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Popat S, Curioni-Fontecedro A, Dafni U, Shah R, O'Brien M, Pope A, Fisher P, Spicer J, Roy A, Gilligan D, Gautschi O, Nadal E, Janthur WD, López Castro R, García Campelo R, Rusakiewicz S, Letovanec I, Polydoropoulou V, Roschitzki-Voser H, Ruepp B, Gasca-Ruchti A, Peters S, Stahel RA. A multicentre randomised phase III trial comparing pembrolizumab versus single-agent chemotherapy for advanced pre-treated malignant pleural mesothelioma: the European Thoracic Oncology Platform (ETOP 9-15) PROMISE-meso trial. Ann Oncol 2020; 31:1734-1745. [PMID: 32976938 DOI: 10.1016/j.annonc.2020.09.009] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/19/2020] [Accepted: 09/13/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is an aggressive malignancy characterised by limited treatment options and a poor prognosis. At relapse after platinum-based chemotherapy, single-agent chemotherapy is commonly used and single-arm trials of immune-checkpoint inhibitors have demonstrated encouraging activity. PATIENTS AND METHODS PROMISE-meso is an open-label 1:1 randomised phase III trial investigating the efficacy of pembrolizumab (200 mg/Q3W) versus institutional choice single-agent chemotherapy (gemcitabine or vinorelbine) in relapsed MPM patients with progression after/on previous platinum-based chemotherapy. Patients were performance status 0-1 and unselected for programmed cell death ligand 1 (PD-L1) status. At progression, patients randomly assigned to receive chemotherapy were allowed to crossover to pembrolizumab. The primary end point was progression-free survival (PFS), assessed by blinded independent central review (BICR). Secondary end points were overall survival (OS), investigator-assessed PFS, objective response rate (ORR), and safety. Efficacy by PD-L1 status was investigated in exploratory analyses. RESULTS Between September 2017 and August 2018, 144 patients were randomly allocated (pembrolizumab: 73; chemotherapy: 71). At data cut-off [20 February 2019, median follow-up of 11.8 months (interquartile range: 9.9-14.5)], 118 BICR-PFS events were observed. No difference in BICR-PFS was detected [hazard ratio = 1.06, 95% confidence interval (CI): 0.73-1.53; P = 0.76], and median BICR-PFS (95% CI) for pembrolizumab was 2.5 (2.1-4.2), compared with 3.4 (2.2-4.3) months for chemotherapy. A difference in ORR for pembrolizumab was identified (22%, 95% CI: 13% to 33%), over chemotherapy (6%, 95% CI: 2% to 14%; P = 0.004). Forty-five patients (63%) assigned to chemotherapy received pembrolizumab at progression. With follow-up to 21 August 2019 [17.5 months: (14.8-19.7)], no difference in OS was detected between groups (HR = 1.12, 95% CI: 0.74-1.69; P = 0.59), even after adjusting for crossover. Pembrolizumab safety was consistent with previous observations. Exploratory efficacy analyses by PD-L1 status demonstrated no improvements in ORR/PFS/OS. CONCLUSION This is the first randomised trial evaluating the efficacy of pembrolizumab in MPM patients progressing after/on previous platinum-based chemotherapy. In biologically unselected patients, although associated with an improved ORR, pembrolizumab improves neither PFS nor OS over single-agent chemotherapy.
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Ragavan P, Kaur A, Kumar M, Singhal V, Patel A, Khunt A, Shah R, Wazeer S, Rathod R, Mane A, Mehta S, Veligandla K. Retrospective analysis of EMR database to assess the effectiveness of Saccharomyces boulardii CNCM I-745 in children with acute diarrhoea during routine clinical practice. New Microbes New Infect 2020; 38:100766. [PMID: 33093961 PMCID: PMC7568184 DOI: 10.1016/j.nmni.2020.100766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to assess the efficacy of Saccharomyces boulardii, a yeast probiotic, in the management of acute diarrhoeal disorders in the paediatric population in outpatient settings. It was a multicentre retrospective analysis of medical records of children who were treated for acute diarrhoea by routine treatment (oral rehydration solution and zinc) with or without S. boulardii. Overall, 160 children presenting with acute diarrhoea at seven different outpatient paediatric settings were included in the study. Children were divided into two categories based on their treatment with S. boulardii (SB group) or without S. boulardii (Non-SB group). Baseline demographic, anthropometric and clinical variables were compared between the two groups. The median duration of diarrhoea post-treatment was significantly shorter in the S. boulardii group (3 days) than in the non-SB group (4 days). A significant reduction in the frequency of stools was observed post-treatment in the S. boulardii group (1.7 versus 2.5 in the non-SB group). There was a significant weight gain in the S. boulardii group post-treatment (300 g) in comparison with the non-SB group (mean loss of 400 g). This study established the positive role of S. boulardii in the management of acute diarrhoeal diseases in children. Moreover, the S. boulardii probiotic was seen to be effective in diarrhoeal diseases in children with dehydration.
