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Yu Q, Kwak D, Ungchusri E, Van Ha T, Kumari D, Patel M, Marshall E, Pillai A, Liao A, Zhang M, Hwang G, Ahmed O. Abstract No. 265 Segmental Radioembolization using Yttrium-90 Glass Microspheres Greater than 400 Gray: A Real-World Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Loh MM, Yaxley N, Moore G, Holmes D, Todd S, Smith A, Macdonald E, Semple S, Cherrie M, Patel M, Hamill R, Leckie A, Dancer SJ, Cherrie JW. Measurement of SARS-CoV-2 in air and on surfaces in Scottish hospitals. J Hosp Infect 2023; 133:1-7. [PMID: 36473553 PMCID: PMC9721166 DOI: 10.1016/j.jhin.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are still uncertainties in our knowledge of the amount of SARS-CoV-2 virus present in the environment - where it can be found, and potential exposure determinants - limiting our ability to effectively model and compare interventions for risk management. AIM This study measured SARS-CoV-2 in three hospitals in Scotland on surfaces and in air, alongside ventilation and patient care activities. METHODS Air sampling at 200 L/min for 20 min and surface sampling were performed in two wards designated to treat COVID-19-positive patients and two non-COVID-19 wards across three hospitals in November and December 2020. FINDINGS Detectable samples of SARS-CoV-2 were found in COVID-19 treatment wards but not in non-COVID-19 wards. Most samples were below assay detection limits, but maximum concentrations reached 1.7×103 genomic copies/m3 in air and 1.9×104 copies per surface swab (3.2×102 copies/cm2 for surface loading). The estimated geometric mean air concentration (geometric standard deviation) across all hospitals was 0.41 (71) genomic copies/m3 and the corresponding values for surface contamination were 2.9 (29) copies/swab. SARS-CoV-2 RNA was found in non-patient areas (patient/visitor waiting rooms and personal protective equipment changing areas) associated with COVID-19 treatment wards. CONCLUSION Non-patient areas of the hospital may pose risks for infection transmission and further attention should be paid to these areas. Standardization of sampling methods will improve understanding of levels of environmental contamination. The pandemic has demonstrated a need to review and act upon the challenges of older hospital buildings meeting current ventilation guidance.
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Yu Q, Ahmed O, Gutti S, Iyer D, Angle J, Navuluri R, Lorenz J, Sellers E, Ahmed S, Said A, Wahoud W, Patel M. Abstract No. 579 Meta-Analysis of Transjugular Intrahepatic Portosystemic Shunt Creation with Intravascular Ultrasound Guidance. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Schreeder D, Badin F, Dakhil S, Lammers P, Patel M, Slater D, Migas J, Naveh N, Boccuti A, Hanvesakul R, Li W, Halmos B. PP01.77 EMERGE 402: Real-world Characteristics and Safety of Lurbinectedin in Small-cell Lung Cancer (SCLC). J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Malik A, Strolia I, Moazeni Y, Patel M, Salem R, Riaz A. Abstract No. 567 Safety and Efficacy of Percutaneous Management of Acute Cholangitis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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VEERANKI V, Prasad N, Meyyappan J, Bhadauria D, Kaul A, Patel M, Kushwaha R, Behera M, Yachha M. WCN23-1143 DOES THE CHANGING EPIDEMIOLOGY AND THE THERAPEUTICS HAVE INFLUENCE ON THE SPECTRUM OF RENAL DISEASES IN PATIENTS WITH DIABETES MELLITUS? Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Schoeffski P, Yamamoto N, Bauer T, Patel M, Lorusso P, Lahmar M, Durland-Busbice S, Geng J, Gounder M. 42O A phase Ia/b, dose-escalation and expansion study evaluating the MDM2–p53 antagonist BI 907828 in patients with solid tumours: Safety and efficacy in patients with dedifferentiated liposarcoma (DDLPS). ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Anees M, Dweik A, Dharmarpandi G, Moseley K, Patel M, Naguib T. Duodenal diverticulitis with perforation and abscess formation requiring pylorus preserving pancreaticoduodenectomy. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00660-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Dweik N, Mohanakrishnan B, Khan I, Elmahi M, Varghese J, Patel M. Oxycodone induced leukoencephalopathy in a young female following acute toxicity. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00708-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Hayne D, Stockler M, Martin A, Mccombie S, Zebic D, Krieger L, Anderson P, Bastick P, Beardsley E, Blatt A, Frydenberg M, Green W, Grummet J, Hawks C, Ischia J, Mitterdorfer A, Patel M, Roberts M, Sengupta S, Srivastav R, Winter M, Redfern A, Davis I. Adding Mitomycin to BCG as adjuvant intravesical therapy for high-risk, non-muscle-invasive -bladder cancer: A randomised phase 3 trial: The BCG+MM Study (ANZUP1301). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Anees M, Dweik A, Dharmarpandi G, Moseley K, Patel M, Naguib T. A Challenging diagnosis of progressive multifocal leukoencephalopathy. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Patel M, Aitken E. 1176 DEMOGRAPHIC AND CLINICAL PRESENTATION OF HOSPITALISED PATIENTS WITH SARS-COV-2 OMICRON VARIANT. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract
Introduction
Objectives of this retrospective study were to describe clinical presentations and mortality outcome of hospitalised patients with COVID-19 omicron variant within two acute district general hospitals and to evaluate demographic factors associated with these presentations and mortality.
Methods
Data was obtained over a month in 2021-22 from a retrospective survey of all patients hospitalised and detected to have SARS-COV-2 omicron variant infection. The trust serves a diverse multi-ethnic inner-city population. Data included socio-demographic details, vaccination status, admitting specialty and mortality outcome. Patients were sub-divided into three groups; Group 1 were admitted with ‘true’ COVID pneumonitis; Group 2 were found to have ‘incidental’ COVID on admission screening; Group 3 were negative for COVID on admission but developed COVID >7days after admission.
Results
Of 553 patients, only 24.1%[133/553] were in Group 1; 322[58.2%] in Group 2; 98[17.7%] in Group 3. Patients with Group 1 and Group 3 were significantly older than those in Group 2 (p<0.001). 30% patients from BAME ethnicity had COVID pneumonitis compared to 19% from white ethnicity[p=0.002]. 20% patients were admitted within non-medical specialties i.e. surgical specialties, paediatrics and obstetrics. Of 36 requiring critical care, only 21 were in Group 1; 20/21[95%] of these were unvaccinated; 7/21 who died were all unvaccinated[100%]. This study showed that common COVID presentations included delirium, falls (and fractures), seizures, COPD, and antenatal problems. 13.7%[76/553] patients died; only 21 were in Group 1[27.6%]. Only 26 deaths were directly attributable to COVID; 4.7%[26/553] of all patients.
Discussion
This large multi-ethnic study has described clinical presentations and mortality of hospitalised patients with omicron. It has determined socio-demographic factors associated with these presentations including ethnicity and vaccination rates. The study useful information for future COVID studies examining outcomes and presentations of omicron and future COVID variants.
