Scottish Medical Journal最新文献

{"title":"Chromopsy: Cytogenetic and molecular characterization of diseases.","authors":"Alhussaini J Abeer, Ghulam Nabi","doi":"10.1177/00369330221132493","DOIUrl":"https://doi.org/10.1177/00369330221132493","url":null,"abstract":"In this issue of SMJ, Murat et al. used power of cytogenetic to investigate infertility and mild intellectual disability (MID) in a 34 years of man and found de novo ring 13 (r(13)) chromosomes. Genetic abnormalities manifest in different phenotypes and in this case, authors have detected de novo ring 13 chromosome through karyotyping. They used Fluorescence in Situ Hybridization (FISH) and Combined Genomic Hybridization (CGH) techniques on blood and tissue samples. The result of these techniques shows a positive relation between ring chromosome and infertility and MID of the patient. Y chromosome microdeletions analysis showed that there was no deletion in the AZF (AZFa, AZFb and AZFc) region of the Y chromosome. Patient’s peripheral blood karyotype analysis result was mos46,XY,r(13)[75]/45, XY,-13[14]/46,XY,dic r(13)[8]/47,XY, dic r((13)[2])[2]/ 46,XY,tetrac r(13). His parents had normal karyotypes. FISH method’s results supported the findings of the cytogenetic analysis. While, aCGH analysis revealed a 1.5 megabase deletion at the end of chromosome 13, including the CHAMP1 gene. Fluorescence in situ hybridization (FISH) powerful method of visualization specific genes in a diseased cell. The test detects presence (positive) or absence (negative) of gene copies. Although the technique has been reported for more than 30 years, consensus on its interpretation of positive or negative still remains unclear. The issue of inter-laboratories criteria still persists. On few occasions, more than one pathologist should report on the test HER2 test reporting in borderline cases is an example. The FISH test detects specific areas nucleotide genetic change in a cell or tissue which is fixed in a wax. For solid tumors, we work with tissue from the biopsy that is preserved in wax. This is achieved by using a labengineered segments of artificial DNA that have fluorescent molecules attached called probes. These probes are hybridized with patients’ cells and bind to the complementary chromosomal changes in patients’ material. The hybridized material glows and provide signal for the detection under fluorescent microscope. FISH probes can be used either to target pericentromeric region of chromosome (CEPs or CENs) or locus-specific indicators (LSI) The test is used when there is extra copy of chromosome (amplification), deletion of chromosome or translocation of a portion to another chromosome. Apart from breast cancer, FISH test is routinely used for diagnosis of lung, bladder and blood cancers. In contrast to FISH, comparative genomic hybridization (CGH) compares two sets of chromosomal DNA by examining variations in the copy number and position of particular sequences in genomic DNA. It offers a comprehensive picture of chromosomal increases and or losses across a target’s entire genome. This method involves labeling the target DNA with a green fluorochrome, mixing it (1:1) with red-labeled normal DNA, and then hybridizing it to typical human metaphase preparati","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"171-172"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How UK surgeons experience burnout and the link between burnout and patient care: A qualitative investigation.","authors":"Tmam Al-Ghunaim,&nbsp;Judith Johnson,&nbsp;Chandra Shekhar Biyani,&nbsp;Daryl B O'Connor","doi":"10.1177/00369330221122348","DOIUrl":"https://doi.org/10.1177/00369330221122348","url":null,"abstract":"<p><strong>Background and aims: </strong>Poor well-being affects the performance of all kinds of workers, including surgeons. This study aimed to answer two questions: (1) how does burnout affect surgeons personally, and what is their burnout experience like? (2) How does burnout affect the care that surgeons provide in the United Kingdom (UK)?</p><p><strong>Method: </strong>This study conducted thematic analysis of semi-structured interviews with 14 surgeons recruited from the UK National Health Service (NHS).</p><p><strong>Result: </strong>The study found three themes in surgeons' experiences of burnout: first, burnout is common but frequently not recognised nor understood; second, burnout is a personal crisis; and third, burnout creates vulnerability at work. The study also revealed four themes related to burnout's effect on patient care: first, burnout reduces the quality of surgeon-patient relationships; second, burnout affects patient safety; third, burnout impairs staff relationships; and fourth, burnout makes surgeons less motivated to improve.</p><p><strong>Conclusion: </strong>Burnout is common but not well recognised in surgeons. Improving understanding and treatment of burnout could have benefits for both surgeons themselves and the care they provide to patients.