and reduced after drainage ({IL}-8 113.6 to 20.7 pg/ml; lipopolysaccharide binding protein 24.2 to 16.5 μg/ml; {sCD}14 17.4 to 7.6 μg/ml; bactericidal/permeability increasing protein 2.9 to 1.8 ng/ml). Levels of other cytokines, augmented in animals, were only slightly increased and not changed after drainage (tumour necrosis factor ({TNF}): 21.7 and 18.4 pg/ml; {sTNFr} p55/75: 2.9/7.0 and 2.7/5.6 ng/ml; {IL}-6: 4.2 and 6.1 pg/ml; {IL}-10: 4.5 and 2.7 pg/ml). Elastase and lactoferrin tended towards reduction after drainage. All bile cultures were positive after stenting.
{CONCLUSIONS} The effects of obstructive jaundice in humans on endotoxin and cytokines are different from those in animal models. Obstructive jaundice causes alterations in circulating endotoxin binding proteins and {IL}-8. Concentrations of other mediators ({TNF}, previously suggested as being responsible for systemic endotoxaemia effects) are low and not affected by drainage.},
	pages = {725--731},
	number = {5},
	journaltitle = {Gut},
	shortjournal = {Gut},
	author = {Kimmings, A. N. and Deventer, S. J. H. van and Obertop, H. and Rauws, E. a. J. and Huibregtse, K. and Gouma, D. J.},
	urldate = {2015-08-21},
	date = {2000-05-01},
	langid = {english},
	pmid = {10764720},
	keywords = {cytokines, endotoxin, endotoxin binding proteins, {OBSTRUCTIVE} {JAUNDICE}},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\TB6HQU8Q\\Kimmings et al. - 2000 - Endotoxin, cytokines, and endotoxin binding protei.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AD3WRSW5\\725.html:text/html}
}

@article{fujii_preoperative_2015,
	title = {Preoperative internal biliary drainage increases the risk of bile juice infection and pancreatic fistula after pancreatoduodenectomy: a prospective observational study},
	volume = {44},
	issn = {1536-4828},
	doi = {10.1097/MPA.0000000000000265},
	shorttitle = {Preoperative internal biliary drainage increases the risk of bile juice infection and pancreatic fistula after pancreatoduodenectomy},
	abstract = {{OBJECTIVES}: The objective of this study was to identify the most appropriate endoscopic biliary drainage method in patients with pancreatic head cancer.
{METHODS}: A prospectively collected database comprising 122 consecutive patients who underwent pancreatoduodenectomy, including 72 patients treated by endoscopic retrograde biliary drainage ({ERBD}) and 50 patients treated by endoscopic nasobiliary drainage ({ENBD}) procedures, was analyzed.
{RESULTS}: All bile cultures collected intraoperatively were positive in the {ERBD} group, and the positive rates of drainage fluid cultures on postoperative days 1, 3, and 5 and the incidence of postoperative abdominal abscess formation were significantly higher than those in the {ENBD} group. Moreover, {ERBD} was identified as an independent predictive factor for postoperative pancreatic fistula ({POPF}) formation (hazards ratio, 11.81; P {\textless} 0.001). The receiver operating characteristic curve analysis for the preoperative drainage period in the {ERBD} group revealed that the determined cutoff level for the onset of {POPF} was 29 days.
{CONCLUSIONS}: Endoscopic retrograde biliary drainage resulted in more frequent postoperative complications, including {POPF}, compared with {ENBD}. Postoperative pancreatic fistula is more likely to occur if the {ERBD} period exceeds 1 month in patients scheduled to undergo pancreatoduodenectomy.},
	pages = {465--470},
	number = {3},
	journaltitle = {Pancreas},
	shortjournal = {Pancreas},
	author = {Fujii, Tsutomu and Yamada, Suguru and Suenaga, Masaya and Kanda, Mitsuro and Takami, Hideki and Sugimoto, Hiroyuki and Nomoto, Shuji and Nakao, Akimasa and Kodera, Yasuhiro},
	date = {2015-04},
	pmid = {25423556}
}

@article{spanier_incidence_2013,
	title = {Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years 1995-2005},
	volume = {19},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/23716981},
	doi = {Acute pancreatitis;Chronic pancreatitis;Epidemiology;Incidence;Mortality},
	abstract = {To analyze trends in incidence and mortality of acute pancreatitis ({AP}) and chronic pancreatitis ({CP}) in the Netherlands and for international standard populations.},
	pages = {3018--26},
	number = {20},
	journaltitle = {World J Gastroenterol},
	author = {Spanier, B W Marcel and Bruno, Marco J and Dijkgraaf, Marcel G W},
	date = {2013-05}
}

@article{goran_total_2000,
	title = {Total body fat does not influence maximal aerobic capacity},
	volume = {24},
	issn = {0307-0565},
	doi = {10.1038/sj.ijo.0801241},
	abstract = {{OBJECTIVE}: The objective of this study was to examine the influence of body weight and body composition on aspects of aerobic fitness. Our hypothesis was that increased body weight, specifically increased fat mass ({FM}), would not limit {VO}2max relative to fat-free mass ({FFM}), but would reduce maximal and sub-maximal {VO}2max relative to body weight. {DESIGN}: We used data from two ongoing studies. In Study 1 a cross-sectional analysis of 129 children across a wide spectrum of body composition was performed. In Study 2 we examined data from 31 overweight women before and after weight loss. {METHODS}: {VO}2max was measured using a treadmill test. Sub-maximal aerobic capacity was evaluated with respiratory exchange ratio ({RER}), heart-rate ({HR}), and oxygen uptake relative to {VO}2max at a given workload (\%{VO}2max). Body composition was assessed using dual energy X-ray absorptiometry ({DXA}) (Study 1) and a four-compartment model (Study 2). {RESULTS}: In Study 1, {FFM} was the strongest determinant of {VO}2max (r = 0.87; P {\textless} 0.0001). After adjusting for {FFM}, there was no significant influence of {FM} on {VO}2max. After separating children into lean and obese sub-groups, absolute {VO}2max was significantly higher in the obese (1.24+/-0.27 vs 1.56+/-0.40) and {VO}2max relative to body weight was significantly lower (44.2+/-3.2 vs 32.0+/-4.1 ml/(kg-min)), whereas there was no significant difference when expressed relative to {FFM} (57.9+/-5.8 vs 59.2+/-4.9 ml/({kgFFM}-min)). Sub-maximal aerobic capacity was significantly lower in the obese children, as indicated by a higher {HR} and \%{VO}2max; time to exhaustion was significantly lower in the obese children (15.3+/-2.9 vs 11.1+/-2.1 min). In Study 2, {FFM} was also the strongest determinant of {VO}2max before and after weight loss. The relationship between {VO}2max and {FFM} was identical before and after weight loss so that {VO}2max relative to {FFM} was identical before and after weight loss (43.8+/-4.9 vs 45.5+/-6.4 ml/({kgFFM}-min)). However, sub-maximal aerobic capacity was lower in the obese state, as indicated by a significantly higher {RER} (0.85+/-0.06 vs 0.79+/-0.05), {HR} (124+/-14 vs 102+/-11 bpm), and \%{VO}2max (44\% vs 36\%). {CONCLUSION}: The major influence of body weight on {VO}2max is explained by {FFM}; {FM} does not have any effect on {VO}2max. Fatness and excess body weight do not necessarily imply a reduced ability to maximally consume oxygen, but excess fatness does have a detrimental effect on submaximal aerobic capacity. Thus, fatness and {VO}2max should be considered independent entities.},
	pages = {841--848},
	number = {7},
	journaltitle = {International Journal of Obesity},
	shortjournal = {Int. J. Obes.},
	author = {Goran, M. and Fields, D. A. and Hunter, G. R. and Herd, S. L. and Weinsier, R. L.},
	date = {2000-07},
	note = {{WOS}:000088025500005},
	keywords = {aerobic fitness, all-cause mortality, Body Composition, Body Weight, cardiorespiratory fitness, cardiovascular-disease mortality, energy-expenditure, Exercise, men, obese children, Obesity, physical   activity, physical-fitness, statistical considerations, women},
	file = {Goran et al. - 2000 - Total body fat does not influence maximal aerobic .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UVDV4IM9\\Goran et al. - 2000 - Total body fat does not influence maximal aerobic .pdf:application/pdf}
}

@article{jamieson_adiponectin_2004,
	title = {Adiponectin and the systemic inflammatory response in weight-losing patients with non-small cell lung cancer.},
	volume = {27},
	rights = {Copyright 2004 Elsevier Ltd.},
	doi = {10.1016/j.cyto.2004.03.017},
	abstract = {The aim of the present study was to examine the relationship between adiponectin  and the systemic inflammatory response in weight-losing patients with non-small cell lung cancer ({NSCLC}). Measurement of anthropometry, acute phase proteins, interleukin-6, leptin (total and free) and adiponectin were carried out on healthy subjects (n = 13) and non-small cell lung cancer patients with weight loss (n = 20). The groups were age and sex matched. Compared with the controls the cancer group had a lower {BMI} (p {\textless} 0.01), mid-upper arm circumference (p {\textless} 0.001), triceps skinfold thickness (p {\textless} 0.05) and circulating concentrations of albumin (p {\textless} 0.001), haemoglobin (p {\textless} 0.05), free and total leptin (p {\textless} 0.05) and adiponectin (p {\textless} 0.01). In contrast, the cancer group had elevated circulating concentrations of interleukin-6 and C-reactive protein concentrations (p {\textless} 0.001). In the cancer group circulating adiponectin concentrations were significantly inversely correlated with both free (rs = -0.675, p = 0.001) and total leptin concentrations (rs = -0.690, p = 0.001). However, neither weight loss, interleukin-6 or C-reactive protein concentrations were correlated with either adiponectin, free or total leptin concentrations in the cancer group. These results suggest that adipokine production is normal and is unlikely to play a major role in the abnormal fat metabolism in weight-losing cancer patients.},
	pages = {90--92},
	number = {2},
	journaltitle = {Cytokine},
	shortjournal = {Cytokine},
	author = {Jamieson, Nigel B. and Brown, Duncan J. F. and Michael Wallace, A. and {McMillan}, Donald C.},
	date = {2004-08-21},
	pmid = {15242698},
	keywords = {*Body Mass Index, *Weight Loss, Adiponectin, Aged, Carcinoma, Non-Small-Cell Lung/*blood/pathology, C-Reactive Protein/analysis, Fats/metabolism, Female, Humans, Inflammation, Intercellular Signaling Peptides and Proteins/*blood, Leptin/blood, Lung Neoplasms/*blood/pathology, Male, Middle Aged}
}

@article{koch_reference_2008,
	title = {Reference values for cardiopulmonary exercise testing in healthy volunteers: the {SHIP} study},
	volume = {33},
	issn = {0903-1936, 1399-3003},
	url = {http://erj.ersjournals.com/cgi/doi/10.1183/09031936.00074208},
	doi = {10.1183/09031936.00074208},
	shorttitle = {Reference values for cardiopulmonary exercise testing in healthy volunteers},
	pages = {389--397},
	number = {2},
	journaltitle = {European Respiratory Journal},
	author = {Koch, B. and Schaper, C. and Ittermann, T. and Spielhagen, T. and Dorr, M. and Volzke, H. and Opitz, C. F. and Ewert, R. and Glaser, S.},
	urldate = {2014-01-27},
	date = {2008-09-17},
	file = {Koch et al. - 2008 - Reference values for cardiopulmonary exercise test.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\P938S2RC\\Koch et al. - 2008 - Reference values for cardiopulmonary exercise test.pdf:application/pdf}
}

@article{ostrow_molecular_2004,
	title = {Molecular basis of bilirubin-induced neurotoxicity},
	volume = {10},
	issn = {14714914},
	url = {http://linkinghub.elsevier.com/retrieve/pii/S1471491403002752},
	doi = {10.1016/j.molmed.2003.12.003},
	pages = {65--70},
	number = {2},
	journaltitle = {Trends in Molecular Medicine},
	author = {Ostrow, J.Donald and Pascolo, Lorella and Brites, Dora and Tiribelli, Claudio},
	urldate = {2014-01-27},
	date = {2004-02},
	file = {Ostrow et al. - 2004 - Molecular basis of bilirubin-induced neurotoxicity.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EWFZZVXH\\Ostrow et al. - 2004 - Molecular basis of bilirubin-induced neurotoxicity.pdf:application/pdf}
}

@article{chuniaud_cytotoxicity_1996,
	title = {Cytotoxicity of bilirubin for human fibroblasts and rat astrocytes in culture. Effect of the ratio of bilirubin to serum albumin},
	volume = {256},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/9027422},
	abstract = {The sensitivity of rat brain astrocytes and human fibroblasts in culture to unconjugated bilirubin was investigated. Medium containing 6 mumol/1 bilirubin and increasing concentrations of human serum albumin giving ratios of 0.5-1.5 that resulted in an increase of the free bilirubin concentrations. The {LDH} activity in the culture medium was an index of cytolysis and the {MTT} assay was used as an index of mitochondrial impairment. The ratios producing half-maximum cell lysis after 24, 48, and 72 h, were 1.1, 0.9 and 0.85, for astrocytes, and 1.2, 0.75 and 0.75, for fibroblasts. Mitochondrial activity decreased after 24 h for ratio = 0.7 and partly recovered at 48 h. Mitochondrial activity was more impaired in fibroblasts than in astrocytes above ratio = 0.7. The cytotoxic effects were linked to the free bilirubin concentration. We conclude that astrocytes are less sensitive to bilirubin cytotoxic effects than are fibroblasts.},
	pages = {103--14},
	number = {2},
	journaltitle = {Clin Chim Acta},
	author = {Chuniaud, L and Dessante, M and Chantoux, F and Blondeau, J P and Francon, J and Trivin, F},
	date = {1996-12},
	file = {Chuniaud et al. - 1996 - Cytotoxicity of bilirubin for human fibroblasts an.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\273RWIHU\\Chuniaud et al. - 1996 - Cytotoxicity of bilirubin for human fibroblasts an.pdf:application/pdf}
}

