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Nezafati P, Dinh D, Duffy S, Reid C, Ajani A, Clark D, Brennan A, Hiew C, Freeman M, Roberts L, Sharma A, Oqueli E. Percutaneous Coronary Intervention Outcomes Based on American College of Cardiology/American Heart Association Coronary Lesion Classification Over 14 Years – Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sampaio RT, Koshy A, Gow P, Clark D, Horrigan M, Farouque O. Feasibility and Safety of Drug-Eluting Stent Implantation in Patients with End-Stage Liver Disease Prior to Liver Transplantation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Liang D, Dinh D, Gayed D, Tan M, Clark D, Duffy S, Brennan A, Ajani A, Oquiel E, Roberts L, Cooke J, Reid C, Chandrasekhar J, Freeman M. Are Public Holidays, Sporting Events and Significant Historical Events Triggers of ST-elevation Myocardial Infarction (STEMI) Presentations in Victoria? A Melbourne Interventional Group (MIG) Observational Study. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Toner L, Sampaio Rodrigues T, Undrill S, Ajani A, Yeoh J, Clark D. Takotsubo Cardiomyopathy Complicated by Cardiogenic Shock Secondary to Left Ventricular Outflow Tract Obstruction and Severe Mitral Regurgitation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Liew S, Dinh D, Brennan A, Reid C, Duffy S, Oqueli E, Ajani A, Clark D, Freeman M, Hiew C, Jaworski C, Hutchison A, Mok M, Sebastian M. Ultrathin Strut, Biodegradable-Polymer, Sirolimus-Eluting Stents versus Thin-Strut, Durable-Polymer, Drug-Eluting Stents for Percutaneous Coronary Revascularisation in the ST-Elevation Myocardial Infarction (STEMI) Population. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gayed D, Dinh D, Liang D, Tan M, Oquiel E, Duffy S, Ajani A, Brennan A, Clark D, Roberts L, Reid C, Freeman M. Is There a Mortality Benefit of Statin Use for Secondary Prevention of Coronary Artery Disease (CAD) in an Older Population? Insights from the Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tan M, Dinh D, Gayed D, Liang D, Brennan A, Duffy S, Clark D, Ajani A, Oqueli E, Roberts L, Reid C, Freeman M, Chandrasekhar J. Associations Between DAPT Score and Long-term Mortality Post PCI. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dawson L, Dinh D, Duffy S, Brennan A, Guymer E, Clark D, Oqueli E, Freeman M, Hiew C, Reid C, Ajani A. Long-term outcomes following percutaneous coronary intervention for patients with rheumatoid arthritis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is associated with increased risk of cardiovascular events and mortality. Despite this, data regarding long-term outcomes following percutaneous coronary intervention (PCI) are limited.
Methods
We identified 756 patients with RA from the Melbourne Interventional Group PCI registry (2005–2018) and compared outcomes to the remaining cohort (N=38,579). Cox regression analysis was performed to assess risk of adverse cardiac events including long-term mortality (derived from linkage with the National Death Index [NDI]).
Results
Patients with RA were older (68.9±10.0 vs. 64.6±12.0 years) and more often female (40% vs. 23%), with higher rates of hypertension (70% vs 67%), previous stroke (9% vs 6%), peripheral vascular disease (9% vs 6%), obstructive sleep apnoea (10% vs 5%), chronic lung disease (22% vs 12%), prior myocardial infarction (32% vs 27%), and impaired renal function (eGFR<60 ml/min/1.73m2 in 31% vs 24%), while rates of current smoking were lower (20% vs. 25%), all p<0.05. Lesions were more frequently complex (ACC/AHA type B2/C in 61% vs 57%), required longer stents (>20mm in 39% vs 35%), and rates of no reflow were higher (5% vs 3%), all p<0.05. 30-day mortality was higher (4.4% vs. 3.3%, p=0.04) mainly owing to higher non-cardiac mortality (1.6% vs. 0.8%, p=0.01). National Death Index-linked long-term mortality was 28% vs. 19% (p<0.01) with mean follow-up 4.6 vs. 5.4 years. Risk of 30-day and long-term mortality (including by indication subgroup) are presented in the Table.
