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Scotcher M, Chong HH, Asif A, Kulkarni K. Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review. Malays Orthop J 2023; 17:26-32. [PMID: 38107363 PMCID: PMC10722999 DOI: 10.5704/moj.2311.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/16/2022] [Indexed: 12/19/2023] Open
Abstract
Introduction Forearm fractures are common in children. The remodelling capacity of growing long bones in children makes these potentially forgiving injuries, recovering with good outcomes despite minimal intervention. Clinicians rely on radiological characteristics that vary with age to guide treatment decisions and minimise adverse sequelae. The purpose of this review was to consolidate the evidence base of radiological indications for intervention in paediatric mid-shaft forearm fractures. Materials and methods The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed for this review. Citable research output reporting radiological criteria for mid-shaft forearm fractures in paediatric patients (age ≤16 years) was screened and analysed to ascertain acceptable radiological criteria for non-operative management. Results A total of 2,059 papers were initially identified; 14 were selected following screening. Sagittal angulation >15°, coronal angulation >10°, and/or >50% (or >1cm) translation were the most common radiological indications for intervention in children aged 0 to 10 years. For children over 10 years of age, the most common radiological indication for intervention was sagittal angulation >10°, coronal angulation >10°, and/or >50% (or >1cm) translation. Conclusion This study revealed a scarcity of high-quality evidence to guide management and significant variation in outcome reporting throughout the published literature. Since Noonan and Price's 1998 recommendations, there has been no significant evolution in the evidence-base guided threshold for intervention in paediatric mid-shaft forearm fractures. There remains a pressing need for a robust multicentre observational study using the patient-reported outcome measurement information system (PROMIS) to address this complex and controversial area of uncertainty in paediatric trauma management.
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Affiliation(s)
- M Scotcher
- Department of Plastic Surgery, Addenbrooke's Hospital Cambridge University, Cambridge, United Kingdom
| | - H H Chong
- Department of Orthopaedic and Trauma, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - A Asif
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - K Kulkarni
- Department of Plastic Surgery, Addenbrooke's Hospital Cambridge University, Cambridge, United Kingdom
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Osman FH, Koe JSE, Lau ESW, Nagaraj D, Ng HHL, Ong LA, McGuire L, Ng A, Asif A, Uberoi R, Chan VWS, Lakshminarayan R, Wah TM. Evaluation of learning and exposure in the undergraduate interventional radiology curriculum (ELIXIR). Clin Radiol 2023; 78:e773-e781. [PMID: 37550131 DOI: 10.1016/j.crad.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/19/2023] [Accepted: 07/02/2023] [Indexed: 08/09/2023]
Abstract
AIM To gauge current final year medical students' exposure to interventional radiology (IR)and assess their perceptions of IR as a prospective career option. MATERIALS AND METHODS An online questionnaire comprising of questions that gauge final-year medical students' understanding of and exposure to IR based on the recommendations set out by the British Society of Interventional Radiology (BSIR), was sent out to final-year students across 34 UK medical schools. RESULTS Five hundred and ten responses were collected from 33 out of 34 eligible medical schools. Sixty-four per cent of respondents rated their own IR knowledge as inadequate. On average, only 50% of all subtopics proposed in the BSIR undergraduate curriculum was covered during medical school and 32.7% of respondents were not exposed to any fundamental IR principles and techniques recommended by the BSIR during medical school. Regarding careers, 2.7% of respondents reported a definite interest in pursuing a career in IR. Most respondents (89.8%) felt that there was insufficient undergraduate teaching on IR and that they lacked information to consider pursuing a career in IR (87.5%). CONCLUSION Insufficient exposure and teaching on IR throughout medical schools have led to a lack of awareness and consideration of IR as a future career choice amongst UK medical students. The re-evaluation of IR teaching in the medical school curricula is needed. In the long-term, such recommendations could provide the much-needed solution to the workforce shortages seen in IR.
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Affiliation(s)
- F H Osman
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - J S E Koe
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - E S W Lau
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - D Nagaraj
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - H H-L Ng
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - L A Ong
- University of Nottingham Medical School, University of Nottingham, Nottingham NG7 2UH, UK
| | - L McGuire
- Undergraduate School of Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - A Ng
- UCL Medical School, University College London, London WC1E 6DE, UK; British Urology Researchers in Surgical Training (BURST), London W1W 7TS, UK
| | - A Asif
- British Urology Researchers in Surgical Training (BURST), London W1W 7TS, UK; Leicester Medical School, University of Leicester, Leicester LE1 7HA, UK
| | - R Uberoi
- Department of Radiology, John Radcliffe Hospital, Oxford OX3 9BQ, UK
| | - V W-S Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK; British Urology Researchers in Surgical Training (BURST), London W1W 7TS, UK
| | - R Lakshminarayan
- Department of Vascular Radiology, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, UK
| | - T M Wah
- Division of Diagnostic and Interventional Radiology, Institute of Oncology, St. James's University Hospital, Leeds LS9 7TF, UK; Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.
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Ng A, Asif A, Nathan A, Khetrapal P, Chan V, Rossiter M, Punwani S, Clarke C, Brew-Graves C, Emberton M, Agarwal R, Takwoingi Y, Deeks J, Giganti F, Allen C, Moore C, Kasivisvanathan V, Prime S. Comparison of biparametric and multiparametric magnetic resonance imaging for prostate cancer detection: an 8-month update on the PRIME Study (NCT04571840). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Asif A, Nathan A, Patel S, Georgi M, Hang M, Mullins W, Fricker M, Ng A, Ghosh A, Francis N, Collins J, Sridhar A. Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): A prospective, cross-over, effectiveness study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ng A, Nathan A, Patel S, Georgi M, Hang K, Mullins W, Asif A, Fricker M, Francis N, Collins J, Sridhar A. Can virtual classroom training improve the acquisition of robotic training skills? A prospective, cross-over, effectiveness study (V-ROBOT). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02268-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Syed ZA, Dallai R, Nasirzadeh N, Brill JA, O’Grady PM, Cong S, Leef EM, Rice S, Asif A, Nguyen S, Hansen MM, Dorus S, Pitnick S. Sperm Cyst "Looping": A Developmental Novelty Enabling Extreme Male Ornament Evolution. Cells 2021; 10:cells10102762. [PMID: 34685746 PMCID: PMC8534658 DOI: 10.3390/cells10102762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023] Open
Abstract
Postcopulatory sexual selection is credited as a principal force behind the rapid evolution of reproductive characters, often generating a pattern of correlated evolution between interacting, sex-specific traits. Because the female reproductive tract is the selective environment for sperm, one taxonomically widespread example of this pattern is the co-diversification of sperm length and female sperm-storage organ dimension. In Drosophila, having testes that are longer than the sperm they manufacture was believed to be a universal physiological constraint. Further, the energetic and time costs of developing long testes have been credited with underlying the steep evolutionary allometry of sperm length and constraining sperm length evolution in Drosophila. Here, we report on the discovery of a novel spermatogenic mechanism—sperm cyst looping—that enables males to produce relatively long sperm in short testis. This phenomenon (restricted to members of the saltans and willistoni species groups) begins early during spermatogenesis and is potentially attributable to heterochronic evolution, resulting in growth asynchrony between spermatid tails and the surrounding spermatid and somatic cyst cell membranes. By removing the allometric constraint on sperm length, this evolutionary innovation appears to have enabled males to evolve extremely long sperm for their body mass while evading delays in reproductive maturation time. On the other hand, sperm cyst looping was found to exact a cost by requiring greater total energetic investment in testes and a pronounced reduction in male lifespan. We speculate on the ecological selection pressures underlying the evolutionary origin and maintenance of this unique adaptation.
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Affiliation(s)
- Zeeshan A. Syed
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
- Correspondence: (Z.A.S.); (S.P.)
| | - Romano Dallai
- Department of Life Sciences, University of Siena, via Aldo Moro 2, 53100 Siena, Italy;
| | - Negar Nasirzadeh
- Cell Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; (N.N.); (J.A.B.)
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Julie A. Brill
- Cell Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; (N.N.); (J.A.B.)
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | | | - Siyuan Cong
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Ethan M. Leef
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Sarah Rice
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Amaar Asif
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Stephanie Nguyen
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Matthew M. Hansen
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Steve Dorus
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
| | - Scott Pitnick
- Center for Reproductive Evolution, Department of Biology, Syracuse University, Syracuse, NY 13244, USA; (S.C.); (E.M.L.); (S.R.); (A.A.); (S.N.); (M.M.H.); (S.D.)
- Correspondence: (Z.A.S.); (S.P.)
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Asif A, Lauzon M, Sopko G, Bittner V, Reis S, Handberg E, Pepine CJ, Mankad S, Bairey Merz N. Prognostic significance of anemia in women with suspected ischemia, an insight from the women ischemia syndrome evaluation study (WISE). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Anemia is associated with adverse cardiovascular outcomes in patients with myocardial infarction and congestive heart failure. Anemia is more prevalent in women. We investigated the prognosis of anemia in women with suspected ischemic heart disease.
Purpose
To study if hemoglobin levels at baseline in women with symptoms of ischemia predicts long term all-cause mortality and major adverse cardiac events.
Methods
We studied 885 women enrolled in WISE (1997–2001) undergoing clinically indicated coronary angiography for suspected ischemia. Anemia was defined as hemoglobin (Hb) level <12g/dL. Major adverse cardiovascular event (MACE) included all-cause death, nonfatal myocardial infarction, stroke and heart failure hospitalization. Cox regression models and Kaplan-Meier methods were was used.
Results
Overall, 885 women, mean age 58.4±11.7 years, 21.1% and anemia were followed for 6.8 years. Anemic women had higher creatinine, history of diabetes mellitus, hypertension and CHF (p<0.05), but not obstructive coronary artery disease compared to non-anemia women (p=0.97). Anemic women had higher all-cause mortality and MACE (Figure). In multivariate analysis, anemia was independently associated with increased MACE risk (hazard ratio (HR): 1.5, 95% confidence interval [1.11- 2.01, p=0.007]) but not all-cause mortality (HR: 1.2 [0.84–1.72, p=0.30]).