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"197-206"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40354045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do surgeons experience burnout? It's relevance to the workforce of the future.","authors":"Stephen R Payne","doi":"10.1177/00369330221132487","DOIUrl":"https://doi.org/10.1177/00369330221132487","url":null,"abstract":"Burnout is an easy word to use, and is something that has become commonplace on many doctors lips over the last 10 years. This has especially been so at difficult times in service provision like the recent COVID-19 pandemic, something that has been amplified by the outcomes for both trainees and trainers mental health, in the very recent GMC 2022 National Training Survey. A career in surgery has never been easy. It was always assumed that surgeons had greater resilience to the underlying causes of burnout, workplacebased stress, but this has now been suggested, perhaps, not to be the case. There are multitudinous factors contributing to stress during surgical careers, from incomplete training for the consultant role, unrealistic expectations of work intensity through to excessive stressors from non-clinical commitments and complaint management. Recognition of the roles these different factors play in the generation of burnout in surgeons has been demonstrated, although the objective definition of what constitutes burnout for the individual is often absent. Those studies that have taken place with scientific rigour have mainly used the Maslach inventory as their benchmark of stress, and generated a score based upon the result. The relevance of Maslach’s domains to a contemporary understanding of workplace-based stress, and its effect on the workforce, isn’t, however, particularly comprehensible to the majority of individuals who work in a surgical environment. Al-Ghunaim and colleagues have adopted a different structure to their study, reported this month. They purposively sampled trainee and consultant surgeons for indicators of burnout prior to the COVID-19 pandemic. Reflective data was collected from structured interviews about how burnout affected the surgeon individually, whether burnout constituted a personal crisis for them or created a vulnerability at work. They also enquired about how burnout affected their relationships with patients, whether it increased their risk of making errors, made teamworking less effective and them less motivated. These are all concepts practicing surgeons will be able to relate to. Although this was only a small study of 9 consultants and five trainees, data processing by thematic analysis, with crosscorrelation between raters, found that respondents had poor knowledge of what burnout was and that workplace-based stress induced burnout, with a negative impact on all of the parameters measured. Objectively, they quantified how burnout affected surgeons personally, and how it could also affect patient safety. Their terms of reference are couched in language that practicing clinicians will find easier to relate to than a psychological scoring methodology. This small study points the way for further research into the impact of work and how it, and its environment, affect surgeons during their careers. Management of expectation of what a surgeon’s career involves, or modification or amelioration, of the stresses in","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"196"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and testing of the safety of the SARUS-CPR hood for novice resuscitators.","authors":"P Wasik,&nbsp;G A McLeod,&nbsp;R Mountain,&nbsp;S Watts,&nbsp;H Briggs,&nbsp;N Maini,&nbsp;I Belford,&nbsp;B McGuire,&nbsp;W Brown,&nbsp;R Clark,&nbsp;I Eley,&nbsp;E Richardson,&nbsp;P Stonebridge","doi":"10.1177/00369330221112186","DOIUrl":"https://doi.org/10.1177/00369330221112186","url":null,"abstract":"<p><strong>Background and aims: </strong>Bystanders should be protected against aerosols, droplets, saliva, blood and vomitus during resuscitation after cardiac arrest The SARUS (safer - airway - resuscitation) CPR airway hood™ is a clear plastic cover and integrated mask that envelopes the head and torso. Our objectives were to test leakage using saline aerosol generation tests, then assess the performance of the hood during mock cardio-pulmonary resuscitation on a manikin.</p><p><strong>Methods: </strong>A checklist was validated by comparing the performance of 10 novices against 10 experts during mock resuscitation. Thereafter, 15 novices were tested with and without the hood, in a randomised cross-over study, one week apart.</p><p><strong>Results: </strong>Laboratory analysis showed a > 99% reduction of saline particles detected 5 cm, 75 cm and 165 cm above volunteers wearing the hood. On manikins, experts scored better compared to novices, 8.5 (0.7) vs 7.6 (1.2), difference (95%CI) 0.9 (0.4-1.3), P = 0.0004. Novice performance was equivalent using the hood and standard equipment, 7.3 (1.4) vs 7.3 (1.1) respectively, difference (90%CI) 0.0 (-0.3 - 0.3), P = 0.90.</p><p><strong>Conclusion: </strong>Aerosol transmission reduced in the breathing zone. Simulated resuscitation by novices was equivalent with and without the hood.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"189-195"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytogenetic and molecular characterization of a patient having infertility and mild intellectual disability with a very rare unstable ring chromosome 13.","authors":"Murat Kaya,&nbsp;Ilknur Suer,&nbsp;Tugba Kalayci,&nbsp;Birsen Karaman,&nbsp;Sukru Ozturk,&nbsp;Sukru Palanduz","doi":"10.1177/00369330221114426","DOIUrl":"https://doi.org/10.1177/00369330221114426","url":null,"abstract":"<p><strong>Introduction: </strong>Ring chromosomes arise from breakage and fusion at distal regions of short and long arms of the chromosomes. The effect of the ring chromosome on the phenotype may vary widely depending on the amount of the deletion in the chromosomal areas and genes implicated in these regions.