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Tayler-Gray J, Patel M, Wigley A, McCall B, Gossage J. 1296 DEMOGRAPHIC AND MORTALITY EVALUATION OF URGENT COMMUNITY RESPONSE REFERRALS THAT ARE MANAGED IN COMMUNITY VS THOSE HOSPITALISED. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Demographic evaluation of urgent community response teams [UCR] is important to ensure equity of access and clinical outcomes for patients from all socio-demographic groups using such services. This retrospective descriptive study aimed to evaluate demographic and mortality differences between patients referred to UCR in terms of those managed in the community [Group1] versus those subsequently hospitalised [Group2].
Methods
Data was obtained over a 12-month period [2021-2022] for all new patients referred to a 7-day consultant-led UCR that serves a multi-ethnic, inner-city population. Data included demographic details, source of referral, urgency of referral and mortality within 60 days.
Results
Of 995 patients, 75.6%[n=752] were in Group 1; 24.4%[243] were in Group 2. The two groups were comparable in terms of age [mean(SD): 80.1(12.6) vs 80.0(11.4), p=ns] and gender [males:39.4% vs 42.4%,p=ns]. There were similar proportion of Black and minority ethnic patients within the two groups [21.0% (158) vs 24.7% (60), p=ns]. Source of referral were comparable between the two groups[p=ns]; overall, 67.7%[674] were from GP practices, 5.6%[56] Community Practitioners, 4.7%[47] NHS111, 2.7%[27] Ambulance, 32%[32] Palliative care, 5.9%[59] Emergency department, 10.1%[100] post-hospitalisation. Compared to Group 1 [46.9% (353)], significantly more patients in Group 2 were referred for urgent assessment within 2 hours [65.4% (159), p<0.001]. More patients died in Group2 within 60 days [22.2% (54) vs 11.3% (85), p<0.001].
Discussion
This large survey has described age, gender and ethnic similarities between the two groups, demonstrating equity of provision irrespective of protected characteristics. As might be clinically expected, patients referred for hospitalisation were assessed more urgently and had higher mortality rates compared to those managed in the community. This study provides valuable information for clinicians and researchers of similar UCR services in future.
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Awatramani S, Kulendran A, Umasankar U, Patel M. 1178 RETROSPECTIVE SURVEY OF DIFFERENTIAL DIAGNOSES IN A NEUROVASCULAR CLINIC. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to describe frequency of alternative diagnoses in a busy inner-city neurovascular clinic and evaluate processes of assessment and investigations of ‘true’ TIA patients.
Methods
Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a busy consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, final clinical diagnoses, and process measures including speed of assessment and rate of neurological and cardiological investigations.
Results
Of 1764 patients, 39.3%[694] were diagnosed as TIA; 60.7%[1070] had 40 distinct differential diagnoses. Top ten diagnoses included migraine including ocular migraine [9.5%], Syncope [5.5%], Local Eye conditions (non-neurological)[5.3%], non-cervical radiculopathy [4.0%], Benign Paroxysmal Positional Vertigo [4.0%], Previous/Incidental Stroke [3.7%], Transient Global Amnesia [2.4%], Orthostatic Hypotension [1.8%], Non-migraine Headache syndromes [1.6%], Cervical Neuropathy [1.3%]. 10.9%[193] had no organic pathological diagnosis. For 694 TIA patients, 100% had neuroimaging [CT/MRI] and 98% had carotid dopplers on or before day of clinic. Non-urgent cardiovascular investigations performed included echocardiogram [83%], Holter monitoring [75%] and bubble echocardiogram [5%].
Discussion
This large survey has described the frequency of TIA and alternative diagnoses in a dedicated neurovascular service. The study highlights the importance of accurate diagnosis of TIA by experienced clinicians for appropriate secondary prevention. We also described the efficiency, and speed of assessment and proportion of investigations undertaken in these patients. This study provides valuable information to clinicians, researchers and commissioners of stroke services in future.
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Patel M, Awatramani S, Kulendran A, Umasankar U. 1177 SOCIO-DEMOGRAPHIC AND RISK FACTOR DIFFERENCES BETWEEN TIA AND TIA MIMICS. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Introduction
Diagnosis of Transient Ischaemic Attack [TIA] is important to minimise risk of future strokes. This retrospective descriptive study aimed to evaluate socio-demographic and risk factor differences between TIA and TIA ‘mimics’ in patients presenting to an inner-city neurovascular clinic.
Methods
Data was obtained over a 2-year period [2019-2020] for all new patients assessed in a consultant-provided daily week-day neurovascular service that serves a million multi-ethnic, population. Data collected included socio-demographic details, clinical risk factors, source of referral and final clinical diagnoses.
Results
Of 1764 patients, 39% [694] were diagnosed as TIA; 61% [1070] were TIA mimics with 40 distinct differential diagnoses. Compared to TIA mimics, TIA patients were older [mean(SD): 69.3(13.8) vs 59.7(16.1),p<0.001]; higher prevalence of TIA mimics in females vs males [66% vs 54%; p<0.001]. There were proportionately more patients with TIA mimics from Black and minority ethnic groups (401/610:66%) compared whites (669/1154:58%)[p=0.034]. Compared to TIA mimics, TIA patients had higher prevalence of hypertension [56% vs 40%,p<0.001], Diabetes [22% vs 14%,p<0.001], Atrial Fibrillation [10% vs 4%,p<0.001], Chronic Heart Disease [18% vs 9%,p<0.001] and moderate to severe carotid stenosis [5% vs 0.4%,p<0.001]. Prevalence of other risk factors in TIA patients included Patent Foramen Ovale [1.4%], Cardiolipin Antibodies [3.2%], and Thrombophilia [2.3%]. 14% of TIA patients had no identifiable risk factors.
Discussion
This large survey has described socio-demographic [age, gender and ethnicity] differences and prevalence of risk factors between TIA patients and TIA mimics. These differences may be useful in terms accurate diagnosis of TIA by experienced clinicians. This study provides valuable information for clinicians and researchers of stroke services in future.
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Madiba M, Oluremi BB, Gulube Z, Oderinlo OO, Marimani M, Osamudiamen PM, Patel M. Anti-Streptococcus mutans, anti-adherence and anti-acidogenic activity of Uvaria chamae P. Beauv. JOURNAL OF ETHNOPHARMACOLOGY 2023; 300:115673. [PMID: 36096348 DOI: 10.1016/j.jep.2022.115673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Streptococcus mutans a key pathogen, produces biofilm, acids and extracellular polysaccharides in the oral cavity; which leads to the development of dental caries. Control of these pathogenic markers can prevent dental caries. Uvaria chamae P. Beauv. is a medicinal plant traditionally used for many ailments including oral infections. Root, leaves and bark extracts has proven antibacterial activity including activity against caries causing S. mutans. However, its effect on the virulence properties of S. mutans, responsible for the development of dental caries, has not been studied. AIM OF THE STUDY This study investigated the phytochemical constituents, anti-S. mutans, anti-adherence and anti-acidogenic activity of U. chamae root extract. MATERIALS AND METHODS Extracts were prepared and phytochemical analysis was performed. Minimum inhibitory concentrations (MIC) were determined, and MIC and sub-MIC concentrations of the best solvent were selected for their effect on the virulence factors of S. mutans. The results were analysed using one-way ANOVA and Wilcoxon Rank Sum Tests. RESULTS The dichloromethane extract, with proanthocyanidin as a major chemical constituent, produced an MIC of 0.02 mg/ml. At 6 h, exposure to 0.005, 0.01, and 0.02 mg/ml extract significantly reduced S. mutans adherence by 39, 59, and 77% respectively (p < 0.05). Uvaria chamae also significantly inhibited acid production in S. mutans at 10, 12, 14 and 16 h (p < 0.05). At ½ MIC, the plant extract caused remarkable downregulation of the virulence genes responsible for the adherence, biofilm formation, extracellular polysaccharide synthesis and acid production. CONCLUSIONS This suggests that U. chamae extract may potentially be used to inhibit the proliferation of S. mutans and silencing the expression of pathology-related genes, which will prevent the development of dental caries.