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Shah R, Klotz L, Feißt M, Schneider M, Kriegsmann M, Ried M, Wesseler C, Christoph D, de Wit M, Jürgens J, Kopp HG, Wehler T, Reck M, Sackmann S, Waller C, Reinmuth N, Bischoff H, Winter H, Eichhorn M, Thomas M. 1912TiP NICITA: Nivolumab with chemotherapy in pleural mesothelioma after surgery. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1455] [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] Open
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Shah R, Labroo A, Davis DA, Le FK. Increased risk of stent thrombosis with use of a direct oral anticoagulant and a single antiplatelet agent after PCI: A meta-analysis. Catheter Cardiovasc Interv 2020; 98:E490-E492. [PMID: 32845076 DOI: 10.1002/ccd.29205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 11/07/2022]
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Shah R, Nayyar M, Le FK, Labroo A, Davis DA, Brilakis ES, Kandzari DE. Meta-Analysis of Optimal Revascularization Strategy for Patients With ST-Segment Elevation Myocardial Infarction and Multi-Vessel Coronary Artery Disease. Am J Cardiol 2020; 129:19-24. [PMID: 32540166 DOI: 10.1016/j.amjcard.2020.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Several clinical trials have shown that complete revascularization (CR) lowers the risks of revascularization and nonfatal myocardial infarction (MI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease compared with infarct-related artery-only revascularization (IRA-OR). However, individual trials have been underpowered for hard outcomes such as cardiovascular (CV) mortality. Therefore, we conducted an updated meta-analysis representing the largest sample size to date inclusive of contemporary studies comparing CR versus IRA-OR. Pooled risk ratios (RRs) were calculated using random effects model. Data from 11 RCTs involving 7,343 patients showed that compared with IRA-OR, CR was associated with lower CV mortality (RR 0.75; 95% confidence interval [CI] 0.57 to 0.99; p = 0.04), MI (RR 0.70; 95% CI 0.53 to 0.93), and recurrent revascularization (RR 0.38; 95% CI 0.27 to 0.54), but similar all-cause mortality (RR 0.85; 95% CI 0.70 to 1.05). In conclusion, in patients with STEMI and multivessel coronary artery disease, compared with IRA-OR, CR was associated with lower risk for CV mortality, MI, and recurrent revascularization, suggesting that CR should be the standard of care for STEMI patients.
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Howle R, Sultan P, Shah R, Sceales P, Van de Putte P, Bampoe S. Gastric point-of-care ultrasound (PoCUS) during pregnancy and the postpartum period: a systematic review. Int J Obstet Anesth 2020; 44:24-32. [PMID: 32693329 DOI: 10.1016/j.ijoa.2020.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022]
Abstract
Personalised risk assessment of the likelihood of pulmonary aspiration is recommended for pregnant women undergoing general anaesthesia and gastric point-of-care ultrasound (PoCUS) may help to achieve this. Traditionally, risk assessment is based upon adherence to fasting times, but gastric emptying may vary during pregnancy and surgery often needs to be expedited. We systematically reviewed the evidence for gastric PoCUS up to August 2018 in pregnant and postpartum women to determine whether it can identify and quantify stomach contents, provide aspiration risk assessment via qualitative or quantitative means, and determine how gastric emptying is affected by pregnancy. Twenty-two articles comprising 1050 participants were included and studies were classified by qualitative or quantitative findings. The evidence suggests that gastric PoCUS is a reliable and feasible method of imaging the stomach in pregnancy in clinical practice. Qualitative assessment via the Perlas grading system can provide rapid assessment of gastric volume states. If fluid is visible, identification of patients at high risk of pulmonary aspiration requires measurement of antral cross-sectional area. Cut-off values of 608 mm2 and 960 mm2 are recommended in the semi-recumbent and right lateral semi-recumbent positions, respectively. Validated methods to quantify stomach volumes are available, however their usefulness is currently restricted to research. Gastric PoCUS also provides evidence that gastric emptying of ingested food is delayed by term pregnancy, labour and during the early postpartum period. However, the passage of fluids through the stomach appears unaffected throughout the peripartum period.