@article{oliver_ventilatory_2015,
	title = {Ventilatory and Metabolic Response in the Incremental Shuttle and 6-Min Walking Tests Measured by Telemetry in Obese Patients Prior to Bariatric Surgery},
	issn = {1708-0428},
	doi = {10.1007/s11695-014-1548-8},
	abstract = {{BACKGROUND}: Low cardiopulmonary fitness, measured by oxygen uptake peak ({VO}2pk), is associated with postoperative complications and mortality. Obese people have difficulty in performing the cardiopulmonary exercise test, which requires maximal exertion. The incremental shuttle walking test ({ISWT}) and 6-min walking test (6MWT) have been used to assess cardiorespiratory capacity, mortality, and complications in the postoperative phase. However, the physiological response elicited by these tests in obese people is unknown. This study analyzed and compared cardiopulmonary fitness (oxygen uptake [{VO}2] and {CO}2 output [{VCO}2]) in the {ISWT} and 6MWT in obese adults using a telemetry system.
{METHODS}: Fifteen obese patients (10 women; mean age 39.4 ± 10.1 years; mean body mass index 43.5 ± 6.8 kg/m(2)) with normal forced vital capacity (\% {FVC} 93.7) performed the 6MWT and {ISWT} in the field in this cross-sectional study. Metabolic ({VO}2pk, {VCO}2) and respiratory (minute ventilation; {VE}) variables were recorded using telemetry.
{RESULTS}: Obese patients performed the {ISWT} with an incremental and exponential cardiopulmonary response, with higher {VO}2pk (15.4 ± 2.9 ml/kg/min), {VCO}2 (1.7 ± 0.7 l/min), and {VE} (51.4 ± 21.3 l/min) than the 6MWT ({VO}2pk = 13.2 ± 2.59 ml/kg/min, {VCO}2 = 1.4 ± 0.6 l/min; {VE} = 41.2 ± 16.6 l/min (all p {\textless} 0.01). They also demonstrated more effort intensity, assessed by {VO}2, (p = 0.006) and heart rate (p = 0.04) in the {ISWT} than the 6MWT. In the 6MWT, patients showed a fast rise in ventilatory and metabolic response, reaching a plateau.
{CONCLUSION}: The {ISWT} test generated superior metabolic and ventilatory stress than the 6MWT and may be more suitable for assessing cardiopulmonary fitness than self-paced tests.},
	journaltitle = {Obesity Surgery},
	shortjournal = {Obes Surg},
	author = {Oliver, Nicole and Onofre, Tatiana and Carlos, Renata and Barbosa, Juliana and Godoy, Eudes and Pereira, Eliane and Guerra, Ricardo O. and Bruno, Selma},
	date = {2015-01-09},
	pmid = {25573458}
}

@article{bortul_[preoperative_1991,
	title = {[Preoperative transhepatic biliary drainage in the jaundiced patient: our experience]},
	volume = {62},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1755609},
	abstract = {The authors assessed the efficacy of {PTBD} in a group of 72 patients with obstructive jaundice due to lithiasis or malignant obstruction, that underwent preoperatively {PTBD} procedure. They analysed the early and late complications and its effectiveness in decreasing the bilirubin levels. The results, in agreement with the most recent reports, suggest the uselessness of the preoperative {PTBD} in the treatment of the patients with a jaundice due to a biliary lithiasis. Concerning the patients with a neoplastic jaundice, this procedure seems to be more effective in the patients with a biliary obstruction due to pancreatic head or distal choledochus carcinoma: in the patients with a far advanced cancer, the {PTBD} procedure could be the first step to the insertion of biliary endoprosthesis; on the other hand, in the patients that may undergo a curative treatment, {PTBD} could be useful preoperatively both to reach an adequate water-electrolyte [correction of hydroelectrolithic] balance and nutritional status both to complete the diagnostic procedure.},
	pages = {265--71; discussion 272},
	number = {3},
	journaltitle = {Ann Ital Chir},
	author = {Bortul, M and Calligaris, L and Moro, E and Bazzocchi, M and Strami, G},
	date = {1991-06}
}

@article{watt_comment_2015,
	title = {Comment on "prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases".},
	volume = {32},
	doi = {10.1007/s12032-015-0617-8},
	number = {5},
	journaltitle = {Medical oncology (Northwood, London, England)},
	shortjournal = {Med Oncol},
	author = {Watt, David G. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2015-05},
	pmid = {25904501}
}

@article{straatman_predictive_2015,
	title = {Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery: A Systematic Review and Pooled-Analysis},
	volume = {10},
	issn = {1932-6203},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503561/},
	doi = {10.1371/journal.pone.0132995},
	shorttitle = {Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery},
	abstract = {Background
Early diagnosis and treatment of complications after major abdominal surgery can decrease associated morbidity and mortality. Postoperative {CRP} levels have shown a strong correlation with complications. Aim of this systematic review and pooled-analysis was to assess postoperative values of {CRP} as a marker for major complications and construct a prediction model.

Study design
A systematic review was performed for {CRP} levels as a predictor for complications after major abdominal surgery ({MAS}). Raw data was obtained from seven studies, including 1427 patients. A logit regression model assessed the probability of major complications as a function of {CRP} levels on the third postoperative day. Two practical cut-offs are proposed: an optimal cut-off for safe discharge in a fast track protocol and another for early identification of patients with increased risk for major complications.

Results
A prediction model was calculated for major complications as a function of {CRP} levels on the third postoperative day. Based on the model several cut-offs for {CRP} are proposed. For instance, a two cut-off system may be applied, consisting of a safe discharge criterion with {CRP} levels below 75 mg/L, with a negative predictive value of 97.2\%. A second cut-off is set at 215 mg/L (probability 20\%) and serves as a predictor of complications, indicating additional {CT}-scan imaging.

Conclusions
The present study provides insight in the interpretation of {CRP} levels after major abdominal surgery, proposing a prediction model for major complications as a function of {CRP} on postoperative day 3. Cut-offs for {CRP} may be implemented for safe early-discharge in a fast-track protocol and, secondly as a threshold for additional examinations, such as {CT}-scan imaging, even in absence of clinical signs, to confirm or exclude major complications. The prediction model allows for setting a cut-off at the discretion of individual surgeons or surgical departments.},
	number = {7},
	journaltitle = {{PLoS} {ONE}},
	shortjournal = {{PLoS} One},
	author = {Straatman, Jennifer and Harmsen, Annelieke M. K. and Cuesta, Miguel A. and Berkhof, Johannes and Jansma, Elise P. and van der Peet, Donald L.},
	urldate = {2015-08-20},
	date = {2015-07-15},
	pmid = {26177542},
	pmcid = {PMC4503561},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\QCCB64P8\\Straatman et al. - 2015 - Predictive Value of C-Reactive Protein for Major C.pdf:application/pdf}
}

@article{martin_irreversible_2013,
	title = {Irreversible electroporation in locally advanced pancreatic cancer: potential improved overall survival},
	volume = {20 Suppl 3},
	issn = {1534-4681},
	doi = {10.1245/s10434-012-2736-1},
	shorttitle = {Irreversible electroporation in locally advanced pancreatic cancer},
	abstract = {{BACKGROUND}: Locally advanced unresectable pancreatic adenocarcinoma ({LAC}) is characterized by poor survival despite chemotherapy and conventional radiation therapy. We have recently reported on the safety of using irreversible electroporation ({IRE}) for the management of {LAC}. The purpose of this study was to evaluate the overall survival in patients with {LAC} treated with {IRE}.
{METHODS}: A prospective, multi-institutional evaluation of 54 patients who underwent {IRE} for unresectable pancreatic cancer from December 2009 to October 2010 was evaluated for overall survival and propensity matched to 85 matched stage {III} patients treated with standard therapy defined as chemotherapy and radiation therapy alone.
{RESULTS}: A total of 54 {LAC} patients have undergone {IRE} successfully, with 21 women, 23 men (median age, 61 (range, 45-80) years). Thirty-five patients had pancreatic head primary and 19 had body tumors; 19 patients underwent margin accentuation with {IRE} and 35 underwent in situ {IRE}. Forty-nine (90 \%) patients had pre-{IRE} chemotherapy alone or chemoradiation therapy for a median duration 5 months. Forty (73\%) patients underwent post-{IRE} chemotherapy or chemoradiation. The 90 day mortality in the {IRE} patients was 1 (2 \%). In a comparison of {IRE} patients to standard therapy, we have seen an improvement in local progression-free survival (14 vs. 6 months, p = 0.01), distant progression-free survival (15 vs. 9 months, p = 0.02), and overall survival (20 vs. 13 months, p = 0.03).
{CONCLUSIONS}: {IRE} ablation of locally advanced pancreatic tumors remains safe and in the appropriate patient who has undergone standard induction therapy for a minimum of 4 months can achieve greater local palliation and potential improved overall survival compared with standard chemoradiation-chemotherapy treatments. Validation of these early results will need to be validated in the current multi-institutional Phase 2 {IDE} study.},
	pages = {S443--449},
	journaltitle = {Annals of Surgical Oncology},
	shortjournal = {Ann. Surg. Oncol.},
	author = {Martin, Robert C. G. and {McFarland}, Kelli and Ellis, Susan and Velanovich, Vic},
	date = {2013-12},
	pmid = {23128941},
	keywords = {Adenocarcinoma, Aged, Aged, 80 and over, Electroporation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Pancreatic Neoplasms, prognosis, Prospective Studies, Survival Rate}
}

@article{babu_open_2010,
	title = {Open pancreatic necrosectomy in the multidisciplinary management of postinflammatory necrosis},
	volume = {251},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/20195152},
	abstract = {Abstract {OBJECTIVE}: To examine clinical outcome in a consecutive cohort of patients undergoing open necrosectomy for postinflammatory necrosis. {BACKGROUND} {INFORMATION}: The last decade has witnessed major developments in the surgical management of pancreatic necrosis. Minimally invasive approaches have become established. However, there are limited data from contemporary open necrosectomy, in particular where multidisciplinary care and aggressive interventional radiology are used. This report provides data on outcome from open necrosectomy in a tertiary referral Hepatobiliary unit over the last decade. {METHODS}: During the period January 1, 2000 to July 31, 2008, 1535 patients were admitted with a final discharge code of acute pancreatitis. Twenty-eight (1.8\%) of all admissions underwent open surgical necrosectomy. Twenty-four (86\%) were tertiary referral patients. {RESULTS}: The median {APACHE} {II} score on admission was 10.5 (5-26). Median logistic organ dysfunction score on admission was 3 (0-10). Median {LODS} score after surgery was 2 (0-8). Twenty patients (71\%) underwent radiologically guided drainage of collections before surgery. Thirty-day mortality occurred in 2 (7\%), 4 further deaths occurred in patients after discharge from intensive care resulting in a total of 6 (22\%) episode-related deaths. {CONCLUSIONS}: Modern open necrosectomy can be performed without the procedure-related deterioration in organ dysfunction associated with major debridement. Multidisciplinary care with an emphasis on aggressive radiologic intervention before and after surgery results in acceptable outcomes in this cohort of critically ill patients. Newer laparoscopic techniques must demonstrate similar outcomes in the setting of stage-matched severity before wider acceptance.},
	pages = {783--6},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Babu, Benoy I and Sheen, Aali J and Lee, Stephen H and O'Shea, Sarah and Eddleston, Jane M and Siriwardena, Ajith K},
	date = {2010-05},
	file = {Babu et al. - 2010 - Open pancreatic necrosectomy in the multidisciplin.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DIWS9MBG\\Babu et al. - 2010 - Open pancreatic necrosectomy in the multidisciplin.pdf:application/pdf}
}

@article{starr_convalescence_1945,
	title = {Convalescence from Surgical Procedures {II}. Studies of Various Physiological Responses to a Mild Exercise Test},
	volume = {210},
	issn = {0002-9629},
	shorttitle = {{CONVALESCENCE} {FROM} {SURGICAL} {PROCEDURES}},
	pages = {713--725},
	number = {6},
	journaltitle = {Journal of the Medical Sciences},
	author = {Starr, Isaac M. D. and Mayock, Robert L. M. D. and Battles, Mahjorie G.},
	date = {1945-12},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\FCBXFHT8\\Starr et al. - 1945 - CONVALESCENCE FROM SURGICAL PROCEDURES II. Studie.pdf:application/pdf}
}

@article{mcmillan_metabolism_1990-1,
	title = {Metabolism of the arylamide herbicide propanil. {II}. Effects of propanil and its derivatives on hepatic microsomal drug-metabolizing enzymes in the rat.},
	volume = {103},
	abstract = {Propanil (3,4-dichloropropionanilide) is an arylamide herbicide that has been reported to be contaminated with the cytochrome P450 enzyme inducers 3,3',4,4'-tetrachloroazobenzene ({TCAB}) and 3,3',4,4'-tetrachloroazoxybenzene ({TCAOB}), which are structural analogs of 2,3,7,8-tetrachlorodibenzo-p-dioxin ({TCDD}). We determined if treatment of rats with {TCAB}, {TCAOB}, propanil, 3,4-dichloroaniline, {TCDD}, or phenobarbital induced the hepatic microsomal metabolism of propanil and 3,4-dichloroaniline. Acylamidase-catalyzed hydrolysis  of propanil to 3,4-dichloroaniline was not induced by any of the pretreatments; however, hydroxylation of propanil at the 2'-position was induced by {TCDD}, {TCAB},  {TCAOB}, propanil, and 3,4-dichloroaniline pretreatments. Ring- and},
	pages = {102--112},
	number = {1},
	journaltitle = {Toxicology and applied pharmacology},
	shortjournal = {Toxicol Appl Pharmacol},
	author = {{McMillan}, D. C. and Leakey, J. E. and Arlotto, M. P. and {McMillan}, J. M. and Hinson, J. A.},
	date = {1990-03-15},
	pmid = {2315923},
	keywords = {Anilides/*toxicity, Aniline Compounds/metabolism, Animals, Azo Compounds/pharmacology, Chlorobenzenes/pharmacology, Enzyme Induction/*drug effects, Male, Microsomes, Liver/drug effects/*enzymology, Oxidation-Reduction, Propanil/metabolism/*toxicity, Rats, Rats, Inbred Strains, Tetrachlorodibenzodioxin/pharmacology}
}