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Eneling J, Darsaut TE, Patel M, Raymond J. Understanding explanatory and pragmatic trials: Examples from randomized controlled trials on vertebroplasty. Neurochirurgie 2023; 69:101403. [PMID: 36566693 DOI: 10.1016/j.neuchi.2022.101403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To better understand the explanatory-pragmatic distinction in the design and interpretation of randomized controlled trials (RCTs). METHODS We review the explanatory-pragmatic distinction in clinical trial design. We use the PRECIS-2 tool to evaluate the trial design of selected RCTs on percutaneous vertebroplasty for osteoporotic vertebral compression fractures. We discuss difficulties in the selection of criteria and in the construction of PRECIS diagrams. We also examine how inconsistency in the selection of various items of trial design can cause confusion in the interpretation of results. RESULTS The selection of criteria and the scoring of multiple PRECIS domains were subjective and thus debatable. The pragmascope patterns of various vertebroplasty trials were heterogeneous. Many trials had both pragmatic and explanatory components. Some placebo-controlled trial goals seem to have been explanatory, but their design actually included enough pragmatic items such that the meaning of negative trial results remains ambiguous. CONCLUSION The results of a trial cannot be interpreted without understanding the various design choices made along the explanatory-pragmatic spectrum.
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Nazari MA, Abd-Elmoniem KZ, Jha A, Matta J, Talvacchio S, Charles K, Feeley J, Patel M, Feelders R, Pacak K, Gharib AM. Reduced coronary artery luminal area in pheochromocytoma and paraganglioma patients. J Endocrinol Invest 2022:10.1007/s40618-022-01982-5. [PMID: 36538160 DOI: 10.1007/s40618-022-01982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022]
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Yeku O, D. Shepard, Patel M, Fleming G, Vaena D, Rasco D, Chmielowski B, Sharma M, Hamilton E, Sullivan R, Papadopoulos K, Izar B, Cojocaru G, Ophir E, Ferre P, Dumbrava E. 159P COM701 in combination with nivolumab demonstrates preliminary antitumor activity in patients with platinum-resistant epithelial ovarian cancer. IMMUNO-ONCOLOGY AND TECHNOLOGY 2022. [DOI: 10.1016/j.iotech.2022.100271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Matisz CE, Patel M, Hong NS, McDonald RJ, Gruber AJ. Chronic gut inflammation impairs contextual control of fear. Sci Rep 2022; 12:20586. [PMID: 36446873 PMCID: PMC9709066 DOI: 10.1038/s41598-022-24901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Chronic inflammatory diseases are highly comorbid with anxiety in humans. The extent to which chronic inflammation is responsible for this relationship remains to be determined. We therefore tested the hypothesis that prolonged, but not brief, gut inflammation is sufficient to evoke anxiety-related behaviours in mice. We used the discriminative fear to context conditioning paradigm to assess fear generalization, which is a prominent feature of anxiety disorders. Gut inflammation was induced by exposure to dextran sodium sulfate (DSS) in the drinking water, a well-established rodent model of ulcerative colitis evoking prolonged inflammation. Neither acute (1 × 5 day cycle) nor chronic (3 × 5 day cycles) exposure to DSS affected fear responses when tested shortly after conditioning. Mice in all groups generated more fear responses (freezing) in a chamber previously paired with mild shock, as compared to a chamber with no pairing. This suggests DSS exposure had no effect on acquisition or expression of conditioned fear. Acute and control animals showed this same contextual control of freezing when tested 9 days later. In contrast, at this remote time point, the chronically treated animals exhibited increased freezing in the unpaired chamber such that freezing was equivalent in both contexts. These animals, however, showed intact preference for the unpaired chamber when allowed to freely move between chambers. These data suggest that some mnemonic process engaged after training, such as memory consolidation, is affected by past chronic inflammation so as to generalize negative associations and engage fearful responding in inappropriate contexts, despite intact knowledge that the chambers have different affective associations sufficient for place preference.
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Janopaul-Naylor J, Rupji M, Switchenko J, Stokes W, Patel M, Bates J. O2.2 Ninety-day mortality following TORS or definitive radiotherapy for oropharyngeal cancer at American commission on cancer-accredited facilities. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Patel M, Kulshrestha A, Patel Shah S, Shah A, Kunikullaya S. 200P A retrospective institutional analysis on gynecological malignant mixed Mullerian tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Patel M, Stephen E, Laursen L, Bandi S. IMPLEMENTING A REFERRAL PROTOCOL FOR PENICILLIN ALLERGY TESTING OF PREGNANT WOMEN. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Noldner C, Bae J, Kartsonis W, Cattell R, Patel M, Pierce A, Sehgal G, Soff S, Ryu S, Czerwonka L, Prasanna P, Mani K. Pre-Radiation CT-Based Radiomic Features Predict Locoregional and Distant Failure in Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Nissen C, Kalantari F, Patel M, Prabhu A, Kesaria A, Kim T, Maraboyina S, Harrell L, Xia F, Lewis G. Analysis of Resident/Faculty Contour Concordance: A Potential Tool for Quantitative Assessment of Residents’ Performance in Target Volume Delineation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1784] [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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Newell R, George S, Patel M, Dawe H, Roelas M, Wedmore F, Morris M. Improving the quality of translation for patients with language barriers. Eur J Public Health 2022; 32:ckac129.639. [PMCID: PMC9593623 DOI: 10.1093/eurpub/ckac129.639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024] Open
Abstract
Background Patients with language barriers have worse health outcomes. To promote equitable care, efforts must be made to ensure effective communication with patients, including providing professional translation. In a busy, overstretched health service this can be difficult to achieve. Language translators can reduce barriers, improve safety and ensure impartiality. Description of the Problem Aims - To understand the quality of translation and explore interventions that could improve this in a busy diverse hospital in East London. Methods A quality improvement project in the Medical Admissions Unit of the Royal London Hospital was completed over two years. Patients with language barriers were identified, methods of translation were analysed and interventions to improve access to independent translation were introduced. Results Cycle 1- All medical admissions over a two-week period were analysed. 36 patients had documented evidence of a language barrier with 7 (19.4%) having independent professional translation. 20 (55.6%) patients had family members providing translation, for 4 patients limited English was used and previous documentation was used for 3 patients. Cycle 2- Posters and information leaflets were disseminated regarding how to access translation services. There was no improvement in the types of translation used. Only 1 patient had impartial professional translation, out of 43 patients identified. Cycle 3- Advocates (Bengali speaking professional translators) were made available on the ward twice a week. Results showed no significant improvement, with only 6 (10%) identified having impartial professional translation. However staff and patient feedback has been positive. Lessons Impartial professional translation is essential in reducing barriers and delivering equitable health care. This can be difficult to achieve in busy healthcare services. Education alone is not enough. Good accessibility to translation services is paramount in promoting usage. Key messages • Healthcare services often fall short of providing impartial professional translation. • Education alone is not enough. Good accessibility to translation services is paramount in promoting usage.
