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Kably I, Sandhu J, Amin A, Luka J. 03:27 PM Abstract No. 202 Safety and efficacy of radiofrequency ablation with cementoplasty in the palliative treatment of sacral metastases using a thermal protection technique. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kably I, Dupaix R, Amin A, Bhatia S, Chang Y. Abstract No. 455 Prostatic arterial embolization (PAE) for inoperable prostate cancer patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Sandhu J, Amin A, Kably I, Shah K, Richardson A, Garcia J, Bhatia S. Abstract No. 458 Safety and feasibility of prostate artery embolization via transradial access: single-center experience. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.539] [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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Ganju RG, Savvides G, Korentager S, Ward MJ, TenNapel M, Amin A, Wagner J, Mitchell M. Incidence of breast lymphedema and predictors of its development in patients receiving whole breast radiation therapy after breast-conservation surgery. Lymphology 2019; 52:126-133. [PMID: 31874124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
One common adverse effect following breast-conservation surgery and adjuvant radiation is lymphedema. While lymphedema of the arm has been well-characterized, there has been less investigation into lymphedema of the breast. We sought to characterize rates of breast lymphedema (BLE) in women with early-stage breast cancer and identify potential predictors in its development. Two hundred and thirty consecutive patients treated with lumpectomy and adjuvant whole breast radiation therapy (WBRT) from January 2016 - June 2017 were included. All patients were seen in our lymphedema monitoring clinic for baseline and at least one follow-up lymphedema measurement. BLE grades were assigned by trained nurses in the lymphedema clinic. Data regarding patient demographic and treatment factors were extracted from the electronic medical record. Comparisons between groups were made using Chi-Square analysis performed in SAS. The median age of the sample was 62 (range 31-90). Median follow-up from surgery was 15.3 months. Forty-three patients were diagnosed with lymphedema of the breast (18.7%). Rates of grade 1 and 2 BLE were 93% and 7%, respectively; there were no cases of severe lymphedema. Sixty-three percent of cases resolved by last follow-up with treatment recommendations. There was no association between development of BLE and patient factors investigated, including age, T stage, radiation dose and fractionation, lymph node biopsy, number of lymph nodes removed, development of arm lymphedema, and use of chemotherapy. Tumor subtype was found to be significant (P = 0.04) and there was a trend towards significance for receipt of trastuzumab (P = 0.09). BLE is a distinct entity from arm lymphedema and is a common finding in women treated with breast-conserving surgery and adjuvant WBRT. It is a generally mild and self-limiting process. There were no treatment or patient-related factors that correlated with increased risk of lymphedema development in our sample except for HER-2 positive disease and receipt of trastuzamab.
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Boilève A, Carlo MI, Barthélémy P, Oudard S, Borchiellini D, Voss MH, George S, Chevreau C, Landman-Parker J, Tabone MD, Chism DD, Amin A, Bilen MA, Bosse D, Coulomb-L'hermine A, Su X, Choueiri TK, Tannir NM, Malouf GG. Immune checkpoint inhibitors in MITF family translocation renal cell carcinomas and genetic correlates of exceptional responders. J Immunother Cancer 2018; 6:159. [PMID: 30591082 PMCID: PMC6307255 DOI: 10.1186/s40425-018-0482-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/13/2018] [Indexed: 01/05/2023] Open
Abstract
Background Microphthalmia Transcription Factor (MITF)family translocation renal cell carcinoma (tRCC) is a rare RCC subtype harboring TFE3/TFEB translocations. The prognosis in the metastatic (m) setting is poor. Programmed death ligand-1 expression was reported in 90% of cases, prompting us to analyze the benefit of immune checkpoint inhibitors (ICI) in this population. Patients and methods This multicenter retrospective study identified patients with MITF family mtRCC who had received an ICI in any of 12 referral centers in France or the USA. Response rate according to RECIST criteria, progression-free survival (PFS), and overall survival (OS) were analyzed. Genomic alterations associated with response were determined for 8 patients. Results Overall, 24 patients with metastatic disease who received an ICI as second or later line of treatment were identified. Nineteen (82.6%) of these patients had received a VEGFR inhibitor as first-line treatment, with a median PFS of 3 months (range, 1–22 months). The median PFS for patients during first ICI treatment was 2.5 months (range, 1–40 months); 4 patients experienced partial response (16,7%) and 3 (12,5%) had stable disease. Of the patients whose genomic alterations were analyzed, two patients with mutations in bromodomain-containing genes (PBRM1 and BRD8) had a clinical benefit. Resistant clones in a patient with exceptional response to ipilimumab showed loss of BRD8 mutations and increased mutational load driven by parallel evolution affecting 17 genes (median mutations per gene, 3), which were enriched mainly for O-glycan processing (29.4%, FDR = 9.7 × 10− 6). Conclusions MITF family tRCC is an aggressive disease with similar responses to ICIs as clear-cell RCC. Mutations in bromodomain-containing genes might be associated with clinical benefit. The unexpected observation about parallel evolution of genes involved in O-glycosylation as a mechanism of resistance to ICI warrants exploration.