@article{mohammed_comparison_2012-1,
	title = {Comparison of visual and automated assessment of {HER}2 status and their impact on  outcome in primary operable invasive ductal breast cancer.},
	volume = {61},
	rights = {(c) 2012 Blackwell Publishing Ltd.},
	doi = {10.1111/j.1365-2559.2012.04280.x},
	abstract = {{AIMS}: To compare visual and computerized image analysis of {HER}2 immunohistochemistry ({IHC}) with fluorescence in-situ hybridization ({FISH}) for {HER}2 status, and to examine the relationships with outcome in patients with primary operable invasive ductal breast cancer. {METHODS} {AND} {RESULTS}: Tissue microarrays for 431 breast cancer patients were used to compare different approaches to the assessment of {HER}2 status. The cores were scored visually and with the Slidepath Tissue {IA} system, using the {NICE}-approved scoring system for the {HercepTest}, as well as by {FISH}. The agreement between visual and image analysis of {HER}2 {IHC} was excellent [interclass correlation coefficient ({ICCC}) = 0.95, rs = 0.90, r = 0.91, k = 0.81, and P {\textless} 0.001]. The agreement of {HER}2 {FISH} with visual and image analysis of {HER}2 {IHC} was also excellent ({ICCC} = 0.95 and {ICCC} = 0.92, respectively). Univariate survival analysis showed equivalent associations of visual and image analysis of {HER}2 and {HER}2 {FISH} with both recurrence-free survival (all P {\textless} 0.01) and cancer-specific survival (all P {\textless} 0.05) in patients with invasive ductal breast cancer. {CONCLUSION}: Computerized image analysis of {HER}2 {IHC} gives results comparable to those obtained with visual assessment, with possible advantages in diagnostic pathology.},
	pages = {675--684},
	number = {4},
	journaltitle = {Histopathology},
	shortjournal = {Histopathology},
	author = {Mohammed, Zahra M. A. and Going, James J. and {McMillan}, Donald C. and Orange, Clare and Mallon, Elizabeth and Doughty, Julie C. and Edwards, Joanne},
	date = {2012-10},
	pmid = {22747525}
}

@article{singh_systematic_2014,
	title = {Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery},
	volume = {101},
	issn = {1365-2168},
	doi = {10.1002/bjs.9354},
	abstract = {{BACKGROUND}: Several recent studies have investigated the role of C-reactive protein ({CRP}) as an early marker of anastomotic leakage following colorectal surgery. The aim of this systematic review and meta-analysis was to evaluate the predictive value of {CRP} in this setting.
{METHODS}: A systematic literature search was performed using {MEDLINE}, Embase and {PubMed} to identify studies evaluating the diagnostic accuracy of postoperative {CRP} for anastomotic leakage following colorectal surgery. A meta-analysis was carried out using a random-effects model and pooled predictive parameters were determined along with a {CRP} cut-off value at each postoperative day ({POD}).
{RESULTS}: Seven studies, with a total of 2483 patients, were included. The pooled prevalence of leakage was 9·6 per cent and the median day on which leakage was diagnosed ranged from {POD} 6 to 9. The serum {CRP} level on {POD} 3, 4 and 5 had comparable diagnostic accuracy for the development of an anastomotic leak with a pooled area under the curve of 0·81 (95 per cent confidence interval 0·75 to 0·86), 0·80 (0·74 to 0·86) and 0·80 (0·73 to 0·87) respectively. The derived {CRP} cut-off values were 172 mg/l on {POD} 3, 124 mg/l on {POD} 4 and 144 mg/l on {POD} 5; these corresponded to a negative predictive value of 97 per cent and a negative likelihood ratio of 0·26-0·33. All three time points had a low positive predictive value for leakage, ranging between 21 and 23 per cent.
{CONCLUSION}: {CRP} is a useful negative predictive test for the development of anastomotic leakage following colorectal surgery.},
	pages = {339--346},
	number = {4},
	journaltitle = {The British Journal of Surgery},
	shortjournal = {Br J Surg},
	author = {Singh, P. P. and Zeng, I. S. L. and Srinivasa, S. and Lemanu, D. P. and Connolly, A. B. and Hill, A. G.},
	date = {2014-03},
	pmid = {24311257},
	keywords = {Anastomotic leak, Biological Markers, C-Reactive Protein, Epidemiologic Methods, Humans, Postoperative Care, Rectal Neoplasms}
}

@article{park_impact_2014,
	title = {The impact of anti-inflammatory agents on the outcome of patients with colorectal cancer.},
	volume = {40},
	rights = {Copyright (c) 2013 Elsevier Ltd. All rights reserved.},
	doi = {10.1016/j.ctrv.2013.05.006},
	abstract = {Although there is increasing appreciation of the role of the host inflammatory response in determining outcome in patients in colorectal cancer, there has been  little concerted effort to favourably manipulate cancer-associated inflammation,  either alone or in combination with current oncological treatment. Epidemiological and cardiovascular disease studies have identified aspirin, other nonsteroidal anti-inflammatory drugs and statins as potential chemotherapeutic agents which may manipulate the host inflammatory response to the benefit of the  patient with cancer. Similarly, evidence of a chemotherapeutic effect of histamine-2 receptor antagonists, again mediated by an immunomodulatory effect, has previously led to increased interest in their use in gastrointestinal cancer. Extensive pre-clinical data and a limited number of clinical investigations have  proposed a direct effect of these agents on tumour biology, with an anti-tumour effect on several of the hallmarks of cancer, including proliferative capacity, evasion from apoptosis and cell cycle regulation, and invasive capability of tumour cells. Furthermore, clinical evidence has suggested a pertinent role in down-regulating the systemic inflammatory response whilst favourably influencing  the local inflammatory response within the tumour microenvironment. Despite such  compelling results, the clinical applicability of nonsteroidal anti-inflammatory  drugs, statins and histamine-2 receptor antagonists has not been fully realised,  particularly in patients identified at high risk on the basis of inflammatory parameters. In the present review, we examine the potential role that these agents may play in improving survival and reducing recurrence in patients with potentially curative colorectal cancer, and in particular focus on their effects  on the local and systemic inflammatory response.},
	number = {1},
	journaltitle = {Cancer treatment reviews},
	shortjournal = {Cancer Treat Rev},
	author = {Park, J. H. and {McMillan}, D. C. and Horgan, P. G. and Roxburgh, C. S.},
	date = {2014-02},
	pmid = {23773805},
	keywords = {Animals, Anti-Inflammatory Agents/pharmacology/*therapeutic use, Antineoplastic Agents/pharmacology/*therapeutic use, Chemotherapy, Adjuvant, Colorectal Neoplasms/*drug therapy/mortality/pathology, Humans, Hydroxymethylglutaryl-{CoA} Reductase Inhibitors/pharmacology/therapeutic use, Randomized Controlled Trials as Topic, Treatment Outcome}
}

@article{wallace_circulating_2002,
	title = {Circulating concentrations of "free" leptin in relation to fat mass and appetite  in gastrointestinal cancer patients.},
	volume = {44},
	doi = {10.1207/S15327914NC4402_06},
	abstract = {Recent studies have suggested that circulating concentrations of leptin might play a role in cancer cachexia. In the first part of the study, we compared circulating concentrations of free and total leptin, percent fat mass, and the inflammatory markers C-reactive protein ({CRP}) and interleukin-6 ({IL}-6), together  with appetite score, in age- and gender-matched healthy controls (n = 11) and advanced gastrointestinal cancer patients (n = 26). In the second part of the study, the same measurements were repeated before and after megestrol acetate treatment of weight-losing gastrointestinal cancer patients (n = 10). Body mass index and percent fat mass were significantly lower (P {\textless} 0.05) and {IL}-6 and {CRP} were significantly higher (P {\textless} 0.05) in cancer patients than in controls. There was no difference in the percentage of leptin bound in the circulation between controls and cancer patients. Circulating "free" leptin concentrations correlated with percent fat mass in controls (r = 0.745, P = 0.008) and cancer patients (r = 0.600, P = 0.001). In cancer patients, circulating leptin concentrations, either  free or total, were not correlated with {IL}-6 or {CRP} concentrations. When adjusted for fat mass, the circulating concentrations of free and total leptin were significantly lower in the cancer patients (P {\textless} 0.01). Megestrol acetate treatment significantly increased circulating free and total leptin concentrations in the cancer patients (P {\textless} 0.05). There was a significant positive correlation between the change in circulating concentrations of free and total leptin and the change in percent fat mass (r = 0.685, P {\textless} 0.05 and r = 0.661, P {\textless} 0.05, respectively). The results of the present study indicate that the proportions of free and bound leptin in the circulation do not differ between normal subjects and patients with gastrointestinal cancer and in both groups are  related to fat mass. Furthermore, the increase in circulating leptin concentrations after megestrol acetate treatment is not associated with any alteration in leptin binding.},
	pages = {157--160},
	number = {2},
	journaltitle = {Nutrition and cancer},
	shortjournal = {Nutr Cancer},
	author = {Wallace, A. Michael and Kelly, Anne and Sattar, Naveed and {McArdle}, Colin S. S. and {McMillan}, Donald C.},
	date = {2002},
	pmid = {12734062},
	keywords = {Aged, Aged, 80 and over, Appetite/*physiology, Body Composition/drug effects/*physiology, Body Mass Index, C-Reactive Protein/analysis, Female, Gastrointestinal Neoplasms/*blood, Humans, Interleukin-6/blood, Leptin/*blood, Male, Megestrol Acetate/administration \& dosage, Middle Aged, Radioimmunoassay, Statistics, Nonparametric}
}

@article{maffeis_maximal_1994,
	title = {Maximal Aerobic Power During Running and Cycling in Obese and Nonobese Children},
	volume = {83},
	issn = {0803-5253},
	doi = {10.1111/j.1651-2227.1994.tb12965.x},
	abstract = {The maximal aerobic capacity while running and cycling was measured in 22 prepubertal children (mean age +/- {SD} 9.5 +/- 0.8 years): 14 obese (47.3 +/- 10 kg) and 8 non-obese (31.1 +/- 6.1 kg). Oxygen consumption ({VO}2) and carbon dioxide production were measured by an open circuit method. Steady state {VO}2 was determined at different levels of exercise up to the maximal power on the cycloergometer (92 W in obese and 77 W in non-obese subjects) and up to the maximal running speed on the treadmill at a 2\% slope (8.3 km/h in obese and 9.0 km/h in lean children). Expressed in absolute values, the {VO}2max in obese children was significantly higher than in controls (1.55 +/- 0.29 l/min versus 1.23 +/- 0.221/ min, p {\textless} 0.05) for the treadmill test and comparable in the two groups (1.4 +/- 0.2 l/min versus 1.16 +/- 0.2 l/min, ns) for the cycloergometer test. When {VO}2max was expressed per kg fat free mass, the difference between the two groups disappeared for both tests. These data suggest that obese children had no limitation of maximal aerobic power. Therefore, the magnitude of the workload prescribed when a physical activity program is intended for the therapy of childhood obesity, it should be designed to increase caloric output rather than to improve cardiorespiratory fitness.},
	pages = {113--116},
	number = {1},
	journaltitle = {Acta Paediatrica},
	shortjournal = {Acta Paediatr.},
	author = {Maffeis, C. and Schena, F. and Zaffanello, M. and Zoccante, L. and Schutz, Y. and Pinelli, L.},
	date = {1994-01},
	note = {{WOS}:A1994MZ16200024},
	keywords = {body-composition, children, Exercise, growth, Obesity, oxygen-uptake, weight-loss}
}