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Gabel C, Chakrala T, Shah R, Danesh M, Walls A, Nigwekar S, Song P, Kroshinsky D. 441 Penile calciphylaxis: A retrospective analysis of ten cases. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.449] [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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Shah R. Letter by Shah Regarding Article, "Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials". Circ Cardiovasc Qual Outcomes 2020; 13:e006788. [PMID: 32482085 DOI: 10.1161/circoutcomes.120.006788] [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: 01/09/2023]
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Hesterberg K, Rawal A, Khan S, Rashid A, Jones D, Siddiqui T, Khader TA, Nayyar M, Shah R. A Meta-Analysis Comparing Aspirin Alone Versus Dual Antiplatelet Therapy for the Prevention of Venous Graft Failure Following Coronary Artery Bypass Surgery. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:792-796. [DOI: 10.1016/j.carrev.2019.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/04/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Bravo Berguño D, Bronner C, Bubak A, Buizza Avanzini M, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Molina Bueno L, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O'Keeffe HM, O'Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Parker WC, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Pinzon Guerra ES, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Search for Electron Antineutrino Appearance in a Long-Baseline Muon Antineutrino Beam. PHYSICAL REVIEW LETTERS 2020; 124:161802. [PMID: 32383902 DOI: 10.1103/physrevlett.124.161802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/26/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Electron antineutrino appearance is measured by the T2K experiment in an accelerator-produced antineutrino beam, using additional neutrino beam operation to constrain parameters of the Pontecorvo-Maki-Nakagawa-Sakata (PMNS) mixing matrix. T2K observes 15 candidate electron antineutrino events with a background expectation of 9.3 events. Including information from the kinematic distribution of observed events, the hypothesis of no electron antineutrino appearance is disfavored with a significance of 2.40σ and no discrepancy between data and PMNS predictions is found. A complementary analysis that introduces an additional free parameter which allows non-PMNS values of electron neutrino and antineutrino appearance also finds no discrepancy between data and PMNS predictions.
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Arihara T, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Berguño DB, Bronner C, Bubak A, Avanzini MB, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Cicerchia M, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eguchi A, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hassani S, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Junjie X, Jurj PB, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kikutani H, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McElwee J, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Bueno LM, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Naseby CER, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Noah E, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O’Keeffe HM, O’Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Pari M, Parker WC, Parsa S, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Guerra ESP, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Santucci G, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Constraint on the matter–antimatter symmetry-violating phase in neutrino oscillations. Nature 2020; 580:339-344. [DOI: 10.1038/s41586-020-2177-0] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
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Maheshwari J, Kolaitis N, Anderson M, Benvenuto L, Gao Y, Katz P, Wolters P, Golden J, Kukreja J, Hays S, Greenland J, Shah R, Leard L, Trinh B, Oyster M, Covinsky K, Calabrese D, Venado A, Patel P, Huang C, Glidden D, Kleinhenz M, Sutter N, Tietje-Ulrich G, Brown M, Arcasoy S, Christie J, Diamond J, Singer J. Sarcopenia is Associated with Frailty in Lung Transplant Candidates. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Shah R, Le FK, Labroo A, Khan MR. Contrast-associated acute kidney injury. Quant Imaging Med Surg 2020; 10:891-894. [PMID: 32355657 DOI: 10.21037/qims.2020.03.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Waldman G, Gift T, Turvey K, Ho J, Shah R, Thomas S, Carlson W, Ton V, Ibrahim N, Rogers C, Nayor M, Spahillari A, Coglianese E, D'Alessandro D, Lewis G. Optimal Dosing of Enoxaparin to Achieve Therapeutic Anticoagulation in Heart Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Davies AM, Shah A, Shah R, Patel A, James SL, Botchu R. Are the tubular bones of the hand really the commonest site for an enchondroma? Clin Radiol 2020; 75:533-537. [PMID: 32183998 DOI: 10.1016/j.crad.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
Abstract
