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Sebai A, Elaifia R, Atri S, Mahmoud AB, Haddad A, Kacem JM. Primary giant hydatid cyst of the retroperitoneum: Diagnosis and therapeutic approaches. Int J Surg Case Rep 2024; 117:109484. [PMID: 38471222 PMCID: PMC10945243 DOI: 10.1016/j.ijscr.2024.109484] [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] [Received: 02/09/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Primary hydatid cyst of the retroperitoneum is an exceedingly rare manifestation of hydatid disease. Diagnosis proves challenging due to nonspecific symptoms, and the condition is typically not suspected when facing a retroperitoneal cystic mass, necessitating awareness among clinicians and surgeons, particularly in endemic regions. CASE PRESENTATION A 45-year-old male with a three-month history of progressive abdominal enlargement and pain. Living in a rural area, he exhibited a 30 cm, well-defined retroperitoneal cyst, with no guarding confirmed by CT-scan, with characteristic daughter cysts. The diagnosis of primary retroperitoneal hydatid cyst was supported by positive hydatid serology and eosinophilia. Surgical intervention was crucial, and a complete pericystectomy, with 4 cm of pericyst on the aorta due to safety concerns, was performed after three months of preoperative albendazole-based treatment. The postoperative course was uneventful, and a two-year follow-up revealed no recurrence. CLINICAL DISCUSSION The prevalence of hydatid disease in North Africa is high, yet retroperitoneal cases are rare. The difficulty to diagnosis retroperitoneal masses, underscores the importance of precise patient evaluation and detailed imaging analysis. Percutaneous puncture is contraindicated due to the risk of dissemination, highlighting even more the significance of accurate preoperative diagnosis. Surgery, coupled with Albendazole treatment, remains the gold-standard, associated with meticulous intraoperative precautions to prevent disease dissemination. CONCLUSION Primary retroperitoneal hydatid cyst is rare. Diagnosis is difficult. Precise determination of patient's background and detailed analysis of imaging findings are mandatory. Percutaneous puncture is forbidden as it leads to disease spreading or even anaphylactic shock. Surgical excision is the gold-standard.
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Affiliation(s)
- A Sebai
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia
| | - R Elaifia
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia.
| | - S Atri
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia
| | - A Ben Mahmoud
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia
| | - A Haddad
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia
| | - J M Kacem
- The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; Surgery Department A, Rabta Hospital, Tunis, Tunisia
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Sebai A, Elaifia R, Atri S, Hammami M, Haddad A, Kacem JM. Intrauterine device migration resulting in acute appendicitis: A case report. Int J Surg Case Rep 2024; 117:109515. [PMID: 38471208 PMCID: PMC10945246 DOI: 10.1016/j.ijscr.2024.109515] [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] [Received: 02/07/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE The Intrauterine Contraceptive Device (IUD), a widely used contraceptive since 1965, has demonstrated efficacy but is associated with complications such as bleeding, pain, and rare occurrences of perforation. This case report details an IUD migration into the peritoneal cavity, leading to acute appendicitis. CASE PRESENTATION A 33-year-old woman, with a history of IUD insertion 16 months prior, presented with pelvic pain. Gynecological examination and computed tomography, revealed the IUD intraperitoneal migration. The patient underwent laparoscopic extraction of the IUD which was embedded in the appendix and appendectomy, with an uneventful recovery. CLINICAL DISCUSSION This case emphasizes the complexity of IUD migration and its rare association with acute appendicitis, underscoring the importance of vigilant monitoring and prompt intervention. We also explored factors contributing to IUD perforation risk, imaging modalities for detection, and emphasizes the necessity of surgical removal upon confirmation. We highlight the fact that despite the atypical presentation with minimal symptoms, we should always consider emergency situations. Surgical intervention, particularly laparoscopy, may be the standard approach for managing migrated IUDs. CONCLUSION We insist about the critical need for thorough assessment and vigilance in managing IUD-related complications, emphasizing timely intervention to ensure patient safety. This case contributes valuable insights into the complexities surrounding IUD migration, urging healthcare professionals to remain attentive to potential injuries in patients with a history of IUD insertion and abdominal pain.
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Affiliation(s)
- A Sebai
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - R Elaifia
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - S Atri
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M Hammami
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - A Haddad
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - J M Kacem
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Sebai A, Elaifia R, Atri S, Ben Brahim M, Haddad A, Kacem JM. Septic shock revealing boerhaave's syndrome a case report. Int J Surg Case Rep 2024; 117:109482. [PMID: 38471207 PMCID: PMC10945167 DOI: 10.1016/j.ijscr.2024.109482] [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] [Received: 01/31/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Boerhaave's syndrome, recognized as spontaneous esophageal rupture, is an uncommon and perilous medical condition marked by the spontaneous tearing of the esophagus. This paper highlights the importance of an early diagnosis and its correlation to better outcomes for a rare pathology with high mortality. CLINICAL PRESENTATION A 67-year-old female presenting with unexplored vomiting and hypertension, presented to the ER with a septic shock. The patient's clinical deterioration prompted emergency exploration, revealing a dilated esophagus with a 3-cm perforation. Despite surgical intervention, including suturing with a T-tube and esophageal exclusion, the patient succumbed to multiorgan failure. CLINICAL DISCUSSION Boerhaave's syndrome, triggered by forceful vomiting, presents diverse clinical manifestations, making accurate diagnosis challenging. The characteristic triad of vomiting, pain, and subcutaneous emphysema is observed in a minority of cases, often overshadowed by acute respiratory distress. Diagnostic modalities include chest X-rays, contrast esophagography, and computed tomography, aiding in visualizing contrast leakage and confirming the diagnosis. The choice of surgical technique, ranging from esophageal suturing to esophagectomy, depends on the duration between rupture and surgery initiation. In this case, a bipolar esophageal exclusion was performed due to the patient's critical condition. CONCLUSION Boerhaave's syndrome demands consideration in patients presenting with thoracic pain and vomiting, particularly in those with a pathological esophagus. Early diagnosis and surgical intervention remain pivotal in improving outcomes. Identification of hydro-pneumothorax in radiographic studies should prompt consideration of spontaneous esophageal rupture, highlighting the need for heightened clinical suspicion in nonspecific clinical scenarios.
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Affiliation(s)
- A Sebai
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - R Elaifia
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - S Atri
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M Ben Brahim
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - A Haddad
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - J M Kacem
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Sebai A, Elaifia R, Atri S, Hammami Y, Haddad A, Kacem JM. Surgical management of a proximal splenic artery aneurysm: A case report. Int J Surg Case Rep 2024; 117:109499. [PMID: 38492317 PMCID: PMC10958614 DOI: 10.1016/j.ijscr.2024.109499] [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] [Received: 01/31/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Splenic artery aneurysms (SAA's) pose a rare yet clinically significant challenge, characterized by the weakening and ballooning of the splenic artery, potentially leading to severe complications such as rupture and hemorrhage. CASE PRESENTATION A 52-year-old female presenting with biliary colic. Diagnostic imaging revealed a saccular lesion closely associated with gallstones. A multidisciplinary approach guided the decision for surgery due to the size and location of the aneurysm. A bi sub costal laparotomy was performed, after the resection of the aneurysm, an arterial anastomosis with pds 5/0 suture was performed. CLINICAL DISCUSSION SAA's treatment modalities are tailored based on aneurysm localization and size. Imaging modalities such as Doppler ultrasound and CT angiography play a crucial role in accurate diagnosis, providing essential information for treatment planning. Treatment options include endovascular embolization, and surgical intervention. Traditionally open surgical techniques, including ligation of the splenic artery, aneurysmectomy, and splenectomy. Surgical treatment, especially for proximal aneurysms, is highlighted, with the presented alternative approach of resection with end-to-end anastomosis, showcasing an alternative surgical technique aimed at reducing the risk of spleen infarction. CONCLUSION SAA's are a rarity that emphasizes the need for early detection and intervention. We are urged to maintain a high index of suspicion, particularly in high-risk individuals. We report an alternative surgical technique that we hope will contributes to the expanding repertoire of approaches, calling for further research to optimize SAA management strategies in the quest for improved patient outcomes.
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Affiliation(s)
- A Sebai
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - R Elaifia
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - S Atri
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Y Hammami
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - A Haddad
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - J M Kacem
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Atri S, Elaifia R, Sebai A, Hammami M, Haddad A, Kacem JM. Pleural migration of biliary stent 10 years following treatment of hepatic hydatic echinococcosis: A case report. Int J Surg Case Rep 2024; 117:109518. [PMID: 38492316 PMCID: PMC10955414 DOI: 10.1016/j.ijscr.2024.109518] [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] [Received: 01/27/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Echinococcosis, caused by larval stages of taeniid cestodes, primarily affects the liver and is commonly treated surgically. However, a complication post-treatment is biliary fistula, necessitating interventions like biliary stents. While stent complications are recognized, proximal migration leading to pneumonia is exceptionally rare. This case report details an unusual occurrence of biliary stent migration years after hepatic hydatid echinococcosis treatment. CASE PRESENTATION A 42-year-old patient underwent 2014 surgery for a large hydatid cyst, resulting in a biliary fistula. Endoscopic sphincterotomy and biliary stent placement led to a successful outcome. Lost to follow-up, the patient reappeared in 2022 with basithoracic pain, fever, and a thoracic CT scan revealing transdiaphragmatic stent migration causing basal pneumonitis. Antibiotic therapy and endoscopic stent removal ensued with an uncomplicated recovery. CLINICAL DISCUSSION This report emphasizes a rare complication that is proximal migration of a biliary stent 10 years post-initial placement for biliary fistula management. Despite the absence of typical risk factors. We managed a successful endoscopic retrieval. This highlights the importance of vigilance and follow-up for potential complications associated with biliary stent. Unusual presentations, like pneumonitis, underscore the need for awareness and a cautious approach. CONCLUSION The primary complication following surgical intervention for hepatic hydatid cysts is the development of an external biliary fistula, necessitating the use of biliary stents for treatment. Given the rarity of complications observed in our case, the removal of stents post-treatment for biliary fistula becomes crucial, underscoring the significance of vigilant follow-up care.
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Affiliation(s)
- S Atri
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - R Elaifia
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - A Sebai
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M Hammami
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - A Haddad
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - J M Kacem
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Haddad A, Faillot M, Bacquet R, Decq P, Henry C, Bonnan M. Post-lumbar puncture intracranial hypotension with spinal extradural collection: Lessons from a case report. Rev Neurol (Paris) 2024:S0035-3787(24)00424-7. [PMID: 38458838 DOI: 10.1016/j.neurol.2024.01.004] [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] [Received: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 03/10/2024]
Affiliation(s)
- A Haddad
- Department of Neurology, Delafontaine Hospital, Saint-Denis, France.
| | - M Faillot
- Department of Neurosurgery, Beaujon Hospital, Paris, France
| | - R Bacquet
- Department of Radiology, Beaujon Hospital, Paris, France
| | - P Decq
- Department of Neurosurgery, Beaujon Hospital, Paris, France
| | - C Henry
- Department of Neurology, Delafontaine Hospital, Saint-Denis, France
| | - M Bonnan
- Department of Neurology, Delafontaine Hospital, Saint-Denis, France
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Atri S, Elaifia R, Sebai A, Hammami M, Haddad A, Kacem JM. Bouveret Syndrome: A rare form of gallstone ileus a case report. Int J Surg Case Rep 2024; 116:109438. [PMID: 38428049 PMCID: PMC10944084 DOI: 10.1016/j.ijscr.2024.109438] [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] [Received: 01/31/2024] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Bouveret Syndrome, a rare form of gallstone ileus, involves the migration and impaction of a gallstone in the duodenum or stomach, causing gastric outlet obstruction. Early intervention and a comprehensive care plan are essential for favorable outcomes. CASE PRESENTATION This article presents a case of an 82-year-old female with a history of coronary artery disease and untreated gallstones. The patient experienced nausea, vomiting, and abdominal pain for two weeks. Diagnostic procedures revealed a cholecystoduodenal fistula with a 4 cm stone lodged at the duodenojejunal angle. For our patient the gallstone was moved to the jejunum, followed by enterotomy and a latero_lateral gastroenteroanastomosis. CLINICAL DISCUSSION The rarity of Bouveret Syndrome and its nonspecific symptoms make diagnosis challenging, necessitating differentiation from other gastrointestinal disorders. Esophagogastroduodenoscopy (EGD) and imaging, such as computed tomography (CT), play crucial roles in diagnosis. In this case, the EGD did not show gallstones up to the second part of the duodenum. Management involves a multidisciplinary approach, with supportive care for stabilization and the primary goal of removing the impacted stone. Treatment options include endoscopic, surgical, or lithotripsy techniques. Bouveret Syndrome poses challenges due to its rarity, leading to delayed diagnosis. Prognosis varies based on factors such as stone size, location, and overall patient condition. CONCLUSION Through this case we emphasizes the importance of awareness, timely diagnosis, and appropriate management, with EGD and CT scan playing key roles in diagnosis. Surgical intervention remains a viable treatment option when endoscopic approaches are unavailable. The article highlights the controversial nature of fistula repair in Bouveret Syndrome.