@article{arslan_anthropometric_2010,
	title = {Anthropometric measures, body mass index, and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium ({PanScan})},
	volume = {170},
	issn = {1538-3679},
	doi = {10.1001/archinternmed.2010.63},
	shorttitle = {Anthropometric measures, body mass index, and pancreatic cancer},
	abstract = {{BACKGROUND}: Obesity has been proposed as a risk factor for pancreatic cancer.
{METHODS}: Pooled data were analyzed from the National Cancer Institute Pancreatic Cancer Cohort Consortium ({PanScan}) to study the association between prediagnostic anthropometric measures and risk of pancreatic cancer. {PanScan} applied a nested case-control study design and included 2170 cases and 2209 control subjects. Odds ratios ({ORs}) and 95\% confidence intervals ({CIs}) were estimated using unconditional logistic regression for cohort-specific quartiles of body mass index ({BMI} [calculated as weight in kilograms divided by height in meters squared]), weight, height, waist circumference, and waist to hip ratio as well as conventional {BMI} categories (underweight, {\textless}18.5; normal weight, 18.5-24.9; overweight, 25.0-29.9; obese, 30.0-34.9; and severely obese, {\textgreater} or = 35.0). Models were adjusted for potential confounders.
{RESULTS}: In all of the participants, a positive association between increasing {BMI} and risk of pancreatic cancer was observed (adjusted {OR} for the highest vs lowest {BMI} quartile, 1.33; 95\% {CI}, 1.12-1.58; P(trend) {\textless} .001). In men, the adjusted {OR} for pancreatic cancer for the highest vs lowest quartile of {BMI} was 1.33 (95\% {CI}, 1.04-1.69; P(trend) {\textless} .03), and in women it was 1.34 (95\% {CI}, 1.05-1.70; P(trend) = .01). Increased waist to hip ratio was associated with increased risk of pancreatic cancer in women (adjusted {OR} for the highest vs lowest quartile, 1.87; 95\% {CI}, 1.31-2.69; P(trend) = .003) but less so in men.
{CONCLUSIONS}: These findings provide strong support for a positive association between {BMI} and pancreatic cancer risk. In addition, centralized fat distribution may increase pancreatic cancer risk, especially in women.},
	pages = {791--802},
	number = {9},
	journaltitle = {Archives of Internal Medicine},
	shortjournal = {Arch. Intern. Med.},
	author = {Arslan, Alan A. and Helzlsouer, Kathy J. and Kooperberg, Charles and Shu, Xiao-Ou and Steplowski, Emily and Bueno-de-Mesquita, H. Bas and Fuchs, Charles S. and Gross, Myron D. and Jacobs, Eric J. and Lacroix, Andrea Z. and Petersen, Gloria M. and Stolzenberg-Solomon, Rachael Z. and Zheng, Wei and Albanes, Demetrius and Amundadottir, Laufey and Bamlet, William R. and Barricarte, Aurelio and Bingham, Sheila A. and Boeing, Heiner and Boutron-Ruault, Marie-Christine and Buring, Julie E. and Chanock, Stephen J. and Clipp, Sandra and Gaziano, J. Michael and Giovannucci, Edward L. and Hankinson, Susan E. and Hartge, Patricia and Hoover, Robert N. and Hunter, David J. and Hutchinson, Amy and Jacobs, Kevin B. and Kraft, Peter and Lynch, Shannon M. and Manjer, Jonas and Manson, Joann E. and McTiernan, Anne and McWilliams, Robert R. and Mendelsohn, Julie B. and Michaud, Dominique S. and Palli, Domenico and Rohan, Thomas E. and Slimani, Nadia and Thomas, Gilles and Tjønneland, Anne and Tobias, Geoffrey S. and Trichopoulos, Dimitrios and Virtamo, Jarmo and Wolpin, Brian M. and Yu, Kai and Zeleniuch-Jacquotte, Anne and Patel, Alpa V. and {Pancreatic Cancer Cohort Consortium (PanScan)}},
	date = {2010-05-10},
	pmid = {20458087},
	pmcid = {PMC2920035},
	keywords = {Adult, Aged, Aged, 80 and over, Body Mass Index, Case-Control Studies, Female, Humans, Logistic Models, Male, Middle Aged, Obesity, Overweight, Pancreatic Neoplasms, Risk Factors, Sex Distribution, United States, Waist Circumference}
}

@article{merchant_adjuvant_2009,
	title = {Adjuvant chemoradiation therapy for pancreatic adenocarcinoma: who really benefits?},
	volume = {208},
	issn = {1879-1190},
	doi = {10.1016/j.jamcollsurg.2008.12.020},
	shorttitle = {Adjuvant chemoradiation therapy for pancreatic adenocarcinoma},
	abstract = {{BACKGROUND}: The role of adjuvant chemoradiation therapy ({CRT}) in pancreatic cancer remains controversial. The primary aim of this study was to determine if {CRT} improved survival in patients with resected pancreatic cancer in a large, multiinstitutional cohort of patients.
{STUDY} {DESIGN}: Patients undergoing resection for pancreatic adenocarcinoma from seven academic medical institutions were included. Exclusion criteria included patients with T4 or M1 disease, R2 resection margin, preoperative therapy, chemotherapy alone, or if adjuvant therapy status was unknown.
{RESULTS}: There were 747 patients included in the initial evaluation. Primary analysis was performed between patients that had surgery alone (n=374) and those receiving adjuvant {CRT} (n=299). Median followup time was 12.2 months and 14.5 months for survivors. Median overall survival for patients receiving adjuvant {CRT} was significantly longer than for those undergoing operation alone (20.0 months versus 14.5 months, p=0.001). On subset and multivariate analysis, adjuvant {CRT} demonstrated a significant survival advantage only among patients who had lymph node ({LN})-positive disease (hazard ratio 0.477, 95\% {CI} 0.357 to 0.638) and not for {LN}-negative patients (hazard ratio 0.810, 95\% {CI} 0.556 to 1.181). Disease-free survival in patients with {LN}-negative disease who received adjuvant {CRT} was significantly worse than in patients who had surgery alone (14.5 months versus 18.6 months, p=0.034).
{CONCLUSIONS}: This large multiinstitutional study emphasizes the importance of analyzing subsets of patients with pancreas adenocarcinoma who have {LN} metastasis. Benefit of adjuvant {CRT} is seen only in patients with {LN}-positive disease, regardless of resection margin status. {CRT} in patients with {LN}-negative disease may contribute to reduced disease-free survival.},
	pages = {829--838; discussion 838--841},
	number = {5},
	journaltitle = {Journal of the American College of Surgeons},
	shortjournal = {J. Am. Coll. Surg.},
	author = {Merchant, Nipun B. and Rymer, Jennifer and Koehler, Elizabeth A. S. and Ayers, G. Daniel and Castellanos, Jason and Kooby, David A. and Weber, Sharon H. and Cho, Clifford S. and Schmidt, C. Max and Nakeeb, Atilla and Matos, Jesus M. and Scoggins, Charles R. and Martin, Robert C. G. and Kim, Hong Jin and Ahmad, Syed A. and Chu, Carrie K. and {McClaine}, Rebecca and Bednarski, Brian K. and Staley, Charles A. and Sharp, Kenneth and Parikh, Alexander A.},
	date = {2009-05},
	pmid = {19476845},
	pmcid = {PMC4167601},
	keywords = {Adenocarcinoma, Aged, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Pancreatic Neoplasms, Proportional Hazards Models, Radiotherapy, Adjuvant, Survival Analysis}
}

@article{braga_prognostic_2011,
	title = {A prognostic score to predict major complications after pancreaticoduodenectomy},
	volume = {254},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/22042466},
	abstract = {To develop and validate a simple prognostic score to predict major postoperative complications after pancreaticoduodenectomy ({PD}).},
	pages = {702--7; discussion 707--8},
	number = {5},
	journaltitle = {Ann Surg},
	author = {Braga, Marco and Capretti, Giovanni and Pecorelli, Nicolò and Balzano, Gianpaolo and Doglioni, Claudio and Ariotti, Riccardo and Di Carlo, Valerio},
	date = {2011-11},
	file = {Braga et al. - 2011 - A prognostic score to predict major complications .pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\DFVUQP8I\\Braga et al. - 2011 - A prognostic score to predict major complications .pdf:application/pdf}
}

@article{tanaka_accumulation_2009,
	title = {Accumulation of Excess Visceral Fat Is a Risk Factor for Pancreatic Fistula Formation After Total Gastrectomy},
	volume = {16},
	issn = {1068-9265, 1534-4681},
	url = {http://www.springerlink.com/index/10.1245/s10434-009-0391-y},
	doi = {10.1245/s10434-009-0391-y},
	pages = {1520--1525},
	number = {6},
	journaltitle = {Annals of Surgical Oncology},
	author = {Tanaka, Koji and Miyashiro, Isao and Yano, Masahiko and Kishi, Kentaro and Motoori, Masaaki and Seki, Yousuke and Noura, Shingo and Ohue, Masayuki and Yamada, Terumasa and Ohigashi, Hiroaki and Ishikawa, Osamu},
	urldate = {2015-04-28},
	date = {2009-06},
	langid = {english},
	file = {Tanaka et al. - 2009 - Accumulation of Excess Visceral Fat Is a Risk Fact.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\VDDR4P39\\Tanaka et al. - 2009 - Accumulation of Excess Visceral Fat Is a Risk Fact.pdf:application/pdf}
}

@article{mcmillan_propanil-induced_1990,
	title = {Propanil-induced methemoglobinemia and hemoglobin binding in the rat.},
	volume = {105},
	abstract = {Administration of [ring-U-14C]propanil (3,4-dichloropropionanilide) to male Sprague-Dawley rats (30, 100, and 300 mg/kg, ip) increased the formation of methemoglobin at the two highest doses. Following a propanil dose of 100 mg/kg, methemoglobin formation attained a maximum level of 5\% by 1.5 hr and declined to  normal levels (approximately 2.5\%) by 12 hr. Hemoglobin binding attained a maximum level of 50 pmol/mg protein by 12 hr, and remained constant for 24 hr. Following a propanil dose of 300 mg/kg, methemoglobin formation attained a maximum level of 24\% by 4.5 hr, and declined to a level of 5\% by 24 hr. Hemoglobin binding attained a maximum level of 425 pmol/mg protein by 12 hr, and  remained constant for 24 hr. Hemoglobin binding was also detected at the lowest propanil dose (10 pmol/mg protein) even though methemoglobin formation was not observed. {HPLC} analysis of alkaline-treated hemoglobin from propanil-treated rats indicated the presence of one radiolabeled compound with the same {HPLC} retention  time as 3,4-dichloraniline. These data are consistent with the concept that propanil is converted to N-hydroxy-3,4-dichloroaniline in the liver. Subsequently, this metabolite enters the erythrocyte and is oxidized by hemoglobin to 3,4-dichloronitrosobenzene with concomitant conversion of oxyhemoglobin to methemoglobin. The 3,4-dichloronitrosobenzene binds to cysteine  residues on hemoglobin as the corresponding sulfinic acid amide adduct. These data suggest that human exposure to propanil may be monitored in the absence of observable toxicity by the analysis of propanil metabolites bound to hemoglobin.},
	pages = {503--507},
	number = {3},
	journaltitle = {Toxicology and applied pharmacology},
	shortjournal = {Toxicol Appl Pharmacol},
	author = {{McMillan}, D. C. and {McRae}, T. A. and Hinson, J. A.},
	date = {1990-09-15},
	pmid = {2237922},
	keywords = {Animals, Carbon Radioisotopes/diagnostic use, Hemoglobins/*metabolism, Male, Methemoglobin/biosynthesis, Methemoglobinemia/*chemically induced/metabolism, Propanil/metabolism/*toxicity, Protein Binding, Rats, Rats, Inbred Strains, Time Factors}
}

@article{tajima_anatomy-specific_2009,
	title = {Anatomy-specific pancreatic stump management to reduce the risk of pancreatic fistula after pancreatic head resection},
	volume = {33},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/19657576},
	abstract = {The anatomical status of the pancreatic remnant after a pancreatic head resection varies greatly among patients. The aim of the present study was to improve management of the pancreatic remnant for reducing pancreatic fistula after pancreatic head resection.},
	pages = {2166--76},
	number = {10},
	journaltitle = {World J Surg},
	author = {Tajima, Yoshitsugu and Kuroki, Tamotsu and Tsuneoka, Noritsugu and Adachi, Tomohiko and Kosaka, Taiichiro and Okamoto, Tatsuya and Takatsuki, Mitsuhisa and Eguchi, Susumu and Kanematsu, Takashi},
	date = {2009-10}
}

@article{mcmillan_albumin_2001,
	title = {Albumin Concentrations Are Primarily Determined by the Body Cell Mass and the Systemic Inflammatory Response in Cancer Patients With Weight Loss},
	volume = {39},
	issn = {0163-5581},
	url = {http://dx.doi.org/10.1207/S15327914nc392_8},
	doi = {10.1207/S15327914nc392_8},
	abstract = {The association between hypoalbuminemia and poor prognosis in patients with cancer is well recognized. However, the factors that contribute to the fall in albumin concentrations are not well understood. In the present study, we examined the relationship between circulating albumin concentrations, weight loss, the body cell mass (measured using total body potassium), and the presence of an inflammatory response (measured using C-reactive protein) in male patients (n = 40) with advanced lung or gastrointestinal cancer. Albumin concentrations were significantly correlated with the percent ideal body weight (r = 0.390, p {\textless} 0.05), extent of reported weight loss (r = -0.492, p {\textless} 0.01), percent predicted total body potassium (adjusted for age, height, and weight, r = 0.686, p {\textless}0.001), and log10 C-reactive protein concentrations (r = -0.545, p {\textless} 0.001). On multiple regression analysis, the percent predicted total body potassium and log10C-reactive protein concentrations accounted for 63\% of the variation in albumin concentrations (r2 = 0.626, p {\textless} 0.001). The interrelationship between albumin, body cell mass, and the inflammatory response is consistent with the concept that the presence of an ongoing inflammatory response contributes to the progressive loss of these vital protein components of the body and the subsequent death of patients with advanced cancer.},
	pages = {210--213},
	number = {2},
	journaltitle = {Nutrition and Cancer},
	author = {{McMillan}, Donald C. and Watson, Walter S. and O'Gorman, Patricia and Preston, Tom and Scott, Hazel R. and {McArdle}, Colin S.},
	urldate = {2015-08-21},
	date = {2001-03-01},
	pmid = {11759282},
	keywords = {*Weight Loss, Aged, Colonic Neoplasms/blood/complications, C-Reactive Protein/analysis, Esophageal Neoplasms/blood/complications, Humans, Inflammation/*complications, Lung Neoplasms/blood/complications, Male, Middle Aged, Neoplasm Metastasis, Neoplasms/*blood/*complications, Pancreatic Neoplasms/blood/complications, Potassium/*analysis, Prognosis, Regression Analysis, Serum Albumin/*analysis/deficiency, Stomach Neoplasms/blood/complications},
	file = {McMillan et al. - 2001 - Albumin Concentrations Are Primarily Determined by.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\BXMW398H\\McMillan et al. - 2001 - Albumin Concentrations Are Primarily Determined by.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\SW5QIJ9X\\S15327914nc392_8.html:text/html}
}