Conclusions
Among women evaluated for symptoms of ischemia, anemia is associated with and independently predicts MACE. Further research targeting anemia treatment in women to mitigate these adverse outcomes is warranted.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NIH USA
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Affiliation(s)
- A Asif
- Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Los Angeles, United States of America
| | - M Lauzon
- Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Los Angeles, United States of America
| | - G Sopko
- National Heart Lung and Blood Institute, Division of Heart and Vascular Disease, Bethesda, United States of America
| | - V Bittner
- University of Alabama Birmingham, Division of Cardiology, Birmingham, United States of America
| | - S Reis
- University of Pittsburgh Medical Centre, Cardiovascular Institute, Pittsburgh, United States of America
| | - E Handberg
- University of Florida, Cardiology, Gainesville, United States of America
| | - C J Pepine
- University of Florida, Cardiology, Gainesville, United States of America
| | - S Mankad
- Allegheny General Hospital, Pittsburgh, United States of America
| | - N Bairey Merz
- Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Los Angeles, United States of America
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Hirniak J, Hussein F, Seyedzenouzi G, Adil S, Vaghela M, Liu G, Asif A, Churchill T, Zargaran A. 1695 Undergraduate Cardiothoracic Surgery: Pumping Up Knowledge and Inspiration with High-Fidelity Simulation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Alongside declining ST3 applications, cardiothoracic surgery (CTS) is underrepresented in the medical curriculum with 90% of medical students reporting no exposure to the specialty in medical school placements. This may result in clinicians having difficulties recognising emergency presentations, with subsequent referrals made inappropriately.
Method
A simulation course involving teaching around common CTS conditions and procedures was delivered by CTS trainees to undergraduate medical students (n = 50). This involved both theory and high-fidelity simulations of coronary anastomoses using cardiac surgical equipment on porcine hearts and ureters. Delegates were given pre and post-test questionnaires, and another at six-weeks to test knowledge retention. Results were statistically analysed using paired and independent sample t-tests.
Results
Delegates demonstrated significant improvements in post-test knowledge of 56% (p<0.01), and sustained improvement of 51% (p<0.01) six-weeks later compared to baseline. 64% of delegates reported an increased interest in pursuing CTS as a career; 40% reported improved confidence performing a coronary anastomosis.
Conclusions
Immediate and long-term knowledge retention of key CTS concepts and ability to assess common CTS pathological scenarios were demonstrated in this study. CTS simulation therefore represents an effective mechanism by which key concepts can be taught to undergraduate medical students, whilst enhancing interest in pursuing CTS as a career. As an educational adjunct, simulation can help bridge the gap between taught theory and applied practice, with the potential to empower future doctors to make more informed referrals and management decisions.
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Affiliation(s)
- J Hirniak
- St George’s, University of London, London, United Kingdom
| | - F Hussein
- St George’s, University of London, London, United Kingdom
| | - G Seyedzenouzi
- St George’s, University of London, London, United Kingdom
| | - S Adil
- St George’s, University of London, London, United Kingdom
| | - M Vaghela
- Brighton and Sussex Medical School, Brighton, United Kingdom
| | - G Liu
- Anglia Ruskin University School of Medicine, Essex, United Kingdom
| | - A Asif
- University of Leicester Medical School, Leicester, United Kingdom
| | - T Churchill
- St George’s, University of London, London, United Kingdom
| | - A Zargaran
- St Thomas’ Hospital, London, United Kingdom
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10
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Tan L, Mullins W, Gargan K, Shea J, Brice J, Gargan A, Townsend J, Jang C, Shukla S, Asif A, Fricker M, Nathan A, Mohan M. 734 Evaluation of A Webinar Based Surgical Teaching Course (EDUCATE) - A Prospective Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Anecdotal evidence suggests Foundation Year (FY) doctors start surgical rotations with less confidence than medical rotations. The study aimed to determine the effect of a national webinar-based surgical teaching course on participants’ confidence, and to assess attitudes surrounding undergraduate surgical education.
Method
This prospective cohort study is reported with reference to STROBE guidelines and received ethical approval. A series of 15 free-access webinars was developed based on the Royal College of Surgeons Undergraduate Curriculum. An expert-validated questionnaire was used to collect data before and after the course. Inclusion criteria were UK-based medical students and FY doctors who attended at least one webinar. The primary outcome was confidence in completing common tasks during surgical rotations.
Results
Completed pre-course (484) and post-course (352) questionnaires yielded 92 paired samples (63% female). 85% were medical students, representing 29 UK universities, and 15% FY doctors. Mean confidence in assessing, investigating, and implementing initial management of surgical conditions was greater after the intervention (p ≤ 0.001). Mean confidence in managing on-call tasks and starting a surgical FY job was also higher post-course greater (p ≤ 0.001). These improvements correlated with webinar attendance (p ≤ 0.05). 27.1% of participants were satisfied with the quality of undergraduate surgical education. 22.9% agreed that surgical placements prepared them well to manage surgical tasks.
Conclusions
Medical students and FY doctors report low confidence and feel unprepared in managing surgical tasks. Additionally, they report poor satisfaction with undergraduate surgical education. This shortfall may be improved through delivery of a national, accessible, targeted online webinar series and curriculum.
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Affiliation(s)
- L Tan
- University of Cambridge, Cambridge, United Kingdom
| | - W Mullins
- University of Cambridge, Cambridge, United Kingdom
| | - K Gargan
- University of Cambridge, Cambridge, United Kingdom
| | - J Shea
- University of Cambridge, Cambridge, United Kingdom
| | - J Brice
- University of Cambridge, Cambridge, United Kingdom
| | - A Gargan
- Charing Cross Hospital, London, United Kingdom
| | - J Townsend
- Harrogate Hospital, Harrogate, United Kingdom
| | - C Jang
- University of Cambridge, Cambridge, United Kingdom
| | - S Shukla
- University of Cambridge, Cambridge, United Kingdom
| | - A Asif
- University of Leicester, Leicester, United Kingdom
| | - M Fricker
- University of Newcastle, Newcastle, United Kingdom
| | - A Nathan
- Royal Free Hospital, London, United Kingdom
| | - M Mohan
- Addenbrookes Hospital, Cambridge, United Kingdom
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11
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Fricker M, Nathan A, Hanna N, Asif A, Patel S, Georgi M, Hang K, Sinha A, Mullins W, Shea J, Lamb B, Sridhar A, Kelly J, Collins J. 81 VIRTUAL: Virtual Interactive Surgical Skills Classroom – An Ongoing Randomized Controlled Trial. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
High costs and inaccessibility are significant barriers to face-to-face basic surgical skills (BSS) training. Virtual classrooms enable the combination of computer-based learning with interactive expert instruction. They may optimise resources and increase accessibility, facilitating larger-scale training with a similar educational benefit. We aim to evaluate the efficacy of virtual BSS classroom training compared to both non-interactive video and face-to-face teaching.
Method
72 medical students will be randomly assigned to three equal intervention groups based on year group and surgical skill confidence. Interventions will be implemented following an instructional video. Group A will practice independently, Group B will receive face-to-face training, and Group C will attend a virtual classroom. Participants will be recorded placing three interrupted sutures with hand tied knots pre- and post-intervention, and Objective Structured Assessment of Technical Skills (OSATS) will be blind marked by two experts. Change in confidence, time to completion and a granular performance score will also be measured. Each intervention’s feasibility and accessibility will be assessed.
Results
Data collection will be completed in January 2021. Significant improvement in OSATS within groups will be indicative of intervention quality. Difference in improvement between groups will determine the relative performance of the interventions.
Conclusions
To our knowledge, this will be the largest randomised control trial investigating virtual BSS classroom training. It will serve as a comprehensive appraisal of the virtual classroom’s suitability as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient training programs during the COVID-19 pandemic and in the future.
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Affiliation(s)
- M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - A Nathan
- University College London, London, United Kingdom
| | - N Hanna
- University of Cambridge, Cambridge, United Kingdom
| | - A Asif
- University of Leicester, Leicester, United Kingdom
| | - S Patel
- University College London, London, United Kingdom
| | - M Georgi
- University College London, London, United Kingdom
| | - K Hang
- University College London, London, United Kingdom
| | - A Sinha
- University of Cambridge, Cambridge, United Kingdom
| | - W Mullins
- University of Cambridge, Cambridge, United Kingdom
| | - Jessie Shea
- University of Cambridge, Cambridge, United Kingdom
| | - Benjamin Lamb
- Cambridge University Hospitals, Cambridge, United Kingdom
| | | | - John Kelly
- University College London, London, United Kingdom
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12
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Nathan A, Patel S, Georgi M, Hang K, Mullins W, Asif A, Fricker M, Ng A, Sridhar A, Collins J. 1420 ViRtual prOficiency Based prOgression for Robotic Training (VROBOT): A Prospective Cohort Study Protocol. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Robotic surgery is an evolving field that requires specialist training. Historically, robotic surgery training has lacked standardisation. Recently, training centres have introduced proficiency-based modules and curriculums to certify and progress the skills of novice robotic surgeons. However, training tends to be self-directed and non-interactive. Limited interactive teaching does exist but can be inaccessible and expensive. We aim to validate the effectiveness of the current Fundamentals of Robotic Surgery (FRS) training curriculum with the addition of interactive virtual classroom teaching.
Method
16 novice surgical trainees will be assigned to two training groups. The interventions will be implemented following a one-week robotic skills induction. Both groups will receive access to the FRS curriculum for one week. The intervention group will additionally receive virtual classroom robotic skills training. The primary outcome will be the objective performance scores after training using a synthetic model based on task errors, time taken and contact pressure. In week 3, each group will receive the alternate intervention and objective performance scores will be measured to determine the trajectory of scores.
Results
Significant objective performance improvement following the intervention will be indicative of intervention quality.
Conclusions
This will be the first feasibility study evaluating the efficacy of interactive virtual robotic surgery training. It will determine the effect size of virtual classroom training on the development of basic robotic surgical skills in addition to the proficiency-based FRS curriculum. The findings will assist the development and implementation of further resource-efficient virtual robotic surgical skills training programs.
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Affiliation(s)
- A Nathan
- University College London, London, United Kingdom
| | - S Patel
- University College London, London, United Kingdom
| | - M Georgi
- University College London, London, United Kingdom
| | - K Hang
- University College London, London, United Kingdom
| | - W Mullins
- University of Cambridge, Cambridge, United Kingdom
| | - A Asif
- University of Leicester, Leicester, United Kingdom
| | - M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - A Ng
- University College London, London, United Kingdom
| | - A Sridhar
- University College London, London, United Kingdom
| | - J Collins
- University College London, London, United Kingdom
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13
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Ng A, Chan VWS, Asif A, Lam CM, Light A, Jayaraajan K, Cambridge WA, Matthew MG, Clement KD, Kulkarni M, Bhatt NR, Khadhouri S, Kasivisvanathan V. 1160 LEARN (Urological Teaching in British Medical Schools Nationally): A Multicentre Cross-Sectional Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Urology is a common rotation for UK Foundation Year (FY) doctors, and accounts for >25% of acute surgical referrals. In 2012, the British Association of Urological Surgeons (BAUS) produced ‘An Undergraduate Syllabus for Urology’, advising on common clinical areas of urology to be covered during medical school. However, its national uptake remains unknown. LEARN aims to assess undergraduate urology teaching across UK medical schools.