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Affiliation(s)
- S Atri
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - R Elaifia
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - A Sebai
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M Hammami
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - A Haddad
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - J M Kacem
- Department of Surgery A La Rabta Hospital, Tunis, Tunisia; Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Venner E, Patterson K, Kalra D, Wheeler MM, Chen YJ, Kalla SE, Yuan B, Karnes JH, Walker K, Smith JD, McGee S, Radhakrishnan A, Haddad A, Empey PE, Wang Q, Lichtenstein L, Toledo D, Jarvik G, Musick A, Gibbs RA. The frequency of pathogenic variation in the All of Us cohort reveals ancestry-driven disparities. Commun Biol 2024; 7:174. [PMID: 38374434 PMCID: PMC10876563 DOI: 10.1038/s42003-023-05708-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/13/2023] [Indexed: 02/21/2024] Open
Abstract
Disparities in data underlying clinical genomic interpretation is an acknowledged problem, but there is a paucity of data demonstrating it. The All of Us Research Program is collecting data including whole-genome sequences, health records, and surveys for at least a million participants with diverse ancestry and access to healthcare, representing one of the largest biomedical research repositories of its kind. Here, we examine pathogenic and likely pathogenic variants that were identified in the All of Us cohort. The European ancestry subgroup showed the highest overall rate of pathogenic variation, with 2.26% of participants having a pathogenic variant. Other ancestry groups had lower rates of pathogenic variation, including 1.62% for the African ancestry group and 1.32% in the Latino/Admixed American ancestry group. Pathogenic variants were most frequently observed in genes related to Breast/Ovarian Cancer or Hypercholesterolemia. Variant frequencies in many genes were consistent with the data from the public gnomAD database, with some notable exceptions resolved using gnomAD subsets. Differences in pathogenic variant frequency observed between ancestral groups generally indicate biases of ascertainment of knowledge about those variants, but some deviations may be indicative of differences in disease prevalence. This work will allow targeted precision medicine efforts at revealed disparities.
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Affiliation(s)
- Eric Venner
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.
| | - Karynne Patterson
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Divya Kalra
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Marsha M Wheeler
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Yi-Ju Chen
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Sara E Kalla
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Bo Yuan
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Jason H Karnes
- University of Arizona, R Ken Coit College of Pharmacy, Department of Pharmacy Practice and Science, Tucson, AZ, USA
- Vanderbilt University Medical Center, Department of Biomedical Informatics, Boston, MA, USA
| | - Kimberly Walker
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Joshua D Smith
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Sean McGee
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | | | - Andrew Haddad
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Philip E Empey
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Qiaoyan Wang
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | | | - Diana Toledo
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Gail Jarvik
- Department of Medicine (Medical Genetics), University of Washington School of Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Anjene Musick
- NIH All of Us Research Program, National Institutes of Health Office of the Director, Bethesda, MD, USA
| | - Richard A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
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Turner AJ, Haidar CE, Yang W, Boone EC, Offer SM, Empey PE, Haddad A, Tahir S, Scharer G, Broeckel U, Gaedigk A. Updated DPYD HapB3 haplotype structure and implications for pharmacogenomic testing. Clin Transl Sci 2024; 17:e13699. [PMID: 38129972 PMCID: PMC10777430 DOI: 10.1111/cts.13699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The DPYD gene encodes dihydropyrimidine dehydrogenase, the rate-limiting enzyme for the metabolism of fluoropyrimidines 5-fluorouracil and capecitabine. Genetic variants in DPYD have been associated with altered enzyme activity, therefore accurate detection and interpretation is critical to predict metabolizer status for individualized fluoropyrimidine therapy. The most commonly observed deleterious variation is the causal variant linked to the previously described HapB3 haplotype, c.1129-5923C>G (rs75017182) in intron 10, which introduces a cryptic splice site. A benign synonymous variant in exon 11, c.1236G>A (rs56038477) is also linked to HapB3 and is commonly used for testing. Previously, these single-nucleotide polymorphisms (SNPs) have been reported to be in perfect linkage disequilibrium (LD); therefore, c.1236G>A is often utilized as a proxy for the function-altering intronic variant. Clinical genotyping of DPYD identified a patient who had c.1236G>A, but not c.1129-5923C>G, suggesting that these two SNPs may not be in perfect LD, as previously assumed. Additional individuals with c.1236G>A, but not c.1129-5923C>G, were identified in the Children's Mercy Data Warehouse and the All of Us Research Program version 7 cohort substantiating incomplete SNP linkage. Consequently, testing only c.1236G>A can generate false-positive results in some cases and lead to suboptimal dosing that may negatively impact patient therapy and prospect of survival. Our data show that DPYD genotyping should include the functional variant c.1129-5923C>G, and not the c.1236G>A proxy, to accurately predict DPD activity.
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Affiliation(s)
| | - Cyrine E. Haidar
- Department of Pharmacy and Pharmaceutical SciencesSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Wenjian Yang
- Department of Pharmacy and Pharmaceutical SciencesSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Erin C. Boone
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research Institute (CMRI)Kansas CityMissouriUSA
| | - Steven M. Offer
- Department of Molecular Pharmacology and Experimental TherapeuticsMayo ClinicRochesterMinnesotaUSA
| | - Philip E. Empey
- Department of Pharmacy and TherapeuticsUniversity of Pittsburgh School of PharmacyPittsburghPennsylvaniaUSA
| | - Andrew Haddad
- Department of Pharmaceutical SciencesUniversity of Pittsburgh School of PharmacyPittsburghPennsylvaniaUSA
| | - Saba Tahir
- Medical College of Wisconsin, School of PharmacyMilwaukeeWisconsinUSA
| | | | | | - Andrea Gaedigk
- Division of Clinical Pharmacology, Toxicology & Therapeutic InnovationChildren's Mercy Research Institute (CMRI)Kansas CityMissouriUSA
- School of MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
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10
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Song J, Brown C, Dennis K, Gaudet M, Haddad A. Palliative Radiotherapy for Haemostasis in Malignancy: a Systematic Review. Clin Oncol (R Coll Radiol) 2023; 35:e478-e488. [PMID: 37355413 DOI: 10.1016/j.clon.2023.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 06/26/2023]
Abstract
AIMS Palliative radiotherapy is commonly used to achieve haemostasis for malignancy-induced haemorrhages. Our study aimed to examine the efficacy of palliative radiotherapy in the control of haemorrhages caused by various types of malignancy. MATERIALS AND METHODS A systematic review of the literature was conducted to determine the level of evidence for the use of palliative radiotherapy in achieving haemostasis. Searches of the Medline, Embase and Cochrane databases were completed for studies published between January 1947 and May 2017. Studies that reported either a qualitative or a quantitative effect of radiotherapy were selected for inclusion during the review process. RESULTS In total, 836 abstracts were screened; 13 prospective and 45 retrospective studies met the criteria for inclusion in the review. Selected studies were sorted based on the underlying tumour type to provide readers the opportunity to compare dose and fractionation schedules. Significant variations in reporting of outcomes and low total patient numbers did not allow for a quantitative analysis to be carried out. A higher median dose and a hypofractionated schedule seem to provide numerically higher rates of control based on the available data. CONCLUSIONS Palliative radiotherapy is useful in the management of bleeding related to advanced and incurable malignancies. Brachytherapy seems to be effective in haemostasis of certain malignancies, especially that of gynaecological origin. Treatment should be tailored to individual patient situations given the palliative goals of any such therapy. Further prospective studies could help to delineate optimal dose and fractionation schedules.
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Affiliation(s)
- J Song
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - C Brown
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - K Dennis
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - M Gaudet
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - A Haddad
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada.
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Shehada S, Jasarevic M, Jarkas S, Haddad A, Al-Rashid F, Thielmann M, Koch A, Pizanis N, Kamler M, Ruhparwar A, Schmack B. Mechanical Circulatory Support Using Impella 5.5 for Patients Presented with Ischemic Heart Disease and Severely Impaired Left Ventricular Function Undergoing Coronary Artery Bypass Surgery: A Three-Year Single Centre Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1051] [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: 04/05/2023] Open
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Garraud O, Hamzeh-Cognasse H, Chalayer E, Duchez AC, Tardy B, Oriol P, Haddad A, Guyotat D, Cognasse F. Platelet transfusion in adults: An update. Transfus Clin Biol 2023; 30:147-165. [PMID: 36031180 DOI: 10.1016/j.tracli.2022.08.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/07/2023]
Abstract
Many patients worldwide receive platelet components (PCs) through the transfusion of diverse types of blood components. PC transfusions are essential for the treatment of central thrombocytopenia of diverse causes, and such treatment is beneficial in patients at risk of severe bleeding. PC transfusions account for almost 10% of all the blood components supplied by blood services, but they are associated with about 3.25 times as many severe reactions (attributable to transfusion) than red blood cell transfusions after stringent in-process leukoreduction to less than 106 residual cells per blood component. PCs are not homogeneous, due to the considerable differences between donors. Furthermore, the modes of PC collection and preparation, the safety precautions taken to limit either the most common (allergic-type reactions and febrile non-hemolytic reactions) or the most severe (bacterial contamination, pulmonary lesions) adverse reactions, and storage and conservation methods can all result in so-called PC "storage lesions". Some storage lesions affect PC quality, with implications for patient outcome. Good transfusion practices should result in higher levels of platelet recovery and efficacy, and lower complication rates. These practices include a matching of tissue ABH antigens whenever possible, and of platelet HLA (and, to a lesser extent, HPA) antigens in immunization situations. This review provides an overview of all the available information relating to platelet transfusion, from donor and donation to bedside transfusion, and considers the impact of the measures applied to increase transfusion efficacy while improving safety and preventing transfusion inefficacy and refractoriness. It also considers alternatives to platelet component (PC) transfusion.
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Affiliation(s)
- O Garraud
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France.
| | | | - E Chalayer
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - A C Duchez
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - B Tardy
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - P Oriol
- CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - A Haddad
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Sacré-Cœur Hospital, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | - D Guyotat
- Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - F Cognasse
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
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Haddad A, Bessi NO, Guerchani M, Djermane D, Chikouche A, Himeur H, Benkhedda S. Pronostic factors in heart failure with preserved ejection fraction in an Algerian cohort. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.101] [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: 12/31/2022]
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Haddad A, Rambaud T, Tran Ba S, Manceau P, Degos B, Mongin M. Anti-NMDAR encephalitis following herpes simplex encephalitis: A case report and update on diagnostic and treatment. Rev Neurol (Paris) 2022; 178:1107-1109. [PMID: 36369066 DOI: 10.1016/j.neurol.2022.08.001] [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] [Received: 04/19/2022] [Revised: 05/29/2022] [Accepted: 08/13/2022] [Indexed: 11/11/2022]
Affiliation(s)
- A Haddad
- Service de neurologie, AP-HP, hôpital Avicenne, Bobigny, France.
| | - T Rambaud
- Service de réanimation, AP-HP, hôpital Avicenne, Bobigny, France; Université Sorbonne Paris Nord, Bobigny, France
| | - S Tran Ba
- Service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France; Service de radiologie, Fondation Rothschild, Paris, France
| | - P Manceau
- Service de neurologie, AP-HP, hôpital Avicenne, Bobigny, France; Université Sorbonne Paris Nord, Bobigny, France
| | - B Degos
- Service de neurologie, AP-HP, hôpital Avicenne, Bobigny, France; Université Sorbonne Paris Nord, Bobigny, France
| | - M Mongin
- Service de neurologie, AP-HP, hôpital Avicenne, Bobigny, France; Université Sorbonne Paris Nord, Bobigny, France
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Spiliopoulos M, Haddad A, Al-Kouatly HB, Haleema S, Paidas MJ, Iqbal SN, Glazer RI. MicroRNA analysis in maternal blood of pregnancies with preterm premature rupture of membranes reveals a distinct expression profile. PLoS One 2022; 17:e0277098. [PMID: 36327243 PMCID: PMC9632843 DOI: 10.1371/journal.pone.0277098] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To determine the expression profile of microRNAs in the peripheral blood of pregnant women with preterm premature rupture of membranes (PPROM) compared to that of healthy pregnant women. Study design This was a pilot study with case-control design in pregnant patients enrolled between January 2017 and June 2019. Patients with healthy pregnancies and those affected by PPROM between 20- and 33+6 weeks of gestation were matched by gestational age and selected for inclusion to the study. Patients were excluded for multiple gestation and presence of a major obstetrical complication such as preeclampsia, diabetes, fetal growth restriction and stillbirth. A total of ten (n = 10) controls and ten (n = 10) patients with PPROM were enrolled in the study. Specimens were obtained before administration of betamethasone or intravenous antibiotics. MicroRNA expression was analyzed for 800 microRNAs in each sample using the NanoString nCounter Expression Assay. Differential expression was calculated after normalization and log2- transformation using the false discovery rate (FDR) method at an alpha level of 5%. Results Demographic characteristics were similar between the two groups. Of the 800 miRNAs analyzed, 116 were differentially expressed after normalization. However, only four reached FDR-adjusted statistical significance. Pregnancies affected by PPROM were characterized by upregulation of miR-199a-5p, miR-130a-3p and miR-26a-5p and downregulation of miR-513b-5p (FDR adjusted p-values <0.05). The differentially expressed microRNAs participate in pathways associated with altered collagen and matrix metalloprotease expression in the extracellular matrix. Conclusion Patients with PPROM have a distinct peripheral blood microRNA profile compared to healthy pregnancies as measured by the NanoString Expression Assay.