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Patel M, Newell R, George S, Clark H. Understanding clinician barriers to providing equitable healthcare for ethnic minority populations. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.522] [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
Background
It has long been recognised that ethnic minority groups have worse health outcomes in the UK. Social determinants of health (SDH) contribute significantly to these inequalities. However, inequalities persist, even after controlling for these determinants. As well as being less likely to engage with healthcare services, ethnic minority groups are more likely to report poor experiences. The majority of healthcare in the UK is delivered through patient: clinician interactions (PCI), therefore a good working relationship with patients is paramount. Recent focus has been placed on ensuring “cultural competence”. Whilst this is important, we suggest also examining the culture within healthcare itself. Healthcare professionals are not immune to bias, preconceptions and the stresses of work and this must be taken into account. A seminal piece of work on this is the “culture of medicine” framework proposed by Boutin-Foster et al, which examines the impact of these factors.
Aims and Methodology
This paper aims to examine barriers within PCI that impact healthcare for ethnic minorities. A formal literature review was conducted and 131 relevant studies were identified. Grounded theory was used for analysis and data was categorised into themes with Boutin-Foster’s framework used as a structure.
Results
The review found that the concept of implicit bias was paramount in PCI. Three major barriers resulting from this bias are suggested: its impact on clinical decision making, the impact on clinician-patient communication and finally the resultant lack of trust in clinicians and poor perceived quality of care by ethnic minority groups.
Conclusions
Clinician implicit bias is a major barrier to equitable healthcare for ethnic minority populations. A solution we propose is to acknowledge our own preconceptions. Awareness of our own culture, preconceptions and the pressures around us will allow us to find solutions to these barriers, including further research and education.
Key messages
• Clinician implicit bias within the “Culture of Medicine” is a barrier to equitable healthcare for ethnic minority populations.
• Awareness of our own culture and preconceptions is paramount to addressing these barriers.
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Patel M, Ali S, Robson J, Clements R, Theodoulou A, Wright P, Kearney M, Patel R, Sohaib A, Antoniou S. Pharmacist-led multidisciplinary approach in preventing strokes in people with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.613] [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/Introduction
Targets set by Public Health England (PHE) state that 90% of patients with atrial fibrillation (AF) are expected to receive anticoagulation by 2029. In 2019/2020, across three London boroughs serving a population of 770,000, the percentage of AF patients at high risk of stroke (CHA2DS2VASc>2) anticoagulated was below the target set by PHE. In addition, optimisation of risk factors can significantly reduce the risk of cardiovascular disease and associated mortality in these patients.
Purpose
To provide specialist input from a cardiovascular pharmacist to prevent AF-related strokes through improvement of anticoagulation rates and optimisation of cardiovascular risk factors in patients with AF across three London boroughs over one year, as well as minimising bleed risk in patients on dual antithrombotic therapy.
Methods
A specialist cardiovascular pharmacist was commissioned to identify high-risk AF patients (CHA2DS2VASc>2) by working with primary care clinicians. Utilising “proactive care frameworks” created by UCLPartners and Clinical Effectiveness Group Queen Mary University of London, patients were stratified and prioritised for review. Patients not on anticoagulation were deemed to be at highest risk, requiring an urgent review to assess suitability for anticoagulation. A virtual multidisciplinary team (MDT) would review any complex patients and agree an action plan. Patients on dual antithrombotic therapy were also assessed to determine if antiplatelet therapy was indicated to minimise risk of major bleeding. All AF patients were reviewed for suitability of statin initiation to optimise cardiovascular risk prevention.
Results
At baseline, 86% (7581/8582) of AF patients with a CHA2DS2VASc>2 across the three boroughs were anticoagulated. 1001 patients were reviewed by a specialist pharmacist, with 84% (841/1001) of patients having a CHA2DS2VASc between 2–5, and 28% (280/1001) on antiplatelet monotherapy. Analysis at 12 months following intervention reported that 95% (7888/8280) of AF patients with a CHA2DS2VASc>2 were suitably anticoagulated, an improvement of 9%. 6% (61/1001) of patients were switched from antiplatelets and 25% (246/1001) were newly initiated on anticoagulation. 13% (130/1001) of patients required specialist MDT input to determine appropriateness for anticoagulation initiation. There was also a reduction in dual anticoagulation and antiplatelet therapy from 429 to 252 patients (41% reduction). Lastly of those reviewed, 2609 patients received a recommendation to start a statin for either primary (n=1981) or secondary prevention (n=628).
Conclusion(s)
Provision of a specialist cardiovascular pharmacist supported a multidisciplinary workforce to significantly improve and optimise cardiovascular risk, and reduce the risk of stroke in this high-risk population for people with AF across all three boroughs. By extrapolating these results nationally, 3600 strokes could be averted over 18 months.
Funding Acknowledgement
Type of funding sources: None.
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Rohold A, Boetker HE, Leipsic J, Sand NPR. Prognostic value of FFRCT in patients with stable chest pain – a 3-year follow-up of the ADVANCE-DK registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.202] [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
Introduction
The short-term safety of using coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) to guide downstream testing after CTA is well documented. Whether the prognostic information provided by FFRCT can be extended to sustained follow-up and to patients with a high degree of coronary artery calcification (CAC) is unknown.
Purpose
To evaluate the association between FFRCT and clinical outcomes in new onset stable symptomatic patients with coronary stenosis up to 3 years after CTA index testing.
Methods
Multicenter 3-year follow-up study of 900 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. The criterium for an abnormal FFRCT test result was an FFRCT value ≤0.80 (2 cm distal to stenosis). High CAC was defined as a CAC score ≥400. The primary endpoint (PE) was a composite of all-cause death and spontaneous myocardial infarction (MI). The secondary endpoint (SE) was a composite of cardiovascular (CV) death and spontaneous MI. Events were adjudicated by an independent clinical committee.
