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Yin WJ, Li LM, Wang L, Huang A, Qiao AX, Jia YT, Feng Y. [Correlation between BRAP expression and prognosis of patients with laryngeal squamous cell carcinoma]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 33:1081-1084. [PMID: 31914300 DOI: 10.13201/j.issn.1001-1781.2019.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the expression of BRCA1 associated protein(BRAP) and its correlations with clinicopathological features and prognosis of patients with laryngeal squamous cell carcinoma(LSCC). Method:The protein expression of BRAP in LSCC tissues and normal laryngeal tissues were assessed by immunohistochemistry and Western blot, and their correlations with clinicopathological features and prognosis were statistically analyzed. Result:The expression of BRAP in LSCC was significantly higher than that in normal laryngeal tissues(P<0.05). BRAP expression was significantly correlated with the TNM stage and lymph node metastasis(P<0.05). Kaplan-Meier survival analysis showed that LSCC patients with high BRAP expression had worse overall survival than those with low BRAP expression(P<0.01). Multivariate Cox proportional-hazards analysis showed that the high expression of BRAP protein was an important poor prognostic indicator of the patients. Conclusion:BRAP is related with the development of LSCC, and it may be used as an important prognostic biomarker for LSCC patients.
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Ortega-Gutierrez S, Samaniego EA, Reccius A, Huang A, Zheng-Lin B, Masukar A, Marshall RS, Petersen NH. Changes on Dynamic Cerebral Autoregulation Are Associated with Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage. ACTA NEUROCHIRURGICA. SUPPLEMENT 2020; 127:149-153. [PMID: 31407076 DOI: 10.1007/978-3-030-04615-6_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Early identification of vasospasm prior to symptom onset would allow prevention of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH). Dynamic cerebral autoregulation (DCA) is a noninvasive means of assessing cerebral blood flow regulation by determining independence of low-frequency temporal oscillations of systemic blood pressure (BP) and cerebral blood flow velocities (CBFV). METHODS Eight SAH patients underwent prospectively a median of 7 DCA assessments consisting of continuous measurements of BCFV and BP. Transfer function analysis was applied to calculate average phase shift (PS) in low (0.07-0.2 Hz) frequency range for each hemisphere as continuous measure of DCA. Lower PS indicated poorer regulatory response. DCI was defined as a 2-point decrease in Glasgow Coma Score and/or infarction on CT. RESULTS Three subjects developed symptomatic vasospasm with median time-to-DCI of 9 days. DCI was significantly associated with lower PS over the entire recording period (Wald = 4.28; p = 0.039). Additionally, there was a significant change in PS over different recording periods after adjusting for DCI (Wald = 15.66; p = 0.001); particularly, a significantly lower mean PS day 3-5 after bleed (14.22 vs 27.51; p = 0.05). CONCLUSIONS DCA might be useful for early detection of symptomatic vasospasm. A larger cohort study of SAH patients is currently underway.
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Yu X, Xin M, Huang A, Chen L, Cai X, Shen J, Zou T, Yang T, Miao Y. Ginsenoside Rg2 Attenuates Ischemia/Reperfusion-induced Injury to Spinal Cord in Rats. Indian J Pharm Sci 2020. [DOI: 10.36468/pharmaceutical-sciences.spl.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Huang A, Kim ASI. Bayesian Conway–Maxwell–Poisson regression models for overdispersed and underdispersed counts. COMMUN STAT-THEOR M 2019. [DOI: 10.1080/03610926.2019.1682162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bauml J, Yoon D, Yan P, Katz S, Jeffries S, Davis C, Aggarwal C, Cohen R, Marmarelis M, Singh A, Ciunci C, Wherry E, Albelda S, Langer C, Huang A. P2.04-02 Effect of Chemotherapy, Chemoimmunotherapy, and Immunotherapy on Parameters of T Cell Exhaustion in Metastatic Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1508] [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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Huang A, Mugharbil A, Anastasius M, Ghadiri S, Leipsic J, Elahi N, Brunham L, Pimstone S, Golmohammadzadeh M, Thompson CR, Argulian E, Narula J, Ahmadi A. P3432Coronary artery calcium score is of limited sensitivity in detecting subclinical atherosclerosis in young individuals with family history of coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0306] [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
Family history of premature coronary artery disease (CAD) is known to predispose individuals to adverse CAD events, often at a younger age. Current risk stratification strategy is suboptimal, as up to 50% of individuals were considered “low-risk” prior to their first presentation of myocardial infarction. Coronary artery calcium score (CACS) is a marker of atherosclerosis and provides incremental value in risk stratification. However, the utility of CACS may be limited in younger patients as they often have non-calcified atherosclerotic plaques. In this study, we evaluate the sensitivity of CACS in detecting subclinical atherosclerosis in different age groups.