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Affiliation(s)
- Michail Spiliopoulos
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine and Genetics, University of Miami, Miami, Florida, United States of America
- * E-mail:
| | - Andrew Haddad
- Department of Obstetrics, Gynecology & Women’s Health, Division of Maternal Fetal Medicine & Surgery, Hackensack Meridian School of Medicine, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Huda B. Al-Kouatly
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Saeed Haleema
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Michael J. Paidas
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine and Genetics, University of Miami, Miami, Florida, United States of America
| | - Sara N. Iqbal
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Robert I. Glazer
- Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
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Morell A, Budagaga Y, Vagiannis D, Zhang Y, Laštovičková L, Novotná E, Haddad A, Haddad M, Portillo R, Hofman J, Wsól V. Isocitrate dehydrogenase 2 inhibitor enasidenib synergizes daunorubicin cytotoxicity by targeting aldo-keto reductase 1C3 and ATP-binding cassette transporters. Arch Toxicol 2022; 96:3265-3277. [PMID: 35972551 DOI: 10.1007/s00204-022-03359-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/03/2022] [Indexed: 12/01/2022]
Abstract
Targeting mutations that trigger acute myeloid leukaemia (AML) has emerged as a refined therapeutic approach in recent years. Enasidenib (Idhifa) is the first selective inhibitor of mutated forms of isocitrate dehydrogenase 2 (IDH2) approved against relapsed/refractory AML. In addition to its use as monotherapy, a combination trial of enasidenib with standard intensive induction therapy (daunorubicin + cytarabine) is being evaluated. This study aimed to decipher enasidenib off-target molecular mechanisms involved in anthracycline resistance, such as reduction by carbonyl reducing enzymes (CREs) and drug efflux by ATP-binding cassette (ABC) transporters. We analysed the effect of enasidenib on daunorubicin (Daun) reduction by several recombinant CREs and different human cell lines expressing aldo-keto reductase 1C3 (AKR1C3) exogenously (HCT116) or endogenously (A549 and KG1a). Additionally, A431 cell models overexpressing ABCB1, ABCG2, or ABCC1 were employed to evaluate enasidenib modulation of Daun efflux. Furthermore, the potential synergism of enasidenib over Daun cytotoxicity was quantified amongst all the cell models. Enasidenib selectively inhibited AKR1C3-mediated inactivation of Daun in vitro and in cell lines expressing AKR1C3, as well as its extrusion by ABCB1, ABCG2, and ABCC1 transporters, thus synergizing Daun cytotoxicity to overcome resistance. This work provides in vitro evidence on enasidenib-mediated targeting of the anthracycline resistance actors AKR1C3 and ABC transporters under clinically achievable concentrations. Our findings may encourage its combination with intensive chemotherapy and even suggest that the effectiveness of enasidenib as monotherapy against AML could lie beyond the targeting of mIDH2.
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Affiliation(s)
- Anselm Morell
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Youssif Budagaga
- Department of Pharmacology, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Dimitrios Vagiannis
- Department of Pharmacology, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Yu Zhang
- Department of Pharmacology, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Lenka Laštovičková
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Eva Novotná
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Andrew Haddad
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Melodie Haddad
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Ramon Portillo
- Department of Pharmacology, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Jakub Hofman
- Department of Pharmacology, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic
| | - Vladimír Wsól
- Department of Biochemical Sciences, Charles University, Faculty of Pharmacy, Akademika Heyrovskeho 1203, 50005, Hradec Kralove, Czech Republic.
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Furer V, Eviatar T, Peleg H, Hagin D, Freund T, Levartovsky D, Paran D, Kaufman I, Broyde A, Polachek A, Elalouf O, Feld J, Haddad A, Gazitt T, Elias M, Hijaze N, Kharouf F, Gertel S, Nevo S, Pel S, Zisman D, Elkayam O. OP0177 IMMUNOGENICITY INDUCED BY TWO AND THREE DOSES OF THE BNT162B2 mRNA VACCINE IN PATIENTS WITH AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASES AND IMMUNOCOMPETENT CONTROLS: A LONGITUDINAL MULTI-CENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2074] [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: 11/03/2022]
Abstract
BackgroundData on the kinetics of the immune response to SARS-CoV-2 vaccination in patients with autoimmune inflammatory rheumatic diseases (AIIRD) are limited.ObjectivesTo evaluate the kinetics of the immune response induced by two and three doses of the BNT162b2 mRNA vaccine in adult patients with AIIRD and immunocompetent controls.MethodsA prospective multicenter study investigated the antibody response to the BNT162b2 vaccine by serial measurement of serum anti-SARS-CoV-2 S1/S2 IgG titers at the following time points: 2-6 weeks (AIIRD n=720, controls n=122) and six months (AIIRD n=628, controls=116) after the second vaccine dose, and 2-6 weeks after the third vaccine dose (AIIRD n=169, controls n=45). A seropositive response was defined as a detectable anti-S1/S2 IgG titer ≥ 15 BAU/ml. T-cell immune response was evaluated in a sample of patients (n=28) and controls (n=9) by intracellular staining of S-stimulated CD4+ T-cells for TNFα and IFNγ production.ResultsThe two-dose vaccine regimen induced a higher humoral response in controls compared to patients, as reflected by the post-vaccination seropositivity rates of 100% vs 84.72%, p<0.0001, and 96.55% vs 74.26%, p<0.0001 at 2-to-6 weeks and at 6 months, respectively. The decline of S1/S2 IgG titers within six months was similar in controls and patients. Following the 3rd vaccine, the seropositivity rate increased to 80.47% and 100% in AIIRD and control groups, p=0.0028, with a significantly higher increase of S1/S2 IgG titers in controls compared with AIIRD patients, 284.09±76.58 vs 219.39±151.55 BAU/ml, p=0.0016. At all-time points, S1/S2 IgG titers were significantly lower in AIIRD patients compared with controls (Figure 1).We further investigated the impact of therapies on the vaccine‘s immunogenicity (Figure 1). Glucocorticoids (GC) were associated with a significantly lower seropositivity rate and lower S1/S2 IgG titers compared to controls at all time points. Monotherapy with methotrexate (MTX) was associated with a comparable to controls humoral response at all time points. Anti-cytokine biologics (TNFi, IL6i, IL17i) were associated with an initial high seropositivity rate, similar to controls, followed by a steeper decline at 6 months, 79.82% vs 96.55%, p=0.0001, and restoration of seropositivity after the 3rd vaccine dose in all patients. JAKi were associated with a mildly decreased seropositivity rate after the 2nd vaccine dose and similar to controls response after the 3rd vaccine dose. Abatacept was associated with a reduced immunogenicity after the 2nd vaccine dose, but was restored to 100% seropositivity after the 3rd vaccine dose. Rituximab (RTX) significantly blunted the humoral response at all time points, with a seropositivity rate of 42% after the 2nd vaccine dose, 29% at 6 months, and with increase to 40% after the 3rd vaccine dose. A third of the RTX-treated patients who were seronegative after two vaccine doses, seroconverted after the 3rd dose. The multivariate model for predicting the seropositive response to vaccination found that higher S1/S2 IgG titers after the 2nd vaccine dose was associated with a higher seropositivity rate following the 3rd vaccine dose, OR 1.026 (1.008-1.045), p=0.0027, and that treatment with RTX was associated with a 14.3-fold risk for a negative humoral response, p≤0.0001. Cellular immune response, evaluated mainly in RTX treated patients, was preserved prior to and after the 3rd vaccine dose and was similar to controls.ConclusionOver a six-month period, the two dose BNTb262 vaccination was associated with a similar extent of waning of the humoral immune response in AIIRD patients and controls. The 3rd vaccine dose restored the response in all controls and in patients treated with MTX monotherapy, anti-cytokine biologics, abatacept, and JAKi. Treatment with GC and RTX was associated with an impaired humoral response at all time points.AcknowledgementsWe would like to thank the statistician Mr Yishai Friedlander and Mr Yoram Neufeld for their valuable assistance.Disclosure of InterestsNone declared
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Elkayam O, Eviatar T, Peleg H, Paran D, Levartovsky D, Kaufman I, Broyde A, Elalouf O, Polachek A, Feld J, Haddad A, Gazitt T, Elias M, Hijaze N, Aassi M, Quebe-Fehling E, Alarcon I, Pel S, Zisman D, Furer V. POS1244 THE EFFECT OF SECUKINUMAB ON THE HUMORAL RESPONSE FOLLOWING TWO AND THREE DOSES OF THE BNT162b2 mRNA VACCINE IN PATIENTS WITH SPONDYLOARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3284] [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: 11/04/2022]
Abstract
BackgroundData on the effect of secukinumab on the humoral response to the BNT162b2 mRNA vaccine are limited.ObjectivesWe aimed to assess prospectively the humoral response to the BNT162b2 mRNA vaccine in patients with spondyloarthritis (SpA) treated with secukinumab in comparison to immunocompetent controls.MethodsPatients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS) treated with secukinumab for at least 3 months and immunocompetent controls were vaccinated with two-dose regimen of the BNT162b2 mRNA vaccine. Clinical and laboratory assessments were performed at 2-8 weeks [SpA: 37 on secukinumab, (median age 53% female), 122 controls (median age 53, 51% female)], and 6 months [SpA: 27 on secukinumab, 116 controls] after the second vaccine dose. A subgroup of patients (22 SpA on secukinumab, 45 controls) were evaluated after the third vaccine dose. The seropositive response was defined as a detectable S1/S2 IgG ≥15 binding antibody units (BAU)/ml.ResultsThe two-dose vaccine regimen induced a similar immunogenic response in patients and controls reflected by the seropositivity rates of 100% in both groups. After six months, the rate of seropositivity remained as high as 96% in both secukinumab-treated patients and immunocompetent controls. The decline of S1/S2 IgG titer within six months was similar in controls and secukinumab-treated patients, -66.4 (95% CI {-70.9, -39.9}) and -55 BAU/ml (95% CI {-95.42, -36.87)). Following the third vaccine, the seropositivity rate increased to 100 % in both groups. At all-time points, S1/S2 IgG titers were similar in secukinumab treated patients and immunocompetent controls (Figure 1).Figure 1.Kinetics of an immunogenic response (S1/S2 IgG titer) to two and three doses of the BNT162b2 mRNA vaccine in SpA patients treated with secukinumab and immunocompetent controls.ConclusionSpA patients treated with secukinumab consistently demonstrated an adequate humoral response to the BNT162b2 mRNA vaccination similar to immunocompetent controls, both short-term and within six months after two vaccine doses and after the third vaccine dose.AcknowledgementsWe would like to thank Mr Yishai Friedlander and Mr Yoram Neufeld for their assistance.Disclosure of InterestsOri Elkayam: None declared, Tali Eviatar: None declared, Hagit Peleg: None declared, Daphna Paran: None declared, David Levartovsky: None declared, Ilana Kaufman: None declared, Adi Broyde: None declared, Ofir Elalouf: None declared, Ari Polachek: None declared, Joy Feld: None declared, Amir Haddad: None declared, Tal Gazitt: None declared, Muna Elias: None declared, Nizar Hijaze: None declared, Maher Aassi Employee of: Novartis Pharma AG, Erhard Quebe-Fehling Employee of: Novartis Pharma AG, Ivette Alarcon Employee of: Novartis Pharma AG, Sara Pel: None declared, Devy Zisman: None declared, Victoria Furer: None declared
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Mitchard D, Widger P, Haddad A. Analysis of light emission and Schlieren from short gap high voltage streamers representing lightning impulses. Sci Rep 2021; 11:24324. [PMID: 34934151 PMCID: PMC8692483 DOI: 10.1038/s41598-021-03839-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/06/2021] [Indexed: 11/09/2022] Open
Abstract
Light emissions and Schlieren structures were simultaneously observed from streamers produced by tens of kilovolts 1.2/50 μs impulses, representing the high voltage component of lightning, applied across a 4 cm air gap between a variety of electrode geometries and a ground plane in an unconfined environment. The results demonstrated that the light emissions and Schlieren structures coincide along the same streamer filaments but on different timescales; the light existing only during the microsecond timeframe impulse whereas the Schlieren continued to develop into the millisecond timeframe, moving towards the centre of the air gap whilst diffusing into the surrounding air within 100 ms. If an electrical breakdown did occur, the Schlieren structures outside the arc remained visible. Streamer formation theory for high voltage impulses is subsequently refined to include the observed Schlieren mechanism.