Results
Patient characteristics are given in Table 1. Coronary stenosis ≥50% was present in 750 (83%) patients. In total 36 patients suffered a PE (all-cause death, n=24; MI, n=12) and 22 an SE (CV death, n=10; MI, n=12). An abnormal vs a normal FFRCT test result was associated with an increased risk of the PE and of the SE both overall and in patients with high CAC; PE (all), 6.6% vs 2.1%, relative risk (RR): 3.1; 95% CI: 1.6–6.3, p<0.001, SE (all), 5.0% vs 0.6%, RR: 8.7; 95% CI: non assessable, p<0.001, PE (high CAC), 9.0% vs 2.2%, RR: 4.1; 85% CI: 1.4–11.8, p=0.001, and SE (high CAC), 6.6% vs 0.5%, RR: 12.0; 95% CI: non assessable, p=0.01, respectively, Figure 1. The observed increased risk in patients with an abnormal vs a normal FFRCT test result persisted after adjustment for degree of stenosis by CCTA (< / ≥50%) and amount of CAC (< / ≥400): PE, adjusted RR: 2.5; 95% CI: 1.2–5.2, p=0.02, and SE, adjusted RR: 8.0; 95% CI: 2.1–30.2, p=0.002.
Conclusion
Patients with stable chest pain, stenosis by CTA and a normal FFRCT test result have a low risk of adverse outcomes during 3 years of follow-up. An abnormal FFRCT identifies patients at increased risk of death or spontaneous MI. These associations are consistent in patients with high levels of CAC.
Funding Acknowledgement
Type of funding sources: None.
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Thomsen KK, Boetker HE, Leipsic J, Sand NPR. FFRCT and recurrent symptoms in patients with stable chest pain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.200] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
The major benefit of coronary revascularization when compared with optimal medical treatment (OMT) in patients with stable chest pain (CP) relates to improvement of symptoms and reduction of reinterventions. Non-invasive methods are warranted to discriminate between patients at low and high risk of recurrent CP for subsequent guidance of antianginal treatment (invasive or OMT).
Purpose
To evaluate the association between coronary CT angiography (CTA) derived fractional flow reserve (FFRCT), recurrent CP and quality of life (QOL) in patients with new onset stable CP and stenosis by CTA.
Methods
Multicenter cohort 3-year follow-up sub-study of 769 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. An abnormal FFRCT was defined as the lowest in vessel FFRCT value ≤0.80. Patients were classified according to completeness of revascularization by FFRCT: 1) completely revascularized (CR-FFRCT), all coronary arteries with an abnormal FFRCT test result revascularized; 2) incompletely revascularized (IR-FFRCT), ≥1 coronary artery with an abnormal FFRCT test result not revascularized. All patients completed the Seattle Angina Questionnaire (SAQ-7), the EuroQol questionnaire (EQ-5D-5L) and graded (0–100) overall health using the EQ VAS scale at 3-year follow-up. Recurrent CP was defined as CP within the last 4 weeks prior to this follow-up.
Results
Patient characteristics are given in Table 1. At follow-up 23% patients reported recurrent CP. An abnormal vs a normal FFRCT increased the risk of recurrent CP, 27% vs 15%, RR: 1.82; 95% CI: 1.31–2.52, p<0.001. Amongst patients with abnormal FFRCT, revascularization (+/−) was associated to a numerical, but not statistical significantly, reduced risk of recurrent CP, 23% vs 30%, RR: 0.76; 95% CI: 0.56–1.03, p=0.07. IR-FFRCT vs CR-FFRCT had a higher risk for recurrent CP, 31% vs 13%, RR: 2.34; 95% CI: 1.48–3.68, p<0.001, whilst no difference was observed for CR-FFRCT vs normal FFRCT, 13% vs 15%, RR: 0.92; 95% CI: 0.54–1.54, p=0.74. IR-FFRCT vs CR-FFRCT or normal FFRCT, had lower SAQ-7, EQ-5D-5L and EQ-VAS scores, Table 1, all p<0.005. Scores for three selected SAQ-7 domains are shown in Figure 1. Use of antianginal medicine was higher in IR-FFRCT compared to CR-FFRCT and normal FFRCT, mean ± SD: 1.2±0.05 vs 1.0±0.04, p=0.02.
Conclusion
An abnormal FFRCT identifies patients with an increased risk of recurrent CP up to 3 years after index testing. Completeness of revascularization by FFRCT reclassifies patients with abnormal FFRCT into groups with low and high risk for recurrent CP and impaired QOL.
Funding Acknowledgement
Type of funding sources: None.
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Bonaca M, Debus S, Nehler M, Anand S, Patel M, Pap AF, Deng H, Hodge S, Szarek M, Haskell L, Muehlhofer E, Berkowitz S, Bauersachs R. Evaluation of the benefit of rivaroxaban on VOYAGER PAD primary composite of limb, heart and brain outcomes using the global rank and win ratio methods. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1971] [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: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The VOYAGER PAD trial demonstrated that rivaroxaban 2.5 mg twice daily added to background antiplatelet therapy reduced a composite of irreversible harm events of the heart limb and brain versus placebo in patients with symptomatic peripheral artery disease (PAD) after lower extremity revascularization. The primary analysis was performed as time to first event with equal weighting of components including fatal and non-fatal events.
Purpose
Traditional time to event analyses of composites generally assess outcomes with equal weights. Analyses evaluating outcomes using ranked or weighted methods may provide clinicians a mechanism to interpret results including different weighting and enable shared decision making with patients.
Methods
Exploratory analyses of the primary composite outcome were prespecified prior to trial completion/database lock. Two previously described approaches to evaluate composite outcomes by ranking or weighting were utilized. The first was the global rank method which includes ranking all components of the composite by order of clinical importance (Table 1) with a primary and alternative ranking prespecified. Each patient is assigned a rank with the worse rank for worse outcome and for patients with the same outcome, those occurring earlier assigned the worse rank. Van Elteren test for differences between groups was applied stratified by type of procedure and clopidogrel use consistent with the primary trial analysis. The second was the unmatched win ratio method according to Pocock's rule which ranked CV death higher than non-fatal events and then compared pairs of subjects, one from each treatment group for wins and losses for wins and losses as outlined in Table 1. Finkelstein and Schoenfeld statistics were utilized with confidence intervals provided from bootstrapping.
Results
A total of 6564 patients were randomized and all outcomes through the common study end date were counted. The global rank method using both the primary and alternative method yielded a statistically significant superior effect of rivaroxaban versus placebo (p-value for primary ranking 0.0158, p-value for alternative ranking 0.0155). When using the win-ratio approach, there were more wins for rivaroxaban (14.8%) than placebo (12.8%) with 72.4% of patients having no primary component events (Figure 1). The overall win ratio was 1.16 95% CI (1.03–1.30) in favor of rivaroxaban with p=0.0167.
Conclusion(s)
Rivaroxaban significantly reduces acute limb ischemia, amputation, MI, ischemic stroke or CV death in PAD after lower extremity revascularization. Exploratory analyses of this efficacy composite show consistent superiority either when considered as a ranked hierarchy of outcomes with CV death as the worst or whether considering a win-ratio approach ranking CV death as worse followed by non-fatal events. These data support the robustness of the primary trial results when considering ranking of the composite components.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Rohold A, Boetker HE, Leipsic J, Sand NPR. Completeness of revascularization by FFRCT and prognosis in stable chest pain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.201] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Major randomized trials of patients with stable chest pain (CP) demonstrated no prognostic benefits of coronary revascularization over optimal medical treatment (OMT). However, in a recent large-scale study, completeness of revascularization was associated with a reduced risk of all-cause death and non-fatal myocardial infarction (MI).