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Long G, Milhem M, Amin A, Hoimes C, Medina T, Conry R, Lao C, Daniels G, Reddy S, Mehmi I, Andtbacka R, Barve M, Shaheen M, Tueting T, Chisamore M, Xing B, Candia A, Gamelin E, Janssen R, Ribas A. Phase Ib/II, open label, multicenter, study of the combination of SD-101 and pembrolizumab in patients with advanced melanoma who are naïve to anti-PD-1 therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ribas A, Mehmi I, Medina T, Lao C, Kummar S, Amin A, Deva S, Salama A, Tueting T, Milhem M, Hoimes C, Daniels G, Shaheen M, Jang S, Barve M, Powell A, Chandra S, Schmidt E, Janssen R, Long G. Phase Ib/II study of the combination of SD-101 and pembrolizumab in patients with advanced melanoma who had progressive disease on or after prior anti-PD-1 therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bharmal M, Amin A, Stapelkamp C, Pescott C, Hatswell A, Lilley C, Bullement A, Willis A. Cost-effectiveness (CE) of avelumab vs standard care (SC) for the treatment of patients (pts) with metastatic Merkel cell carcinoma (mMCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cohen E, Algazi A, Laux D, Wong D, Amin A, Nabell L, Chisamore M, Gamelin E, Janssen R, Bishnoi S. Phase Ib/II, open label, multicenter study of intratumoral SD-101 in combination with pembrolizumab in anti-PD-1 treatment naïve patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Eckart A, Hausfater P, Amin D, Amin A, Haubitz S, Bernard M, Baumgartner A, Struja T, Kutz A, Christ-Crain M, Huber A, Mueller B, Schuetz P. Hyponatremia and activation of vasopressin secretion are both independently associated with 30-day mortality: results of a multicenter, observational study. J Intern Med 2018; 284:270-281. [PMID: 29664160 DOI: 10.1111/joim.12764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hyponatremia is a common feature of acute illness and associated with increased mortality. This may be explained by a stress-mediated activation of the vasopressin system with an increase in free-water reabsorption. OBJECTIVES To investigate whether the association between hyponatremia and mortality could be explained by activation of the vasopressin system. METHODS We prospectively enrolled adult, medical patients seeking emergency care in three centres in Switzerland, France and the United States. We investigated associations between admission plasma sodium and copeptin, a stable portion of the vasopressin-precursor peptide, with 30-day mortality. We performed uni- and multivariate regression analysis. RESULTS Of 6962 included patients, 18% had hyponatremia (sodium ≤135 mmol L-1 ), which doubled their risk for mortality compared to patients with normonatremia (8.3% vs. 3.8%). This association was confirmed in a multivariate-adjusted logistic regression analysis [adjusted odds ratio (OR) 1.47, 95% CI 1.12-1.93, P = 0.005]. Vasopressin levels, mirrored by copeptin, were also increased in nonsurvivors and strongly associated with mortality (adjusted OR 3.42, 95% CI 2.76-4.25, P < 0.001). The association between hyponatremia and mortality remained unchanged when adding copeptin levels to the regression model (fully adjusted OR 1.53, 95% CI 1.16-2.00, P = 0.002). CONCLUSION This prospective study including medical patients upon emergency room admission found hyponatremia as well as an activation of the vasopressin system to be independently associated with mortality. This suggests that stress- and vasopressin-independent mechanisms are responsible for the association of low sodium levels with mortality.