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Affiliation(s)
- D Mitchard
- Advanced High Voltage Engineering Research Centre, School of Engineering, Cardiff University, Wales, CF24 3AA, UK.
| | - P Widger
- Advanced High Voltage Engineering Research Centre, School of Engineering, Cardiff University, Wales, CF24 3AA, UK
| | - A Haddad
- Advanced High Voltage Engineering Research Centre, School of Engineering, Cardiff University, Wales, CF24 3AA, UK
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Haddad A, Sebai A, Chelly B, Maghrebi H, Chaker Y, Jouini M, Kacem M. Tuberculous severe acute colitis. A case report. Ann Med Surg (Lond) 2021; 69:102756. [PMID: 34484727 PMCID: PMC8405927 DOI: 10.1016/j.amsu.2021.102756] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/16/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction and importance: Intestinal tuberculosis represents 2% of the ten million cases of tuberculosis reported in 2018. Herein, we report a case of tuberculous severe acute colitis. It is a rare and life-threatening condition. Our literature review found only five published cases. It occurs generally in immunocompromised patients. Extended colonic inflammation seems to be the main predictive factor of death. Moreover, an early diagnosis and rapid onset of antituberculous treatment are mandatory to save the patient's life. Case presentation Herein, we present a case of tuberculous severe acute colitis with a review of the reported cases. The patient presented with a severe and idiopathic acute colitis. He was put on broad-spectrum antibiotics and intravenous corticosteroids. At day two, he developed septic shock and colic perforation. Colectomy was performed. Microbiology investigation and pathology examination confirmed tuberculous colitis. Clinical discussion Tuberculous severe acute colitis occurs generally in immunocompromised patients. Extended colic inflammation seems to be the main predictive factor of death. Moreover, an early diagnosis and rapid onset of antituberculous treatment are mandatory to save the patient's life. However, diagnosis is difficult as symptoms aren't specific. Microbiology and pathology were compulsory to retain colic tuberculosis in all the reported cases. Conclusion Tuberculous severe acute colitis is a challenging and life-threatening condition. It usually occurs in immunocompromised patients. Abdominal CT-scan may evoke the diagnosis. Microbiology and pathology are mandatory to retain the diagnosis. Early diagnosis and onset of antituberculous treatment are compulsory to save the patient's life. Diagnosis of tuberculous severe acute colitis is difficult. It usually occurs in immunocompromised patients. Surgery is mandatory if perforation occurs. Early diagnosis and onset of antituberculous treatment are compulsory to save the patient's life.
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Affiliation(s)
- A Haddad
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - A Sebai
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - B Chelly
- Pathology Department, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - H Maghrebi
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Y Chaker
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - M Jouini
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia
| | - M Kacem
- Surgery Department A, La Rabta Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
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21
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Haddad A, Sebai A, Maghrebi H, Chaker Y, Jouini M, Kacem M. Enterosalpingeal fistula complicating Crohn's disease: Report of two cases and review of the literature. Ann Med Surg (Lond) 2021; 69:102734. [PMID: 34466222 PMCID: PMC8384770 DOI: 10.1016/j.amsu.2021.102734] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/15/2021] [Accepted: 08/15/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction and importance Reports of enterosalpingeal fistulae complicating Crohn's disease are scarce. They involve the last ileal loop and lead to a progressive destruction of the salpinx. Usually, no genital symptoms are found. In all the cases reported in the literature, the fistula was diagnosed intra-operatively and resection of the right salpinx was performed without the patient's pre-operative consent. Case presentation We describe 2 cases of women presenting with an Enterosalpingeal fistulae complicating Crohn's disease. Radiological findings allowed a pre-operative diagnosis. Thus, the patients were warned of the right salpinx resection and consent was obtained. Clinical discussion Enterosalpingeal fistulae complicating Crohn's disease are exceptional. Indeed, to the best of our knowledge, only five cases have been reported till now. In all the reported cases, no genital signs were present. As for our patients who didn't experience such symptoms. Moreover, no radiological evidence of the enterosalpingeal fistula was found in the literature. Consequently, the fistula was always diagnosed intra-operatively. For our patients, radiological findings allowed a pre-operative diagnosis. This permitted to warn them of a possible resection of the fallopian tube. Intra-operative findings were unfortunately conflicting with its preservation. Conclusion Enterosalpingeal fistula is an exceptional complication of the Crohn's disease. No clinical findings are present. The diagnosis should be evoked when the CT-scan or the MRI show an abnormal apposition between the fallopian tube, the last loop and the cecum. Surgical resection of the involved salpinx with the diseased intestinal segment is unfortunately usually needed in a young patient population. Report of two cases of an unusual form of Crohn's disease. Unique preoperative imaging. Preoperative diagnosis of the fistulae. Thus, patients were warned of salpingectomy.
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Affiliation(s)
- A Haddad
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - A Sebai
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - H Maghrebi
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Y Chaker
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - M Jouini
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - M Kacem
- Surgery Department A - La Rabta Hospital of Tunis, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Chahir R, Haddad A, Mtalai N, El Maaloum L, Allali B, El Kettani A. Recurrent palpebral herpes complicated by preseptal cellulitis in a child. J Fr Ophtalmol 2021; 44:1079-1081. [PMID: 34243997 DOI: 10.1016/j.jfo.2021.01.017] [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] [Received: 11/30/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- R Chahir
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco.
| | - A Haddad
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco
| | - N Mtalai
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco
| | - L El Maaloum
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco
| | - B Allali
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco
| | - A El Kettani
- Hassan II University of Casablanca, Department of pediatric ophtalmology, Ibn Rochd University Hospital of Casablanca, 1, rue des Hôpitaux, Casablanca, Morocco
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Haddad A, Yahia DBH, Chaker Y, Maghrebi H, Daghfous A, Kacem MJ. Intraperitoneal migrating mesh plug wrongfully taken for right colon cancer: A case report. Int J Surg Case Rep 2021; 84:106088. [PMID: 34186460 PMCID: PMC8254107 DOI: 10.1016/j.ijscr.2021.106088] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The use of mesh has become nowadays a standard for hernia repairs. It allows a tension-free hernioplasty and has shown that it is an effective way to prevent recurrences. But complications have been described. Intraperitoneal migration of mesh plug is an uncommon complication. CASE REPORT In this paper we report a case of a 57 year old male who has been operated on 12 years ago, he had a mesh plug repair for a ventral incisional hernia. The mesh migrated into the abdominal cavity and it was wrongfully taken for a locally advanced right colon cancer. Colonoscopy was done and biopsies were taken, but the results were not conclusive. He was operated on. We found the mesh that had migrated and eroded the hepatic flexure. There was a granulation tissue that also included some of the small intestine. There was also an abscess in the abdominal wall. He had an en-bloc resection of a part of the abdominal wall, small intestine and right colon. CONCLUSION Mesh hernioplasty is a frequent, simple and effective procedure with a low recurrence rate but it can be associated to serious complications such as mesh migration.
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Affiliation(s)
- A Haddad
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - D Bel Haj Yahia
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Y Chaker
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - H Maghrebi
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A Daghfous
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - M J Kacem
- Surgery department A, Rabta Hospital, Rue Jbel Lakhdar, La Rabta Jebbari 1007, Tunis, Tunisia; The Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Carabelli E, Ross A, Haddad A, Patil P, Islam S, Dass C, Gannon M, Van Decker W, Edmundowicz D. Progression To Non-zero Coronary Artery Calcium Scores And Presence Of Aortic Calcifications: Insights From An Employer Health Benefits Screening Program. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.241] [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: 12/01/2022]
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Haddad A, Saliba W, Lavi I, Batheesh A, Kasem S, Gazitt T, Feldhamer I, Cohen A, Zisman D. OP0219 THE ASSOCIATION OF PSORIATIC ARTHRITIS WITH ALL-CAUSE MORTALITY AND LEADING CAUSES OF DEATH IN PSORIATIC ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1895] [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: 11/04/2022]
Abstract
Background:Data on the association between PsA and mortality remains conflicting as it has been hampered by small sample size with few events and the potential for confounders of selection and severity biases from clinic-based studies.Objectives:To examine the association between PsA and all-cause mortality in a cohort of PsA patients and matched controls, using data from a population-based large medical record database.Methods:Patients with newly diagnosis of PsA between January 1st, 2003 and December 31st, 2018 from the Clalit Health database were identified. 4 controls without PsA were selected and matched to cases of PsA by age (within 1 year), sex, ethnicity (Jewish vs. non-Jewish), and index date. The two groups were followed from the index date until the first occurrence of death from any cause or end of follow-up (June 30, 2019). Data on mortality and on the immediate cause of death was based on the Notification of Death form legally required by the Israeli Ministry of the Interior for every deceased person in the country. Demographic data including age, sex, ethnicity (Jewish or Arab), and socioeconomic status (SES) at inception were retrieved from the CHS database. Data regarding tobacco use (ever), obesity, body mass index, diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, prior cerebrovascular accident, congestive heart failure, chronic renal failure, chronic obstructive pulmonary disease, cirrhosis, prior malignancy, psoriasis, and the concomitant use of glucocorticosteroids, conventional and biologic disease-modifying anti-rheumatic drugs (cDMARDs and bDMARDs, respectively) were extracted from the database.We estimated the attributable fraction of the various causes of death in PsA patients and compared it to the proportionate mortality rate (PMR) of the leading causes of death in Israel during 2014-2016 based on a recently published report by the Central Bureau of Statistics. Cox proportional hazard regression models were used to estimate the crude and the multivariate adjusted hazard ratio (HR) for the association between PsA and all-cause mortality, as well as for factors associated with mortality within the PsA group.Results:A total of 5275 PsA patients were identified between 2003 and 2018 and where matched to 21,011 controls based on age, sex, and ethnicity. The mean age was 51.7 ± 15.4 years of whom 53% were females. More individuals in the PsA group were smokers, obese, with diabetes, hypertension, and dyslipidemia, as well as with a history of ischemic heart disease, cerebrovascular disease, congestive heart failure, chronic obstructive pulmonary disease, chronic renal failure and cirrhosis than patients in the control group, and 38.2% of PsA patients were on b-DMARDS. Overall 471 (8.9%) patients died in the PsA group compared to 1,668 (7.9%) in the control group during a mean follow-up of 7.2 ± 4.4 years. The crude HR for the association of PsA and all-cause mortality was 1.16 (95% CI, 1.042-1.29). However, the association was not significant on multivariate analysis with HR of 1.096 (95% CI, 0.977-1.229).In PsA patients, malignancy was the leading cause of death, constituting 26% of all deaths, followed by ischemic heart disease 15.8%, diabetes 6.2%, cerebrovascular diseases 5.5% and septicemia 5.5%, in keeping with the order of the leading causes of death in the general population of Israel during 2014-2016 as recently reported by the Central Bureau of Statistics.On multivariate model Cox regression analysis, male sex, increased body mass index, increased Charlson comorbidity index scores and history of hospitalization in a year prior to death were associated with higher mortality, whereas treatment bDMARDs and cDMARDs were associated with a lower relative risk of death.Conclusion:No clinically relevant increase in mortality rate was observed in PsA patients from the period 2003-2018. The most common causes of specific proportionate mortality rates in our cohort were similar to those in the general population.Disclosure of Interests:None declared
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Berman J, Furer V, Berman M, Isakov O, Zisman D, Haddad A, Matz H, Elkayam O. AB0551 TREATMENT WITH IXEKIZUMAB FOLLOWING SECUKINUMAB FAILURE IN PATIENTS WITH PSORIATIC ARTHRITIS: REAL-LIFE EXPERIENCE FROM A RESISTANT POPULATION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2186] [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: 11/04/2022]
Abstract
Background:Anti-IL17 agents, such as Secukinumab (SEC) and Ixekizumab (IXE) have been shown to be efficacious for the treatment of psoriasis and PsA12. In the field of psoriasis, there is growing evidence of a successful switching between the two anti-IL-17 agents in case of an insufficient response to one of the treatments3 There is no information on the efficacy of switching between anti IL17 agents in PsA.Objectives:To assess the clinical response to IXE in patients with PsA following SEC failure.Methods:A retrospective observational study was conducted in two rheumatology centers in Israel, including PsA patients with a history of treatment with SEC, further treated with IXE for a minimum of 3 months. Lack of efficacy, loss of efficacy, and side effects over time were reported as a reason for switching to another anti-IL17 agent. The mean difference between the beginning of the follow up period and the different follow up points (6 and 12 months) was tested using a one-sample t-test. Time until treatment failure was estimated using Kaplan–Meier curves, and compared using the log-rank test. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated using the Cox proportional-hazards model to test the association between each variable and the time to treatment failure.Results:The study included 23 PsA patients (11♀/12♂), mean age 58.7 years±13.4 SD. Most patients (n=20, 86%) received 2+ TNFi and 10 patients (43%) received both TNFi and ustekinumab. Median number of biologics prior to SEC was 3 (IQR 2-4). There was a significant improvement in TJC at 6 and 12 months (-2.16 [-4.0, -0.3]; p=0.025 and-1.69 [-3.09, -0.28]; p=0.022, respectively). SJC was significantly improved at 6 months but not at 12 months (-2.68 [-5.3, -0.04]; p= 0.046 and -1.50 [-4.25,1.25]; p=0.26, respectively). CDAI score was significantly improved at 6 months (-10.19, [-16.26, -4.1], p=0.002) and at 12 months (-9.29 [-14.8, -3.71], p=0.003) as was SDAI score (-10.13 [-16.4, -3.8], p=0.003 and -12.2 [-17.1, -7.2], p=0.0002). At six months, PASI50 was achieved by 81% (13 patients), PASI75 was achieved by 63% (10 patients), PASI90 was achieved by 50% (8 patients) and PASI100 by 31% (10 patients). At 12 months, PASI50 and PASI75 was achieved by 57% (8 patients), PASI90 was achieved by 43% (6 patients) and PASI100 by 21% (3 patients).Over time, of the 23 patients treated with IXE, 15 patients (65%) had experienced treatment failure, with a median treatment period of 8 months (IQR 6.5-13.5), of which 4 (17%) had primary treatment failure and 11 patients (48%) secondary treatment failure. Reasons for treatment cessation were: worsening psoriasis (4 patients (27%)), worsening peripheral arthritis (4 patients (27%)), both (7 patients (47%)), worsening of axial disease (2 patients (13%)) and adverse events (1 patient, 6%).Conclusion:patients after failure of multiple biologic treatments experienced significant response of peripheral arthritis and dermatologic disease on IXE after they had previously failed SEC. . However, in this refractory cohort of PsA, the effect was limited on time with 65% failure after a median time of 8 months.Within class switch from SEC to IXE is a plausible therapeutic option in PsA patients following secukinumab failure.References:[1]Mease PJ, McInnes IB, Kirkham B, et al. N Engl J Med. 2015;373(14):1329-1339.[2]Nash P, Kirkham B, Okada M, et al. Lancet Lond Engl. 2017;389(10086):2317-2327.[3]Bokor-Billmann T, Schäkel K. J Dermatol Treat. 2019;30(3):216-220Disclosure of Interests:None declared.