@article{rios_trends_1999,
	title = {Trends in indications and outcomes in the Whipple procedure over a 40-year period},
	volume = {65},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/10484097},
	abstract = {There have been increasing changes in the role of pancreatoduodenectomy ({PD}) in the management of benign and malignant pancreatic disease. The aim of this paper was to compare the current role of {PD} with that of our earlier experience. The records of patients undergoing {PD} at our institution between 1983 and 1996 (Group A) were reviewed and compared with cases between 1956 and 1982 (Group B). Student's t test was used to analyze differences between groups. A total of 153 {PDs} were performed with 98 (64\%) in Group A (88\% of these in the last 6 years) and 55 (36\%) in Group B. Carcinoma of the head of the pancreas was the most common indication for surgery in both periods (43\% and 47\% for Groups A and B, respectively). In Group A, the next most common indication was chronic pancreatitis, accounting for 28 per cent versus 13 per cent in Group B. Carcinoma of ampulla of Vater was also a common indication, making up 21 per cent of the cases in Group A and 20 per cent in Group B. Preoperative biliary drainage was performed in 62 per cent of Group A and 3 per cent of Group B patients (P {\textless} 0.001). Postoperative complications were comparable in both groups: delayed gastric emptying (22\%), wound infection (17\%), pancreatic fistula (13\%), gastrointestinal bleeding (8\%), and intestinal obstruction (3\%). The perioperative mortality rate was significantly different between the two groups: 1 per cent in Group A versus 16 per cent in Group B (P {\textless} 0.001). Mean postoperative length of stay was 17 days in Group A (22 days for benign disease) and 25 days for Group B (P {\textless} 0.01). In the last 40 years, there has been a rise in the use of {PD} for chronic pancreatitis and a significant decrease in postoperative mortality and hospital length of stay. These data support the safety of {PD} in the management of patients with both benign and malignant periampullary disease.},
	pages = {889--93},
	number = {9},
	journaltitle = {Am Surg},
	author = {Rios, G and Conrad, A and Cole, D and Adams, D and Leveen, M and O'Brien, P and Baron, P},
	date = {1999-09}
}

@article{catheline_preoperative_2008,
	title = {Preoperative cardiac and pulmonary assessment in bariatric surgery},
	volume = {18},
	issn = {0960-8923},
	doi = {10.1007/s11695-007-9329-2},
	abstract = {{BACKGROUND}: Morbidly obese patients have a high prevalence of known and unknown cardiopulmonary diseases. The aim of this study was to assess the value of cardiopulmonary tests routinely performed before bariatric surgery.
{METHODS}: The population studied included 67 women and 10 men, aged 39 +/- 10 years, with a body mass index of 43 +/- 4 kg/m2. All patients, candidates for laparoscopic gastric banding, underwent after clinical evaluation: resting electrocardiography ({ECG}), Doppler-echocardiography, exercise stress testing, Epworth Sleepness Scale, and polysomnography, spirometry, blood gases, and chest x-ray.
{RESULTS}: The {ECG} demonstrated conduction or {ST}-T wave abnormalities in 48 patients (62\%). Prolongation of the {QT} interval {\textgreater}10\% was found in 13 patients (17\%). Stress tests were negative in 56 patients (73\%) and were not interpretable in the remaining 21 patients (27\%). Doppler-echocardiography showed hypertrophy of the left ventricular posterior wall in 47 patients (61\%) without any consequences on perioperative management. Polysomnography showed an obstructive sleep apnea-hypopnea syndrome ({OSAHS}) in 31 patients (40\%), leading to preoperative continuous positive airway pressure ({CPAP}) treatment in 17 patients (22\%). Nevertheless, the Epworth Sleepness Scale was pathological in only 17 patients (22\%). Ten patients (13\%) presented minor chest x-ray alterations. Spirometry demonstrated an obstructive respiratory syndrome in 13 patients (17\%) and a restrictive syndrome in five patients (6\%). Hypoxemia {\textless}80 {mmHg} was observed in 21 patients (27\%) and hypercapnia {\textgreater}45 {mmHg} in six patients (8\%), without any consequences on the management of the perioperative period.
{CONCLUSION}: We recommend the preoperative assessment by clinical evaluation, {ECG}, and polysomnography. For patients with cardiac or pulmonary histories and/or {ECG} abnormalities, we recommend echocardiography, spirometry, and blood gases.},
	pages = {271--277},
	number = {3},
	journaltitle = {Obesity Surgery},
	shortjournal = {Obes Surg},
	author = {Catheline, Jean-Marc and Bihan, Hélène and Le Quang, Toan and Sadoun, Danièle and Charniot, Jean-Christophe and Onnen, Igor and Fournier, Jean-Luc and Bénichou, Joseph and Cohen, Régis},
	date = {2008-03},
	pmid = {18204992},
	keywords = {Adult, Blood Gas Analysis, Diagnostic Tests, Routine, echocardiography, Electrocardiography, Female, Gastroplasty, Heart Function Tests, Humans, Laparoscopy, Male, Middle Aged, Obesity, Morbid, Polysomnography, Radiography, Thoracic, Respiratory Function Tests}
}

@article{byers_impact_2008,
	title = {The impact of socioeconomic status on survival after cancer in the United States},
	volume = {113},
	rights = {Copyright © 2008 American Cancer Society},
	issn = {1097-0142},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/cncr.23567/abstract},
	doi = {10.1002/cncr.23567},
	abstract = {{BACKGROUND}.

Understanding the ways in which socioeconomic status ({SES}) affects mortality is important for defining strategies to eliminate the unequal burden of cancer by race and ethnicity in the United States.


{METHODS}.

Disease stage, treatment, and 5-year mortality rates were ascertained by reviewing medical records, and {SES} was determined by analyzing income and education at the census tract level for 4844 women with breast cancer, 4332 men with prostate cancer, and 4422 men and women with colorectal cancer who were diagnosed in 7 U.S. states in 1997.


{RESULTS}.

Low {SES} was associated with more advanced disease stage and with less aggressive treatment for all 3 cancers. The hazard ratio ({HR}) for 5-year all-cause mortality associated with low {SES} was elevated after a diagnosis of breast cancer when the analysis was adjusted for age ({HR}, 1.59; 95\% confidence interval [{CI}], 1.35-1.87). Adjustment for mediating factors of race/ethnicity, comorbid conditions, cancer stage, and treatment reduced the association. The age-adjusted mortality risk associated with low {SES} was elevated after a diagnosis of prostate cancer ({HR}, 1.33; 95\% {CI}, 1.13-1.57), and multivariate adjustments for mediating factors also reduced that association. There was less association between {SES} and mortality after a diagnosis of colorectal cancer. For all 3 cancer sites, low {SES} was a much stronger predictor of mortality among individuals aged {\textless}65 years and among individuals from racial/ethnic minority groups.


{CONCLUSIONS}.

The current results indicated that low {SES} is a risk factor for all-cause mortality after a diagnosis of cancer, largely because of a later stage at diagnosis and less aggressive treatment. These findings support the need to focus on {SES} as an underlying factor in cancer disparities by race and ethnicity. Cancer 2008. © 2008 American Cancer Society.},
	pages = {582--591},
	number = {3},
	journaltitle = {Cancer},
	shortjournal = {Cancer},
	author = {Byers, Tim E. and Wolf, Holly J. and Bauer, Katrina R. and Bolick-Aldrich, Susan and Chen, Vivien W. and Finch, Jack L. and Fulton, John P. and Schymura, Maria J. and Shen, Tiefu and Van Heest, Scott and Yin, Xiang},
	urldate = {2015-05-26},
	date = {2008-08-01},
	langid = {english},
	keywords = {cancer, mortality, poverty, race, socioeconomic status},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\AB82RCX2\\Byers et al. - 2008 - The impact of socioeconomic status on survival aft.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\93GPIDMG\\abstract.html:text/html}
}

@article{hilmy_relationship_2005,
	title = {The relationship between the systemic inflammatory response and survival in patients with transitional cell carcinoma of the urinary bladder.},
	volume = {92},
	doi = {10.1038/sj.bjc.6602406},
	abstract = {The relationship between tumour stage, grade, elevated C-reactive protein concentration ({\textless}10/{\textgreater}10 mg l(-1)), adjuvant therapy and survival was examined in patients with biopsy proven bladder cancer (n=105). On multivariate analysis stage ({HR} 3.37, 95\% {CI} 1.37-8.29, P=0.008), grade ({HR} 2.01, 95\% {CI} 1.14-3.57, P=0.017) and preoperative C-reactive protein ({HR} 3.31, 95\% {CI} 1.09-10.09, P=0.035) were independently associated with cancer-specific survival.},
	pages = {625--627},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Hilmy, M. and Bartlett, J. M. S. and Underwood, M. A. and {McMillan}, D. C.},
	date = {2005-02-28},
	pmid = {15726119},
	pmcid = {PMC2361870},
	keywords = {Aged, Analysis of Variance, Carcinoma, Transitional Cell/blood/*complications/*mortality/pathology/therapy, Confidence Intervals, C-Reactive Protein/metabolism, Disease-Free Survival, Female, Humans, Male, Middle Aged, Odds Ratio, Survival Analysis, Systemic Inflammatory Response Syndrome/blood/*complications/*mortality, Urinary Bladder Neoplasms/blood/*complications/*mortality/pathology/therapy}
}

@article{mcsorley_postoperative_2015,
	title = {Postoperative C-reactive protein measurement predicts the severity of complications following surgery for colorectal cancer.},
	doi = {10.1007/s00384-015-2229-3},
	abstract = {{PURPOSE}: Studies have shown that postoperative serum C-reactive protein ({CRP}) measurement may be useful in predicting the type of complication, infective or otherwise, following surgery for colorectal cancer. It may be that the magnitude  of the postoperative {CRP} is also associated with the severity of the complication. The aim of the present study was to examine the relationship between daily postoperative {CRP} concentrations and Clavien-Dindo complication grade. {PATIENTS} {AND} {METHODS}: Data was recorded prospectively for patients undergoing elective, potentially curative, surgery for colorectal cancer in two hospitals between January 2011 and January 2013, n = 241. All patients had daily  {CRP} measurement following surgery for the first four postoperative days. Complications were retrospectively classified by Clavien-Dindo grade. {RESULTS}: Of the 241 patients, the majority were male (59 \%) and were over 65 years old (69 \%). The majority had colonic (86 \%) and node negative (65 \%) disease. One hundred nineteen patients (49 \%) developed a complication, and 28 (12 \%) of these were Clavien-Dindo grade 3, 4 or 5. Median and established threshold {CRP} concentrations on postoperative days 2 ({\textgreater}190 mg/L), 3 ({\textgreater}170 mg/L) and 4 ({\textgreater}125 mg/L) were directly associated with an increase in the Clavien-Dindo grade (all p {\textless} 0.001). {CONCLUSION}: There was a direct association between exceeding established postoperative day 2, 3 and 4 {CRP} thresholds and the severity of complications defined by the Clavien-Dindo grade.},
	journaltitle = {International journal of colorectal disease},
	shortjournal = {Int J Colorectal Dis},
	author = {{McSorley}, Stephen T. and Ramanathan, Michelle L. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2015-04-29},
	pmid = {25922147}
}

@article{aloia_delayed_2007,
	title = {Delayed recovery after pancreaticoduodenectomy: a major factor impairing the delivery of adjuvant therapy?},
	volume = {204},
	issn = {1072-7515},
	doi = {10.1016/j.jamcollsurg.2006.12.011},
	shorttitle = {Delayed recovery after pancreaticoduodenectomy},
	abstract = {{BACKGROUND}: Delayed recovery after pancreaticoduodenectomy ({PD}) is believed to preclude adjuvant therapy for approximately 30\% of patients who undergo elective {PD} as initial treatment for pancreatic adenocarcinoma. This study reexamined the frequency of delayed recovery and assessed other factors associated with adjuvant therapy administration after {PD} at a high-volume center.
{STUDY} {DESIGN}: Preoperative and perioperative variables were reviewed in a consecutive series of 85 patients with pancreatic adenocarcinoma undergoing {PD} without preoperative chemotherapy or radiotherapy from 1990 to 2004.
{RESULTS}: Study groups included patients undergoing emergency {PD} (group 1, n=13); elective {PD} with good preoperative Eastern Cooperative Oncology Group ({ECOG}) performance status ({PS}) (group 2, {ECOG} {PS}: 0 to 1, n=63); and elective {PD} with marginal preoperative {PS} (group 3, {ECOG} {PS}: 2 to 3, n=9). Delayed recovery of {PS} precluded adjuvant therapy in 23\% of patients in group 1, 6\% of patients in group 2, and 44\% of patients in group 3 (p=0.0001).
{CONCLUSIONS}: The impact of delayed recovery after {PD} on the delivery of adjuvant therapy depends on the urgency of surgery and the preoperative {PS}. For patients with good preoperative {PS} who undergo elective {PD} at a high-volume center, it is uncommon for delayed recovery to preclude delivery of adjuvant therapy.},
	pages = {347--355},
	number = {3},
	journaltitle = {Journal of the American College of Surgeons},
	shortjournal = {J. Am. Coll. Surg.},
	author = {Aloia, Thomas A. and Aloia, Thomas E. and Lee, Jeffrey E. and Vauthey, Jean-Nicolas and Abdalla, Eddie K. and Wolff, Robert A. and Varadhachary, Gauri R. and Abbruzzese, James L. and Crane, Christopher H. and Evans, Douglas B. and Pisters, Peter W. T.},
	date = {2007-03},
	pmid = {17324767},
	keywords = {Adenocarcinoma, adjuvant therapy, Adolescent, Adult, Aged, Antineoplastic Agents, {AT}, Chemotherapy, Adjuvant, Eastern Cooperative Oncology Group, {ECOG}, Elective Surgical Procedures, Female, Follow-Up Studies, Humans, length of stay, Male, Middle Aged, Pancreatic Neoplasms, Pancreaticoduodenectomy, {PD}, performance status, Prospective Studies, {PS}, Radiotherapy, Adjuvant, Risk Factors, Time Factors, Treatment Outcome},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\PVZTE59A\\abstract.html:text/html}
}