Conclusions
Patients with RA undergoing PCI have more comorbidities and longer, more complex coronary lesions. After adjustment, risk of short-term adverse outcomes are similar, while risk of long-term mortality is higher, particularly among patients with acute coronary syndromes.
Funding Acknowledgement
Type of funding source: None
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Clark D, Goodwin PC. Rehabilitation of Watson-Jones proximal tibial avulsion injury in elite academy level football: A report of two separate cases in one season. Phys Ther Sport 2020; 46:23-29. [PMID: 32871361 DOI: 10.1016/j.ptsp.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Watson-Jones proximal tibial avulsion injuries occur more frequently in athletic and muscular adolescent males. However, they are rare and therefore infrequently described in the medical literature. Two of these injuries occurred in a Category 1 football academy in the same season within a six-month period. We have described the cases with the hope of better informing other clinicians should they encounter this injury. METHODS This case report describes the injury mechanism, surgical management and rehabilitation for the two cases [Players A and B]. Outcomes measures including player speed, agility and power were compared with scores from players of the same age group at the time of injury in the Premier League academies. Risk factors are also discussed. RESULTS Both players were managed surgically, initially. Player B had the surgical fixation removed during rehabilitation. Player A still has the fixation in situ. Post-surgery, player A returned to full play at thirty-two weeks and thirty-eight weeks for player B. No critical incidents occurred during rehabilitation. CONCLUSION Watson-Jones avulsion fractures, although rare, can be managed successfully. Athletes can achieve a successful return to play at their previous level.
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Baker KL, Thomas CA, Casey DT, Hohenberger M, Khan S, Spears BK, Landen OL, Nora R, Woods DT, Milovich JL, Berger RL, Strozzi D, Weber C, Clark D, Hurricane OA, Callahan DA, Kritcher AL, Bachmann B, Benedetti LR, Bionta R, Celliers PM, Fittinghoff D, Goyon C, Hatarik R, Izumi N, Gatu Johnson M, Kyrala G, Ma T, Meaney K, Millot M, Nagel SR, Patel PK, Turnbull D, Volegov PL, Yeamans C, Wilde C. Hotspot parameter scaling with velocity and yield for high-adiabat layered implosions at the National Ignition Facility. Phys Rev E 2020; 102:023210. [PMID: 32942378 DOI: 10.1103/physreve.102.023210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
This paper presents a study on hotspot parameters in indirect-drive, inertially confined fusion implosions as they proceed through the self-heating regime. The implosions with increasing nuclear yield reach the burning-plasma regime, hotspot ignition, and finally propagating burn and ignition. These implosions span a wide range of alpha heating from a yield amplification of 1.7-2.5. We show that the hotspot parameters are explicitly dependent on both yield and velocity and that by fitting to both of these quantities the hotspot parameters can be fit with a single power law in velocity. The yield scaling also enables the hotspot parameters extrapolation to higher yields. This is important as various degradation mechanisms can occur on a given implosion at fixed implosion velocity which can have a large impact on both yield and the hotspot parameters. The yield scaling also enables the experimental dependence of the hotspot parameters on yield amplification to be determined. The implosions reported have resulted in the highest yield (1.73×10^{16}±2.6%), yield amplification, pressure, and implosion velocity yet reported at the National Ignition Facility.
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Warrier SK, Bell S, Guest G, Heriot A, Kong JC, Eglinton TW, Hayes J, Merrie A, Clark D, Stevenson A. Locoregional recurrences after transanal total mesorectal excision of rectal cancer during the exploration phase. Br J Surg 2020; 107:e353. [DOI: 10.1002/bjs.11753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 11/07/2022]
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Lo STH, Yong AS, Sinhal A, Shetty S, McCann A, Clark D, Galligan L, El-Jack S, Sader M, Tan R, Hallani H, Barlis P, Sechi R, Dictado E, Walton A, Starmer G, Bhagwandeen R, Leung DY, Juergens CP, Bhindi R, Muller DWM, Rajaratnum R, French JK, Kritharides L. Consensus guidelines for interventional cardiology services delivery during covid-19 pandemic in Australia and new Zealand. Heart Lung Circ 2020; 29:e69-e77. [PMID: 32471696 PMCID: PMC7202321 DOI: 10.1016/j.hlc.2020.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.