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Zisman D, Safieh M, Simanovich E, Feld J, Kinarty A, Zisman L, Gazitt T, Haddad A, Elias M, Rosner I, Kaly L, Amit Rahat M. POS0613 TOCILIZUMAB DECREASES ANGIOGENESIS IN RHEUMATOID ARTHRITIS THROUGH ITS REGULATORY EFFECT ON EMMPRIN/CD147. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1616] [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: 11/04/2022]
Abstract
Background:Angiogenesis is an important contributor to the development of Rheumatoid arthritis (RA). Tocilizumab (TCZ), an anti-IL-6 receptor antibody, is an immunosuppressant used in the treatment of RA patients, but its effects on angiogenesis and the molecular mechanisms regulating new blood vessel formation are not fully elucidated.Objectives:To evaluate the concentrations of pro- and anti-angiogenic factors in serum samples of RA patients, before and after the initiation of TCZ treatment and to explore in an in vitro co-culture system the mechanisms of TCZ action.Methods:We evaluated the concentrations of EMMPRIN, VEGF, MMP-9, IL-6, NGAL, endostatin and thrombospondin-1 (Tsp-1) using commercial ELISA kits from 40 RA patients, before and 4 months after the initiation of TCZ treatment. The levels of secreted EMMPRIN, VEGF MMP-9 and Tsp-1 were measured in an in vitro co-culture system of HT1080 fibroblasts and U937 monocytes with and without addition of anti-EMMPRIN blocking antibody. In the tube formation assay serum samples and supernatnats from the co-cultures were added to endothelial layer. Images were obtained after 6 hours of incubation and the number of closed lumens were counted in two separate fields. In the wound assay, supernatants from the co-cultures, with or without the addition of the anti-EMMPRIN antibody were added to the endothelial layer after scratching. The scratch site area was measured immediately and compared to the area after 24 hours of incubation to assess the distance of cell migration.Results:Study population included 40 RA patients, 33 (82.5%) females, mean age of 57.5±11.1 years, disease duration of 7.7±5.6 years, and 53.9% positive for rheumatoid factor initiating treatment with TCZ. In this patient cohort, 25/40 (62.5%) patients were classified as “responders” according to EULAR criteria.Following 4 mounts of treatment, statistically significant reductions in the levels of EMMPRIN/CD147 (p=0.035), without significant changes in serum levels of MMP-9, VEGF, MMP-3 and MMP-7 and of the anti-angiogenetic factors Tsp-1 and endostatin were found. A statistically significant decrease in the ratio between the pro-angiogenic factor EMMPRIN and the anti-angiogenic factor Tsp-1 that was calculated for each patient 4 months after initiating TCZ was found(p=0.031). The decrease in angiogenesis was manifested by the reduced number of closed lumen tube-like structures formed by EaHy926 endothelial cell line after incubation with serum samples 4 months after initiation of TCZ, relative to the number of closed lumens formed prior to TCZ initiation (p=0.007). The ratio between EMMPRIN and Tsp-1 was significantly reduced in the responding patients versus non-responders (p=0.033), while the levels of VEGF, MMP-9, Tsp-1, and EMMPRIN were unchanged.In vitro, the accumulation of the pro-angiogenic factors EMMRPIN, VEGF and MMP-9 in the supernatants was increased in the co-culture, while the accumulation of the anti-angiogenic factor Tsp-1 was decreased. When EMMPRIN was neutralized with a blocking antibody, supernatants derived from these co-cultures exhibited reduced migration, proliferation, and tube-like structure formation in functional assays.Conclusion:Our findings suggest an important role for EMMPRIN in mediating pro-angiogenic signals in RA patients, with EMMPRIN/Tsp-1 ratio serving as a marker of angiogenesis in RA. When administered to RA patients, TCZ in turn, exerts an anti-angiogenic effect through its regulation of EMMRPIN/CD147 levels.Disclosure of Interests:None declared
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Gazitt T, Pesachov J, Lavi I, Elias M, Haddad A, Feldhamer I, Cohen A, Saliba W, Zisman D. POS0147 ANALYSIS OF VENOUS THROMBOEMBOLIC RISK AMONG PSORIATIC ARTHRITIS PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1811] [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: 11/04/2022]
Abstract
Background:Psoriatic arthritis (PsA) is a chronic, immune-mediated, systemic inflammatory arthritis associated with comorbidities including metabolic syndrome, cardiovascular risk factors and cardiovascular disease (CVD).Objectives:To evaluate the prevalence of venous thromboembolism (VTE) in a PsA patient cohort using a large health care provider database.Methods:A large health care provider database serving 4.7 million healthcare subscribers was interrogated for an adult patient cohort who were newly diagnosed with PsA between January 2005 (start date) and 31 December 2018 with date of diagnosis considered the index date. A risk set was employed to randomly select 4 controls without PsA as a comparator group to the PsA cohort matched by age, sex, ethnic group, and index date. Both groups were followed from the index date until the first occurrence of VTE event, death, or end of follow-up 31 December 2019, whichever came first. Marginal model with robust covariant estimate counting for the matching was used to estimate the crude and adjusted hazard ratio (HR) for the association between PsA and VTE. Within the group of PSA patients, Cox proportional hazard regression models was used to calculate the risk of having VTE given demographic variables, SES, smoking, selected comorbidities, and conventional vs biologic disease modifying anti-rheumatic drugs (c/bDMARD). Continuous variables were summarized with mean ± standard deviation, and categorical variables were presented as numbers and proportions. All tests were 2-sided; p values of < = 0.05 were considered statistically significant. All data were analyzed using SPSS, 24 (IBM SPSS Statistics for Windows, version 24.0, 2016, Armonk, NY) and SAS, 9.4 (SAS institute Inc, Cary, NC).Results:The PsA cohort consisted of 5,275 patients, 53.2% females with mean age of 51.66 ±15.41. The control group consisted of 21,011 subjects matched for age and sex. In relation to the control group, the PsA cohort had a higher SES (25.1% vs 23.4%, p<0.0001), higher tobacco use (42.2% vs.39.6% p<0.0001) and obesity (33.5% vs 25.8%, p<0.0001). The study group had a statistically significant higher incidence of diabetes (33.8% vs 26.2%, p<0.0001), IHD (10.3% vs 8.6%, p<0.0001), CHF (2.2% vs 1.6%, p=0.004), hypertension (30.1% vs 26.2%, p<0.0001), CVA/TIA (4.6% vs 3.9%, p=0.024) and vascular disease (3.7% vs 3.0%, p=0.005). There were 62 patients (1.2%) diagnosed with VTE in the PsA group as opposed to 176 patients (0.8%) in the control group (p=0.023, HR=1.397, CI 1.05-1.87). The mean age of patients diagnosed with VTE was higher in the PsA group relative to controls (64.90± 13.20 vs 51.54 ± 15.41, respectively, p<0.0001), with higher age, BMI>30, cancer, IHD, vascular disease, and previous VTE found to be associated with VTE in the PsA group relative to controls in both univariate and multivariate analyses. The higher prevalence of VTE in PsA patients relative to controls did not remain statistically significant in multivariate analysis following adjustment for risk factors. Within the PsA group, patients with VTE were more often of older age and with past history of VTE. Both cDMARD and bDMARD were not associated with increased risk of VTE among PsA patients.Conclusion:The prevalence of VTE was higher in PsA group compared to the general population, but after adjustment for comorbidities and risk factors, it no longer remained statistically significant. Among PsA patients, age and previous history of VTE were associated with increased risk of VTE. Addressing VTE risk in the management of patients with PsA is recommended especially in the era of Janus kinase inhibitors.Disclosure of Interests:None declared
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Furer V, Eviatar T, Zisman D, Peleg H, Paran D, Levartovsky D, Zisapel M, Elalouf O, Kaufman I, Meidan R, Broyde A, Polachek A, Wollman J, Litinsky I, Meridor K, Nochomovitz H, Silberman A, Rosenberg D, Feld J, Haddad A, Gazitt T, Elias M, Higazi N, Kharouf F, Shefer G, Sharon O, Pel S, Nevo S, Elkayam O. LB0003 IMMUNOGENICITY AND SAFETY OF THE BNT162b2 mRNA COVID-19 VACCINE IN ADULT PATIENTS WITH AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASES AND GENERAL POPULATION: A MULTICENTER STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.5096] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Vaccination represents a cornerstone in mastering the COVID-19 pandemic. Data on immunogenicity, efficacy, and safety of the novel BNT162b2 mRNA vaccine in patients with autoimmune inflammatory rheumatic diseases (AIIRD) are limited.Objectives:To investigate the immunogenicity, efficacy, and safety of the BNT162b2 mRNA vaccine in patients with AIIRD compared to the general population.Methods:A prospective multicenter study investigated immunogenicity, efficacy, and safety of the two-dose regimen BNT162b2 mRNA vaccine in adult patients with AIIRD including rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthropathy (axSpA), systemic lupus erythematosus (SLE), connective tissues diseases (CTD), systemic vasculitides, and idiopathic inflammatory myositis (IIM), compared to control subjects without rheumatic diseases or immunosuppressive therapies. Serum IgG antibody levels against SARS-CoV-2 spike S1/S2 proteins were measured 2 - 6 weeks after the second vaccine dose. Seropositivity was defined as IgG ≥15 binding antibody units (BAU)/ml. Post-vaccination efficacy defined as post-vaccination COVID-19 infection and safety were assessed. Pre- and post- vaccination disease activity indices were assessed as appropriate for each disease.Results:A total of 686 AIIRD patients and 121 controls participated into the study. AIIRD patients were significantly older than controls, mean age±SD 56.76±14.88 vs 50.76±14.68, respectively, p<0.0001. A total of 95.2% (n=653) AIIRD patients were treated with immunomodulatory medications.The seropositivity rate was 86% (n=590) in patients with AIIRD compared to 100% in controls (p <0.0001) The level of the S1/S2 antibodies was significantly reduced in AIIRD patients compared to controls (mean± SD 132.9±91.7 vs 218.6±82.06, P<0.0001). In patients with PsA, AxSpA, SLE, and LVV, the seropositive rate was above 90%. In RA, the seropositive rate was 82.1% and the lowest seropositive rate (<40%) was observed in patients with AAV and IIM.Anti-CD20 significantly impaired the vaccine’s immunogenicity, with the lowest seropositivity rate of 39%. The use of GC, mycophenolate mofetil (MMF), and abatacept was associated with a significantly lower rate of seropositivity (Figure 1). MTX significantly reduced the seropositivity in patients treated with MTX monotherapy and in combinations with other treatments (92% and 84%, respectively), although at a lesser magnitude than anti-CD20, MMF, and abatacept. More than 97% of patients treated with anti-cytokine therapies including TNFi, interleukin-17 and interleukin-6 inhibitors had an appropriate immunogenic response when used as monotherapy. The combination of TNFi with MTX significantly reduced the rate of seropositivity to 93%, p=0.04. Age over 65 years, a diagnosis of RA, IIM, ANCA-associated vascilitis, and treatment with GC, MMF, anti-CD20, and abatacept were associated with a reduced likelihood of seropositivity.Figure 1.Seropositivity rate by immunosuppressive treatment.There were no post-vaccination symptomatic cases of COVID-19 among AIIRD patients and one mild case in the control group. Major adverse events in AIIRD patients included death (n=2) several weeks after the second vaccine dose, non-disseminated herpes zoster (n=6), uveitis (n=2), and pericarditis (n=1). Post-vaccination disease activity remained stable in the majority of patients.Conclusion:Vaccination with the BNTb262 vaccine resulted in an adequate immunogenic response with an acceptable safety profile in the majority of patients with AIIRD. Treatment with GC, rituximab, MMF, and abatacept may impair BNT162b2-induced immunogenicity. Postponing administration of rituximab, when clinically feasible, seems to be reasonable to improve vaccine-induced immunogenicity. Holding treatment with abatacept and MMF may be considered on an individual basis.Disclosure of Interests:None declared
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Amrani Joutei S, Mataa N, Haddad A, El Maaloum L, Allali B, El Kettani A. Congenital megalocornea or congenital glaucoma: What's the difference? J Fr Ophtalmol 2021; 44:901-903. [PMID: 33933310 DOI: 10.1016/j.jfo.2020.11.014] [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] [Received: 11/09/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 10/21/2022]
Affiliation(s)
- S Amrani Joutei
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco.