@article{lorenzo_increased_2012,
	title = {Increased Preoperative C-Reactive Protein Levels Are Associated with Inhospital Death After Coronary Artery Bypass Surgery},
	volume = {35},
	issn = {0360-3997, 1573-2576},
	url = {http://link.springer.com/article/10.1007/s10753-011-9426-1},
	doi = {10.1007/s10753-011-9426-1},
	abstract = {Increased C-reactive protein ({CRP}) is a predictor of cardiovascular risk, but its influence on outcomes after coronary artery bypass grafting surgery ({CABG}) is still incompletely studied. We studied the association between preoperative {CRP} and inhospital death after {CABG}. Patients with acute or chronic infectious or inflammatory disorders, autoimmune diseases, cancer, and prior cardiac surgery were excluded. Seventy-six patients were studied [27.6\% with elevated {CRP} ({\textgreater}3 mg/l)]. Elevated {CRP} was more frequently found in patients who died than in those who survived (83.3\% vs 17.1\%, p = 0.003); mean {CRP} levels were, respectively, 6.5 ± 3.4 vs 2.4 ± 3.5 mg/l (p = 0.03). The hazard ratio of death was 11.7 for elevated {CRP}, and the {ROC} curve for the discrimination of death with {CRP} had an area under the curve of 0.82. An improvement to mortality risk prediction following {CABG} may be offered by the preoperative analysis of {CRP}.},
	pages = {1179--1183},
	number = {3},
	journaltitle = {Inflammation},
	shortjournal = {Inflammation},
	author = {Lorenzo, Andrea De and Pittella, Felipe and Rocha, Antonio},
	urldate = {2015-08-20},
	date = {2012-01-10},
	langid = {english},
	keywords = {coronary artery bypass surgery, coronary artery disease, C-Reactive Protein, Internal Medicine, Pathology, Pharmacology/Toxicology, Rheumatology},
	file = {Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J6UT3N25\\10.html:text/html}
}

@article{mustafa_energy-dependent_1967,
	title = {On the energy-dependent bilirubin-induced mitochondrial swelling},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/6077803},
	pages = {661--6},
	number = {5},
	journaltitle = {Biochem Biophys Res Commun},
	author = {Mustafa, M G and Cowger, M L and King, T E},
	date = {1967-12}
}

@article{kos_evaluation_2014,
	title = {Evaluation of the effect of comorbidity on survival in pancreatic cancer by using "Charlson Comorbidity Index" and "Cumulative Illness Rating Scale"},
	volume = {126},
	issn = {1613-7671},
	doi = {10.1007/s00508-013-0453-9},
	abstract = {{BACKGROUND}: Effect of comorbidity on the treatments that patients receive is not clear, as healthy elderly patients and the elderly with less comorbid diseases are included in the studies. In the present study, the effect of comorbidity on the survival was evaluated using Charlson Comorbidity Index ({CCI}) and Cumulative Illness Rating Scale ({CIRS}).
{MATERIAL} {AND} {METHOD}: The general features and comorbid diseases of the pancreatic cancer patients were retrospectively screened from the patient files using the automated system. {CCI} and {CIRS} were used as the comorbidity indices.
{RESULTS}: A total of 106 patients with pancreatic cancer were included in the study. The median overall survival rate was 9.0 [95 \% confidence interval ({CI}): 6.7-11.3] months. The median overall survival rate was found as 9.4 (95 \% {CI}: 6.7-12.1) months in the patients whose {CCI} score was ≤ 2 and was found as 6.2 (95 \% {CI}: 4.0-8.3) months in the patients with {CCI} scores ≥ 3 (p = 0.05). The median overall survival rate was calculated as 9.8 (95 \% {CI}: 6.3-13.4) months in the patients with {CIRS} scores ≤ 2 and was calculated as 8.3 (95 \% {CI}: 6.0-10.6) months in the patients with {CIRS} scores ≥ 3 (p = 0.51). When surgery, radiotherapy, grading, and {CCI} score were evaluated using multivariate analysis, it was observed that only the treatment modality had a significant effect on the survival rate.
{CONCLUSION}: The results on the use of comorbidity indices are contradictory for the cancers with lower survival rates such as pancreatic cancer. New prognostic scales might be developed for this patient group by considering the side effects of chemotherapy.},
	pages = {36--41},
	number = {1},
	journaltitle = {Wiener Klinische Wochenschrift},
	shortjournal = {Wien. Klin. Wochenschr.},
	author = {Kos, F. Tugba and Yazici, Ozan and Civelek, Burak and Seker, Metin and Arik, Zafer and Aksoy, Sercan and Uncu, Dogan and Ozdemir, Nuriye and Zengin, Nurullah},
	date = {2014-01},
	pmid = {24249323},
	keywords = {Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Comorbidity, Diabetes Complications, Digestive System Diseases, Humans, Incidence, Middle Aged, Neoplasms, Multiple Primary, Pancreatic Neoplasms, prognosis, Proportional Hazards Models, Retrospective Studies, Risk assessment, Severity of Illness Index, Survival, Turkey}
}

@article{dunne_pmo-029_2012,
	title = {{PMO}-029 Prehabilitation program for liver surgery},
	volume = {61},
	issn = {, 1468-3288},
	url = {http://gut.bmj.com/content/61/Suppl_2/A85.1},
	doi = {10.1136/gutjnl-2012-302514b.29},
	abstract = {Introduction Rehabilitation exercise programs improve recovery from surgery and quality of life. Prehabilitation improves fitness prior to surgery. This is challenging before liver resection as patients tend to be sedentary and time is limited. Our aim was to design a 4 week program, suitable for sedentary individuals, which would yield a 1.5 ml/kg/min increase (10\%) in the relative {VO}2 uptake at the anaerobic threshold ({AT}), as measured by a cardiopulmonary exercise test ({CPET}).
Methods Interval based exercise program of 12 sessions on a stationary bike. Each session 40 min long consisting of six intervals, warm up and cool down. The interval intensities were calculated using anaerobic threshold detected by initial {CPET}. {AT} is independent of volition and can be detected with reliability in most patients. This represents a measure for designing exercise programs for patients. Eleven healthy volunteers completed the exercise program.
Results The 11 volunteers had a mean age of 46 years (range 38–60). They consisted of two men nine women. Mean {BMI} 30.7 (range 25.5–39.2), two smokers, nine non-smokers, no significant comorbidities. 96\% attendance with 9/11 volunteers achieving 100\% attendance. Mean relative {VO}2 at {AT} was 12.4 ml/kg/min pre exercise program and 14.0 ml/kg/min post exercise program, a 12\% improvement (p{\textless}0.001). Mean resting O2 uptake decreased by 28\% (p-0.014). There was a trend to lower resting O2 pulse rate. At {AT} significant differences were achieved in mean O2 pulse (+11.6\%), and power (25.7\%) p{\textless}0.001. Peak values also improved with mean peak O2 pulse climbing by 10.7\% (p-0.001), and mean peak power by 14.7\% (p-0.006).
Conclusion This is the first 4 week exercise program designed for patients prior to liver resection and the only 4 week exercise program based round {AT}. It is feasible in sedentary healthy volunteers and achieves a {\textgreater}10\% fitness improvement. An {RCT} is underway assessing this program's feasibility in patients prior to liver resection. Using our {CPET} risk stratification protocol a 10\% fitness improvement in these patients would move 30\% of our patients from high to low operative risk.
Competing interests None declared.},
	pages = {A85--A85},
	issue = {Suppl 2},
	journaltitle = {Gut},
	shortjournal = {Gut},
	author = {Dunne, D. and Jones, R. and Malik, H. and Poston, G. and Palmer, D. and Jack, S. and Fenwick, S.},
	urldate = {2015-08-09},
	date = {2012-07-01},
	langid = {english},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\EQDQ7GE5\\Dunne et al. - 2012 - PMO-029 Prehabilitation program for liver surgery.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\MEWPAR5Z\\A85.html:text/html}
}

@article{gilsdorf_factors_1973,
	title = {Factors influencing morbidity and mortality in pancreaticoduodenectomy.},
	volume = {177},
	issn = {0003-4932},
	url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1355536/},
	pages = {332--337},
	number = {3},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann Surg},
	author = {Gilsdorf, R B and Spanos, P},
	urldate = {2015-08-08},
	date = {1973-03},
	pmid = {4540286},
	pmcid = {PMC1355536},
	file = {PubMed Central Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\NMCI2RQP\\Gilsdorf and Spanos - 1973 - Factors influencing morbidity and mortality in pan.pdf:application/pdf}
}

@article{watt_neutrophil_2015,
	title = {Neutrophil count is the most important prognostic component of the differential white cell count in patients undergoing elective surgery for colorectal cancer.},
	rights = {Copyright (c) 2015 Elsevier Inc. All rights reserved.},
	doi = {10.1016/j.amjsurg.2014.12.031},
	abstract = {{BACKGROUND}: Systemic inflammatory scoring systems such as the {NLR} have been reported to have prognostic value in many solid organ cancers. The aim of this study was to examine the relationships between the components of the white cell count ({WCC}) and survival in patients undergoing elective surgery for colorectal cancer. {METHODS}: Patients undergoing elective resection at a single center (1997  to 2008) were identified from a prospective database (n = 508). Patient demographics and preoperative laboratory measurements including the differential  {WCC} and their association with cancer-specific survival ({CSS}) and overall survival were examined. {RESULTS}: There were 172 cancer deaths and 120 noncancer deaths. On Kaplan-Meier analysis of the whole cohort, age, Tumor, Nodal, and Metastasis stage, venous invasion, margin involvement, peritoneal involvement and tumor perforation, and white cell and neutrophil count (all P {\textless} .05) were associated with {CSS}. In those with node-negative colon cancer (n = 226), on multivariate analysis, age, venous invasion, modified Glasgow Prognostic Score, and neutrophil count (all P {\textless} .05) were independently associated with {CSS}. {CONCLUSION}: Of the components of a differential {WCC}, only the neutrophil count was independently associated with survival, particularly in node-negative colon cancer.},
	journaltitle = {American journal of surgery},
	shortjournal = {Am J Surg},
	author = {Watt, David G. and Martin, John C. and Park, James H. and Horgan, Paul G. and {McMillan}, Donald C.},
	date = {2015-03-12},
	pmid = {25842358}
}

@article{van_baal_systematic_2011,
	title = {Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis},
	volume = {98},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/21136562},
	abstract = {The role of percutaneous catheter drainage ({PCD}) in patients with (infected) necrotizing pancreatitis was evaluated.},
	pages = {18--27},
	number = {1},
	journaltitle = {Br J Surg},
	author = {van Baal, M C and van Santvoort, H C and Bollen, T L and Bakker, O J and Besselink, M G and Gooszen, H G},
	date = {2011-01}
}

@article{mathur_increasing_2015,
	title = {Increasing body mass index portends abbreviated survival following pancreatoduodenectomy for pancreatic adenocarcinoma},
	volume = {209},
	issn = {1879-1883},
	doi = {10.1016/j.amjsurg.2014.12.037},
	abstract = {{BACKGROUND}: Body mass index ({BMI}), a common surrogate marker for grading obesity, does not differentiate between metabolically active visceral fat and the relatively inert subcutaneous fat. We aim to determine the utility of {BMI} as a prognostic marker for the impact of obesity on outcomes and survival following pancreatoduodenectomy for pancreatic adenocarcinoma.
{METHODS}: From a database of over 1,000 patients who had undergone pancreatoduodenectomy, 228 patients with a diagnosis of pancreatic adenocarcinoma were identified. Demographic data including {BMI} and perioperative parameters-operative time, estimated blood loss, length of stay, survival, nodal status, and American Joint Committee on Cancer stage-were obtained. Data are presented as median.
{RESULTS}: One hundred ninety-two patients had a {BMI} less than or equal to 29 and 36 patients had a {BMI} greater than or equal to 30 (24 vs. 34, P {\textless} .001). Median age was 70 and the majority of the patients (52\%) were male and the 2 groups of patients did not differ in this regard. A significantly greater number of obese patients had positive nodes (69\% vs. 62\%, P {\textless} .05) and this was associated with a worse survival (14 vs. 18 months, P {\textless} .05).
{CONCLUSIONS}: For patients with pancreatic adenocarcinoma undergoing pancreatoduodenectomy, obesity does not impact operative complexity or length of stay but results in a shortened survival. Therefore, we conclude that {BMI} is an important prognostic marker that portends an abbreviated survival following pancreatoduodenectomy for pancreatic adenocarcinoma.},
	pages = {969--973},
	number = {6},
	journaltitle = {American Journal of Surgery},
	shortjournal = {Am. J. Surg.},
	author = {Mathur, Abhishek and Luberice, Kenneth and Paul, Harold and Franka, Co and Rosemurgy, Alexander},
	date = {2015-06},
	pmid = {25916614},
	keywords = {Adenocarcinoma, Adult, Aged, Body Mass Index, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Obesity, Pancreatic Neoplasms, Pancreaticoduodenectomy, Risk Factors, Treatment Outcome}
}