Method
From 310 referrals to a specialized unit in the management of early atherosclerosis, 222 individuals with a family history of premature CAD (defined as CAD events in first-degree family members, male<55 and female<65) and aged between 35 and 55 were enrolled for assessment of their CAD risks. Individuals with possible, probably or definite familial hypercholesterolemia were excluded. In addition to clinical and risk factor evaluation, cardiac CT and CACS were performed in select individuals, at the discretion of the treating physician.
Results
Of the 141 (59% male, mean age 45.9±6.0 year) individuals that completed clinical evaluation, 65 (73% male, mean age 47.4±6.9 years) have subclinical atherosclerosis (defined by the presence of atherosclerotic plaques in any of the coronary artery segments in cardiac CT). Of them, 52 have CACS>0, giving an overall sensitivity of 80%. The breakdown by age group is shown in table 1. The sensitivity of CACS in detecting subclinical atherosclerosis is quite modest in younger individuals (60% in individuals <45 year-old) but improves with patient age (>85% in >45 years).
Table 1. Sensitivity of CACS in different age groups Age group True Positive Fast Negative Sensitivity N (CAC+ CTCA+) (CAC+ CTCA−) (%) <40 6 4 60 10 41–45 7 4 55 11 46–50 19 3 86 22 51–55 20 1 95 21
Conclusion
In younger individuals (<45 years) with family history of premature CAD, CACS is of limited sensitivity in detecting subclinical atherosclerosis, and should not be used to rule out CAD. Further studies are warranted.
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Ghadiri S, Leipsic J, Elahi N, Anastasius M, Huang A, Mugharbil A, Brunham L, Pimstone S, Golmohammadzadeh M, Thompson C, Argulian E, Narula J, Ahmadi A. P3412Risk factors, biomarkers and framingham risk estimate fail to identify presence of subclinical atherosclerosis in young individual with family history of premature coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0286] [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
Patients with family history of premature coronary artery disease (CAD) are at increased risk of CAD events at a younger age. Risk factor based approaches and clinical evaluation are most commonly used to assess these individuals. However, it has been recently shown that up to 50% of individual presenting with their first myocardial infarction (MI) were considered to be “low risk” prior to that event. MI is often a result of plaque rupture preceded by progression of subclinical atherosclerosis. Detection of subclinical atherosclerosis may therefore help target prevention of plaque progression. We assessed the value of clinical risk factor, biomarkers and Framingham Risk Score (FRS) in predicting subclinical atherosclerosis in individuals with a family history of premature CAD.
Methods
From 310 referrals, 222 individuals between the ages of 35 and 55 with a family history of premature CAD (CAD events in first-degree family members (male <55, female <65)) were enrolled for evaluation of risk of CAD. Those with familial hypercholesteremia (possible, probable or definite) were excluded. Patients underwent clinical and risk factor evaluations as well as Cardiac CT or Calcium Score (CS) to assess presence of subclinical / clinical atherosclerosis at the discretion of the treating physician.