| | - N Mataa
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco
| | - A Haddad
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco
| | - L El Maaloum
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco
| | - B Allali
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco
| | - A El Kettani
- Pediatric Ophthalmology Department, 2Oth august 1953 hospital, Ibn Rochd university hospital center, Casablanca, Morocco
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Haddad A, Saeed H, Fries M, Iqbal S. 583 The epigenetic effect of metformin on the fetus. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.604] [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: 11/28/2022]
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Yuan B, Lysak DH, Soong R, Haddad A, Hisatsune A, Moser A, Golotvin S, Argyropoulos D, Simpson AJ, Muir DCG. Chlorines Are Not Evenly Substituted in Chlorinated Paraffins: A Predicted NMR Pattern Matching Framework for Isomeric Discrimination in Complex Contaminant Mixtures. Environ Sci Technol Lett 2020; 7:496-503. [PMID: 32685603 PMCID: PMC7365351 DOI: 10.1021/acs.estlett.0c00244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 05/06/2023]
Abstract
Chlorinated paraffins (CPs) can be mixtures of nearly a half-million possible isomers. Despite the extensive use of CPs, their isomer composition and effects on the environment remain poorly understood. Here, we reveal the isomeric distributions of nine CP mixtures with single-chain lengths (C14/15) and varying degrees of chlorination. The molar distribution of C n H2n+2-m Cl m in each mixture was determined using high-resolution mass spectrometry (MS). Next, the mixtures were analyzed by applying both one-dimensional 1H, 13C and two-dimensional nuclear magnetic resonance (NMR) spectroscopy. Due to substantially overlapping signals in the experimental NMR spectra, direct assignment of individual isomers was not possible. As such, a new NMR spectral matching approach that used massive NMR databases predicted by a neural network algorithm to provide the top 100 most likely structural matches was developed. The top 100 isomers appear to be an adequate representation of the overall mixture. Their modeled physicochemical and toxicity parameters agree with previous experimental results. Chlorines are not evenly distributed in any of the CP mixtures and show a general preference at the third carbon. The approach described here can play a key role in understanding of complex isomeric mixtures such as CPs that cannot be resolved by MS alone.
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Affiliation(s)
- Bo Yuan
- Department
of Environmental Science, Stockholm University, SE-10691 Stockholm, Sweden
| | - Daniel Henryk Lysak
- Environmental
NMR Centre, University of Toronto, Toronto, ON, Canada M1C 1A4
| | - Ronald Soong
- Environmental
NMR Centre, University of Toronto, Toronto, ON, Canada M1C 1A4
| | - Andrew Haddad
- Environmental
NMR Centre, University of Toronto, Toronto, ON, Canada M1C 1A4
| | - Arika Hisatsune
- Environmental
NMR Centre, University of Toronto, Toronto, ON, Canada M1C 1A4
| | - Arvin Moser
- ACD/Labs, 8 King Street East, Toronto, ON, Canada M5C 1B5
| | | | | | - Andre J. Simpson
- Environmental
NMR Centre, University of Toronto, Toronto, ON, Canada M1C 1A4
| | - Derek C. G. Muir
- Canada
Centre for Inland Waters, Environment and
Climate Change Canada, Burlington, ON, Canada L7S 1A1
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Haddad A, Gazitt T, Feldhamer I, Feld J, Cohen A, Zisman D. AB0780 TREATMENT PERSISTENCE OF BIOLOGICS AMONG PATIENTS WITH PSORIATIC ARTHRITIS (PsA). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1760] [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: 11/04/2022]
Abstract
Background:Persistence in biologic therapy in psoriatic arthritis is critical to optimize symptom remission, functional capacity and health care costs.Objectives:To estimate the persistence to biologic treatment prescribed to PsA patients in a real-life setting as well as factors associated with improved biologic drug survival in these patients.Methods:Patients with PsA from a large health care provider database with at least two consecutive dispensed prescriptions of a biologic agent indicated for PsA from January 1st, 2002 until December 31st, 2018 were identified and followed until medication stop date or the end of observation period. Patients were considered non-persistent whenever a new prescription was dispensed and a permissible gap of 6 months was exceeded prior to starting on this biologic agent from the prescription date. Treatment changes were based on physician decisions and patient preferences.Demographic data including age, sex, BMI, ethnicity, smoking history and socioeconomic status as well as Charlson comorbidity index were retrieved. Data regarding use of steroids and non-biologic disease-modifying anti-rheumatic drugs were also extracted. Descriptive statistics, including means (standard deviations) for continuous variables and frequencies (%) for categorical variables, were used. Persistence estimates were derived using non-parametric survival analysis using Kaplan-Meier functions, with treatment discontinuations as failure events. Cox regression hazard ratio models were conducted to investigate factors associated with drug persistence.Results:2301 PsA patients with 2958 treatment periods were identified and included in the analyses. The mean age was 50.9±14 years of whom 54% were females, 70.4% of the study population had a BMI>25, and 36% were obese(BMI>30), 40% were current smokers, and 76% had a Charlson comorbidity index higher than 1. The most commonly prescribed drug was etanercept, followed by adalimumab, golimumab, secukinumab, ustekinumab and infliximab at 33%, 29%, 12%, 10%,8% and 8%, respectively. Only about 20% of patients remained on a particular biologic agent after 5 years, whereas about 40% persisted on therapy following 20 months of treatment. A Kaplan-Mayer survival analysis with pairwise comparisons of all treatment choices with respect to lines of therapy was conducted. When analyzing the data for all treatment periods and taking into account all lines of therapy, secukinumab had a higher persistency than adalimumab, infliximab and ustekinumab, with a Log Rank of 0.022, 0.047 and 0.001, respectively, as is shown in figure 1. Female sex and smoking were associated with lower drug persistence (HR=1.25, 95%CI 1.13-1.38 and HR=1.109, 95%CI 1.01-1.21, respectively). When analyzing the data regarding second-line biologic agents, secukinumab was found to be superior to adalimumab, etanercept, infliximab and ustekinumab but not to golimumab with a Log-Rank P value of 0.001, 0.004, 0.025 and 0.002, respectively (figure 2). On analyzing the data using only the first indicated biologic line, no superiority of any single anti-Tumor Necrosis Factor-alpha (anti-TNFα) agent was observed.Conclusion:In this large observational cohort, in the era of biologic therapy, a relatively low persistence was observed, with female sex and smoking having a negative impact on persistency. None of the anti-TNFα agents as first line therapy was found to be more persistent than others, while secukinumab was found to be superior to other biologics when indicated as second line of therapy.References:NoneFigure 1.Figure 2.Acknowledgments:noneDisclosure of Interests:None declared
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Monseur BC, Anastasio HB, Haddad A, Al‐Kouatly HB. Review of familial hemiplegic migraine, successful outcome in a pregnant patient. Clin Case Rep 2019; 7:2495-2499. [PMID: 31893087 PMCID: PMC6935667 DOI: 10.1002/ccr3.2513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/23/2019] [Accepted: 10/11/2019] [Indexed: 12/30/2022] Open
Abstract
As the field of neurogenetics is expanding rapidly and variant classification criteria evolve, genetic variants in databases are re-evaluated overtime allowing updated classifications of pathogenicity predication. When caring for patients with genetic disorders, it is important to obtain the original genetic report and also consider an updated reanalysis.
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Affiliation(s)
- Brent C. Monseur
- Department of Obstetrics and GynecologySidney Kimmel Medical College of Thomas Jefferson UniversityPhiladelphiaPennsylvania
| | - Hannah B. Anastasio
- Division of Maternal Fetal MedicineDepartment of Obstetrics and GynecologySidney Kimmel Medical College of Thomas Jefferson UniversityPhiladelphiaPennsylvania
| | - Andrew Haddad
- Division of Maternal Fetal MedicineDepartment of Obstetrics and GynecologyMedStar Washington Hospital CenterWashingtonDistrict of Columbia
| | - Huda B. Al‐Kouatly
- Division of Maternal Fetal MedicineDepartment of Obstetrics and GynecologySidney Kimmel Medical College of Thomas Jefferson UniversityPhiladelphiaPennsylvania
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Power R, Bartha G, Harris J, Boyle S, Levy E, Milani P, Tandon P, Li R, Chinnappa M, Haddad A, McNitt P, McClory R, Morra M, Saldivar S, Clark M, Haudenschild C, Newburn E, Johnson C, Chen R, West J. A comprehensive tumour immunogenomics platform for precision immunotherapy: Enabling simultaneous characterization of tumours and the TME from a single FFPE sample. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.030] [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: 11/13/2022] Open
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Bahia W, Soltani I, Haddad A, Radhouani A, Mahdhi A, Ferchichi S, Almawi WY. Links between SNPs in TLR-2 and TLR-4 and idiopathic recurrent pregnancy loss. Br J Biomed Sci 2019; 77:64-68. [DOI: 10.1080/09674845.2019.1687151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- W Bahia
- Research Unit of Clinical and Molecular Biology, Faculty of pharmacy, University of Monastir, Monastir, Tunisia
| | - I Soltani
- Molecular and Cellular Hematology Laboratory, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A Haddad
- Department Obstetrics and Gynecology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - A Radhouani
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Abdelkarim Mahdhi
- Laboratory of Analysis, Treatment and Valorization of Pollutants of the Environment and Products, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - S Ferchichi
- Research Unit of Clinical and Molecular Biology, Faculty of pharmacy, University of Monastir, Monastir, Tunisia
| | - WY Almawi
- Faculty of Sciences, El Manar University, Tunis, Tunisia
- School of Medicine, Nazarbayev University, Astana, Kazakhstan
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Ilchenko S, Haddad A, Sadana P, Recchia FA, Sadygov RG, Kasumov T. Calculation of the Protein Turnover Rate Using the Number of Incorporated 2H Atoms and Proteomics Analysis of a Single Labeled Sample. Anal Chem 2019; 91:14340-14351. [PMID: 31638786 DOI: 10.1021/acs.analchem.9b02757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Rate constant estimation with heavy water requires a long-term experiment with data collection at multiple time points (3-4 weeks for mitochondrial proteome dynamics in mice and much longer in other species). When tissue proteins are analyzed, this approach requires euthanizing animals at each time point or multiple tissue biopsies in humans. Although short-term protocols are available, they require knowledge of the maximum number of isotope labels (N) and accurate quantification of observed 2H-enrichment in the peptide. The high-resolution accurate mass spectrometers used for proteome dynamics studies are characterized by a systematic spectral error that compromises these measurements. To circumvent these issues, we developed a simple algorithm for the rate constant calculation based on a single labeled sample and comparable unlabeled (time 0) sample. The algorithm determines N for all proteogenic amino acids from a long-term experiment to calculate the predicted plateau 2H-labeling of peptides for a short-term protocol and estimates the rate constant based on the measured baseline and the predicted plateau 2H-labeling of peptides. The method was validated based on the rate constant estimation in a long-term experiment in mice and dogs. The improved 2 time-point method enables the rate constant calculation with less than 10% relative error compared to the bench-marked multi-point method in mice and dogs and allows us to detect diet-induced subtle changes in ApoAI turnover in mice. In conclusion, we have developed and validated a new algorithm for protein rate constant calculation based on 2-time point measurements that could also be applied to other biomolecules.