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Hisler G, Pedersen S, Clark D, Rothenberger S, Hasler B. 0216 Is There a Daily Rhythm in Alcohol Craving and Does It Vary by Circadian Timing? Sleep 2020. [DOI: 10.1093/sleep/zsaa056.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
People with later circadian timing tend to consume more alcohol, potentially due to altered rhythms in when and how much they crave alcohol throughout the day. However, whether circadian factors play a role in alcohol craving has received scant attention. Here, we investigated if the daily rhythm of alcohol craving varied by circadian timing in two independent studies of late adolescent and young adult drinkers.
Methods
In Study 1, 32 participants (18–22 years of age; 61% female; 69% White) completed momentary reports of alcohol craving five times a day for 14 days. Participants wore wrist actigraphs and completed two in-lab assessments of dim light melatonin onset (DLMO). Average actigraphically-assessed midpoint of sleep on weekends and average DLMO were used as indicators of circadian timing. In Study 2, 231 participants (21–35 years of age; 28% female; 71% White) completed momentary reports of alcohol craving six times a day for 10 days. Average midpoint of self-reported time-in-bed on weekends was used to estimate circadian timing.
Results
Multilevel cosinor analysis revealed a 24-hour daily rhythm in alcohol craving which was moderated by circadian timing in both studies (p’s<0.05). In both Study 1 and 2, people with later circadian timing had a later timed peak of craving. In Study 1, but not Study 2, later circadian timing predicted a blunted amplitude in craving.
Conclusion
Findings support a daily rhythm in craving that varies by individual differences in circadian timing. Because craving is an important predictor of future alcohol use, the findings implicate circadian factors as a useful area to advance alcohol research and potentially improve interventions.
Support
R21AA023209; R01DA044143; K01AA021135; ABMRF/The Foundation for Alcohol Research.
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Borton Z, Shivji F, Simeen S, Williams R, Tambe A, Espag M, Cresswell T, Clark D. Diabetic patients are almost twice as likely to experience complications from arthroscopic rotator cuff repair. Shoulder Elbow 2020; 12:109-113. [PMID: 32313560 PMCID: PMC7153207 DOI: 10.1177/1758573219831691] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/25/2019] [Indexed: 11/15/2022]
Abstract
AIMS Large population-based studies have demonstrated increased prevalence of rotator cuff disease amongst diabetics. Recent studies have suggested comparable clinical outcomes from rotator cuff repair despite suggestions of increased complication rates amongst diabetics. However, there is a relative paucity of studies considering the effect of diabetes upon complication rate. We aim to report and quantify the effect of diabetes on complication rates following arthroscopic rotator cuff repair. MATERIALS AND METHODS A retrospective review of a consecutive series of patients undergoing arthroscopic rotator cuff repair between January 2011 and December 2014 was performed. Diabetic status and complication data defined as infection, frozen shoulder, re-tear or re-operation were collected and interrogated. RESULTS A total of 462 patients were included at median follow-up of 5.6 years. Diabetics were significantly more likely to experience frozen shoulder (15.8% vs. 4.4%, p = 0.001), re-tear (26.3% vs. 15.6%, p = 0.042) or at least one complication following surgery (35.1% vs. 22.7%, p = 0.041) compared to non-diabetics. These equated to odds ratios of 4.03, 1.94 and 1.84, respectively. CONCLUSIONS Diabetic patients are almost twice as likely to experience complications following arthroscopic rotator cuff repair, including double the risk of repair failure and more than four times the risk of frozen shoulder.