Results
In this pilot, 141 individuals (59% male, mean age 45.9±6.0 years) completed evaluation, and 65 (46%) had evidence of subclinical atherosclerosis on CT coronary angiography or CT calcium score with a mean segment involvement score (SIS) of 2.8 and mean CS of 152, putting them above the 80th percentile for their age and sex. Aside from male sex, age, and smoking history, other traditional risk factors and biomarkers including diabetes mellitus, hypertension, total cholesterol, LDL-C, HDL-C and Cholesterol/HDL-C were not significantly different between those with or without subclinical atherosclerosis (Table 1).
Table 1
Conclusion
In young individuals with a family history of premature CAD, risk factors, biomarkers, and FRS failed to identify individuals with premature, subclinical atherosclerosis in this pilot study. Detection of subclinical atherosclerosis and early implementation of treatment with the aim of stabilizing plaques and stopping progression might prove vital in reducing events in these individuals. Further studies are warranted.
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Huang A, Slinger PD. Reintubation After Pleurodesis: Further Insight Into an Understated Problem With Limited Solutions. J Cardiothorac Vasc Anesth 2019; 33:2471-2472. [DOI: 10.1053/j.jvca.2019.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/09/2019] [Indexed: 11/11/2022]
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Huang A, Nardone B, West D, Colavincenzo M. 674 Hair loss and psychoactive medications: Stimulants and antidepressants: A retrospective analysis from the RADAR (Research on Adverse Drug events And Reports) Program. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.750] [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]
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Huang A, Delozier S, Lauderdale CJ, Zhao S, Clayton DB, Pope JC, Tanaka ST, Adams MC, Shannon CN, Brock JW, Thomas JC. Do repeat ultrasounds affect orchiectomy rate in patients with testicular torsion treated at a pediatric institution? J Pediatr Urol 2019; 15:179.e1-179.e5. [PMID: 30704855 DOI: 10.1016/j.jpurol.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Testicular torsion is a urological emergency; as the testicular salvage rate decreases with time, prompt intervention is required to restore the blood flow. Interhospital transfers and ultrasound examinations, while clinically essential to proper treatment and diagnosis, may adversely affect outcomes by delaying surgical intervention. Patients transferred to another institution for treatment of testicular torsion may experience a further time delay by undergoing two ultrasound examinations: one at the initial admitting institution and one at the receiving institution. To the knowledge of the authors, no study has yet explored the time delays and outcomes associated with these repeat ultrasounds. OBJECTIVE The objective was to investigate the impact of repeat ultrasound imaging on time to treatment and patient outcomes in patients with testicular torsion. STUDY DESIGN A retrospective chart review of 133 patients, aged 0-20 years, treated at the authors' institution for testicular torsion was conducted. Neonate patients and patients who did not receive ultrasound were excluded. Demographic and clinical variables were collected from the electronic medical record. Pearson Chi-squared and t-tests were used for univariate comparisons, and multivariate logistic regression analysis was performed to measure the relationships between variables. RESULTS Forty-nine percent of patients were primary patients, and 51% were transfer patients. Fifty-two percent of transfer patients received repeat ultrasounds. In comparison to salvaged patients, those who underwent orchiectomy experienced a greater delay between presentation at the institution and surgical intervention (229 min vs 177 min, p = 0.048). The transfer status does not appear to be related to the outcome, i.e. orchiectomy versus salvage. Patients who underwent orchiectomy were more likely than salvaged patients to have received repeat ultrasounds (p = 0.008). Repeat ultrasound patients had three times the likelihood of orchiectomy of single ultrasound patients. In a subset analysis of transfer patients, repeat ultrasound patients were more likely than single ultrasound patients to receive an orchiectomy (p = 0.03). DISCUSSION In agreement with previous studies, patients who underwent orchiectomy were found to experience greater treatment delays and trend toward transfer. Specifically, repeat ultrasound and time between presentation and intervention appear to influence patient outcomes. The effect of repeat ultrasound on outcomes appears to be independent of the transfer status. The study was limited by its retrospective nature and small sample size. CONCLUSION The analysis suggests that efforts to prevent repeat ultrasounds and minimize the time between presentation and intervention would improve patient outcomes. It is proposed that standardized clinical decision-making procedures, such as the TWIST scoring system, be incorporated into hospital protocols.