</p><p><strong>Case presentation: </strong>We present a 35-year-old male patient with infertility and mild intellectual disability (MID) who has de novo ring 13 (r(13)) chromosomes. To determine chromosomal abnormality, we performed karyotype analysis, Y chromosome microdeletion analysis, FISH, and aCGH techniques.</p><p><strong>Conclusion: </strong>The patient's karyotype analysis result was mos46,XY,r(13)(p13q34)[75]/45,XY,-13[14]/46,XY,dic (13;13)[8]/47,XY,r(13), + r(13)[2]/46,XY,tetrac r(13;13;13;13)[1]. FISH analysis supported the findings of the cytogenetic analysis. Y microdeletion analysis showed that the AZF region was intact. On aCGH analysis, we detected a 1.5 megabase deletion at the end of chromosome 13, including the <i>CHAMP1</i> gene. The loss of the <i>CHAMP1</i> gene, in particular, may explain our patient's MID, and the other deleted genes at 13q34 may explain our patient's infertility.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"173-177"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical procedure time and postoperative complications: Quality assurance of intraoperative events.","authors":"Ghulam Nabi","doi":"10.1177/00369330221112128","DOIUrl":"https://doi.org/10.1177/00369330221112128","url":null,"abstract":"Welcome to September 2022 issue of Scottish Medical Journal. The issue highlights advancements in medical education and researcha basic ambitions of journal since its inception more than 100 years back. Hassan et al. bring in new knowledge on methods of teaching in neuroanatomy. Khatkar and colleagues discuss virtual reality simulation questionnaire survey and reminds us importance of snap-shot assessment. Domenic G et al. report relationship of body composition and BMI with colorectal cancer. In another common cancer in young men, Alifrangis et al. provide a glimpse of current practise perspective of testicular cancer (Seminoma). Clinicians are exposed to risk of radiation injuries and in particularly those working in orthopaedics surgery. Snowden et al. provide an assessment of knowledge amongst orthopaedic surgeons about radiation safety. Li et al. in a meta-analysis describe an interesting association of polycystic ovarian syndrome with various cancers. Finally, Yitgin et al. share their knowledge about optimal duration of surgical procedure for renal stones. They report a lower postoperative complications rate following retrograde intrarenal surgery in patients where procedural time is more than 60 min. There are several implications of these findings: First, it will improve delivery of information to urological surgeons so that careful planning is considered in reducing complications; second, it will help in better patient counselling and may be discuss alternate therapeutic approaches. Collins TC et al. in a previous study reported intraoperative blood transfusion, operative time, return to the operating room, and the number of complications as strong predictors of length of stay in hospital for patients following surgery. These events are inter-related and hence quality assurance of intra-operative events should be focus of quality assurance in the future. I trust the issue will be an enjoyable reading and generate discussion amongst colleagues and the future generations.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"79"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A constructivist approach to teach neuroanatomy lab: Students’ perceptions of an active learning environment","authors":"Sherif S. Hassan, Fauzia Nausheen, Frank Scali, Hina Mohsin, Charity Thomann","doi":"10.1177/00369330221107101","DOIUrl":"https://doi.org/10.1177/00369330221107101","url":null,"abstract":"Background A recent trend in medical education is developing a more dynamic and integrated curriculum. Team-based learning (TBL) increases students’ engagement and the active construction of anatomical knowledge. This initial study aimed to empirically observe medical students’ perceptions of their achievement of learning outcomes and the construction of their neuroanatomy knowledge, critical thinking, and problem-solving using an interactive whiteboard (IWB) as a teaching strategy. Methods An independent neuroanatomy lab survey collected students’ perceptions and comments about their learning experiences using the IWB on a questionnaire using a 5-point Likert scale. Results Student participants felt that using the IWB has facilitated their learning experience. 94.2% of student participants endorsed feelings that new technology has helped them achieve their learning outcomes, helped them integrate both their basic science and clinical science/skills knowledge (90.4%), enhanced their problem-solving skills (92.3%), facilitated their interaction with the neuroanatomy faculty (96.2%) and increase their critical thinking (88.4%). Conclusion Collecting such empirical data about students’ perceptions and their learning environment should help neurosciences faculty in medical schools better outline their activities to faculty at other medical institutions. Applying these methods may enhance the learning process, save time during neuroanatomy lab, and it could also help overcome the shortage of qualified neuroanatomy educators.