AIM To investigate whether the long-held view that the hand is the commonest site for an enchondroma is actually correct in light of more sensitive imaging techniques that are able to demonstrate small enchondromas at other skeletal sites. MATERIALS AND METHODS A two-part retrospective study was undertaken. Part 1 comprised a review of the hand radiographs obtained in two major teaching hospitals over a 10-year period to establish the incidence of enchondroma in the hand. Part 2 was a review of a series of enchondromas of the proximal humerus, distal femur, and proximal tibia <4 cm in length on magnetic resonance imaging (MRI) to see which cases were visible or not on corresponding radiographs. RESULTS Part 1: 84 enchondromas were identified on 116,354 trauma radiographs to give an incidence of 0.07%. Part 2: 157 patients with an enchondroma on MRI <4 cm were reviewed. Only 17% of lesions <2 cm in length were visible on the contemporaneous radiographs. In lesions that were 2-2.9 and 3-3.9 cm the percentage visible on the radiographs increased to 58 and 77%, respectively. CONCLUSION It is well recognised from existing studies that incidental enchondromas can be seen in approximately 2.5% of routine shoulder and knee MRI scans. This figure is 35 times higher than the incidence found in the series of hand trauma radiographs. This infers that the hand should no longer be considered as the commonest site for an enchondroma. This is because radiographs are relatively insensitive to the detection of small lesions in larger bones, such as the proximal humerus and around the knee, when compared with MRI.
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PATEL U, Patel H, Darji P, Patwari D, Shah P, Mazumdar M, Mandowara B, Shah R, Chotai N. SAT-422 SPECTRUM OF ACUTE KIDNEY INJURY IN DENGUE FEVER. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hanley J, Li D, Shah R, Chiang J, McWilliams J, Raman S, Lu D, Padia S, Douek M, Felker E, Masamed R, Bahrami S, Sahagun O. 3:09 PM Abstract No. 200 Comparison of bleeding complications using two techniques for renal transplant biopsy. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Shah R, Tommasi S, Faull R, Gleadle J, Mangoni A, Selvanayagam J. 290 Arginine Analogues as Biomarkers of Myocardial Ischaemia, Assessed with Cardiac Magnetic Resonance in Chronic Kidney Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.297] [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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Shah R, Naz A. Postprocedure bivalirudin infusion for primary percutaneous coronary intervention. Catheter Cardiovasc Interv 2019; 94:900-901. [PMID: 31241248 DOI: 10.1002/ccd.28377] [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: 05/26/2019] [Revised: 06/02/2019] [Accepted: 06/09/2019] [Indexed: 11/08/2022]
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Liman A, Liman A, Shah R, Passero V, Tan J, Rai H, Harrold L, Liman A, Tokarsky J. The effect of radium-223 therapy in agent orange related veterans with metastatic castrate resistance prostate carcinoma (CRPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz424.004] [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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Ahn MJ, Chirovsky D, Kuyas H, Auclair V, Abounit S, Joo S, Shah R, Yang MH. Global longitudinal assessment of treatment outcomes in nasopharyngeal carcinoma (GLANCE-NPC) study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz428.011] [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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98
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Shah R, Khan B, Latham SB, Khan SA, Rao SV. A Meta-Analysis of Aspirin for the Primary Prevention of Cardiovascular Diseases in the Context of Contemporary Preventive Strategies. Am J Med 2019; 132:1295-1304.e3. [PMID: 31153866 DOI: 10.1016/j.amjmed.2019.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The role of aspirin for primary prevention of cardiovascular diseases remains controversial, particularly in the context of contemporary aggressive preventive strategies. METHODS Relevant randomized clinical trials were included, and risk ratios (RRs) were calculated using random-effects models. Additional moderator analyses were performed to compare the pooled treatment effects from recent trials (those reported after the guidelines of the National Cholesterol Education Program Third Adult Treatment Panel were published in 2001; thus, conducted on the background of contemporary preventive strategies) to the results of older trials. RESULTS Data from 14 randomized controlled trials involving 164,751 patients were included. Aspirin use decreased myocardial infarction risk by 16% compared with placebo (RR 0.84; 95% confidence interval [CI], 0.75-0.94); however, in the moderator analyses, aspirin was not associated with a decreased risk of myocardial infarction in recent trials, but was in older trials (P-interaction = .02). Overall, aspirin use significantly increased the occurrence of major bleeding (RR 1.49; 95% CI, 1.32-1.69) and hemorrhagic stroke (RR 1.25; 95% CI, 1.01-1.54). In moderator analyses, the risk of major bleeding (P-interaction = .12) or hemorrhagic stroke (P-interaction = .44) with aspirin was not significantly different between the older and new trials. Differences between aspirin and placebo in the risks for all-cause stroke, cardiac death, and all-cause mortality were not found. CONCLUSIONS In the context of contemporary primary prevention guidelines, the effect of aspirin on myocardial infarction risk was significantly attenuated, whereas its major bleeding and hemorrhagic stroke complications were retained. Therefore, in contemporary practice, routine use of aspirin for the primary prevention of cardiovascular events may have a net harmful effect.