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Nti AA, Serrano LW, Sandhu HS, Uyhazi KE, Edelstein ID, Zhou EJ, Bowman S, Song D, Gangadhar TC, Schuchter LM, Mitnick S, Huang A, Nichols CW, Amaravadi RK, Kim BJ, Aleman TS. FREQUENT SUBCLINICAL MACULAR CHANGES IN COMBINED BRAF/MEK INHIBITION WITH HIGH-DOSE HYDROXYCHLOROQUINE AS TREATMENT FOR ADVANCED METASTATIC BRAF MUTANT MELANOMA: Preliminary Results From a Phase I/II Clinical Treatment Trial. Retina 2019; 39:502-513. [PMID: 29324592 PMCID: PMC6039280 DOI: 10.1097/iae.0000000000002027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess the potential ocular toxicity of a combined BRAF inhibition (BRAFi) + MEK inhibition (MEKi) + hydroxychloroquine (HCQ) regime used to treat metastatic BRAF mutant melanoma. METHODS Patients with stage IV metastatic melanoma and BRAF V600E mutations (n = 11, 31-68 years of age) were included. Treatment was with oral dabrafenib, 150 mg bid, trametinib, 2 mg/day, and HCQ, 400 mg to 600 mg bid. An ophthalmic examination, spectral domain optical coherence tomography, near-infrared and short-wavelength fundus autofluorescence, and static perimetry were performed at baseline, 1 month, and q/6 months after treatment. RESULTS There were no clinically significant ocular events; there was no ocular inflammation. The only medication-related change was a separation of the photoreceptor outer segment tip from the apical retinal pigment epithelium that could be traced from the fovea to the perifoveal retina noted in 9/11 (82%) of the patients. There were no changes in retinal pigment epithelium melanization or lipofuscin content by near-infrared fundus autofluorescence and short-wavelength fundus autofluorescence, respectively. There were no inner retinal or outer nuclear layer changes. Visual acuities and sensitivities were unchanged. CONCLUSION BRAFi (trametinib) + MEKi (dabrafenib) + HCQ causes very frequent, subclinical separation of the photoreceptor outer segment from the apical retinal pigment epithelium without inner retinal changes or signs of inflammation. The changes suggest interference with the maintenance of the outer retinal barrier and/or phagocytic/pump functions of the retinal pigment epithelium by effective MEK inhibition.
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Jagannathan N, Hajduk J, Sohn L, Huang A, Sawardekar A, Albers B, Bienia S, De Oliveira GS. Randomized equivalence trial of the King Vision aBlade videolaryngoscope with the Miller direct laryngoscope for routine tracheal intubation in children <2 yr of age. Br J Anaesth 2018; 118:932-937. [PMID: 28549081 DOI: 10.1093/bja/aex073] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/14/2022] Open
Abstract
Background. We conducted a randomized equivalence trial to compare direct laryngoscopy using a Miller blade (DL) with the King Vision videolaryngoscope (KVL) for routine tracheal intubation. We hypothesized that tracheal intubation times with DL would be equivalent to the KVL in children <2 yr of age. Methods. Two hundred children were randomly assigned to tracheal intubation using DL or KVL. The primary outcome was the median difference in the total time for successful tracheal intubation. Secondary outcomes assessed were tracheal intubation attempts, time to best glottic view, time for tracheal tube entry, percentage of glottic opening score, airway manoeuvres needed, and complications. Results. The median difference between the groups was 5.7 s, with an upper 95% confidence interval of 7.5 s, which was less than our defined equivalence time difference of 10 s. There were no differences in the number of tracheal intubation attempts and the time to best glottic view [DL median 5.3 (4.1-7.6) s vs KVL 5.0 (4.0-6.3) s; P =0.19]. The percentage of glottic opening score was better when using the KVL [median 100 (100-100) vs DL median 100 (90-100); P <0.0001]. Use of DL was associated with greater need for airway manoeuvres during tracheal intubation (33 vs 7%; P <0.001). Complications did not differ between devices. Conclusions. In children <2 yr of age, the KVL was associated with equivalent times for routine tracheal intubation when compared with the Miller blade. Clinical trial registration NCT02590237.