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Affiliation(s)
- Serguei Ilchenko
- Northeast Ohio Medical University , Rootstown , Ohio 44272 , United States
| | - Andrew Haddad
- Northeast Ohio Medical University , Rootstown , Ohio 44272 , United States
| | - Prabodh Sadana
- Northeast Ohio Medical University , Rootstown , Ohio 44272 , United States
| | - Fabio A Recchia
- Institute of Life Sciences , Scuola Superiore Sant'Anna, Pisa, Fondazione Gabriele Monasterio , 56100 Pisa , Italy.,Cardiovascular Research Center , Lewis Katz School of Medicine at Temple University , Philadelphia , Pennsylvania 19140 , United States
| | - Rovshan G Sadygov
- University of Texas Medical Branch , Galveston , Texas 77555 , United States
| | - Takhar Kasumov
- Northeast Ohio Medical University , Rootstown , Ohio 44272 , United States
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Ait Bouchrim SA, Haddad A, Bou Assi T, Oriol P, Guyotat D, Bois C, Garraud O. Residents' knowledge in transfusion medicine and educational programs: A pilot study. Transfus Clin Biol 2019; 27:18-24. [PMID: 31735608 DOI: 10.1016/j.tracli.2019.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Residents' knowledge in transfusion medicine significantly impacts the optimal use of blood and patient safety. Little is known regarding this topic in France in particular. The objectives were to evaluate their basic knowledge, to determine whether the objectives of the curricula were attained and subsequently to suggest ways for improvement. METHODS A cross-sectional study was conducted on 50 first year medical and surgical specialty residents rotating in a French university hospital. RESULTS Major gaps in the knowledge were noted among residents of various specialties, equally between those with low and sustained transfusion practice. The majority of these young doctors expressed difficulties in prescribing and handling transfusions, identifying and managing its complications and understanding their responsibilities. The roles of hemovigilance practitioners were further somehow unclear for participants. CONCLUSION Given these results, action plans appear needed to limit consequences. A special transfusion medicine educational program should be added to the currently available medical education curriculum in order to ensure physicians have adequate knowledge of transfusion basics; at least a practical assisted situation during residency would be of valuable interest.
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Affiliation(s)
- S-A Ait Bouchrim
- Department of General Medicine, Faculty of Medicine of Saint-Étienne, University of Lyon, Saint-Priest en Jarez, France
| | - A Haddad
- EA3064, Faculty of Medicine of Saint-Étienne, University of Lyon, Saint-Priest en Jarez, France; Department of Clinical Pathology and Blood Bank, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon; Department of Laboratory Medicine, Psychiatric Hospital of the Cross, Jaledib, Lebanon
| | - T Bou Assi
- Department of Laboratory Medicine and Blood Bank, Saint Joseph Hospital, Dora, Lebanon
| | - P Oriol
- Hemovigilance, University Hospital of Saint-Étienne, Saint-Priest en Jarez, France
| | - D Guyotat
- Hematology, Institut du Cancer Lucien-Neuwirth, Saint-Priest en Jarez, France
| | - C Bois
- Department of General Medicine, Faculty of Medicine of Saint-Étienne, University of Lyon, Saint-Priest en Jarez, France
| | - O Garraud
- EA3064, Faculty of Medicine of Saint-Étienne, University of Lyon, Saint-Priest en Jarez, France; Palliative Care Unit, the Ruffec Hospital, Ruffec, France; Institut National de la Transfusion Sanguine, Paris, France.
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Ibrahim Y, Sankar K, Mouzaihem H, Kim S, Haddad A, Mamdani H. P1.01-74 A Retrospective Study Evaluating Clinical Predictors of Duration of Response to Immune Checkpoint Inhibitors in Advanced NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.789] [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]
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Mitchard D, Clark D, Carr D, Stone C, Haddad A. Method for Recording Broadband High Resolution Emission Spectra of Laboratory Lightning Arcs. J Vis Exp 2019. [PMID: 31524865 DOI: 10.3791/56336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Lightning is one of the most common and destructive forces in nature and has long been studied using spectroscopic techniques, first with traditional camera film methods and then digital camera technology, from which several important characteristics have been derived. However, such work has always been limited due to the inherently random and non-repeatable nature of natural lightning events in the field. Recent developments in lightning test facilities now allow the reproducible generation of lightning arcs within controlled laboratory environments, providing a test bed for the development of new sensors and diagnostic techniques to understand lightning mechanisms better. One such technique is a spectroscopic system using digital camera technology capable of identifying the chemical elements with which the lightning arc interacts, with these data then being used to derive further characteristics. In this paper, the spectroscopic system is used to obtain the emission spectrum from a 100 kA peak, 100 µs duration lightning arc generated across a pair of hemispherical tungsten electrodes separated by a small air gap. To maintain a spectral resolution of less than 1 nm, several individual spectra were recorded across discrete wavelength ranges, averaged, stitched, and corrected to produce a final composite spectrum in the 450 nm (blue light) to 890 nm (near infrared light) range. Characteristic peaks within the data were then compared to an established publicly available database to identify the chemical element interactions. This method is readily applicable to a variety of other light emitting events, such as fast electrical discharges, partial discharges, and sparking in electrical equipment, apparatus, and systems.
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Affiliation(s)
- D Mitchard
- Morgan-Botti Lightning Laboratory, Advanced High Voltage Research Centre, School of Engineering, Cardiff University;
| | - D Clark
- Morgan-Botti Lightning Laboratory, Advanced High Voltage Research Centre, School of Engineering, Cardiff University
| | - D Carr
- Morgan-Botti Lightning Laboratory, Advanced High Voltage Research Centre, School of Engineering, Cardiff University
| | - C Stone
- Morgan-Botti Lightning Laboratory, Advanced High Voltage Research Centre, School of Engineering, Cardiff University
| | - A Haddad
- Morgan-Botti Lightning Laboratory, Advanced High Voltage Research Centre, School of Engineering, Cardiff University
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Torkzaban M, Haddad A, Baxter JK, Berghella V, Gahl WA, Al-Kouatly HB. Maternal ornithine transcarbamylase deficiency, a genetic condition associated with high maternal and neonatal mortality every clinician should know: A systematic review. Am J Med Genet A 2019; 179:2091-2100. [PMID: 31441224 DOI: 10.1002/ajmg.a.61329] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/25/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022]
Abstract
Ornithine transcarbamylase deficiency (OTCD) is a rare X-linked urea cycle disorder. Maternal OTCD can lead to life-threatening hyperammonemia if untreated. We aimed to compare the outcomes of maternal OTCD when diagnosis is known prior to pregnancy to when diagnosis is made during pregnancy. We performed a systematic literature review on maternal OTCD using the databases Ovid MEDLINE and PubMed from 1982 through 2018. Studies were included if addressed maternal OTCD signs, symptoms, and detailed pregnancy outcomes. We calculated the median or the mean for continuous variables and percentages for categorical variables. Of 36 cases of maternal OTCD, 20 (55%) were diagnosed prior to pregnancy while 16 (45%) were not. In the 20 patients diagnosed prior to pregnancy, 7 (35%) had either a neurologic or psychiatric presentation during pregnancy or postpartum. Two hyperammonemic patients (11%) experienced ICU admission, dialysis, and coma with no maternal deaths. All had a favorable outcome. In the 16 patients not known to have maternal OTCD prior to pregnancy, 13 (81%) had neurologic or psychiatric presentation during pregnancy or postpartum. Four presented with hyperemesis gravidarum. Eleven (69%) hyperammonemic patients had ICU admission and coma and 7 (47%) of them had dialysis. There were 5 (31%) maternal deaths. Three patients (19%) had prolonged hospitalization course. Overall, three male neonatal deaths were reported. Three other male children had liver transplant. Maternal OTCD is associated with high maternal and neonatal morbidity and mortality when diagnosis is made during pregnancy compared to when diagnosis is known prior to pregnancy.
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Affiliation(s)
- Mehnoosh Torkzaban
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Andrew Haddad
- Department of Obstetrics & Gynecology, Medstar Washington Hospital Center, Washington, District of Columbia.,Medical Genetics Branch, National Human Genome Research Institute, National Institute of Health, Bethesda, Maryland
| | - Jason K Baxter
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - William A Gahl
- Section on Human Biochemical Genetics, Medical Genetics Branch, National Human Genome Research Institute, National Institute of Health, Bethesda, Maryland
| | - Huda B Al-Kouatly
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
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Belkhir A, Jrad M, Sebei A, Soudani M, Haddad A, Boukriba S, Frikha W, Mizouni H. Pneumatosis cystoides intestinalis revealed after a hand-to-hand aggression: A case report. Int J Surg Case Rep 2019; 62:100-102. [PMID: 31493662 PMCID: PMC6731346 DOI: 10.1016/j.ijscr.2019.07.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 07/24/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Pneumatosis cystoides intestinalis (PCI) is a condition defined by the presence of multiple gas-filled cysts within the intestinal wall. We demonstrated a case of PCI presenting as pneumoperitoneum following a hand-to-hand aggression. Consent was obtained from the patient for publication of this paper. PRESENTATION OF THE CASE This article describes a case of an 28 year-old man with medical history of gastroduodenal ulcer admitted in the emergency room with an acute abdominal pain secondary to a hand-to-hand aggression. Computed tomography (CT-scan) revealed signs of PCI, the presence of pneumoperitoneum and a small amount of fluid in the Douglas pouch. The patient underwent an urgent laparotomy in front of a high suspicion of a bowel perforation. Per operative findings revealed multiple small cysts of the terminal ileum and there were no bowel perforation. DISCUSSION Pneumatosis cystoides intestinalis may be related to a wide spectrum of gastrointestinal conditions. The diagnosis of PCI can be established by endoscopic ultrasound or CT-scan imaging. Management of PCI is conditioned by the clinical and radiological presentation which is essentially related to the primary cause. Conservative approach is allowed in a stable patient with no signs of complications. In the presence of predictive factors of pathologic PCI, namely transmural ischemia and bowel perforation, surgical operation is required. CONCLUSION The management of PCI may be challenging particularly in the presence of pneumoperitoneum. Complications must be excluded before considering a conservative therapy. Therefore, PCI should be interpreted with relevance to the entire clinical context.
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Affiliation(s)
- A Belkhir
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
| | - M Jrad
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
| | - A Sebei
- Department of Surgery La Rabta University Hospital, Tunis, Tunisia.
| | - M Soudani
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
| | - A Haddad
- Department of Surgery La Rabta University Hospital, Tunis, Tunisia.
| | - S Boukriba
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
| | - W Frikha
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
| | - H Mizouni
- Department of Radiology La Rabta University Hospital, Tunis, Tunisia.