Method
LEARN is the largest ever multicentre cross-sectional study of undergraduate urology teaching. Year 2-5 medical students and FY1 doctors were invited to complete a survey between 3rd October-20th December 2020. The primary objective is to compare current undergraduate urology teaching against the BAUS syllabus. Secondary objectives investigate the type and quantity of teaching provided, the reported performance rate of GMC mandated urological procedures, and the proportion of those considering urology as a career.
Results
A total of 7,611/8,346 (91.2%) responses from 39 medical schools that met the inclusion criteria were analysed. 16.5% of responses were newly appointed FY1 doctors. In their undergraduate training, the most commonly taught topics were urinary tract infection, acute kidney injury and haematuria; the least taught topics were male urinary incontinence, male infertility and erectile dysfunction. 90.6% and 86.3% had reported performing catheterisation as undergraduates on male and female patients respectively, and 16.9% had considered a career in urology.
Conclusion
LEARN provides the largest evaluation of any undergraduate specialty teaching. It has identified areas to improve teaching, to equip the future workforce with the competencies to manage urological pathology, irrespective of future career choice.
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Affiliation(s)
- A Ng
- UCL Medical School, University College London, London, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - V W S Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - A Asif
- Leicester Medical School, University of Leicester, Leicester, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - C M Lam
- Bronglais Hospital, Aberystwyth, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - A Light
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - K Jayaraajan
- Imperial College London, London, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - W A Cambridge
- University of Edinburgh, Edinburgh, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - M G Matthew
- Hull York Medical School, York, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - K D Clement
- Royal Alexandra Hospital, Paisley, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - M Kulkarni
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - N R Bhatt
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - S Khadhouri
- Health Science Research Unit, The School of Medicine, Medical Sciences and Nutrition, Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
| | - V Kasivisvanathan
- Division of Surgery and Interventional Science, UCL, London, United Kingdom
- British Urology Researchers in Surgical Training (BURST), London, United Kingdom
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14
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Nathan A, Fricker M, Hanna N, Asif A, Patel S, Georgi M, Hang K, Sinha A, Mullins W, Shea J, Lamb B, Sridhar A, Kelly J, Collins J. O43 Virtual: virtual interactive surgical skills classroom: a randomized controlled trial (protocol). Br J Surg 2021. [DOI: 10.1093/bjs/znab282.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
High costs and inaccessibility are significant barriers to face-to-face basic surgical skills (BSS) training. Virtual classrooms enable the combination of computer-based learning with interactive expert instruction. They may optimise resources and increase accessibility, facilitating larger-scale training with a similar educational benefit. We aim to evaluate the efficacy of virtual BSS classroom training compared to both non-interactive video and face-to-face teaching.
Method
72 medical students will be randomly assigned to three equal intervention groups based on surgical skills experience and confidence. Interventions will be implemented following an instructional video. Group A will practice independently, Group B will receive face-to-face training, and Group C will attend a virtual classroom. Participants will be recorded placing three interrupted sutures with hand tied knots pre- and post-intervention. Objective Structured Assessment of Technical Skills (OSATS) will be blind marked by two experts.
Result
Change in confidence, time to completion and a novel granular performance score will also be measured. Each intervention’s feasibility and accessibility will be assessed. Significant improvement in OSATS within groups will be indicative of intervention quality. Difference in improvement between groups will determine the relative performance of the interventions.
Conclusion
This will be the largest randomised control trial investigating virtual BSS classroom training. It will serve as a comprehensive appraisal of the suitability of virtual classrooms as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient training programs during the COVID-19 pandemic and beyond.
Take-home Message
This is the first RCT assessing virtual basic surgical skill classroom training and serves as a comprehensive appraisal of the suitability of virtual classrooms as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient training programs during the COVID-19 pandemic and in the future.
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Affiliation(s)
- A Nathan
- University College London, London, UK
| | | | - N Hanna
- University of Cambridge, Cambridge, UK
| | - A Asif
- University of Leicester, Leicester, UK
| | - S Patel
- University College London, London, UK
| | - M Georgi
- University College London, London, UK
| | - K Hang
- University College London, London, UK
| | - A Sinha
- University of Cambridge, Cambridge, UK
| | - W Mullins
- University of Cambridge, Cambridge, UK
| | - J Shea
- University of Cambridge, Cambridge, UK
| | - B Lamb
- Cambridge University Hospitals, Cambridge, UK
| | - A Sridhar
- University College London, London, UK
| | - J Kelly
- University College London, London, UK
| | - J Collins
- University College London, London, UK
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15
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Light A, Gallagher K, Bhatt N, Clement K, Kulkarni MA, Khadhouri S, Zimmermann E, Gao C, Lam C, Anbarasan T, Chan V, Rossi S, Jayaraajan K, Asif A, Shah T, Kasivisvanathan V. 377 Global Recruitment for The RESECT Study (Transurethral Resection and Single-Instillation Intravesical Chemotherapy Evaluation in Bladder Cancer Treatment): An International Observational Cohort Study Aiming to Improve the Quality of Surgery for Non-Muscle Invasive Bladder Cancer. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Non-muscle invasive bladder cancer (NMIBC) can be curatively treated with ‘good quality’ transurethral resection of the bladder tumour (TURBT). However, despite evidence-based international guidelines, there is anecdotal evidence that practice varies widely, and this may affect oncological outcomes. Launching in 2020, RESECT aims to measure and report variation in TURBT quality globally, and determine if outcome reporting improves outcomes.
Method
RESECT was advertised internationally through social media, mailing lists, websites, and in person. Collaborators at each registered site will collect data about current practice and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators.
Results
As of August 27, 508 collaborators have registered to participate. Collaborators represent 321 centres from 54 countries, with the highest number from the United Kingdom (54.5%), Spain (5.9%), and Argentina (3.7%). 51.2% are trainees, 29.9% consultants, and 17.5% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.
Conclusions
RESECT has attracted a large number of collaborators globally and from all training levels. Therefore, the RESECT study has the potential to improve the quality of TURBT surgery across the world.
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Affiliation(s)
- A Light
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Gallagher
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Western General Hospital, Edinburgh, United Kingdom
| | - N Bhatt
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Queen Elizabeth Hospital, King's Lynn, United Kingdom
| | - K Clement
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Royal Alexandra Hospital, Paisley, United Kingdom
| | - M a Kulkarni
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Guy's Hospital, London, United Kingdom
| | - S Khadhouri
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - E Zimmermann
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Torbay Hospital, Torbay, United Kingdom
| | - C Gao
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- William Harvey Hospital, Ashford, United Kingdom
| | - C Lam
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Bronglais Hospital, Aberystwyth, United Kingdom
| | - T Anbarasan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- NHS Lothian, Edinburgh, United Kingdom
| | - V Chan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leeds School of Medicine, Leeds, United Kingdom
| | - S Rossi
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Jayaraajan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Imperial College School of Medicine, London, United Kingdom
| | - A Asif
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leicester Medical School, Leicester, United Kingdom
| | - T Shah
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Charing Cross Hospital, London, United Kingdom
| | - V Kasivisvanathan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- University College London, London, United Kingdom
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16
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Tan L, Mullins W, Gargan A, Townsend J, Gargan K, Brice J, Shea J, Jang C, Shukla S, Asif A, Fricker M, Mohan M, Nathan A. 429 National Evaluation of Confidence and Preparedness for Surgical Rotations in Medical Students and Foundation Year Doctors. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Limited published and anecdotal evidence suggests foundation year (FY) doctors start their surgical rotations with lower confidence than medical rotations. This may be due to insufficient undergraduate practical teaching related to common surgical rotations. This study aimed to evaluate the confidence and preparedness for surgical rotations of medical students and FY doctors.
Method
An expert-validated questionnaire was distributed nationally to UK medical students and FY doctors. The primary outcome was confidence in completing common tasks during surgical rotations.
Results
491 participants (84% medical students, 16% FYs) were recruited from 36 UK medical schools. 80% were likely to pursue a career in surgery however only 7% felt confident about starting a surgical FY job. 66% felt neutral or unsatisfied about the quality of medical school surgical teaching, and 80% indicated that placements did not prepare them well to manage common FY surgical tasks. The internal reliability of the questionnaire was high (=0.939).
Conclusions
Medical students and FY doctors lack confidence and preparation for surgical jobs. High-quality, practically grounded educational courses such as the National Surgical Teaching Society (NSTS) webinar curriculum could improve confidence and preparedness for surgical rotations. Further research evaluating the benefits of such courses is warranted.
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Affiliation(s)
- L Tan
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - W Mullins
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - A Gargan
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - J Townsend
- Harrogate and District NHS Foundation Trust, Leeds, United Kingdom
| | - K Gargan
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - J Brice
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - J Shea
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - C Jang
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - S Shukla
- University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
| | - A Asif
- Leicester University, Leicester, United Kingdom
| | - M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - M Mohan
- University of Cambridge, Department of Clinical Neurosciences, Cambridge, United Kingdom
| | - A Nathan
- Royal Free London, NHS Foundation Trust, London, United Kingdom
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17
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Asif A, Caputo M. P24: MANAGEMENT OF RHEUMATIC VALVE DISEASE OF THE AORTIC VALVE USING THE OZAKI PROCEDURE WITH AUTOLOGOUS PERICARDIUM. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Case-Study
A 15-year-old boy was referred to our tertiary centre from his local paediatric services with a background of rheumatic fever, severe aortic regurgitation (AR) and mild to moderate mitral regurgitation. He had a history of angina and dyspnoea on exertion, a 2/6 ejection systolic murmur and 2/4 end diastolic murmur. Transthoracic echocardiography showed severe aortic valve insufficiency (with flow reversal seen in the descending aorta and an LV end diastolic volume of 173 ml/m2) and trivial pulmonary valve regurgitation. Autograft failure following the favoured Ross procedure deemed the patient as a candidate for an Ozaki procedure. Autologous pericardium was used to replace the diseased aortic valve. Intraoperative transoesophageal echocardiography showed a deficient left coronary cusp leaflet and a retracted right coronary cusp leaflet. The patient was under cardiopulmonary bypass for 124 minutes and on cross-clamping for 99 minutes with no intraoperative complications. Histological examination of the aortic valve leaflets showed neovascularisation, myxoid changes and disarray of the fibrous stroma. Postoperative recovery was uneventful. The postoperative echocardiogram showed trivial AR, end diastolic volume 217ml, end systolic volume 12 ml and 40% ejection fraction. There was full resolution of the dyspnoea, angina and diastolic murmur on follow-up 4-months postoperatively as supported by healthy valve function on echocardiography. This case highlights that in those of risk of multiple valve pathology, such as in rheumatic valve disease, an Ozaki procedure using autologous pericardium is a viable surgical option for paediatric aortic valve repair with good outcomes.