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Huang A, Strombotne KL, Horner E, Lapham SJ. ADOLESCENT COGNITIVE PREDICTORS OF ALZHEIMER’S DISEASE AND RELATED DISORDERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chapman B, Huang A, Horner E, Peters K, Sempeles E, Roberts B, Lapham S. INTERNAL REPLICATION STRATEGIES FOR (MODERATELY) LARGE SAMPLES: CROSS-VALIDATION TECHNIQUES IN PROJECT TALENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2911] [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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Huang A, Swanson C, Babineau D, Whalen E, Gill M, Shao B, Liu A, Jepson B, Gruchalla R, O'Connor G, Pongracic J, Kercsmar C, Hershey GK, Zoratti E, Johnson C, Teach S, Kattan M, Bacharier L, Beigelman A, Sigelman S, Gergen P, Wheatley L, Presnell S, Togias A, Busse W, Jackson D, Altman M. EPITHELIAL CELL GENE NETWORKS UPREGULATED IN OBESE ASTHMATIC CHILDREN. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ma H, Zhang T, Huang A, Xiao Y, Yao J, Jin M, Fan L. 53BP1 Deletion Induced Treatment Resistance in Neoadjuvant Chemoradiotherapy Rectal Patients by Inhibiting Immune Function. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Horner E, Strombotne K, Huang A, J Lapham S. INVESTIGATING THE EARLY LIFE DETERMINANTS OF ADRD USING THE PT-MEDICARE STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ma H, Yao J, Huang A, Xiao Y, Fan L. A classifier of 53BP1, immune score and texture analysis of MRI images can predict pathological response to chemoradiotherapy in locally advanced rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.046] [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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Clarke H, Azargive S, Montbriand J, Nicholls J, Sutherland A, Valeeva L, Boulis S, McMillan K, Ladak SSJ, Ladha K, Katznelson R, McRae K, Tamir D, Lyn S, Huang A, Weinrib A, Katz J. Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service. Can J Pain 2018; 2:236-247. [PMID: 35005382 PMCID: PMC8730554 DOI: 10.1080/24740527.2018.1501669] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND The perioperative period provides a critical window to address opioid use, particularly in patients with a history of chronic pain and presurgical opioid use. The Toronto General Hospital Transitional Pain Service (TPS) was developed to address the issues of pain and opioid use after surgery. AIMS To provide program evaluation results from the TPS at the Toronto General Hospital highlighting opioid weaning rates and pain management of opioid-naïve and opioid-experienced surgical patients. METHODS Two hundred fifty-one high-risk TPS patients were dichotomized preoperatively as opioid naïve or opioid experienced. Outcomes included pain, opioid consumption, weaning rates, and psychosocial/medical comorbidities. RESULTS Six months postoperatively, pain and function were significantly improved. Opioid-naïve and opioid-experienced patients reduced consumption by 69% and 44%, respectively. Forty-six percent and 26% weaned completely. Consumption at hospital discharge predicted weaning in opioid-naïve patients. Pain catastrophizing, neuropathy, and recreational drug use predicted weaning in opioid-experienced patients. CONCLUSIONS The TPS enabled almost half of opioid-naïve patients and one in four opioid-experienced patients to wean. The TPS successfully targets perioperative opioid use in complex pain patients.