Purpose
To evaluate the association between completeness of revascularization relative to the result of coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) and 3-year prognosis in patients with new onset stable CP and coronary stenosis.
Methods
Multicenter cohort 3-year follow-up sub-study of 900 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. The FFRCT result was abnormal when ≤0.80 (2 cm distal to stenosis). Patients were classified according to completeness of revascularization by FFRCT: 1) completely revascularized (CR-FFRCT), all coronary arteries with an abnormal FFRCT test result revascularized; 2) incompletely revascularized (IR-FFRCT), ≥1 coronary artery with an abnormal FFRCT test result not revascularized. The primary endpoint (PE) was a composite of all-cause death and spontaneous MI. The secondary endpoint (SE) was a composite of cardiovascular (CV) death and spontaneous MI.
Results
Patient characteristics are given in Table 1. In total 36 (4.0%) patients suffered a PE (all-cause death, n=24; MI, n=12) and 22 (2.4%) an SE (CV death, n=10; MI, n=12). Overall, an abnormal vs a normal FFRCT test result was associated with an increased risk of both the PE, 6.6% vs 2.1%, relative risk (RR): 3.1; 95% CI: 1.6–6.3, p<0.001 and of the SE, 5.0% vs 0.6%, RR: 8.7; 95% CI: non assessable, p<0.001. In patients with abnormal FFRCT, revascularization vs no revascularization did not reduce the risk of the PE or the SE (data not shown). Patients with IR-FFRCT vs CR-FFRCT had a numerical, but not statistical significantly, increased risk of the PE, 8.6% vs 4.2%, RR: 2.14; 95% CI: 0.87–5.26, p=0.10), and an increased risk of the SE, 7.1% vs 2.4%, RR: 3.13; 95% CI: 1.02–9.63, p=0.04, Figure 1. In CR-FFRCT versus normal FFRCT no difference in the risk of the PE or the SE was observed, Figure 1. Univariate sensitivity analyses performed in the IR-FFRCT group did not reveal any differences in the risk of the PE or the SE after adjustment for neither statin therapy at follow-up (−/+), baseline risk variables (< / ≥3), amount of CAC (< / ≥400), degree of stenosis by CTA (< / ≥50%) nor referral to ICA (−/+).
Conclusion
In symptomatic patients with coronary stenosis by CTA, incomplete revascularization determined by FFRCT is associated with an increased risk of adverse cardiovascular outcomes compared to complete revascularization.
Funding Acknowledgement
Type of funding sources: None.
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Cyr J, Turcios H, Patel M, Brice J, Malcolm JT, Williams J, Cabanas J. 184EMF Implementation of a Novel Fluid Resuscitation Device for the Care of Sepsis Patients: Processes and Perceptions in the Out-of-Hospital Setting. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.208] [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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Presenter RRBN, Shah N, Alencar A, Gerson J, Patel M, Jurczak W, Patel K, Mato A, Cheah C, Wang M. PIRTOBRUTINIB, A HIGHLY SELECTIVE, NON-COVALENT (REVERSIBLE) BTK INHIBITOR IN PREVIOUSLY TREATED MANTLE CELL LYMPHOMA: UPDATED RESULTS FROM THE PHASE 1/2 BRUIN STUDY. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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85
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Hamilton E, Meisel J, Alemany C, Virginia B, Lin N, Wesolowski R, Mathauda-Sahota G, Makower D, Lawrence J, Faltaos D, Mitri Z, Sabanathan D, Clark D, Pluard T, Hui R, McCarthy N, Patel M. Phase 1b results from OP-1250-001, a dose escalation and dose expansion study of OP-1250, an oral CERAN, in subjects with advanced and/or metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer (NCT04505826). Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00896-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patel M, Williams J, Bachman M, Cyr J, Cabanas J, Miller N, Gorstein L, Turcios H, Malcolm JT, Brice J. 406EMF Early Fluid Delivery by Emergency Medical Services for Sepsis Using a Novel Rapid Infusion Device. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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87
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Banks L, Wujcik D, Stricker C, Das M, Shanbhag L, Lin S, Patel M. EP04.02-003 Improving Supportive Care for Patients with Thoracic Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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88
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Bhatia A, Chen Z, Bruce J, Steuer C, Zandberg D, Riess J, Mitchell D, Davis T, Patel M, Kaur V, Arnold S, Owonikoko T. 656MO Phase I study of M6620 (VX-970, berzosertib) in combination with cisplatin and XRT in patients with locally advanced head and neck squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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89
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Patel M, Lee JS, De Miguel M, Burns T, Falcon Gonzalez A, Kim T, Krebs M, Prenen H, Shacham Shmueli E, Desai J, Lorusso P, Sacher A, Choi Y, Dharia N, Lin M, Mandlekar S, Royer-Joo S, Schutzman J, Garralda E. 459MO Phase Ia study to evaluate GDC-6036 monotherapy in patients with solid tumors with a KRAS G12C mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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90
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Schoeffski P, Yamamoto N, Bauer T, Patel M, Gounder M, Geng J, Sailer R, Jayadeva G, Lorusso P. 452O A phase I dose-escalation and expansion study evaluating the safety and efficacy of the MDM2–p53 antagonist BI 907828 in patients (pts) with solid tumours. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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91
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Doi T, Patel M, Falchook G, Koyama T, Friedman C, Piha-Paul S, Gutierrez M, Abdul-Karim R, Awad M, Adkins D, Takahashi S, Kadowaki S, Cheng B, Ikeda N, Laadem A, Yoshizuka N, Qian M, Dosunmu O, Arkenau HT, Johnson M. 453O DS-7300 (B7-H3 DXd antibody-drug conjugate [ADC]) shows durable antitumor activity in advanced solid tumors: Extended follow-up of a phase I/II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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92