Take-home message
In cases of systemic conditions affecting the heart valves where there is multiple valve pathology and risk of autograft failure, such as rheumatic valve disease, the use of autologous pericardium to replace these valves has shown to be a viable option in this paediatric case.
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Affiliation(s)
| | - M Caputo
- University Hospitals Bristol NHS Foundation Trust
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18
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Ng A, Cambridge WA, Jayaraajan K, Lam CM, Light A, Asif A, Chan VWS, Matthews MG, Clement K, Kulkarni M, Bhatt NR, Khadhouri S, Kasivisvanathan V. P73 LEARN: uroLogical tEAching in bRitish medical schools Nationally - a national retrospective multi-centre audit of urology teaching across British medical schools. BJS Open 2021. [PMCID: PMC8030194 DOI: 10.1093/bjsopen/zrab032.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Urological conditions account for approximately 25% of acute surgical referrals and 10-15% of general practitioner appointments. In 2012, the British Association of Urological Surgeons (BAUS) produced ‘An Undergraduate Syllabus for Urology’, advising on common clinical areas of urology that must be covered during undergraduate medical training. However, its uptake nationally remains unknown. This project aims to assess undergraduate urology teaching across UK medical schools.
Methods
A targeted advertising drive using social media, medical school societies, websites and newsletters was performed over 4 weeks. Collaborators are responsible for recruiting survey respondents (year 2 medical students to foundation year 1 (FY1) doctors). Survey respondents will complete a REDCap survey retrospectively assessing their urology teaching to date. The primary objective is to compare current urology teaching in medical schools across the United Kingdom with the BAUS undergraduate syllabus.
Results
Currently, 522 collaborators have registered from 36 medical schools nationally. Of these collaborators, 6.32% (33/522) are FY1s and 93.68% (489/522) are medical students. Each collaborator will be responsible for recruiting at least 15 survey respondents to be eligible for PubMed-indexed collaborator authorship.
Conclusion
LEARN has recruited successfully to date, with all collaborators from the medical student and FY1 cohort. With the role of collaborators to further recruit survey respondents, LEARN will provide the most representative and thorough evaluation of UK undergraduate urological teaching to date. It will provide evidence to support changes in the medical school curriculum, and allow re-evaluation of the current national undergraduate BAUS syllabus.
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Affiliation(s)
- A Ng
- University College London
| | | | | | | | | | - A Asif
- University College London
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19
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Lam CM, Gallagher K, Bhatt N, Clement K, Zimmermann E, Shah T, Khadhouri S, Kulkarni M, Gao C, Light A, Jayaraajan K, Asif A, Anbarasan T, Chan V, Kasivisvanathan V. P57 Global recruitment for the RESECT study (transurethral REsection and Single-instillation intravesical chemotherapy Evaluation in bladder Cancer Treatment) - an international observational cohort study aiming to improve the quality of surgery for non-muscle invasive bladder cancer. BJS Open 2021. [PMCID: PMC8153804 DOI: 10.1093/bjsopen/zrab032.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Non-muscle invasive bladder cancer (NMIBC) is one of the most expensive cancers to treat, driven by high recurrence rates and disease progression. Mortality rates in the UK for all bladder cancers have remained relatively stable over the past decade. NMIBC can be curatively treated with transurethral resection of the bladder tumour (TURBT). Despite international evidence-based guidelines on the TURBT procedure and postoperative single instillation of mitomycin-C, TURBT quality continues to vary widely. RESECT will be the first ever international study of TURBT surgery evaluating the achievement of TURBT quality indicators globally and assessing if audit and performance feedback can improve surgical outcomes.
Methods
RESECT is a prospective, multicentre international observational cohort study. Collaborators at each site will collect data using REDCap about local TURBT practice, early recurrence rates and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators. Advertisement for the study launched in 2020.
Results
As of October 1st, 2020, 524 collaborators have registered to participate. Collaborators represent 334 centres from 54 countries, with the highest number of centres from the United Kingdom (133), Spain (17), and India (16). 50.8% are trainees, 30.3% consultants, and 17.2% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.
Conclusion
RESECT has attracted many collaborators internationally from consultants and trainees at all stages. RESECT has significant potential to positively impact TURBT practice, health economics and ultimately improve outcomes for patients with NMIBC globally.
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Affiliation(s)
- C M Lam
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Gallagher
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - N Bhatt
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Clement
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - E Zimmermann
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - T Shah
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - S Khadhouri
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - M Kulkarni
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - C Gao
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - A Light
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Jayaraajan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - A Asif
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - T Anbarasan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - V Chan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - V Kasivisvanathan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
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H. Sumrra S, Anees M, Asif A, N. Zafar M, Mahmood K, F. Nazar M, Khalid M, A. Nadeem M, U. Khan M. Synthesis, structural, spectral and biological evaluation of metals endowed 1,2,4-triazole. B CHEM SOC ETHIOPIA 2020. [DOI: 10.4314/bcse.v34i2.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Biologically active triazole Schiff base ligand 2,4-dichloro-6-[(1H-1,2,4-triazol-3-ylimino)methyl]phenol (A) has been synthesized by the condensation reaction of an equimolar amount of 1H-1,2,4-triazole-3-amine and 3,5-dichlorosalicylaldehyde and then it coordinated with salts of metals [VO(IV), Fe(II), Co(II), Ni(II), Cu(II) and Zn(II)] in 2:1 molar ratio to derive a series of transition metal chelates (1)-(6). All the compounds were characterized by various physical, spectral, analytical techniques and elemental analysis. Spectral characterization and magnetic moment data of complexes revealed square pyramidal geometry for vanadium complex and octahedral for remaining (2)-(6) complexes. Quantum chemical calculation has been carried out to explore optimized geometry and electronic structure of the ligand. Density functional theory (DFT) with B3LYP/6-311+g(d,p) method was performed to determine vibrational bands, frontier molecular orbitals (FMOs) and natural bond analysis (NBO) of the ligand. NBO analysis showed that the ligand bears higher molecular stability because of hyper conjugate interactions. Computational study results revealed that there was a close interaction of theoretical and experimental spectroscopic data. Global reactivity descriptors calculated by the energies of FMOs, indicated ligand to be bioactive. The synthesized compounds were studied for antibacterial, antifungal, antioxidant and antiglycation activity and the results revealed that ligand has remarkable activity which considerably increased upon chelation.
KEY WORDS: Triazole ligand, Transition metal chelates, Antibacterial, Antifungal, Antioxidant, Computational study
Bull. Chem. Soc. Ethiop. 2020, 34(2), 335-351
DOI: https://dx.doi.org/10.4314/bcse.v34i2.11
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Scotcher M, Asif A, Kulkarni K. Are UK and Ireland trauma and orthopaedic surgeons maintaining their research output? Ann R Coll Surg Engl 2020; 102:625-631. [PMID: 32777931 DOI: 10.1308/rcsann.2020.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Healthcare faces growing challenges. With reports of diminishing research output from the UK and Ireland in the leading surgical journals, this study aimed to ascertain whether this trend had been echoed in the trauma and orthopaedic literature. MATERIALS AND METHODS Citable research output from the 10 globally leading trauma and orthopaedic journals was analysed from five individual years, over a 20-year period, to ascertain trends in absolute output, geographical mix, and level of evidence. RESULTS The overall number of published articles fell by 14.5%. North America saw the greatest decline (-8.0%), followed by Japan (-5.6%) and Europe (-3.3%). The UK and Ireland (+2.9%) and the rest of the world (+13.9%) saw rising output. A decline in lower (levels IV and V) and a rise in higher (levels I, II and III) quality evidence was observed. The UK and Ireland had a greater proportion of higher-quality studies than North America and Japan, but lower than Europe and the rest of the world. The impact factor of the leading journal rose from 4.47 to 7.01. DISCUSSION The research landscape has evolved, with leading journals placing greater emphasis on higher-quality evidence. UK and Irish research output remains stable, contributing 14% of the most highly cited publications in 2018, and challenging North America's dominance with a greater proportion of level I and II evidence in the leading journals. CONCLUSION With the growing emergence of Europe and the rest of the world, UK and Irish authors must build upon the region's output despite political challenges such as Brexit. Increasing international collaboration will continue to play an important role.
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Affiliation(s)
| | - A Asif
- University of Leicester, Leicester, UK
| | - K Kulkarni
- University Hospitals of Leicester NHS Trust, Leicester, UK
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Heshmatzadeh Behzadi A, Velasco N, Bakr M, Asif A, Prince M, Jain S, Zahid U. Abstract No. 488 Trimetazidine in the prevention of contrast-induced nephropathy in patients with renal insufficiency undergoing percutaneous coronary intervention: a systematic review and meta-analysis. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Contreras G, Pardo V, Cely C, Borja E, Hurtado A, De La Cuesta C, Iqbal K, Lenz O, Asif A, Nahar N, Leclerq B, Leon C, Schulman I, Ramirez-Seijas F, Paredes A, Cepero A, Khan T, Pachon F, Tozman E, Barreto G, Hoffman D, Almeida Suarez M, Busse JC, Esquenazi M, Esquenazi A, Garcia Mayol L, Garcia Estrada H. Factors associated with poor outcomes in patients with lupus nephritis. Lupus 2016; 14:890-5. [PMID: 16335581 DOI: 10.1191/0961203305lu2238oa] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this study was to identify the factors associated with important clinical outcomes in a case-control study of 213 patients with lupus nephritis. Included were 47% Hispanics, 44% African Americans and 9% Caucasians with a mean age of 28 years. Fifty-four (25%) patients reached the primary composite outcome of doubling serum creatinine, end-stage renal disease or death during a mean follow-up of 37 months. Thirty-four percent African Americans, 20% Hispanics and 10% Caucasians reached the primary composite outcome ( P < 0.05). Patients reaching the composite outcome had predominantly proliferative lupus nephritis (WHO classes: 30% III, 32% IV, 18% V and 5% II, P < 0.025) with higher activity index score (7 ± 6 versus 5 ± 5, P<0.05), chronicity index (CI) score (4 ± 3 versus 2 ± 2 unit, P<0.025), higher baseline mean arterial pressure (MAP) (111 ± 21 versus 102 ± 14 mmHg, P<0.025) and serum creatinine (1.9 ± 1.3 versus 1.3 ± 1.0 mg/dL, P<0.025), but lower baseline hematocrit (29 ± 6 versus 31 + 5%, P<0.025) and complement C3 (54 ± 26 versus 65 + 33 mg/dL, P<0.025) compared to controls. More patients reaching the composite outcome had nephrotic range proteinuria compared to controls (74% versus 56%, P<0.025). By multivariate analysis, CI (hazard ratio [95% CI] 1.18 [1.07-1.30] per point), MAP (HR 1.02 [1.00-1.03] per mmHg), and baseline serum creatinine (HR 1.26 [1.04-1.54] per mg/dL) were independently associated with the composite outcome. We concluded that hypertension and elevated serum creatinine at the time of the kidney biopsy as well as a high CI are associated with an increased the risk for chronic renal failure or death in patients with lupus nephritis.