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Lee BC, Lin YH, Lee CW, Liu HM, Huang A. Prediction of Borderzone Infarction by CTA in Patients Undergoing Carotid Embolization for Carotid Blowout. AJNR Am J Neuroradiol 2018; 39:1280-1285. [PMID: 29773563 DOI: 10.3174/ajnr.a5672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/24/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Permanent common carotid artery and/or ICA occlusion is an effective treatment for carotid blowout syndrome. Besides postoperative thromboembolic infarction, permanent common carotid artery and/or ICA occlusion may cause borderzone infarction when the collateral flow to the deprived brain territory is inadequate. In this study, we aimed to test the predictive value of CTA for post-permanent common carotid artery and/or ICA occlusion borderzone infarction in patients with carotid blowout syndrome. MATERIALS AND METHODS In this retrospective study, we included 31 patients undergoing unilateral permanent common carotid artery and/or ICA occlusion for carotid blowout syndrome between May 2009 and December 2016. The vascular diameter of the circle of Willis was evaluated using preprocedural CTA, and the risk of borderzone infarction was graded as very high risk, high risk, intermediate risk, low risk, and very low risk. RESULTS The performance of readers' consensus on CTA for predicting borderzone infarction was excellent, with an area under receiver operating characteristic curve of 0.938 (95% confidence interval, 0.85-1.00). We defined very high risk, high risk, and intermediate risk as positive for borderzone infarction, the sensitivity, specificity, positive predictive value, and negative predictive value of CTA for borderzone infarction were 100% (7/7), 62.5% (15/24), 43.8% (7/16), and 100% (15/15), respectively. The interobserver reliability was excellent (κ = 0.807). No significant difference in the receiver operating characteristic curves was found between the 2 readers (P = .114). CONCLUSIONS CTA can be used to predict borderzone infarction after permanent common carotid artery and/or ICA occlusion by measuring the collateral vessels of the circle of Willis.
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Huang K, Hsiao Y, Wu T, Huang A, Ai L, Kuan C. PO-426 Targeting of VEGFR2-expressing cells by chimeric antigen receptor (CAR) T cells for solid tumour therapy. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Yue X, Ge C, Zhuge S, He H, Yang H, Xu H, Huang A, Zhao Y. Changes and analysis of anti-HBs titres after primary immunization in 1- to 16-year-old Chinese children: A hospital-based study. J Viral Hepat 2018; 25:373-380. [PMID: 29091317 DOI: 10.1111/jvh.12818] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
Immunization with the hepatitis B vaccine is the most effective measure to prevent Hepatitis B Virus (HBV) infection. The aim of this study was to investigate the change in antibody levels induced by administration of the hepatitis B vaccine in children aged 1-16 year old in a large sample sized investigation. HBV markers were determined in 93 326 1- to 16-year-old hospitalized children who completed primary immunization as infants from south-west China, Chongqing. Analyses were performed on anti-HBs titre changes with increasing age, and the revaccination effect was evaluated in children aged 7-14. The percentage of protective antibody was between 45.29% and 63.33% in all age groups, but was higher in the 1-, 2- and 3-year-old groups (90.31%, 83.95% and 71.82%, respectively), and the rate of high-responder was 5.03%-10.56%, except in the 1-year-old group (23.33%). Additionally, 3.33%-25.79% of subjects had not seroconverted. There was no significant difference in antibody levels between girls and boys (P > .05). The Geometric Mean Titers in children with confirmed revaccination history were significantly higher than those with unknown or no revaccination history (P < .0001). In conclusion, the overall rate of protective anti-HBs was 67.10% with consecutive age groups from 1 to 16, it decreased from 90.31% to 45.29% for 1- to 8-year-old individuals, and interestingly, the rate increased from 45.46% to 63.33% for subjects aged 9-15. Anti-HBs titres were significantly improved after revaccination. Booster doses are recommended for those without seroconversion, especially children who live in school with other students or have family members with positive HBsAg.
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Mirzan S, Huang A, Muniappan A, Keyes C, Choy E, Uppot R, Fintelmann F. 3:20 PM Abstract No. 45 Thoracic cryoablation for palliation of tumors in chest wall and pleura. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.054] [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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Huang A, Chen Y, Lim B, Yao J, Bobik A, Peter K. Therapeutic Targeting of the Alarmin, HMGB1, Safely and Effectively Prevents Arterial Thrombosis Through Inhibition Of NET Formation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.693] [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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