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"80 - 86"},"PeriodicalIF":2.7,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42309423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic ovary syndrome and the risk of endometrial, ovarian and breast cancer: An updated meta-analysis","authors":"Zhen Li, Yuhua Wang, Linlin Wang, Dingtao Hu, Ying Teng, Tingyu Zhang, Ziye Yan, Fang Wang, Y. Zou","doi":"10.1177/00369330221107099","DOIUrl":"https://doi.org/10.1177/00369330221107099","url":null,"abstract":"Background and Aims This updated meta-analysis aimed to further quantify the risk of endometrial, ovarian, and breast cancer in patients with polycystic ovary syndrome (PCOS), thus providing updated and more reliable estimates. Methods and Results We identified relevant articles by searching electronic databases of PubMed, Embase, Web of Science, and Chinese Biological Medical Literature (CBM) published up to March 20, 2021. The pooled effect estimates and their 95% confidence intervals (CIs) were calculated using the random-effect model or the fixed-effect model. A total of 26 eligible studies were included. We found that PCOS was significantly associated with endometrial cancer (odds ratios [OR]: 3.66, 95%CI: 2.05–6.54, P < 0.001), but not with ovarian or breast cancer (OR: 1.23, 95%CI: 0.99–1.53, P = 0.059; OR: 0.94, 95%CI: 0.78–1.14, P = 0.551, respectively). However, in subgroups of high-quality studies, cohort studies, younger women (54 years or less or premenopausal), and studies with unadjusted body mass index (BMI), PCOS patients had a significantly higher risk of ovarian cancer. Conclusion These results indicated that PCOS is a significant risk factor for endometrial cancer independent of BMI, but not for breast cancer. PCOS may increase the risk of ovarian cancer in younger women.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"109 - 120"},"PeriodicalIF":2.7,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41717379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the attitude of surgical trainees towards virtual reality simulation: A national cross-sectional questionnaire study","authors":"Harman Khatkar, Ashley Ferro, Sanjeev Kotecha, M. Prokopenko, A. Evans, J. Kyriakides, Jonathan Botterill, Miljyot Singh Sangha, Abbas See, Ryan Kerstein","doi":"10.1177/00369330221103279","DOIUrl":"https://doi.org/10.1177/00369330221103279","url":null,"abstract":"Background We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms. Methods The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities. Results VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons. Conclusion Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"87 - 92"},"PeriodicalIF":2.7,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43851591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between BMI, CT-derived body composition and colorectal neoplasia in a bowel screening population","authors":"Domenic Di Rollo, J. McGovern, Christopher Morton, Gillian Miller, R. Dolan, P. Horgan, D. McMillan, D. Mansouri","doi":"10.1177/00369330221102237","DOIUrl":"https://doi.org/10.1177/00369330221102237","url":null,"abstract":"Introduction Obesity is associated with an increased risk of colorectal cancer (CRC). Unlike the indirect measures such as BMI, CT-Body composition (CT-BC) allows for the assessment of both volume and distribution of adipose tissue. Therefore, the aim of this study was to examine the relationship between host characteristics, BMI, CT-BC measurements and the incidence of colorectal neoplasia. Methods Patients undergoing CT Colonography (CTC) as part of the Scottish Bowel Screening Programme, between July 2009 and February 2016, were eligible for inclusion. Data were collected including demographic data, clinicopathological variables and CT-BC measurements including skeletal muscle index (SMI), subcutaneous fat index (SFI) and visceral fat area (VFA). CTC, colonoscopy, and pathology reports were used to identify CRC incidence. Associations between demographic data, clinicopathological variables, CT-BC measurements, colorectal neoplasia and advanced colorectal neoplasia were analysed using univariate and multivariate binary logistics regression. Results 286 patients met the inclusion criteria. Neoplasia was detected in 105 (37%) of the patients with advanced neoplasia being detected in 72 (69%) of patients. On multivariate analysis sex (p < 0.05) and high VFA (p < 0.001) remained independently associated with colorectal neoplasia. On multivariate analysis a high SFI (p < 0.01) remained independently associated with advanced colorectal neoplasia. BMI was not associated with either colorectal neoplasia or advanced colorectal neoplasia. Conclusion When directly compared to BMI, CT derived fat measurements were more closely associated with the degree of neoplasia in patients undergoing colorectal cancer screening. In patients investigated with CT colonography, CT adipose measures may stratify the risk and grade of neoplasia.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"93 - 102"},"PeriodicalIF":2.7,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44860727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}