@article{sano_changing_2007,
	title = {Changing trends in surgical outcomes after major hepatobiliary resection for hilar cholangiocarcinoma: a single-center experience over 25 years},
	volume = {14},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/17909713},
	abstract = {{BACKGROUND}/{PURPOSE}: Hepatobiliary resection ({HBR}) for hilar cholangiocarcinoma ({HCCa}) remains a technically demanding procedure and is still associated with significant rates of morbidity and mortality. The aim of this study was to characterize changes in surgical outcomes following major {HBR} for {HCCa} at a single center over a 25-year period. {METHODS}: Between 1980 and 2004, 126 patients undergoing preoperative biliary drainage, portal vein embolization, and major {HBR} were enrolled in this study. The patients were divided into two groups according to the chronological treatment period; i.e., patients who underwent surgery during the initial 20-year period (1980-1999; early group [{EG}]) and those who underwent surgery during the most recent 5-year period (2000-2004; late group [{LG}]). Clinicopathological variables were compared retrospectively between the two groups. {RESULTS}: The mortality rate improved from 7.9\% in the {EG} to 0\% in the {LG}, but this difference did not reach the level of statistical significance (P = 0.058). The overall survival rate at 1, 3, and 5 years was 82.4\%, 43.9\%, and 35.2\%, respectively. The overall survival rate was similar in the two groups (P = 0.153). Morbidity was documented in 57.1\% of all the patients, and was comparable in the two groups (P = 0.471), but the rate of major morbidity was significantly higher in the {EG} (P = 0.031). Red blood cell and fresh frozen plasma transfusion requirements were significantly reduced in the {LG}, both in regard to the number of patients and the amount of blood product administered. The mean length of postoperative hospital stay was significantly reduced, from 74.4 + -56.3 days in the {EG} to 29.0 + -11.8 days in the {LG} (P {\textless} 0.001). Sixty-nine patients (54.8\%) had stage {III} or {IV} disease (according to the General rules for surgical and pathological studies on cancer of the biliary tract of the Japanese Society of Biliary Surgery), and 55 patients (43.7\%) showed positive surgical margins. There were no differences between the two groups in terms of surgical margins or pathological staging. {CONCLUSIONS}: Improvements were documented in rates of major morbidity, length of hospital stay, and the mortality rate in the {LG} when compared with the {EG}. The overall survival rate was similar in the two groups. Blood transfusion requirements were significantly reduced in the {LG} when compared with the {EG}. However, the high proportion of patients with positive surgical margins remains a significant problem.},
	pages = {455--62},
	number = {5},
	journaltitle = {J Hepatobiliary Pancreat Surg},
	author = {Sano, Tsuyoshi and Shimada, Kazuaki and Sakamoto, Yoshihiro and Esaki, Minoru and Kosuge, Tomoo},
	date = {2007}
}

@article{birkmeyer_relationship_1999,
	title = {Relationship between hospital volume and late survival after pancreaticoduodenectomy},
	volume = {126},
	url = {http://www.sciencedirect.com/science/article/pii/S0039606099701522},
	pages = {178--183},
	number = {2},
	journaltitle = {Surgery},
	author = {Birkmeyer, John D. and Warshaw, Andrew L. and Finlayson, Samuel {RG} and Grove, Margaret R. and Tosteson, Anna {NA}},
	urldate = {2014-01-27},
	date = {1999},
	file = {Birkmeyer et al. - 1999 - Relationship between hospital volume and late surv.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\CHA7E8VB\\Birkmeyer et al. - 1999 - Relationship between hospital volume and late surv.pdf:application/pdf}
}

@article{shack_socioeconomic_2007,
	title = {Socioeconomic inequalities in cancer survival in Scotland 1986-2000},
	volume = {97},
	abstract = {We analysed trends in 5-year survival of the 18 commonest cancers in Scotland diagnosed between 1986 and 2000 and followed up to 2004 in each of five deprivation groups based on patients postcode of residence at diagnosis. We estimated relative survival up to 5 years after diagnosis, adjusting for the different background mortality in each deprivation group by age, sex and calendar period. We estimated trends in overall survival and in the deprivation gap in survival up to 2004. Five-year survival improved for all malignancies except bladder cancer and was associated with a widening in the deprivation gap in survival. For 25 of},
	pages = {999--1004},
	number = {7},
	journaltitle = {British Journal of Cancer},
	author = {Shack, L. G. and Rachet, B. and Brewster, D. H. and Coleman, M. P.},
	date = {2007-10-02},
	note = {{WOS}:000249882000027}
}

@article{artinyan_infectious_2015,
	title = {Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer: a study of 12,075 patients},
	volume = {261},
	issn = {1528-1140},
	doi = {10.1097/SLA.0000000000000854},
	shorttitle = {Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer},
	abstract = {{OBJECTIVE}: We sought to characterize the effect of postoperative complications on long-term survival after colorectal cancer ({CRC}) resection.
{BACKGROUND}: The impact of early morbidity on long-term survival after curative-intent {CRC} surgery remains controversial.
{METHODS}: The Veterans Affairs Surgical Quality Improvement Program and Central Cancer Registry databases were linked to acquire perioperative and cancer-specific data for 12,075 patients undergoing resection for nonmetastatic {CRC} (1999-2009). Patients were categorized by presence of any complication within 30 days and by type of complication (noninfectious vs infectious). Univariate and multivariate survival analyses adjusted for patient, disease, and treatment factors were performed, excluding early deaths ({\textless}90 days). Subset analysis was performed to determine the specific impact of severe postoperative infections.
{RESULTS}: The overall morbidity and infectious complication rates were 27.8\% and 22.5\%, respectively. Patients with noninfectious postoperative complications were older, had lower preoperative serum albumin, had worse functional status, and had higher American Society of Anesthesiologists scores than patients with infectious complications and without complications (all P {\textless} 0.001). The presence of any complication was independently associated with decreased long-term survival [hazard ratio, 1.24; 95\% confidence interval (1.15-1.34)]. Multivariate analysis by complication type demonstrated increased risk only with infectious complications [hazard ratio, 1.31; 95\% confidence interval (1.21-1.42)]. Subset analysis demonstrated this effect predominantly in patients with severe infections [hazard ratio, 1.41; 95\% confidence interval (1.15-1.73)].
{CONCLUSIONS}: The presence of postoperative complications after {CRC} resection is associated with decreased long-term survival, independent of patient, disease, and treatment factors. The impact on long-term outcome is primarily driven by infectious complications, particularly severe postoperative infections.},
	pages = {497--505},
	number = {3},
	journaltitle = {Annals of Surgery},
	shortjournal = {Ann. Surg.},
	author = {Artinyan, Avo and Orcutt, Sonia T. and Anaya, Daniel A. and Richardson, Peter and Chen, G. John and Berger, David H.},
	date = {2015-03},
	pmid = {25185465},
	keywords = {Aged, Colorectal Neoplasms, Female, Hospitals, Veterans, Humans, Infection, Male, Neoplasm Staging, postoperative complications, prognosis, Registries, Risk Factors, Survival Rate}
}

@article{geer_prognostic_1993,
	title = {Prognostic indicators for survival after resection of pancreatic adenocarcinoma},
	volume = {165},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/8380315},
	abstract = {From October 1983 to October 1990, 799 patients with the diagnosis of pancreatic adenocarcinoma were admitted to Memorial Sloan-Kettering Cancer Center, and their records were entered into a prospective database. Curative resection was possible in 146 patients (18\%), with a 30-day operative mortality of 3.4\%. Median follow-up of survivors in the resection group was 28 months. Actuarial 5-year survival in patients who did not undergo resection was 0\% (n = 653), compared with 24\% in the patients who had resection (p {\textless} 0.00001). Of 52 patients available for 5-year follow-up, 10 (19\%) were alive at 5 years. Tumors with lymph node involvement, poor histologic tumor differentiation, and tumor size greater than 2.5 cm were predictors of a significantly worse survival in both univariate and multivariate analysis. Other factors, including blood transfusion, blood loss, and operative time, had no significant effect on survival. The majority of patients with pancreatic adenocarcinoma have unresectable disease with a poor prognosis. For patients who undergo curative resection, their prognosis appears to be determined by the biology of the tumor rather than factors involved in the resection.},
	pages = {68--72; discussion 72--3},
	number = {1},
	journaltitle = {Am J Surg},
	author = {Geer, R J and Brennan, M F},
	date = {1993-01},
	note = {Cited 474},
	file = {Geer and Brennan - 1993 - Prognostic indicators for survival after resection.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\6KR744FN\\Geer and Brennan - 1993 - Prognostic indicators for survival after resection.pdf:application/pdf}
}

@article{read_differential_2004,
	title = {Differential Prognostic Impact of Comorbidity},
	volume = {22},
	issn = {0732-183X, 1527-7755},
	url = {http://jco.ascopubs.org/content/22/15/3099},
	doi = {10.1200/JCO.2004.08.040},
	abstract = {Purpose Cancer patients with concurrent comorbid conditions have worse outcomes than patients with no comorbidities. We hypothesized that the prognostic impact of comorbidities would be greatest for patients with cancers associated with a long natural history and least in patients with aggressive cancers.
Patients and Methods Using the Barnes-Jewish Hospital Oncology Data Services cancer registry, we grouped 11,558 patients with breast, lung, colon, or prostate cancer by morphologic stage at diagnosis and then determined the 1-year overall survival rate for each group. Overall, severity of comorbidity was assessed from chart review and classified into one of four groups: none, mild, moderate, or severe. The relative prognostic impact of comorbidity was measured by the hazard ratio and adjusted for the prognostic impact of age, race, and sex.
Results One-year overall survival rate ranged from 20\% for 1,005 patients with distant spread of lung cancer to 98\% for 3,325 patients with localized prostate cancer. Adjusted hazard ratio of moderate/severe comorbidity (relative to none/mild) ranged from 1.04 to 4.48. The correlation between overall survival rate and severity of comorbidity was statistically significant (r2 = 0.56; P {\textless} .001). The proportion of variance in outcome explained by comorbidity ranged from less than 1\% to almost 9\%, depending on tumor site and stage.
Conclusion Concurrent comorbidities had the greatest prognostic impact among groups with the highest survival rate and the least impact in groups with the lowest survival rate. These findings can be used to help determine the role comorbidity information should play in studies of cancer outcomes.},
	pages = {3099--3103},
	number = {15},
	journaltitle = {Journal of Clinical Oncology},
	shortjournal = {{JCO}},
	author = {Read, William L. and Tierney, Ryan M. and Page, Nathan C. and Costas, Irene and Govindan, Ramaswamy and Spitznagel, Edward L. J. and Piccirillo, Jay F.},
	urldate = {2015-08-22},
	date = {2004-08-01},
	langid = {english},
	pmid = {15284260},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ZK38RSZ7\\Read et al. - 2004 - Differential Prognostic Impact of Comorbidity.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\ARGUH6VE\\3099.html:text/html}
}

@article{joseph_percutaneous_1986,
	title = {Percutaneous transhepatic biliary drainage. Results and complications in 81 patients},
	volume = {255},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/2422404},
	abstract = {Percutaneous transhepatic biliary drainage is usually used for preoperative decompression and for palliation in obstructive jaundice, but little attention has been focused on catheter complications. We retrospectively reviewed our experience with percutaneous transhepatic biliary drainage in 81 consecutive patients. There was a 10.0\% failure rate and an 8.6\% mortality rate. Four patients (4.9\%) required emergency operations for complications and an additional ten patients (12.3\%) required transfusions. The overall sepsis rate was 34.6\%; prophylactic antibiotics decreased the sepsis rate. Thirty-eight patients (47.0\%) required 68 manipulation procedures for catheter malfunctions. No distinguishing characteristics could be found to identify the subgroups having complications or mortalities. The efficacy of preoperative percutaneous transhepatic biliary drainage has not been proved, and the indications for palliation are not clearly defined. Further trials are needed to define the role of percutaneous transhepatic biliary drainage in patients with obstructive jaundice.},
	pages = {2763--7},
	number = {20},
	journaltitle = {{JAMA}},
	author = {Joseph, P K and Bizer, L S and Sprayregen, S S and Gliedman, M L},
	date = {1986-05}
}

@article{lumlertgul_jaundiced_1991,
	title = {The jaundiced heart: evidence of blunted response to positive inotropic stimulation},
	volume = {13},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/1924912},
	abstract = {Obstructive jaundice has been known to cause severe hemodynamic disturbance. The present study was therefore designed to assess the cardiac involvement in jaundiced patients. The multiple-gated blood pool cardioscintigraphic studies were done in 9 jaundiced patients who had either cholestatic or obstructive jaundice (mean total bilirubin 29.30 +/- 3.30 mg/{dL}), and in 8 normal volunteers (total bilirubin less than 1 mg\%). None of the patients had evidences of obvious cirrhosis, intrinisic heart disease, or septicemia. Following intravenous dobutamine there was comparable change of blood pressure and heart rate in both groups. However the response of left ventricular ejection fraction ({LVEF}) to dobutamine (10 micrograms/kg/min x 5 min) was strikingly blunted in the jaundiced patients as compared to that seen in the normal controls (3.56 +/- 0.9 vs. 12.7 +/- 2.2\%, p less than 0.005). Our present data thus show that there is blunted myocardial contractile response to the inotropic stimulation in jaundiced patients. Such myocardial refractoriness to beta-1 stimulation may contribute to the susceptibility of jaundiced patients to postoperative shock and acute renal failure.},
	pages = {15--22},
	number = {1},
	journaltitle = {Ren Fail},
	author = {Lumlertgul, D and Boonyaprapa, S and Bunnachak, D and Thanachaikun, N and Praisontarangkul, O A and Phornphutkul, K and Keoplung, M},
	date = {1991}
}

@article{barker_correcting_2006,
	title = {Correcting data for body size may confound results},
	volume = {129},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/16478872},
	pages = {493; author reply 493--4},
	number = {2},
	journaltitle = {Chest},
	author = {Barker, Diane and Artis, Nigel and Tan, Lip-Bun},
	date = {2006-02},
	note = {Letter states our view; authors response inadequate},
	file = {Barker et al. - 2006 - Correcting data for body size may confound results.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\J4MHN8J8\\Barker et al. - 2006 - Correcting data for body size may confound results.pdf:application/pdf}
}