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Cho B, Ohe Y, Zhou C, Reungwetwattana T, Cheng Y, Chewaskulyong B, Lee K, Planchard D, Vansteenkiste J, Gray J, Shah R, Cheema P, Tiseo M, John T, Hodge R, Rukazenkov Y, Soria JC, Lin MC, Imamura F, Ramalingam S. Osimertinib vs comparator EGFR-TKI as first-line treatment for EGFRm advanced NSCLC (FLAURA): Final overall survival analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.015] [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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Shah R, Rao SV, Latham SB, Kandzari DE. Efficacy and Safety of Drug-Eluting Stents Optimized for Biocompatibility vs Bare-Metal Stents With a Single Month of Dual Antiplatelet Therapy: A Meta-analysis. JAMA Cardiol 2019; 3:1050-1059. [PMID: 30383145 DOI: 10.1001/jamacardio.2018.3551] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Importance A significant number of patients receive bare-metal stents (BMSs) instead of drug-eluting stents (DESs) to shorten the duration of dual antiplatelet therapy (DAPT). Emerging evidence suggests that new-generation DESs, particularly those optimized for biocompatibility, may be more efficacious and safer than BMSs, even with a single month of DAPT after stent implantation. Objective To evaluate the efficacy and safety of DESs compared with BMSs for coronary intervention with a single month of DAPT. Data Sources Human studies found in PubMed, the Cochrane databases through April 2018, and reference lists of selected articles. Study Selection Randomized clinical trials were included if they enrolled patients undergoing percutaneous coronary intervention and randomly assigned each patient to treatment with either DESs or BMSs. The additional inclusion criterion was use of only 1 month of DAPT poststent implantation. Data Extraction and Synthesis Two reviewers independently extracted the data. Odds ratios (ORs) were calculated using random-effects models. Main Outcomes and Measures The efficacy end points were major adverse cardiac events, myocardial infarction, target vessel revascularization, ischemia-driven target lesion revascularization, cardiac mortality, and all-cause mortality at 1 year. The safety outcomes were stent thrombosis and bleeding complications. Results Data from 3 randomized clinical trials involving 3943 patients were included (2457 men [62.3%]; mean [SD] age ranging from 75.7 [9.3] years to 81.4 [4.3] years per trial subgroup). Coronary intervention with DESs reduced the rates for major adverse cardiac events (OR, 0.68 [95% CI, 0.57-0.82]; P < .001), target lesion revascularization (OR, 0.38 [95% CI, 0.22-0.67]; P = .001), target vessel revascularization (OR, 0.50 [95% CI, 0.38-0.65]; P < .001), and myocardial infarction (OR, 0.51 [95% CI, 0.31-0.83]; P = .01) compared with BMSs at 1 year. The incidence of stent thrombosis was also lower with DESs compared with BMSs (1.8% vs 2.8%), but this difference was not statistically significant in the random-effects model. Additionally, the 2 stent types did not differ in the risks of all-cause mortality, cardiac mortality, and bleeding. Conclusions and Relevance In the limited number of randomized clinical trials comparing DESs with BMSs with shortened DAPT durations in patients who have high bleeding risk or are uncertain candidates for prolonged DAPT, coronary intervention with specific DESs optimized for biocompatibility is not only safe but also efficacious, even with only 1 month of DAPT.
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