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Amin A, Keshishian A, Zhang Q, Dina O, Dhamane A, Nadkarni A, Carda E, Liu X, Rosenblatt L, Baser O, Baker C. P3844Effectiveness, safety, and composite clinical outcomes of apixaban, dabigatran, rivaroxaban, relative to warfarin in non-valvular atrial fibrillation patients in the US Medicare population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Amin A, Tsangaris A, Arora A, Satya K. 402Implantable cardioverter defibrillator in patients with hypertrophic cardiomyopathy - A nationwide study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ghalab R, Mansour H, Abdelsalam SH, Elsoughuer S, Amin A. P5496Effect of the time delay of PDA closure on aortic stiffness index and its relation with cardiac function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Amin A, Gold MR, Burke MC, Knight BP, Kalbfleisch SJ, Okabe T, Duffy E, Stahl WK, Husby M, Tyler J, Houmsse M, Daoud EG, Hummel JD, Augostini RS, Weiss R. P2930Subcutaneous implantable cardioverter defibrillator position determines success. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Amin A, Arora A, Tsangaris A, Satya K. 4174Utilization of intravascular optical coherence tomography (OCT) in guiding percutaneous coronary interventions. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amin A, Bassalobre Garcia A, Li X, Dhamane A, Luo X, Di Fusco M, Nadkarni A, Friend K, Rosenblatt L, Mardekian J, Pan X, Baser O, Keshishian A. P979Comparison of effectiveness, safety, and healthcare costs in non-valvular atrial fibrillation patients with heart failure prescribed direct oral anticoagulants. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amin A, Bassalobre Garcia A, Li X, Dhamane A, Luo X, Di Fusco M, Nadkarni A, Friend K, Rosenblatt L, Mardekian J, Pan X, Baser O, Keshishian A. P6590Comparison of effectiveness, safety, and healthcare costs of direct oral anticoagulants with warfarin in nonvalvular atrial fibrillation patients with heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghalab R, Abdel-Salam SH, Elsoughuer S, Amin A. P4589Aortic stiffness index and its association with cardiovascular functions in children prior and afterward trans-catheter closure of the PDA. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsangaris A, Pasala TKR, Amin A, Arora A, Ruiz CE. P5469National trends, outcomes and complications of transcatheter pulmonary valve replacement; a population study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cruickshank L, Amin A, DeSilva A. Small bowel evisceration: a late complication following vaginal hysterectomy. J OBSTET GYNAECOL 2018; 38:733. [PMID: 29944042 DOI: 10.1080/01443615.2018.1444397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We present a case of small bowel evisceration occurring as a late complication following vaginal hysterectomy and subsequent vault prolapse. CASE HISTORY A 92-year-old female presented with sudden onset severe abdominal pain, followed by the sensation of vaginal fullness and the discovery of a large prolapse per vagina, with no history of trauma or sexual intercourse. Past medical history consisted of vaginal hysterectomy 20 years previously with a subsequent sacrospinous vault fixation. On examination, a vaginal vault prolapse was found with 3 feet of oedematous small bowel prolapsed through it. Peristalsis remained visible. An emergency laparotomy was undertaken as a joint procedure between the gynaecology and general surgery teams. The small bowel was gently manipulated back through a 3 cm defect in the vault. Once in the abdomen, it was found to be viable and no resection was required. The vault defect was closed with 1/0 Vicryl and the vault was then fixed to the left lateral side wall of the peritoneum. Routine closure of the abdomen was performed after saline washout. Recovery was complicated by a postoperative ileus requiring nasogastric tube insertion for two days. She recovered well following this and will be followed up in the gynaecology outpatient clinic. DISCUSSION Small bowel evisceration is a rare complication following hysterectomy. With relatively few cases reported in the literature, incidence is difficult to determine. The most commonly reported risk factors are postmenopausal atrophy, previous vaginal surgery and enterocele. Cases have been reported following both abdominal and vaginal surgical approaches, and are commonly precipitated by sexual intercourse, introduction of a foreign body into the vagina or increased intra-abdominal pressure (Gandhi and Jha 2011 ). Vaginal evisceration is a gynaecological emergency. Prompt recognition is vital in order to prevent compromise of intra-abdominal contents (Codd et al. 2010 ). Management requires a multidisciplinary approach and early transfer to theatre for urgent surgical repair; various different approaches have been described, however, if there is any question about organ viability exploration via a midline laparotomy is indicated (Gandhi and Jha 2011 ). Educational message/learning point: We have presented this case in order to raise awareness of small bowel evisceration as a late complication following hysterectomy. Clinicians in both general surgery and gynaecology should be aware of its potentially non-specific presenting symptoms, as eviscerated organs may not be particularly evident on admission. This is a life threatening condition that requires immediate recognition and management via a multidisciplinary approach.
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Gabr H, Abo Elkheir W, Zaki R, Amin A. Thyroid islets tissue engineering: Thyroid organoid implanted intramuscular secretes thyroid hormones in post-thyroidectomy mice. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.233] [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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Sandhu J, Madhusoodanan V, Amin A, Kably I. 3:27 PM Abstract No. 253 Palliative radiofrequency ablation of spinal metastases: safety, technical success, and short-term efficacy. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.283] [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] Open
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Doshi M, Mohan P, Hanson A, Amin A, Salas N, Lencioni R, Narayanan G. 3:27 PM Abstract No. 305 Vascular selectivity of radiopaque beads during transarterial embolization. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.339] [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] Open
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Amin A, Sinha V, Sullivan T, Mehta N, Doshi M, Kuker R, Lencioni R, Narayanan G. 3:27 PM Abstract No. 184 Using FDG PET/CT to predict response to IRE in nonresectable pancreatic cancer: a retrospective analysis of 50 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.207] [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] Open
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Amin A, Prosser C, Kroeker KI, Wang H, Shalapay C, Dhami N, Fedorak DK, Halloran BP, Dieleman LA, Goodman K, Fedorak R, Huang V. A147 COMBINING INFLIXIMAB TROUGH LEVELS AND FECAL CALPROTECTIN LEVELS WITH CLINICAL DATA HAS THE POTENTIAL TO GUIDE CLINICAL DECISION-MAKING IN IMPROVING OUTCOMES FOR INFLAMMATORY BOWEL DISEASE PATIENTS ON MAINTENANCE INFLIXIMAB. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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