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Affiliation(s)
- G Contreras
- Acute Dialysis Unit Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
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Joseph B, Pandit V, Zangbar B, Amman M, Khalil M, O'Keeffe T, Orouji T, Asif A, Kattaa A, Judkins D, Friese RS, Rhee P. Erratum to: Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries. Eur J Trauma Emerg Surg 2016; 40:733. [PMID: 26814791 DOI: 10.1007/s00068-014-0459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- B Joseph
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA.
| | - V Pandit
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - B Zangbar
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - M Amman
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - M Khalil
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - T O'Keeffe
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - T Orouji
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - A Asif
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - A Kattaa
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - D Judkins
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - R S Friese
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - P Rhee
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
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Joseph B, Pandit V, Zangbar B, Amman M, Khalil M, O'Keeffe T, Orouji T, Asif A, Katta A, Judkins D, Friese RS, Rhee P. Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries. Eur J Trauma Emerg Surg 2014; 40:729-32. [PMID: 26814790 DOI: 10.1007/s00068-014-0453-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 09/29/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Traumatic brain injury is a leading cause of disability in bicycle riders. Preventive measures including bicycle helmet laws have been highlighted; however, its protective role has always been debated. The aim of this study was to determine the utility of bicycle helmets in prevention of intra-cranial hemorrhage. We hypothesized that bicycle helmets are protective and prevent the development of intra-cranial hemorrhage. METHODS We performed a 4-year (2009-2012) retrospective cohort analysis of all the patients who presented with traumatic brain injury due to bicycle injuries to our level 1 trauma center. We compared helmeted and non-helmeted bicycle riders for differences in the patterns of injury, need for intensive care unit admissions and mortality. RESULTS A total of 864 patients were reviewed of which, 709 patients (helmeted = 300, non-helmeted = 409) were included. Non-helmeted bicycle riders were more likely to be young (p < 0.001) males (p = 0.01). There was no difference in the median ISS between the two groups (p = 0.3). Non-helmeted riders were more likely to have a skull fracture (p = 0.01) and a scalp laceration (p = 0.01) compared to the helmeted riders. There was no difference in intra-cranial hemorrhage between the two groups (p = 0.1). Wearing a bicycle helmet was not independently associated (p = 0.1) with development of intra-cranial hemorrhage. CONCLUSION Bicycle helmets may have a protective effect against external head injury but its protective role for intra-cranial hemorrhage is questionable. Further studies assessing the protective role of helmets for intra-cranial hemorrhage are warranted.
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Affiliation(s)
- B Joseph
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA.
| | - V Pandit
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - B Zangbar
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - M Amman
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - M Khalil
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - T O'Keeffe
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - T Orouji
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - A Asif
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - A Katta
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - D Judkins
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - R S Friese
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
| | - P Rhee
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Room 5411, P.O. Box 245063, Tucson, AZ, 85724, USA
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Shochat M, Shotan A, Kazatsker M, Asif A, Shochat I, Dahan I, Vasilenko L, Levy Y, Sigalov T, Meisel S. Short and long-term outcome of impedance-guided preemptive therapy provided to prevent pulmonary congestion-edema in the course of acute myocardial infarction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shochat M, Shotan A, Kazatsker M, Asif A, Shochat I, Dahan I, Frimerman A, Levy Y, Blondheim D, Meisel S. Evaluation of the effectiveness of in-hospital treatment of chronic heart failure patients during exacerbation by non-invasive net lung impedance monitoring during during admission. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rangel ML, Alghamdi I, Contreras G, Harrington T, Thomas DB, Barisoni L, Andrews D, Wolf M, Asif A, Nayer A. Catastrophic antiphospholipid syndrome with concurrent thrombotic and hemorrhagic manifestations. Lupus 2013; 22:855-64. [PMID: 23722230 DOI: 10.1177/0961203313491024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Antiphospholipid syndrome (APS) is a distinct autoimmune prothrombotic disorder due to pathogenic autoantibodies directed against proteins that bind to phospholipids. APS is characterized by arterial and venous thrombosis and their clinical sequelae. Catastrophic antiphospholipid syndrome (CAPS) is a rare and often fatal form of APS characterized by disseminated intravascular thrombosis and ischemic injury resulting in multiorgan failure. Rarely, intravascular thrombosis in CAPS is accompanied by hemorrhagic manifestations such as diffuse alveolar hemorrhage. Here, we report a 43-year-old woman who presented with anemia, acute gastroenteritis, abnormal liver function tests, bilateral pulmonary infiltrates, and a systemic inflammatory response syndrome. The patient developed respiratory failure as a result of diffuse alveolar hemorrhage followed by acute renal failure. Laboratory tests disclosed hematuria, proteinuria, and reduced platelet count. Microbiologic tests were negative. A renal biopsy demonstrated acute thrombotic microangiopathy and extensive interstitial hemorrhage. Serologic tests disclosed antinuclear antibodies and reduced serum complement C4 concentration. Coagulation studies revealed the lupus anticoagulant and autoantibodies against cardiolipin, beta 2-glycoprotein I, and prothrombin. High-dose glucocorticoids and plasma exchange resulted in rapid resolution of pulmonary, renal, and hematological manifestations. This rare case emphasizes that CAPS can present with concurrent thrombotic and hemorrhagic manifestations. Rapid diagnosis and treatment may result in complete recovery.
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Affiliation(s)
- M L Rangel
- Division of Nephrology, University of Miami, Clinical Research Building, Suite 825, 1120 NW 14th St., Miami, FL 33136, USA
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Khadim MT, Asif A, Ali Z, Jamal S, Rizwan . Spindle cell rhabdomyosarcoma of the tongue – A rare entity. J Coll Med Sci-Nepal 2012. [DOI: 10.3126/jcmsn.v7i4.6814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Spindle cell variant of Rhabdomyosarcoma is a rare malignant tumor in adults but even more so in tongue. We report a case of a 17 year old boy who presented with a polypoidal swelling on the tip of the tongue. The mass was excised and the specimen was sent to the Histopathology Department of Armed Forces Institute of Pathology for Histomorphological diagnosis. The histological evaluation showed a malignant spindle cell tumor. On the basis of morphological features and immunohistochemistry findings a final diagnosis of Rhabdomyosarcoma, Spindle cell variant was made. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 63-66 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6814