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Abstract
At present six million people are suffering from clinical depression or anxiety disorders, but only a quarter of them are in treatment. NICE Guidelines prescribe the offer of evidence-based psychological therapy, but they are not implemented, due to lack of therapists within the NHS. We therefore estimate the economic costs and benefits of providing psychological therapy to people not now in treatment. The cost to the governement would be fully covered by the savings in incapacity benefits and extra taxes that result from more people being able to work. On our estimates, the cost could be recovered within two years - and certainly within five. And the benefits to the whole economy are greater still. This is not because we expect the extra therapy to be targeted especially at people with problems about work. It is because the cost of the therapy is so small (£750 in total), the recovery rates are so high (50 per cent) and the cost of a person on IB is so large (£750 per month). These findings strongly reinforce the humanitatian case for implementing the NICE Guidelines. Current proposals for doing this would require some 8,000 extra psychological therapists withing the NHS over the six years.
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Koshy A, Dinh D, Brennan A, Fulcher J, Murphy A, Duffy S, Ajani A, Oqueli E, Hiew C, Yudi M, Farouque O, Clark D. 809 Comparison of Ischaemia-Guided Versus Angiography-Guided Revascularization in Stable Ischaemic Heart Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Warren J, Dinh D, Tan C, Clark D, Dagan M, Ajani A, Brennan A, Stehli J, Sebastian M, Freeman M, Oqueli E, Kaye D, Duffy S. 501 Impact of Pre-Procedural Diastolic Blood Pressure on Outcomes in Patients Undergoing Percutaneous Coronary Intervention. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Batchelor R, Dinh D, Brennan A, Noaman S, Clark D, Ajani A, Freeman M, Stub D, Reid C, Oqueli E, Yip T, Duffy S, Chan W. 784 Adverse Long-Term Clinical Outcomes Among Patients With Pre-procedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Scully T, Toner L, Yeoh J, Clark D. 836 Identification of Risk Factors for Failure of a Deferred Revascularisation Strategy in Patients With Fractional Flow Reserve >0.8. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tan C, Dinh D, Clark D, Ajani A, Brennan A, Warren J, Stub D, Freeman M, O'Brien J, Hiew C, Reid C, Oqueli E, Chan W, Duffy S. 909 Trends in Prescribing Patterns of Ticagrelor, Prasugrel and Clopidogrel Following Percutaneous Coronary Intervention for Acute Coronary Syndromes. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prosser H, Dinh D, Roberts L, Chandrasekhar J, Brennan A, Duffy S, Clark D, Ajani A, Oqueli E, Sebastian M, Reid C, Freeman M, Teh A. 571 Use of Renin-Angiotensin System Antagonists Post-PCI is Associated With Lower Mortality in Patients With Reduced and Preserved Left Ventricular (LV) Function. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dagan M, Dinh D, Stehli J, Tan C, Brennan A, Ajani A, Freeman M, Reid C, Hiew C, Oqueli E, Kaye D, Clark D, Duffy S. 165 Sex Differences in Pharmacotherapy and Long-Term Outcomes in Patients With Ischaemic Heart Disease and Left Ventricular Dysfunction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dagan M, Dinh D, Stehli J, Tan C, Brennan A, Ajani A, Freeman M, Reid C, Hiew C, Oqueli E, Kaye D, Clark D, Duffy S. 123 Impact of Sex on Heart Failure Pharmacotherapy and Outcomes in Patients With Ischaemic Heart Disease and Comorbid Heart Failure With Reduced Ejection Fraction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dawson L, Dinh D, Duffy S, Brennan A, Guymer E, Clark D, Oqueli E, Freeman M, Hiew C, Reid C, Ajani A. 861 Outcomes of Percutaneous Coronary Intervention Among Patients With Rheumatoid Arthritis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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O'Brien J, Dinh D, Roberts L, Teh A, Brennan A, Duffy S, Clark D, Ajani A, Oqueli E, Sebastian M, Reid C, Freeman M, Chandrasekhar J. 564 The Impact of the Metabolic Syndrome on Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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