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Shinde R, Kaul A, Bhadauria D, Behera M, Yachha M, Kushwah R, Patel M, Gala R, Prasad N. POS-108 POST-TRANSPLANT INFECTIONS AND LONG TERM OUTCOMES IN RENAL TRANSPLANT RECIPIENTS IN A TERTIARY CARE HOSPITAL IN NORTH INDIA. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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93
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Jacobson B, Patel M, Kratzke R. P1.14-04 Silencing ADAR1 Abrogates Mesothelioma Tumorigenicity. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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94
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Aaij R, Abdelmotteleb ASW, Abellán Beteta C, Abudinén F, Ackernley T, Adeva B, Adinolfi M, Afsharnia H, Agapopoulou C, Aidala CA, Aiola S, Ajaltouni Z, Akar S, Albrecht J, Alessio F, Alexander M, Alfonso Albero A, Aliouche Z, Alkhazov G, Alvarez Cartelle P, Amato S, Amey JL, Amhis Y, An L, Anderlini L, Andersson M, Andreianov A, Andreotti M, Andreou D, Ao D, Archilli F, Artamonov A, Artuso M, Arzymatov K, Aslanides E, Atzeni M, Audurier B, Bachmann S, Bachmayer M, Back JJ, Baladron Rodriguez P, Balagura V, Baldini W, Baptista de Souza Leite J, Barbetti M, Barlow RJ, Barsuk S, Barter W, Bartolini M, Baryshnikov F, Basels JM, Bassi G, Batsukh B, Battig A, Bay A, Beck A, Becker M, Bedeschi F, Bediaga I, Beiter A, Belavin V, Belin S, Bellee V, Belous K, Belov I, Belyaev I, Bencivenni G, Ben-Haim E, Berezhnoy A, Bernet R, Berninghoff D, Bernstein HC, Bertella C, Bertolin A, Betancourt C, Betti F, Bezshyiko I, Bhasin S, Bhom J, Bian L, Bieker MS, Biesuz NV, Bifani S, Billoir P, Biolchini A, Birch M, Bishop FCR, Bitadze A, Bizzeti A, Bjørn M, Blago MP, Blake T, Blanc F, Blusk S, Bobulska D, Boelhauve JA, Boente Garcia O, Boettcher T, Boldyrev A, Bondar A, Bondar N, Borghi S, Borisyak M, Borsato M, Borsuk JT, Bouchiba SA, Bowcock TJV, Boyer A, Bozzi C, Bradley MJ, Braun S, Brea Rodriguez A, Brodzicka J, Brossa Gonzalo A, Brundu D, Buonaura A, Buonincontri L, Burke AT, Burr C, Bursche A, Butkevich A, Butter JS, Buytaert J, Byczynski W, Cadeddu S, Cai H, Calabrese R, Calefice L, Cali S, Calladine R, Calvi M, Calvo Gomez M, Camargo Magalhaes P, Campana P, Campora Perez DH, Campoverde Quezada AF, Capelli S, Capriotti L, Carbone A, Carboni G, Cardinale R, Cardini A, Carli I, Carniti P, Carus L, Carvalho Akiba K, Casais Vidal A, Caspary R, Casse G, Cattaneo M, Cavallero G, Celani S, Cerasoli J, Cervenkov D, Chadwick AJ, Chapman MG, Charles M, Charpentier P, Chavez Barajas CA, Chefdeville M, Chen C, Chen S, Chernov A, Chernyshenko S, Chobanova V, Cholak S, Chrzaszcz M, Chubykin A, 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K, Jacobsson R, Jage H, Jakobsen S, Jans E, Jashal BK, Jawahery A, Jevtic V, Jiang X, John M, Johnson D, Jones CR, Jones TP, Jost B, Jurik N, Juszczak I, Kandybei S, Kang Y, Karacson M, Karpenkov D, Karpov M, Kautz JW, Keizer F, Keller DM, Kenzie M, Ketel T, Khanji B, Kharisova A, Kholodenko S, Kirn T, Kirsebom VS, Kitouni O, Klaver S, Kleijne N, Klimaszewski K, Kmiec MR, Koliiev S, Kondybayeva A, Konoplyannikov A, Kopciewicz P, Kopecna R, Koppenburg P, Korolev M, Kostiuk I, Kot O, Kotriakhova S, Kozachuk A, Kravchenko P, Kravchuk L, Krawczyk RD, Kreps M, Kretzschmar S, Krokovny P, Krupa W, Krzemien W, Kubat J, Kucewicz W, Kucharczyk M, Kudryavtsev V, Kuindersma HS, Kunde GJ, Kvaratskheliya T, Lacarrere D, Lafferty G, Lai A, Lampis A, Lancierini D, Lane JJ, Lane R, Lanfranchi G, Langenbruch C, Langer J, Lantwin O, Latham T, Lazzari F, Le Gac R, Lee SH, Lefèvre R, Leflat A, Legotin S, Leroy O, Lesiak T, Leverington B, Li H, Li K, Li P, Li S, Li Y, Li Z, Liang X, Lin C, Lin T, Lindner R, Lisovskyi V, Litvinov R, Liu G, Liu H, Liu Q, Liu S, Lobo Salvia A, Loi A, Lollini R, Lomba Castro J, Longstaff I, Lopes JH, López Soliño S, Lovell GH, Lu Y, Lucarelli C, Lucchesi D, Luchuk S, Lucio Martinez M, Lukashenko V, Luo Y, Lupato A, Luppi E, Lupton O, Lusiani A, Lyu X, Ma L, Ma R, Maccolini S, Machefert F, Maciuc F, Macko V, Mackowiak P, Maddrell-Mander S, Madhan Mohan LR, Maev O, Maevskiy A, Maisuzenko D, Majewski MW, Malczewski JJ, Malde S, Malecki B, Malinin A, Maltsev T, Malygina H, Manca G, Mancinelli G, Manuzzi D, Manzari CA, Marangotto D, Maratas J, Marchand JF, Marconi U, Mariani S, Marin Benito C, Marinangeli M, Marks J, Marshall AM, Marshall PJ, Martelli G, Martellotti G, Martinazzoli L, Martinelli M, Martinez Santos D, Martinez Vidal F, Massafferri A, Materok M, Matev R, Mathad A, Matiunin V, Matteuzzi C, Mattioli KR, Mauri A, Maurice E, Mauricio J, Mazurek M, McCann M, Mcconnell L, Mcgrath TH, Mchugh NT, McNab A, McNulty R, Mead JV, Meadows B, Meier G, Melnychuk D, Meloni S, Merk M, Merli A, Meyer Garcia L, Mikhasenko M, Milanes DA, Millard E, Milovanovic M, Minard MN, Minotti A, Mitchell SE, Mitreska B, Mitzel DS, Mödden A, Mohammed RA, Moise RD, Mokhnenko S, Mombächer T, Monroy IA, Monteil S, Morandin M, Morello G, Morello MJ, Moron J, Morris AB, Morris AG, Mountain R, Mu H, Muheim F, Mulder M, Müller K, Murphy CH, Murray D, Murta R, Muzzetto P, Naik P, Nakada T, Nandakumar R, Nanut T, Nasteva I, Needham M, Neri N, Neubert S, Neufeld N, Newcombe R, Niel EM, Nieswand S, Nikitin N, Nolte NS, Normand C, Nunez C, Oblakowska-Mucha A, Obraztsov V, Oeser T, O'Hanlon DP, Okamura S, Oldeman R, Oliva F, Olivares ME, Onderwater CJG, O'Neil RH, Otalora Goicochea JM, Ovsiannikova T, Owen P, Oyanguren A, Ozcelik O, Padeken KO, Pagare B, Pais PR, Pajero T, Palano A, Palutan M, Pan Y, Panshin G, Papanestis A, Pappagallo M, Pappalardo LL, Pappenheimer C, Parker W, Parkes C, Passalacqua B, Passaleva G, Pastore A, Patel M, Patrignani C, Pawley CJ, Pearce A, 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D, Vorobyev A, Vorobyev V, Voropaev N, Vos K, Waldi R, Walsh J, Wang C, Wang J, Wang J, Wang J, Wang J, Wang M, Wang R, Wang Y, Wang Z, Wang Z, Wang Z, Ward JA, Watson NK, Websdale D, Weisser C, Westhenry BDC, White DJ, Whitehead M, Wiederhold AR, Wiedner D, Wilkinson G, Wilkinson MK, Williams I, Williams M, Williams MRJ, Williams R, Wilson FF, Wislicki W, Witek M, Witola L, Wong CP, Wormser G, Wotton SA, Wu H, Wyllie K, Xiang Z, Xiao D, Xie Y, Xu A, Xu J, Xu L, Xu M, Xu Q, Xu Z, Xu Z, Yang D, Yang S, Yang Y, Yang Z, Yang Z, Yao Y, Yeomans LE, Yin H, Yu J, Yuan X, Yushchenko O, Zaffaroni E, Zavertyaev M, Zdybal M, Zenaiev O, Zeng M, Zhang D, Zhang L, Zhang S, Zhang S, Zhang Y, Zhang Y, Zharkova A, Zhelezov A, Zheng Y, Zhou T, Zhou X, Zhou Y, Zhovkovska V, Zhu X, Zhu X, Zhu Z, Zhukov V, Zou Q, Zucchelli S, Zuliani D, Zunica G. First Measurement of the Z→μ^{+}μ^{-} Angular Coefficients in the Forward Region of pp Collisions at sqrt[s]=13 TeV. PHYSICAL REVIEW LETTERS 2022; 129:091801. [PMID: 36083649 DOI: 10.1103/physrevlett.129.091801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