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Asif A, Rao VL, Ninan KN. Preparation, characterization, thermo-mechanical, and barrier properties of exfoliated thermoplastic toughened epoxy clay ternary nanocomposites. POLYM ADVAN TECHNOL 2011. [DOI: 10.1002/pat.1533] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Barthelemy O, Silvain J, Brieger D, Bellemain-Appaix A, Cayla G, Beygui F, Lancar R, Collet JP, Mercadier A, Montalescot G, Cha KS, Nam YH, Kim JH, Park SY, Park TH, Kim MH, Kim YD, Lee HC, Ahn MS, Hong TJ, Blanco R, Blanco F, Szarfer J, Garcia Escudero A, Gigena G, Gagliardi J, Rodriguez A, Sarmiento R, Affatatto S, Riccitelli M, Petris A, Datcu MD, Pop C, Radoi M, Arsenescu-Georgescu C, Petrescu I, Petrescu L, Serban L, Nechita E, Tatu-Chitoiu G, Tatu-Chitoiu G, Dorobantu M, Benedek I, Craiu E, Sinescu C, Ionescu DD, Radoi M, Pop C, Ginghina C, Minescu B, Izzo A, Mantovani P, Tomasi L, Dall'oglio L, Bonatti S, Rosiello R, Romano M, Agostini F, Zanini R, Zhao ZY, Wu YJ, Li JJ, Yany YJ, Qian HY, Tang YD, Timoteo AT, Toste A, Lousinha A, Ramos R, Oliveira JA, Ferreira ML, Ferreira RC, Cabades C, Diez Gil JL, Aguar P, Sanmiguel D, Lopez-March A, Marmol R, Guerra L, Girbes V, Ferrando J, Rincon De Arellano A, Timoteo AT, Ramos R, Toste A, Oliveira JA, Patricio L, Ferreira ML, Ferreira RC, Blondal M, Ainla T, Marandi T, Eha J, Timoteo AT, Oliveira MM, Silva MN, Cunha PS, Feliciano J, Silva S, Ferreira RC, Silva B, Oliveira R, Caires G, Drumond A, Araujo J, Suarez-Barrientos A, Vivas D, Castro-Ferreira F, Nunez-Gil I, Franco E, Kanovsky J, Garcia-Rubira JC, Fernandez-Ortiz A, Fuster V, Macaya C, Ibanez Cabeza B, Salinger S, Perisic Z, Milic D, Stanojlovic T, Apostolovic S, Kala P, Obradovic S, Djordjevic-Radojkovic D, Damjanovic M, Koracevic G, Kostic T, Khan MA, Vrapi F, Naeem K, Davar J, Hristova K, Parenica J, Hristova K, Pencheva G, Radeva R, Milanov S, Trambaiolo P, Poli M, De Luca M, Lukic V, Mustilli M, Corsi F, Poloczek M, Simonetti M, Ferraiuolo G, Fareed A, Oraby M, Nasr GM, Maklady F, Dupouy P, Sorensen JT, Terkelsen CJ, Lassen JF, Prymusova K, Trautner S, Christensen EF, Nielsen TT, Botker HE, Andersen HR, Thygesen KA, Checco L, Usmiani T, Sbarra PL, Boffini M, Kubkova L, Saviolo R, Grasso C, Conrotto F, Marchetti M, Rinaldi M, Marra S, Moscoso Costa F, Ferreira J, Raposo L, Aguiar C, Spinar J, Trabulo M, Silva JA, Faria R, Mimoso J, Marques N, Trigo J, Marques V, Gomes V, Swiatkowski A, Kowalczyk J, Olinic D, Lenarczyk R, Chodor P, Honisz G, Was T, Swierad M, Sredniawa B, Polonski L, Kalarus Z, Postadzhiyan AS, Velinov H, Homorodean C, Velchev V, Hazarbasanov D, Apostolova M, Finkov B, Petrovic M, Panic G, Jovelic A, Canji T, Srdanovic I, Popov T, Ober M, Golubovic M, Pavlovic K, Cemerlic-Adjic N, Bro-Jeppesen J, Kjaergaard J, Wanscher MC, Nielsen SL, Rasmussen LS, Hassager C, Bro-Jeppesen J, Olinic M, Kjaergaard J, Wanscher MC, Rasmussen LS, Hassager C, Khan M, Crolla E, Morley H, Akeroyd L, Beaini Y, Morley C, Andrioaia C, Dores H, Leal S, Rosario I, Abecasis J, Monge J, Correia MJ, Arroja I, Fonseca C, Aleixo A, Silva A, Condac A, Bekeredjian RH, Krumsdorf U, Rottbauer W, Katus HA, Pleger S, Providencia RA, Silva J, Barra S, Gomes PL, Seca L, Masmoudi M, Botelho A, Quintal N, Mota P, Leitao-Marques AM, Silva B, Santos N, Cafe H, 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Silenzi S, Fontes-Carvalho R, Caeiro D, Adao L, Oliveira M, Goncalves H, Primo J, Gama V, Fresco C, De Biasio M, Sappa R, Testa M, Muser D, Morocutti G, Bernardi G, Proclemer A, Lombardi C, Metra M, Bugatti S, Pasotti E, Quinzani F, Adamo M, Candelori L, Villa C, Rovetta R, Manerba A, Dei Cas L, Mariani M, Dushpanova A, Baroni M, Cerone E, Nardelli A, Gianetti J, Clementi LN, Berti S, Timoteo AT, Oliveira MM, Silva MN, Toste A, Ramos R, Cunha PS, Feliciano F, Soares R, Santos S, Forlini M, Ferreira RC, Ostadal P, Kruger A, Vondrakova D, Herget J, Di Maio RC, Navarro C, Cromie NA, Anderson JMC, Adgey JAA, Lando L, Tadel-Kocjancic S, Radsel P, Knafelj R, Gorjup V, Noc M, Caeiro Pereira D, Braga P, Fontes Carvalho R, Sousa O, Rodrigues A, Pezzuoli ML, Goncalves H, Ribeiro J, Goncalves M, Simoes L, Gama V, Borisov KV, Corradetti P, Leurent G, Pennec PY, Filippi E, Moquet B, Hacot JP, Druelles P, Rialan A, Rouault G, Coudert I, Le Breton H, Gevaert S, Tromp F, Vandecasteele E, De Somer F, Van Belleghem Y, Bouchez S, Martens F, Herck I, De Pauw M, Spinar J, Ludka O, Sepsi M, Miklik R, Dusek L, Tomcikova D, Marques N, Mimoso J, Gomes V, Garcia-Acuna JM, Aguiar-Souto P, Raposeiras Roubin S, Agra-Bermejo R, Jacquet M, Abu-Assi E, Gonzalez-Juanatey JR, Ibatov A, Labrova R, Spinar J, Karlik R, Kanovsky J, Lokaj P, She Q, Deng SB, Huang SH, Gu LJ, Rong JIAN, Wu ZK, Li Y, Zhang J, Parascan L, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Bobescu E, Radoi M, Datcu G, Dobreanu D, Doka B, Charniot JC, Cosson C, Albertini JP, Bittar R, Giral P, Cherfils C, Guillerm E, Bonnefont-Rousselot D, Craiu E, Rusali A, Cojocaru L, Parepa I, Koizumi T, Iida S, Sato J, Kikutani T, Muramatsu T, Nishimura S, Komiyama N, Lee WP, Ong BB, Haralambos K, Townsend D, Rees JAE, Williams EJ, Halcox JP, Mcdowell I, Damjanovic M, Koracevic G, Djordjevic-Radojkovic D, Pavlovic M, Krstic N, Ciric-Zdravkovic S, Stojkovic A, Perisic Z, Apostolovic S, Faustino A, Seca L, Barra S, Caetano F, Providencia R, Silva J, Gomes P, Costa G, Costa M, Leitao-Marques A, Volkova AL, Arutyunov GP, Bylova NA, Dayter II, Jao YTFN, Fang CC, Chen Y, Yu CL, Wang SP, Valencia J, Perez-Berbel P, Ruiz-Nodar JM, Pineda J, Bordes P, Quintanilla M, Mainar V, Sogorb F, Santos N, Serrao M, Cafe H, Silva B, Oliveira R, Caires G, Drumond A, Araujo J, Providencia RA, Gomes PL, Seca L, Barra S, Silva J, Faustino A, Caetano F, Pais JR, Mota P, Leitao-Marques AM, Farhan S, Jarai R, Tentzeris I, Vogel B, Freynhofer MK, Wojta J, Huber K, Poli M, Trambaiolo P, Corsi F, De Luca M, Mustilli M, Lukic V, Simonetti M, Ferraiuolo G, Lettino M, Casella G, Conte MR, De Luca L, Geraci G, Ceravolo R, Milo M, Pani A, Trambaiolo P, Fradella G, Schratter A, Thiele H, Klemm T, Demmin K, Lehmann D, Mende M, Schuler G, Pittl U, Chernova A, Nikulina SU, Naruke T, Inomata T, Yanagisawa T, Maekawa E, Mizutani T, Shinagawa H, Nishii M, Takeuchi I, Takehana H, Izumi T, Paulo C, Mascarenhas J, Patacho M, Pimenta J, Bettencourt P, Nardai S, Szabo GY, Berta B, Edes I, Merkely B, Delgado Silva J, Seca L, Baptista R, Providencia R, Mota P, Costa M, Leitao-Marques A, Faria R, Trigo J, Gago P, Mimoso J, Marques N, Gomes V, Gheorghe G, Nanea IT, Cristea A, Almarichi S, Martins H, Saraiva F, Baptista R, Jorge E, Mendes PL, Monteiro P, Costa S, Franco F, Providencia LA, Nanea T, Gheorghe GS, Visan S, Paun N, Gaber R, Gaber R, Delewi R, Nijveldt R, De Bruin HA, Hirsch A, Van Der Laan A, Bouma BJ, Tijssen JPG, Van Rossum AC, Zijlstra F, Piek JJ, Rus H, Radoi M, Donea M, Ciurea C, Ifteni G, Casolo G, Chioccioli M, Magnacca M, Del Meglio J, Comella A, Baratto M, Lera J, Salvadori L, Tessa C, Vignali C, Keca Z, Momcilov Popin T, Panic G, White R, Mateen F, Weaver A, Dragu R, Agmon Y, Kapeliovich M, Hammerman H, Timoteo AT, Lousinha A, Santos N, Oliveira JA, Ferreira ML, Ferreira RC, Okisheva E, Tsaregorodtsev D, Sulimov V, Amat Santos IJ, Gonzalez IA, Hernandez C, Sandin MG, Tapia C, Andion R, Alvarado M, Campo A, San Roman JA, Fredman D, Svensson L, Rosenqvist M, Tadel-Kocjancic S, Radsel P, Knafelj R, Gorjup V, Noc M, Zima E, Jenei ZS, Kovacs E, Osztheimer I, Szabo GY, Molnar L, Horvath A, Becker D, Geller L, Merkely B, Maggi R, Furukawa T, Viscardi V, Brignole M, Leal SRN, Dores H, Rosario I, Monge J, Carvalho MJ, Arroja I, Leitao A, Fonseca C, Aleixo A, Silva A, Keuleers S, Herijgers P, Herregods MC, Budts W, Dubois C, Meuris B, Verhamme P, Flameng W, Van De Werf F, Adriaenssens T, Badran H, Elnoamany M, Lolah T, Tatu-Chitoiu G, Dorobantu M, Benedek I, Craiu E, Sinescu C, Ionescu DD, Olariu C, Radoi M, Pop C, Macarie C, Mollik MAH, Hassan AI, Paul TK, Haque MZ, Jahan R, Rahmatullah M, Khatun MA, Rahman MT, Chowdhury MH, Bustamante Munguira J, Tamayo E, Garcia-Cuenca I, Bustamante E, Gualis J, Gomez-Martinez ML, Florez S, Gomez-Herreras JI, Ramirez Rodriguez R, Ramirez Rodriguez AM, Garcia-Bello MA, Hernadez Ortega E, Caballero Dorta E, Garcia Quintana A, Piro Mastraccio V, Medina Fernandez Aceytuno A, Assanelli E, De Metrio M, Rubino M, Lauri G, Cabiati A, Campodonico J, Grazi M, Moltrasio M, Marana I, Marenzi G, Lovlien M, Schei B, Picon-Heras R, Acebal C, Garcia Rubira JC, Vivas Balcones D, Nunez-Gil I, Ruiz-Mateos B, Ibanez B, Fernandez-Ortiz A, Vintila VD, Enescu OA, Stoicescu CI, Udroiu C, Cinteza M, Tatu - Chitoiu G, Vinereanu D, Fresco C, De Biasio M, Muser D, Sappa R, Morocutti G, Bernardi G, Proclemer A, Fontanella B, Affatato A, Ciccarese C, Sacchini M, Volpini M, Bianchetti F, Verzura G, Dei Cas L, Pudil R, Blaha V, Vojacek J, Paraskevaidis