@article{georgopoulos_is_2005,
	title = {Is portal hypertension associated with protein-losing enteropathy?},
	volume = {20},
	doi = {10.1111/j.1440-1746.2004.03475.x},
	abstract = {{BACKGROUND} {AND} {AIM}: Hypoalbuminemia in patients with decompensated cirrhosis has  traditionally been assumed to be a result of to impaired liver synthesis; however, protein-losing enteropathy ({PLE}) may also contribute. The aim of this study was to assess whether hypoalbuminemic cirrhotic patients with portal hypertension had evidence of {PLE}. {METHODS}: Sixteen patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension underwent whole gut lavage with polyethylene glycol solution. The effluent obtained was analyzed for albumin, immunoglobulin (Ig)G and alpha1-antitrypsin (alpha1-{AT}). Serum},
	pages = {103--107},
	number = {1},
	journaltitle = {Journal of gastroenterology and hepatology},
	shortjournal = {J Gastroenterol Hepatol},
	author = {Georgopoulos, Philippos and Mowat, Craig and {McMillan}, Donald C. and Kingstone, Kathleen and Ghosh, Subrata and Stanley, Adrian J.},
	date = {2005-01},
	pmid = {15610454},
	keywords = {Adult, Aged, Female, Humans, Hypertension, Portal/*complications, Hypoalbuminemia/*complications, Liver Cirrhosis/*complications, Male, Middle Aged, Prospective Studies, Protein-Losing Enteropathies/*etiology}
}

@article{mcmillan_inflammatory_2013,
	title = {Inflammatory prognostic markers in clear cell renal cell carcinoma - preoperative},
	volume = {111},
	doi = {10.1111/bju.12020_12},
	number = {3},
	journaltitle = {{BJU} international},
	shortjournal = {{BJU} Int},
	author = {{McMillan}, Donald C.},
	date = {2013-03},
	pmid = {23444936},
	keywords = {Carcinoma, Renal Cell/*blood, C-Reactive Protein/*metabolism, Female, Humans, Inflammation/*blood, Kidney Neoplasms/*blood, Male}
}

@article{gastroenterology_guidelines_2005,
	title = {Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas},
	volume = {54 Suppl 5},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/15888770},
	pages = {v1--16},
	journaltitle = {Gut},
	author = {Gastroenterology, Pancreatric Section-British Society of and Britain, Pancreatic Society of Great and Ireland and Britain, Association of Upper Gastrointestinal Surgeons of Great and Ireland and Pathologists, Royal College of and Radiology, Special Interest Group for Gastro-Intestinal},
	date = {2005-06}
}

@article{sandroussi_sociodemographics_2010,
	title = {Sociodemographics and Comorbidities Influence Decisions to Undergo Pancreatic Resection for Neoplastic Lesions},
	volume = {14},
	issn = {1091-255X, 1873-4626},
	url = {http://link.springer.com/article/10.1007/s11605-010-1255-2},
	doi = {10.1007/s11605-010-1255-2},
	abstract = {Introduction Pancreatic resection is being performed with increasing frequency and safety. Technical outcomes and long-term survival for neoplastic lesions are well reported; however, reasons why patients do not undergo surgery for potentially resectable lesions are not well understood. The aim of this study was to determine the factors contributing to the decision not to operate for resectable pancreatic neoplasms. Methods From 2004 to 2008, all patients with resectable pancreatic neoplasms at a single high-volume hepatopancreaticobiliary center were evaluated. The impact of patient factors, sociodemographics, medical comorbidities (Charlson combined comorbidity index ({CCI}) and {ACCI}), disease factors (tumor characteristics), and surgical factors (type of resection required) on the decision to undergo pancreatectomy were analyzed using univariate and multivariate binary logistic regression analysis. Results Three hundred seventy-five patients with resectable pancreatic lesions were identified. The median age was 62 years (21–93); 203 out of 375 (54.1\%) were males. Fifty-five (14.7\%) did not undergo resection. On univariate analysis, age (odds ratio ({OR}) 1.116, p {\textless} 0.001), non-English speaking background ({NESB}; {OR} 4.276, p = 0.001), tumor type (p = 0.001 increased for cystic neoplasms including intraductal papillary mucinous neoplasm), {CCI} score ({OR} 1.239, p = 0.001), and {ACCI} score ({OR} 1.433, p {\textless} 0.001) were associated with an increased risk of not undergoing resection. Gender, age, marital status, and urban residence were not predictive. On multivariate analysis, {NESB} (p = 0.018) and the {ACCI} (p = 0.002) remained predictive of not undergoing resection. The majority of patients did not undergo surgery because the patient declined in 25 out of 55 (45.5\%), and resection was not offered in 15 out of 55 (27.3\%). In the remainder, medical contraindications precluded surgery. Advanced age, tumor type, comorbidities (27.3\%), age (21.8\%), surgical risk (29.1\%), frailty (18.2\%), and uncertain diagnosis (5.5\%) were cited as reasons for not proceeding with surgery. Conclusion Patients with a higher {ACCI} and those from a {NESB} are less likely to undergo surgery for resectable neoplastic lesions of the pancreas. These factors must be taken into consideration in the decision-making process when considering surgery for patients with pancreatic neoplasms. Novel strategies should be employed to optimize access to surgery for patients with resectable pancreatic neoplasms.},
	pages = {1401--1408},
	number = {9},
	journaltitle = {Journal of Gastrointestinal Surgery},
	shortjournal = {J Gastrointest Surg},
	author = {Sandroussi, Charbel and Brace, Chantelle and Kennedy, Erin D. and Baxter, Nancy N. and Gallinger, Steven and Wei, Alice C.},
	urldate = {2015-05-26},
	date = {2010-06-23},
	langid = {english},
	keywords = {Decision making, Gastroenterology, Neoplasm, pancreas, Pancreatectomy, surgery},
	file = {Full Text PDF:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\UXPIXQXF\\Sandroussi et al. - 2010 - Sociodemographics and Comorbidities Influence Deci.pdf:application/pdf;Snapshot:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\M6KEF9MR\\10.html:text/html}
}

@article{stephan_hemorrhage_1987,
	title = {Hemorrhage without tissue trauma produces immunosuppression and enhances susceptibility to sepsis},
	volume = {122},
	issn = {0004-0010},
	abstract = {To determine whether hemorrhage without major tissue trauma can itself produce immunosuppression, the effect of hemorrhage on the lymphocyte response to T-cell mitogen in endotoxin-resistant C3H/{HEJ} mice was measured. The mice were bled to achieve a mean blood pressure of 35 mm Hg, maintained at that level for one hour, and then adequately resuscitated. On days 1 through 10 thereafter, the proliferative responses of the splenocytes to concanavalin A were measured and allogeneic mixed lymphocyte reaction was performed. The proliferative responses to mitogen stimulation as well as the results of mixed lymphocyte reaction studies indicated that marked immunosuppression occurred at day 1. Immunosuppression persisted for at least five days following hemorrhage, as evidenced by mitogen stimulation assay. Another group of mice was subjected to sepsis three days after hemorrhage and resuscitation. The mortalities in the sham-hemorrhage and hemorrhage groups following sepsis were 58\% and 100\%, respectively. Thus, a significant depression of cellular immunity occurred following simple hemorrhage despite adequate resuscitation, and this immunosuppression enhanced the susceptibility to sepsis.},
	pages = {62--68},
	number = {1},
	journaltitle = {Archives of Surgery (Chicago, Ill.: 1960)},
	shortjournal = {Arch Surg},
	author = {Stephan, R. N. and Kupper, T. S. and Geha, A. S. and Baue, A. E. and Chaudry, I. H.},
	date = {1987-01},
	pmid = {3800651},
	keywords = {Animals, Concanavalin A, Disease Models, Animal, Disease Susceptibility, Hemorrhage, Immunity, Cellular, Immunosuppression, Infection, Lymphocyte Activation, Mice, Mice, Inbred C3H, Spleen, Time Factors}
}

@article{marshall_multiple_1995,
	title = {Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome},
	volume = {23},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/7587228},
	abstract = {To develop an objective scale to measure the severity of the multiple organ dysfunction syndrome as an outcome in critical illness.},
	pages = {1638--52},
	number = {10},
	journaltitle = {Crit Care Med},
	author = {Marshall, J C and Cook, D J and Christou, N V and Bernard, G R and Sprung, C L and Sibbald, W J},
	date = {1995-10}
}

@article{brito_bilirubin_2008,
	title = {Bilirubin injury to neurons: contribution of oxidative stress and rescue by glycoursodeoxycholic acid},
	volume = {29},
	url = {http://view.ncbi.nlm.nih.gov/pubmed/18164405},
	abstract = {It is well established that high levels of unconjugated bilirubin ({UCB}) can be toxic to the central nervous system, and oxidative stress is emerging as a relevant event in the mechanisms of {UCB} encephalopathy. In contrast, the hydrophilic bile acid, ursodeoxycholic acid ({UDCA}), has been reported as a cytoprotective and antioxidant molecule. In this study, we investigated if exposure of rat neurons in primary culture to clinically relevant concentrations of {UCB} leads to oxidative injury. The contribution of oxidative stress in {UCB} neurotoxicity was further investigated by examining whether the reduction of {NO} production by {NAME}, an inhibitor of nitric oxide synthase, prevents the disruption of the redox status and neuronal damage. Moreover, we evaluated the ability of glycoursodeoxycholic acid ({GUDCA}), the most relevant conjugated derivative in the serum of patients treated with {UDCA}, to abrogate the {UCB}-induced oxidative damage. Cultured rat neurons were incubated with 50 or 100microM {UCB} in the presence of 100microM human serum albumin, alone or in combination with 100microM {NAME} or with 50microM {GUDCA}, for 4h at 37 degrees C. Protein carbonyls, 4-hydroxy-2-nonenal-protein adducts, intracellular glutathione content and cell death were determined. The results obtained showed that {UCB} induces protein oxidation and lipid peroxidation, while diminishes the thiol antioxidant defences, events that were correlated with the extent of cell death. Moreover, these events were counteracted by {NAME} and abrogated in the presence of {GUDCA}. Collectively, this study shows that oxidative stress is one of the pathways associated with neuronal viability impairment by {UCB}, and that {GUDCA} significantly prevents such effects from occurring. These findings corroborate the antioxidant properties of the bile acid and point to a new therapeutic approach for {UCB}-induced neurotoxicity due to oxidative stress.},
	pages = {259--69},
	number = {2},
	journaltitle = {Neurotoxicology},
	author = {Brito, Maria A and Lima, Sílvia and Fernandes, Adelaide and Falcão, Ana S and Silva, Rui F M and Butterfield, D Allan and Brites, Dora},
	date = {2008-03},
	file = {Brito et al. - 2008 - Bilirubin injury to neurons contribution of oxida.pdf:C\:\\Users\\vishnuvcb\\AppData\\Roaming\\Zotero\\Zotero\\Profiles\\18snw64h.default\\zotero\\storage\\K3WXE5M9\\Brito et al. - 2008 - Bilirubin injury to neurons contribution of oxida.pdf:application/pdf}
}

@article{dutta_relationship_2012,
	title = {The relationship between tumour necrosis, tumour proliferation, local and systemic inflammation, microvessel density and survival in patients undergoing potentially curative resection of oesophageal adenocarcinoma.},
	volume = {106},
	doi = {10.1038/bjc.2011.610},
	abstract = {{BACKGROUND}: There is increasing evidence that the local and systemic inflammatory responses are associated with survival in oesophageal cancer. The aim of this study was to examine the relationship between tumour necrosis, tumour proliferation, local and systemic inflammation and microvessel density and survival in patients undergoing potentially curative resection of oesophageal adenocarcinoma. {METHODS}: The interrelationship between tumour necrosis, tumour proliferation, local inflammatory response (Klintrup-Makinen criteria, intra-tumoural {CD}8+ lymphocyte and macrophage infiltration), systemic inflammatory response (modified Glasgow Prognostic score ({mGPS})), and microvessel density was examined in 121 patients undergoing potentially curative resection for oesophageal adenocarcinoma (including type I and {II} tumours of the gastro-oesophageal junction). {RESULTS}: Tumour necrosis was not significantly associated with any tumour measure other than the degree of differentiation. On multivariate analysis, only age ({HR} 1.93, 95\% {CI} 1.23-3.04, P=0.004), {mGPS} ({HR} 2.91, 95\% {CI} 1.51-5.62, P=0.001), positive to total lymph node ratio ({HR} 2.38, 95\% {CI} 1.60-3.52, P{\textless}0.001) and macrophage infiltration ({HR} 1.49, 95\% {CI} 1.02-2.18, P=0.041) were independently associated with cancer-specific survival in oesophageal adenocarcinoma. Intra-tumoural macrophages were associated with tumour proliferation (P{\textless}0.001) and {CD}8+ lymphocytes infiltration (P{\textless}0.01). {CONCLUSION}: The results of this study suggest that tumour necrosis does not link  local and systemic inflammatory responses and is not significantly associated with survival. In contrast, tumour macrophage infiltration appears to have a central role in the proliferative activity and the coordination of the inflammatory cell infiltrate and is independently associated with poorer survival in patients with oesophageal adenocarcinoma.},
	pages = {702--710},
	number = {4},
	journaltitle = {British journal of cancer},
	shortjournal = {Br J Cancer},
	author = {Dutta, S. and Going, J. J. and Crumley, A. B. C. and Mohammed, Z. and Orange, C. and Edwards, J. and Fullarton, G. M. and Horgan, P. G. and {McMillan}, D. C.},
	date = {2012-02-14},
	pmid = {22240784},
	pmcid = {PMC3322960},
	keywords = {Adenocarcinoma/immunology/*mortality/*pathology/surgery, Aged, Cell Proliferation, Esophageal Neoplasms/immunology/*mortality/*pathology/surgery, Esophagogastric Junction, Female, Humans, Inflammation/complications/mortality, Lymphocytes, Tumor-Infiltrating/immunology, Macrophages/immunology, Male, Microvessels/physiology, Middle Aged, Necrosis, Prognosis}
}