The first study of the angular distribution of μ^{+}μ^{-} pairs produced in the forward rapidity region via the Drell-Yan reaction pp→γ^{*}/Z+X→ℓ^{+}ℓ^{-}+X is presented, using data collected with the LHCb detector at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 5.1 fb^{-1}. The coefficients of the five leading terms in the angular distribution are determined as a function of the dimuon transverse momentum and rapidity. The results are compared to various theoretical predictions of the Z-boson production mechanism and can also be used to probe transverse-momentum-dependent parton distributions within the proton.
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Morrow A, Gray SR, Bayes HK, Sykes R, McGarry E, Anderson D, Boiskin D, Burke C, Cleland JGF, Goodyear C, Ibbotson T, Lang CC, McConnachie, Mair F, Mangion K, Patel M, Sattar N, Taggart D, Taylor R, Dawkes S, Berry C. Prevention and early treatment of the long-term physical effects of COVID-19 in adults: design of a randomised controlled trial of resistance exercise-CISCO-21. Trials 2022; 23:660. [PMID: 35971155 PMCID: PMC9376905 DOI: 10.1186/s13063-022-06632-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/04/2022] [Indexed: 11/11/2022] Open
Abstract
Background Coronavirus disease-19 (COVID-19) infection causes persistent health problems such as breathlessness, chest pain and fatigue, and therapies for the prevention and early treatment of post-COVID-19 syndromes are needed. Accordingly, we are investigating the effect of a resistance exercise intervention on exercise capacity and health status following COVID-19 infection. Methods A two-arm randomised, controlled clinical trial including 220 adults with a diagnosis of COVID-19 in the preceding 6 months. Participants will be classified according to clinical presentation: Group A, not hospitalised due to COVID but persisting symptoms for at least 4 weeks leading to medical review; Group B, discharged after an admission for COVID and with persistent symptoms for at least 4 weeks; or Group C, convalescing in hospital after an admission for COVID. Participants will be randomised to usual care or usual care plus a personalised and pragmatic resistance exercise intervention for 12 weeks. The primary outcome is the incremental shuttle walks test (ISWT) 3 months after randomisation with secondary outcomes including spirometry, grip strength, short performance physical battery (SPPB), frailty status, contacts with healthcare professionals, hospitalisation and questionnaires assessing health-related quality of life, physical activity, fatigue and dyspnoea. Discussion Ethical approval has been granted by the National Health Service (NHS) West of Scotland Research Ethics Committee (REC) (reference: GN20CA537) and recruitment is ongoing. Trial findings will be disseminated through patient and public forums, scientific conferences and journals. Trial registration ClinicialTrials.gov NCT04900961. Prospectively registered on 25 May 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06632-y.
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Search for continuous gravitational wave emission from the Milky Way center in O3 LIGO-Virgo data. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.042003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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RL, Warner J, Was M, Washington NY, Watchi J, Weaver B, Webster SA, Weinert M, Weinstein AJ, Weiss R, Weller CM, Wellmann F, Wen L, Weßels P, Wette K, Whelan JT, White DD, Whiting BF, Whittle C, Wilken D, Williams D, Williams MJ, Williamson AR, Willis JL, Willke B, Wilson DJ, Winkler W, Wipf CC, Wlodarczyk T, Woan G, Woehler J, Wofford JK, Wong ICF, Wu DS, Wysocki DM, Xiao L, Yamamoto H, Yang FW, Yang L, Yang Y, Yang Z, Yap MJ, Yeeles DW, Yelikar AB, Ying M, Yoo J, Yu H, Yu H, Zadrożny A, Zanolin M, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhang Y, Zhao C, Zhao G, Zhao Y, Zhou R, Zhou Z, Zhu XJ, Zimmerman AB, Zucker ME, Zweizig J, Jeong D, Shandera S. Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run. PHYSICAL REVIEW LETTERS 2022; 129:061104. [PMID: 36018635 DOI: 10.1103/physrevlett.129.061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/18/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2 M_{⊙} and 1.0 M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14 yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200] Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2 M_{⊙}<m_{PBH}<1.0 M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1 M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.
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Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. THE LANCET. RESPIRATORY MEDICINE 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Bhullar P, Boudreaux B, Severson K, Zhang N, Butterfield R, Brumfiel C, Patel M, Li X, Hughes A, Zunich S, Branch E, Nelson S, Sekulic A, Pittelkow M, Mangold A. LB947 An open-label study of topical ruxolitinib in necrobiosis lipoidica. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Patel M, Schultz K, Rosenfeld E. The earliest known reported occurrence of dentigerous cyst in a six-month-old child. Int J Oral Maxillofac Surg 2022; 51:1535-1537. [PMID: 35871878 DOI: 10.1016/j.ijom.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/23/2022] [Accepted: 06/24/2022] [Indexed: 11/15/2022]
Abstract
The earliest reported case of the occurrence of a dentigerous cyst is described; the cyst surrounded an unerupted permanent tooth bud in a 6-month-old infant. Most commonly these lesions present between the second and third decades of life. They rarely occur before 10 years of age and have not been documented prior to 1 year of age. In the case reported here, the treatment instituted was extraction of the adjacent deciduous tooth and enucleation of the cyst along with the permanent molar tooth bud. Clinicians should be aware of the potential for this lesion to occur across a wide range of ages and the importance of prompt diagnosis and treatment to prevent complications and reduce morbidity.
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