I, Ikonomidis I, Parissis J, Papadopoulos C, Stasinos V, Bistola V, Anastasiou-Nana M, Shochat M, Shotan A, Kazatsker M, Gurovich V, Asif A, Noiman E, Levy Y, Blondhaim D, Rabinovich P, Meisel S, Koracevic G, Stojkovic A, Petrovic S, Pavlovic M, Glasnovic J, Tomasevic M, Krstic N, Djordjevic-Radojkovic D, Sakac D, Obradovic S, Londono Sanchez O, Pacreu S, Torres L, Mihaylov G, Shaban GM, Trendafilova E, Krasteva V, Mudrov TS, Didon JP, Panageas V, Vlachos N, Pernat A, Radan I, Mozina H, Izzo A, Tomasi L, Mantovani P, Dall'oglio L, Pepi P, Romano M, Cionini F, Baccaglioni N, Zanini R, Viertel A, Havers J, Ballard G, Groenefeld G, Santos N, Branco LM, Oliveira JA, Ferreira L, Timoteo AT, Fiarresga A, Feliciano J, Ramos R, Ferreira RC, Izzo A, Tomasi L, Mantovani P, Pepi P, Lettieri L, Dall'oglio L, Reggiani A, Zanini R, Garcia Gonzalez MJ, Arroyo Ucar E, Hernandez Garcia C, Juarez Prera R, Blanco Palacios G, Dorta Martin M, Marrero Rodriguez F, Martin AC, Manzo Silberman S, Chaib A, Varenne O, Allouch P, Salengro E, Jegou A, Margot O, Spaulding C, Diego A, De Miguel A, Cuellas C, Fraile E, Martin J, Vega B, Bangueses R, Fernandez-Vazquez F, Perez De Prado A, Rosario I, Dores H, Leal S, Correia MJ, Monge JC, Arroja I, Abecasis J, Aleixo A, Silva A, Dragu R, Agmon Y, Kapeliovich M, Hammerman H, Garcia-Garcia C, Subirana I, Sala J, Bruguera J, Valle V, Sanz G, Fiol M, Aros F, Marrugat J, Elosua R, Barra SNC, Silva J, Gomes P, Providencia R, Seca L, Leitao Marques A, Zhao ZY, Wu YJ, Li JJ, Yang YJ, Xu B, Tang YD, Song GY, G RL, Panic M, Milicevic P, Stankovic I, Ilic I, Kafedzic S, Kalezic T, Milicevic D, Aleksic A, Putnikovic B, Neskovic A, Serpytis P, Rucinskas K, Kalinauskas A, Karvelyte N, Santos De Sousa CI, Ferreira S, Calaca J, Lousada N, Palma Reis R, Gualandro DM, Seguro LFBC, Braga FGM, Silvestre OM, Lage RL, Fabri J, Oliveira MT, Urbano Moral JA, Torres Llergo J, Solanilla Rodriguez R, Sanchez Gonzalez A, Martinez Martinez A, Den Uil CA, Lagrand WK, Van Der Ent M, Jewbali LSD, Cheng JM, Spronk PE, Simoons ML, Mornos C, Petrescu L, Dragulescu D, Ionac A, Guardado J, Azevedo O, Fernandes M, Canario-Almeida F, Sanfins V, Pereira A, Almeida J, Kaplunova VU, Belenkov YN, Privalova EV, Fomin AA, Suvorov AY, Goodkova A, Rubakova MG, Kuznetsova IA, Semernin EN, Keshavarzi F, Kojuri J, Mikhailov VM, Vezhenkova IV, Goodkova AYA, Jarai R, Pavlovic I, Farhan S, Schwarz M, Jakl G, Huber K, Jarai R, Schwarz M, Smetana P, Jakl G, Perkmann T, Farhan S, Huber K, Mayr A, Mair J, Klug G, Schocke M, Trieb T, Jaschke W, Pachinger O, Metzler B, Bronze Carvalho L, Azevedo J, Andrade ML, Arroja I, Relvas MJ, Coucello J, Monge J, Morais G, Seabra M, Aleixo A, Afamefule F, Luaces Mendez M, Teijeiro-Mestre R, Nunez-Gil IJ, Leco-Gil N, Madronal-Cerezo E, Zannin I, Ruiz J, Orynchak MA, Vakalyuk II, Vakalyuk IP, Berezin A, Panasenko T, Cavusoglu Y, Cavusoglu A, Unluoglu I, Tek M, Demirustu C, Gorenek B, Unalacak M, Birdane A, Yuksel F, Ata N, Lee WP, Halcox JPJ, Cavusoglu Y, Beyaztas A, Entok E, Demirustu C, Uslu I, Birdane A, Gorenek B, Ata N, Schaefer A, Flierl U, Seydelmann N, Bauersachs J, Calmac L, Craiu E, Ionescu DD, Nanea T, Pop C, Marinescu S, Macarie C, Tatu Chitoiu G, Fruntelata AG, Dorobantu M, Hamdi S, Maazoun Y, Neji A, Farhat O, Majdoub M, Ben Hamda K, Maatouk F, Balanescu SM, Benedek I, Nedelciuc I, Deleanu D, Dobreanu D, Olinic D, Petrescu L, Ortan F, Mot S, Tatu Chitoiu G, Sinnaeve PR, Moreels S, Adriaenssens T, Dubois C, Coosemans M, Vydt T, Desmet W, Sinnaeve PR, Moreels S, Vydt T, Dubois C, Adriaenssens T, Coosemans M, Desmet W, Poli M, Trambaiolo P, Corsi F, De Luca M, Mustilli M, Lukic V, Simonetti M, Ferraiuolo G, Tobing D, Rifnaldi R, Juzar D, Firdaus I, Dharma S, Irmalita I, Kalim H, Bejiqi R, Retkoceri R, Bejiqi H, Kryeziu L, Kelmendi M, Borovci SH, Victor SM, Gnanaraj A, Deshmukh R, Mullasari AS, Yahalom M, Kaiyal RS, Roguin N, Bornstein J, Atar S, Farah R, Seca LF, Faustino A, Silva J, Providencia R, Gomes P, Barra S, Caetano F, Costa M, Leitao Marques AM, Margato R, Sousa P, Ribeiro H, Rocha L, Correia A, Moreira JI, Carvalho HC, Afifi M, Abed N, Santos N, Serrao M, Cafe H. Abstracts. Eur Heart J Suppl 2010. [DOI: 10.1093/eurheartj/suq023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wasay M, Khatri I, Jabeen K, Ali S, Subhan M, Shahbaz N, Ahmed A, Khoso N, Asif A, Fredrikson S. PO10-TU-03 Multiple Sclerosis, disability and progression in Pakistan. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Asif A, Rao VL, Saseendran V, Ninan K. Thermoplastic toughened layered silicate epoxy ternary nanocomposites-Preparation, morphology, and thermomechanical properties. POLYM ENG SCI 2009. [DOI: 10.1002/pen.21226] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Asif A, Bhimani B. Response to ‘ ‘Too-early’ initiation of dialysis?’. Kidney Int 2008. [DOI: 10.1038/sj.ki.5002762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Besarab A, Ravani P, Spergel LM, Roy-Chaudhury P, Asif A. The native arteriovenous fistula in 2007. Research needs. J Nephrol 2007; 20:668-673. [PMID: 18046668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Several research questions are open in the field of vascular access for hemodialysis. The present paper reviews both prognostic issues, such as the identification of factors for patient stratification before access insertion, and intervention questions, such as comparison of the advantages and disadvantages of different surgical solutions, the effects of different medications on vascular pathology, the different cannulation practices to prevent vessel wall lesions and technologies for early diagnosis of access dysfunction. Given that the quality of the available literature in nephrology is often suboptimal, nephrologists need to pay special attention to methodology issues before embarking on expensive multicenter studies.
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Affiliation(s)
- A Besarab
- Department of Medicine, Henry Ford Health System, Detroit, Michigan ,USA.
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Besarab A, Asif A, Roy-Chaudhury P, Spergel LM, Ravani P. The native arteriovenous fistula in 2007. Surveillance and monitoring. J Nephrol 2007; 20:656-667. [PMID: 18046667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In the past 5 years, some clinical trials have questioned the value of surveillance in managing vascular accesses. Although prolongation of access life span is an important end point, reduction of thrombotic events reduces patient risks resulting from loss of access patency. Most of the available evidence suggests that detection of stenosis and prevention of thrombosis is valuable. When a test indicates the likely presence of a stenosis, then venography or fistulography should be used to definitively establish the presence and degree of the stenosis. In most but not all cases, angioplasty should be performed if the stenosis is greater than 50% by diameter. The value of routine use of any surveillance technique for detecting anatomic stenosis alone, without concomitant functional assessment by measurement of access flow, venous pressure, recirculation or other physiologic parameters, has not been established. Stenotic lesions should not be repaired merely because they are present. If such correction is performed, then intraprocedural or periprocedural measurement of access flow (QA) or intra-access pressure should be conducted to demonstrate a functional improvement with a successful percutaneous transluminal angioplasty.
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Affiliation(s)
- A Besarab
- Department of Medicine, Henry Ford Health System, Detroit, Michigan, USA.
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Abstract
The wound healing activities of the aqueous and methanol extracts of the root of Berberis lyceum were assessed using incision, excision and dead wound space models of wound repair in rats. After application of both extracts it was observed that the area of epithelialization increased, followed by an increase in wound contraction, skin breaking strength, tissue granulation, dry weight and hydroxyproline content. Histopathological studies of the granulation tissue also indicated that there was an increase in collagen formation in those rats treated with the methanol extract, compared with the control group animals. The methanol extract was more effective than the aqueous extract, but both showed significant results compared with the control.
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Affiliation(s)
- A Asif
- Department of Biochemistry, University of Arid Agriculture, Murree Road, Rawalpindi, Pakistan
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Asif A, Leena K, Lakshmana Rao V, Ninan KN. Hydroxyl terminated poly(ether ether ketone) with pendant methyl group-toughened epoxy clay ternary nanocomposites: Preparation, morphology, and thermomechanical properties. J Appl Polym Sci 2007. [DOI: 10.1002/app.26774] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- B Bhimani
- Division of Nephrology Section of Interventional Nephrology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
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Affiliation(s)
- A. Asif
- University of Miami Jackson Memorial Medical Center, Miami, FL - USA
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Asif A. Pro/Con Complications of AV Shunt Intervention: The Spectrum of Percutaneous Complications. J Vasc Access 2006. [DOI: 10.1177/112972980600700423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A. Asif
- University of Miami Jackson Memorial Medical Center, Miami, FL - USA
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Asif A. The Thrombosed AVF: Restoring Flow in the Clotted AVF: Is this Madness or is there a Method? J Vasc Access 2006. [DOI: 10.1177/112972980600700427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A. Asif
- University of Miami Jackson Memorial Medical Center, Miami, FL - USA
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Contreras G, Lenz O, Pardo V, Borja E, Cely C, Iqbal K, Nahar N, de La Cuesta C, Hurtado A, Fornoni A, Beltran-Garcia L, Asif A, Young L, Diego J, Zachariah M, Smith-Norwood B. Outcomes in African Americans and Hispanics with lupus nephritis. Kidney Int 2006; 69:1846-51. [PMID: 16598205 DOI: 10.1038/sj.ki.5000243] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Poor outcomes have been reported in African Americans and Hispanics compared to Caucasians with lupus nephritis. The purpose of this retrospective analysis was to identify independent predictors of outcomes in African Americans and Hispanics with lupus nephritis. In total, 93 African Americans, 100 Hispanics, and 20 Caucasians with a mean age of 28 +/- 13 years and an annual household income of 32.9 +/- 17.3 (in 1000 US dollars) were studied. World Health Organization (WHO) lupus nephritis classes II, III, IV, and V were seen in 9, 13, 52, and 26%, respectively. Important baseline differences were higher mean arterial pressure (MAP) in African Americans compared to Hispanics and Caucasians (107 +/- 19, 102 +/- 15, and 99 +/- 13 mmHg, P < 0.05), and higher serum creatinine (1.66 +/- 1.3, 1.25 +/- 1.0, and 1.31 +/- 1.0 mg/dl, P < 0.025). African Americans had lower hematocrit compared to Hispanics and Caucasians (29 +/- 5, and 31 +/- 6, and 32 +/- 7%, P < 0.05), and lower annual household income (30.8 +/- 14.9, 33.1 +/- 15.9, and 42.2 +/- 29.3 in 1000 US dollars; P < 0.05). Lower prevalence of WHO class IV was seen in Caucasians (30%) compared to Hispanics (57%, P = 0.03) and African Americans (51%, P = 0.09). Development of doubling creatinine or end-stage renal disease was higher in African Americans and Hispanics than in Caucasians (31, 18, and 10%; P < 0.05), as was the development of renal events or death (34, 20, and 10%; P < 0.025). Our results suggest that both biological factors indicating an aggressive disease and low household income are common in African Americans and Hispanics with lupus nephritis, and outcomes in these groups are worse than in Caucasians.
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Affiliation(s)
- G Contreras
- Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Florida 33136, USA.
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Asif A, Lenz O, Merrill D, Cherla G, Cipleu CD, Ellis R, Francois B, Epstein DL, Pennell P. Percutaneous management of perianastomotic stenosis in arteriovenous fistulae: Results of a prospective study. Kidney Int 2006; 69:1904-9. [PMID: 16557220 DOI: 10.1038/sj.ki.5000358] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Surgical creation of new anastomosis has been proposed as the preferred treatment for perianastomotic stenoses of fistulae. However, disadvantages of surgical approach have included (1) frequent conversion of fistula to a graft by using synthetic graft material to create a new anastomosis, (2) shortening the length of the cannulation segment by proximal autologous arteriovenous neoanastomosis, and (3) abandoning the fistula altogether in favor of a synthetic graft. We report the results of a prospective study using percutaneous balloon angioplasty (PTA) to treat fistulae with perianastomotic lesions. Seventy-three consecutive patients undergoing 112 PTA procedures for the treatment of perianastomotic lesions were studied. Primary and secondary patency rates were calculated. Procedure success, procedure-related complications, and conversion of fistulae to grafts were recorded. The initial success rate was 97%. The degree of stenosis before and after PTA was 81 +/- 9 and 11+/-11%, respectively. Primary patency rates at 6, 12, and 18 months were 75, 51, and 41%, respectively. Secondary patency rates at 6, 12, and 18 months were 94, 90, and 90%, respectively. Grade I hematoma occurred in three and vein rupture in two cases. No grafts were inserted. These outcomes are superior to those that have been reported for surgery. The outpatient PTA is safe and effective for the management of perianastomotic stenosis. Because of its advantage of fistula preservation, the percutaneous approach should be considered as the preferred first-line therapy for the management of perianastomotic fistula lesions.
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Affiliation(s)
- A Asif
- Interventional Nephrology, Division of Nephrology, University of Miami Miller School of Medicine, Florida, USA.
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Asif A. Peritoneal dialysis catheter insertion. MINERVA CHIR 2005; 60:417-28. [PMID: 16210990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Peritoneal dialysis (PD) catheter insertion can be accomplished by any 1 of 3 techniques. These include dissective or surgical, the blind or modified Seldinger, and laparoscopic techniques. The dissective technique solely utilized by surgeons, places the catheter by mini-laparotomy under general anesthesia. In the blind or modified Seldinger technique a needle is inserted into the abdomen, a guide-wire placed, a tract dilated and the catheter is inserted through a split-sheath, all without visualization of the peritoneal cavity. Of the various laparoscopes, peritoneoscopic insertion uses a small optical peritoneoscope for direct inspection of the peritoneal cavity and identification of a suitable site for the intraperitoneal portion of the catheter. Hence, of the 3 techniques, only the latter allows for the direct visualization of the intraperitoneal structures. This technique can be easily used by nephrologists as well as surgeons. Peritoneoscopic placement varies from traditional laparoscopic techniques by using: a much smaller scope (2.2 mm diameter) and puncture size, only one peritoneal puncture site, a device to advance the cuff into the musculature, air in the peritoneum rather than CO2, and local anesthesia rather than general anesthesia. Prospective randomized and nonrandomized studies have shown that PD catheters peritoneoscopically placed by nephrologists have less incidence of complications (infection, exit site leak) and longer catheter survival rates than those inserted surgically. The current review focuses on the peritoneoscopic insertion of PD catheter and presents some of the complicating issues (bowel perforation, catheter migration, and prior abdominal surgery) related to this procedure.
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Affiliation(s)
- A Asif
- Section of Interventional Nephrology, Division of Nephrology, University of Miami Miller School of Medicine, Miami, FL, USA.
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Abstract
AIMS The purposes of this paper are: to report our experience employing a comprehensive, multifaceted treatment program to improve the metabolic disturbances of dyslipidemia, hyperglycemia and weight gain observed in our peritoneal dialysis patients, and by post-hoc analysis to demonstrate how the routine clinical lipid profile can be manipulated arithmetically to estimate levels of atherogenic low-density lipids and thereby achieve a more sophisticated clinical analysis of dyslipidemia and its response to therapy. METHODS Data are reported for 56 patients who were stable on peritoneal dialysis for at least 6 months and who had metabolic data available prior to beginning peritoneal dialysis. Metabolic complications of peritoneal dialysis were treated by a comprehensive strategy involving diet, glycemic control and lipid-lowering medications with an emphasis on weight control and exercise. From the measured lipid profile (total cholesterol (TC), high-density lipoprotein (HDL) and triglyceride (TG)), levels of atherogenic low-density lipids (low-density lipoprotein (LDL), non-HDL, very-low-density lipoprotein (VLDL) and intermediate-low-density lipoprotein (IDL) were calculated. RESULTS Before initiation of peritoneal dialysis therapy, the most common lipid abnormalities were low levels of HDL (59%) and elevated levels of triglyceride (41%) with infrequent elevations of total cholesterol (9%) and low-density lipoprotein (23%). After initiation of peritoneal dialysis therapy, all lipid levels, except HDL, increased significantly, and hyperlipidemia, hyperglycemia and obesity, singly or in combination, occurred in 84% of patients. With treatment, elevated lipid levels decreased significantly with reversal of the adverse cardiovascular risk profile of lipids that developed during peritoneal dialysis therapy, and HDL levels increased significantly. On peritoneal dialysis therapy, all diabetic patients required insulin, and glycemic control was achieved in most patients (79%). Excessive weight gain (10-24% body weight) occurred in 20% of peritoneal dialysis patients. Diabetic patients had a higher incidence of being overweight and obese. Post-hoc analysis revealed that levels of VLDL and IDL frequently were elevated both before (57-61%) and during (68-84%) peritoneal dialysis and that target levels of these atherogenic low-density lipoproteins infrequently (22-26%) were achieved. CONCLUSIONS The metabolic complications of peritoneal dialysis are responsive to a comprehensive treatment strategy. Controlling weight gain on peritoneal dialysis therapy maybe a difficult challenge for some patients, particularly those who are diabetic. Patients with renal failure and on dialysis, especially peritoneal dialysis, frequently have elevated levels of the atherogenic lipoproteins fragments VLDL and IDL. Future clinical trials should focus on the efficacy and safety of aggressive therapy to achieve target levels of these atherogenic lipids.
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Affiliation(s)
- P Pennell
- Division of Nephrology and Hypertension, University of Miami School of Medicine, Miami, FL 33101, USA.
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49
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Abstract
The Fe(III)-photoinduced degradation of 4-dodecylbenzenesulphonate (DBS) in aqueous solution was investigated. The mixing of DBS (1 mm) and Fe(III) (1 mm) solutions immediately led to the formation of a precipitate that contained DBS and monomeric Fe(OH)2+, the predominant Fe(III) species. Both species were also present in the supernatant. Irradiation of the supernatant solution resulted in a photoredox process that yielded Fe(II) and *OH radicals. The disappearance of DBS was shown to involve only attack by *OH radicals; the quantum yield of DBS disappearance is similar to the quantum yield of *OH radical formation. A wavelength effect was also observed; the rate of DBS disappearance was higher for shorter wavelength irradiation. Five photoproducts, all containing the benzene sulphonate group, were identified. *OH radicals preferentially abstract hydrogen from the carbon in the alpha position of the aromatic ring. The results show that the Fe(III)-photoinduced degradation of DBS could be used as an alternative method for polluted water treatment.
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Affiliation(s)
- G Mailhot
- Laboratoire de Photochimie Moléculaire et Macromoléculaire, Unité Mixte de Recherche CNRS, Université Blaise Pascal, Aubiere, France
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50
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Abstract
A cadaveric kidney transplant recipient, with no history of a connective tissue disease, was admitted with malaise, arthralgias, diplopia, mild headache, and a painful left eye. The patient was on maintenance immunosuppression for 14 years with cyclosporine and methylprednisolone. Initial laboratory data indicated an elevated serum creatinine from baseline, 2+ proteinuria, and 50 to 100 red blood cells (RBCs)/high-power field (HPF) in the urine. Renal biopsy was consistent with necrotizing vasculitis involving glomerular capillaries, with crescent formation and an absence of immune complexes. Perinuclear antineutrophil cytoplasmic autoantibodies (P-ANCA) and anti-myeloperoxidase (MPO) were found to be elevated. To the best of our knowledge, this is the first reported case of an ANCA-associated small vessel vasculitis (SVV) developing in a renal transplant recipient without history of connective tissue disease.
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Affiliation(s)
- A Asif
- University of Miami School of Medicine, Division of Nephrology and Hypertension and Division of Transplantation, Miami, FL FL 33136, USA
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