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de Leyva P, Eslava J, Pezzi M, Sánchez-Jáuregui E, Haddad A, Baranda E, Bueno A, Hernández-Alfaro F, Acero J. Clear aligners versus fixed orthodontic appliances in surgery first orthognathic surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.582] [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: 11/30/2022]
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Ghanem H, Haddad A, Baydoun S, Abou Hamdan H, Korfali S, Chalak L. In vitro proliferation of Lebanese Lemna minor and Lemna gibba on different nutrient media. Journal of Taibah University for Science 2019. [DOI: 10.1080/16583655.2019.1597450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- H. Ghanem
- Biology Department, Faculty of Sciences, Beirut Arab University, Debbieh, Lebanon
- Plant Production Department, Faculty of Agronomy, Lebanese University, Beirut, Lebanon
| | - A. Haddad
- Plant Production Department, Faculty of Agronomy, Lebanese University, Beirut, Lebanon
| | - S. Baydoun
- Research Center for Environment and Development, Beirut Arab University, Bekaa, Lebanon
| | - H. Abou Hamdan
- Biology Department, Faculty of Sciences I, Lebanese University, Beirut, Lebanon
| | - S. Korfali
- Natural Sciences Department, Lebanese American University, Beirut, Lebanon
| | - L. Chalak
- Plant Production Department, Faculty of Agronomy, Lebanese University, Beirut, Lebanon
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Aarab J, Abbess I, Abdalla F, Abdelaziz Z, Abdelfattah S, Abdelli I, Abdelmajid K, Abdelsselem Z, Abdelwahed N, Abdessayed N, Abid B, Abid K, Abidi R, Abudabbous A, Abujanah S, Aburwais A, Acacha E, Acharfi N, Affes N, Aftis R, Ahalli I, Aid M, Aissaoui D, Alaoui A, Alaoui M, Albatran S, Mamdouh A, Alkikkli R, Allam A, Aloulou S, Alqawi O, Alragig MA, Alsharksi A, Amaadour KOL, Amaadour L, Ameziane N, Ammari A, Ammour H, Amrane R, Annad N, Aouati E, Aouichat S, Aouragh S, Arifi S, Astra M, Atassi M, Ati N, Atoui K, Atreche L, Ayachi S, Ayadi I, Ayadi MA, Ayadi M, Ayari J, Ayed H, Ayed K, Ayedi H, Ayedi I, Azegrar M, Azzouz H, Babdalla F, Bachiri R, Bachiri Z, Baghdad M, Bahloul R, Bahouli A, Bahri M, Baississ I, Bakkali H, Balti M, Baraket O, Bargaoui H, Batti R, Bedioui A, Begag R, Behourah Z, Belaid I, Belaïd A, Ben Abdallah A, Ben Abdallah I, Ben Ahmed S, Ben Ahmed T, Ben Azaiz M, Ben Chehida MA, Ben Fatma L, Ben Ghachem D, Ben Ghachem T, Ben Hassouna J, Ben Hmida S, Ben Nasr S, Ben Nejima D, Ben Rahal K, Ben Rejeb M, Ben Rhouma S, Ben Safta I, Ben Salem A, Ben Zargouna Y, Benabdallah I, Benabdella H, Benabdessalem MZ, Benahmed K, Benahmed S, Benameur H, Benasr S, Benbrahim F, Benbrahim W, Benbrahim Z, Benchehida M, Bencheikh Y, Bendhiab T, Benfatma L, Bengueddach A, Benhami M, Benhassouna J, Benhbib W, Benjaafar N, Benkali R, Benkridis W, Benlaloui A, Benmaitig M, Benmansour A, Benmouhoub M, Benna F, Benna H, Benna M, Benna M, Bennabdellah H, Benrahal K, Bensafta I, Bensalah H, Bensalem A, Bensaud M, Benslama R, Benyoub M, Benzid K, Bergaoui H, Beroual M, Berrad S, Berrazaga Y, Bezzaz Z, Bhiri H, Bibi M, Binous MY, Blel A, Boder JM, Bouaouina N, Bouaziz H, Bouchoucha S, Boudawara T, Boudawara Z, Bouderbala A, Bouhali R, Bouhani M, Boujarnija R, Boujelben S, Boujelbene N, Boukerzaza I, Boukhari H, Boulfoul W, Boulma R, Boumansour N, Bouned A, Bounedjar A, Bouraoui I, Bouraoui S, Bourigua R, Bourmech M, Bousaffa H, Bousahba A, Bousrih C, Boussarsar A, Boussen H, Boutayeb S, Bouzaidi K, Bouzaiene F, Bouzaiene H, Bouzerzour Z, Bouzid K, Bouzid N, Bouzidi D, Bouzidi W, Bouzouita A, Brahimi S, Brahmia A, Buhmeida A, Chaaben K, Chaabouni H, Chaabouni M, Chaabène K, Chaari H, Chaari I, Chaari M, Chabchoub I, Chabeene K, Chaker K, Chakroun M, Charfi M, Charfi S, Chargui R, Charles M, Chebil M, Cheikchouk K, Chelly B, Chelly I, Cheraiet N, Cherif A, Cherif M, Cherifi A, Chikhrouhou T, Chikouche A, Chirouf A, Chraiet N, Collan Y, Cui Z, Dabbebi H, Daldoul A, Damouche I, Daoud H, Daoud N, Daoued J, Darif K, Darwish DO, Derbouz Z, Derouiche A, Dhibe TT, Dhibet T, Djallaoui A, Djami N, Djebbes K, Djedi H, Djeghim S, Djellali L, Djellaoui A, Djilat K, Djouabi R, Doumbia H, Drah M, Dridi M, Hsairi M, Elabbassi S, Elallia F, Elati Z, Elattassi M, Elbenna H, Elfagieh MA, Elfaitori O, Elfannas H, Elghali A, Elghali MA, Elgonti S, Elhadj OE, Elhazzaz R, Elkacemi H, Elkinany K, Elkissi Y, Elloumi F, Elmaalel O, Elmajjaou IS, Elmajjaoui S, Elmhabrech H, Elmrabet F, Elsaghayer WA, Elzagheid A, Emaetig F, Erraichi H, Essid M, Ewshah N, Ezzairi F, Faleh R, Fallah S, Farag AL, Farhat L, Fehri R, Feki J, Fendri S, Fendri S, Fessi Z, Filali T, Fissah A, Fourati M, Fourati N, Frikha M, Fuchs CS, Gabssi A, Gachi F, Gadria S, Gammoudi A, Ganzoui I, Gargoura A, Ghaddabb I, Gharbi I, Gharbi M, Ghazouani E, Gheriani N, Ghorbel A, Ghorbel L, Ghozi A, Ghrissi R, Gouader A, Goucha A, Guebsi A, Guellil I, Guermazi F, Guesmi S, Guetari W, Habak N, Haddad A, Haddad S, Haddaoui A, Hadef I, Hader AF, Hadiji A, Hadjarab F, Hadoussa M, Hadoussa N, Hafsa C, Hafsia M, Hajji A, Hajmansour M, Hamdi S, Hamici Z, Hamida S, Hamila F, Hamissa S, Hammouda B, Haouet S, Harhira I, Haroun A, Hassouni K, Hdiji A, Hechiche M, Hejjane L, Hellal C, Henni M, Herbegue K, Hichami L, Hikem M, Hmad A, Hmida L, Hmissa S, Hochlaf M, Houas A, Houhani M, Huwidi A, Ian C, Ibrahim BN, Ibrahim NY, Idir H, Issaoui D, Itaimi A, Izem AE, Jaidane O, Jamel D, Jamous H, Jarrar M, Jarrar MS, Jarray S, Jebsi M, Jmal H, Juwid A, Kaabia O, Kablouti A, Kacem I, Kacem K, Kaid MY, Kallel M, Kallel R, Kammoun H, Kari S, Karrit S, Kchir H, Kchir N, Kebdani T, Kechad N, Kehili H, Kerboua E, Keskes H, Kessi NN, Khababa N, Khaldi H, Khanfir A, Khater B, Khelif A, Khemiri S, Khennouf K, Khouni H, Khrouf S, Kmira Z, Kochbati L, Korbi A, Kouadri N, Kouhen F, Krarti M, Handoussa M, Hsu Y, Laakom O, Laato M, Labidi S, Lahlali F, Lahmidi A, Lalaoui A, Lamia N, Lamri A, Letaief F, Letaief MR, Aldehmani M, Rafael A, Liepa AM, Limaiem F, Limam K, Loughlimi H, Ltaief F, Maamouri N, Mabrouk M, Madouri R, Mahjoub N, Mahjoubi Z, Mahrsi M, Makrem H, Mallek W, Manitta M, Mansoura L, Mansouri H, Maoua M, Maoui W, Marouene C, Marzouk K, Masmoudi S, May F, Meddeb I, Meddeb K, Meddour S, Medhioub F, Mejri N, Melizi MR, Mellas N, Melliti R, Melzi A, Merair N, Merrouki FZ, Mersali C, Messalbi O, Messaoudi L, Messioud S, Messoudi K, Mestiri S, Mezlini A, Mezlini A, Mghirbi F, Mhabrech H, Mhiri A, Midoun N, Milud R, Missaoui B, Mnasser A, Mnejja W, Mokni M, Mokrani A, Mokrani M, Moujahed R, Moukasse Y, Mouzount A, Mrad K, Mraidha MH, Mrizak N, Mzali R, Mzid Y, M'ghirbi F, Nakhli A, Nasr C, Nasri S, Noubigh G, Nouha D, Nouia L, Nouira Y, Noureddine A, Nouri O, Ohtsu A, Ouahbi H, Oualla K, Ouanes Y, Ouaz H, Ouikene A, Ouldbessi N, Parker I, Pyrhonen S, Rachdi H, Rahal K, Rahal K, Rahoui M, Raies H, Rameh S, Reguieg K, Rejab H, Rejiba R, Rhim MS, Riahi S, Rouimel N, Saad Saoud N, Saadi K, Saadi M, Sadou A, Saguem I, Sahnoun T, Sahnoune H, Sakhri S, Sallemi A, Sassi A, Sbika W, Sedkaoui C, Sefiane S, Sellami A, Seppo P, Sfaoua H, Sghaier S, Shagan A, Siala W, Slim I, Slimene M, Soltani S, Souilah S, Souissi M, Sriha Badreddine B, Swaisi Y, Taibi A, Taktak T, Talbi G, Talha SW, Talima SM, Tbessi S, Tebani N, Tebra S, Tebramrad S, Telaijia D, Tenni A, Tolba A, Topov Y, Touil K, Toumi N, Toumi W, Tounsi N, Trigui A, Trigui R, Triki W, Walha M, Werda I, Yacoub H, Yahyaoui Y, Yaich A, Yaici R, Yamouni M, Yeddes I, Yekrou D, Yousfi M, Yousfi N, Youssfi MA, Zaabar L, Zaied S, Zaim I, Zakhama W, Zayed S, Zehani A, Zemni I, Zenzri Y, Zeraoula S, Zouiten O, Zoukar O, Zrafi W, Zribi A, Zubia N. Poster abstracts of the 18th Pan Arab Cancer Congress. TUNISIA. April 19-21, 2018. Tunis Med 2018; 96:177-182. [PMID: 30430520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
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Bhattacharya G, Ivars J, El-Sayed S, Eapen L, Haddad A, Gaudet M. Effect of Feeding Tube Strategy on Hospitalization Rates and Outcomes in Head and Neck Cancer Patients Treated with Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.828] [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: 10/28/2022]
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Song J, Yegendorf D, Eapen L, El-Sayed S, Gaudet M, Haddad A. Evaluation of Larynx Preservation on Patients with Locally Advanced Laryngeal Cancer in the Era of IMRT: Results from a Single Tertiary Cancer Center. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.789] [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: 10/28/2022]
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Abstract
Mucinous cystadenomas are the most frequent cystic benign tumors of the pancreas. They are characterized by a malignant potential. Acute pancreatitis is their most common complication. This manuscript reports a unique complication of mucinous cystadenomas of the pancreas: retroperitoneal rupture associated to acute pancreatitis. After resuscitation, the patient underwent surgery. A cystic mass of the pancreas tail with retroperitoneal rupture was found. Splenopancreatectomy was performed. Outcomes were straightforward. After 3 years of follow-up, no signs of recurrence are highlighted.
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Affiliation(s)
- A Haddad
- Surgery Department A, La Rabta Hospital, La Rabta Jebbari, 1007 Tunis, Tunisia.
| | - A Sebai
- Surgery Department A, La Rabta Hospital, La Rabta Jebbari, 1007 Tunis, Tunisia.
| | - R Rhaiem
- Surgery Department A, La Rabta Hospital, La Rabta Jebbari, 1007 Tunis, Tunisia.
| | - A Ghedira
- Surgery Department A, La Rabta Hospital, La Rabta Jebbari, 1007 Tunis, Tunisia.
| | - A Makni
- Surgery Department A, La Rabta Hospital, La Rabta Jebbari, 1007 Tunis, Tunisia.
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Lee AC, Haddad A, Fries MH, Al-Kouatly HB. Risk factors, clinical findings, and outcomes in pregnancies with coronary artery dissection: A case series. Eur J Prev Cardiol 2018; 26:544-548. [PMID: 30180768 DOI: 10.1177/2047487318796982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Amy C Lee
- 1 Department of Obstetrics and Gynecology, Medstar Washington Hospital Center, USA
| | - Andrew Haddad
- 1 Department of Obstetrics and Gynecology, Medstar Washington Hospital Center, USA.,2 National Human Genome Research Institute, National Institutes of Health, USA
| | - Melissa H Fries
- 1 Department of Obstetrics and Gynecology, Medstar Washington Hospital Center, USA
| | - Huda B Al-Kouatly
- 1 Department of Obstetrics and Gynecology, Medstar Washington Hospital Center, USA.,2 National Human Genome Research Institute, National Institutes of Health, USA.,3 Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, USA
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Lee K, Haddad A, Osme A, Kim C, Borzou A, Ilchenko S, Allende D, Dasarathy S, McCullough A, Sadygov RG, Kasumov T. Hepatic Mitochondrial Defects in a Nonalcoholic Fatty Liver Disease Mouse Model Are Associated with Increased Degradation of Oxidative Phosphorylation Subunits. Mol Cell Proteomics 2018; 17:2371-2386. [PMID: 30171159 DOI: 10.1074/mcp.ra118.000961] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 07/07/2018] [Revised: 08/21/2018] [Indexed: 12/11/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is associated with hepatic mitochondrial dysfunction characterized by reduced ATP synthesis. We applied the 2H2O-metabolic labeling approach to test the hypothesis that the reduced stability of oxidative phosphorylation proteins contributes to mitochondrial dysfunction in a diet-induced mouse model of NAFLD. A high fat diet containing cholesterol (a so-called Western diet (WD)) led to hepatic oxidative stress, steatosis, inflammation and mild fibrosis, all markers of NAFLD, in low density cholesterol (LDL) receptor deficient (LDLR-/-) mice. In addition, compared with controls (LDLR-/- mice on normal diet), livers from NAFLD mice had reduced citrate synthase activity and ATP content, suggesting mitochondrial impairment. Proteome dynamics study revealed that mitochondrial defects are associated with reduced average half-lives of mitochondrial proteins in NAFLD mice (5.41 ± 0.46 versus 5.15 ± 0.49 day, p < 0.05). In particular, the WD reduced stability of oxidative phosphorylation subunits, including cytochrome b-c1 complex subunit 1 (5.9 ± 0.1 versus 3.4 ± 0.8 day), ATP synthase subunit α (6.3 ± 0.4 versus 5.5 ± 0.4 day) and ATP synthase F(0) complex subunit B1 of complex V (8.5 ± 0.6 versus 6.5 ± 0.2 day) (p < 0.05). These changes were associated with impaired complex III and F0F1-ATP synthase activities. Markers of mitophagy were increased, but proteasomal degradation activity were reduced in NAFLD mice liver, suggesting that ATP deficiency because of reduced stability of oxidative phosphorylation complex subunits contributed to inhibition of ubiquitin-proteasome and activation of mitophagy. In conclusion, the 2H2O-metabolic labeling approach shows that increased degradation of hepatic oxidative phosphorylation subunits contributed to mitochondrial impairment in NAFLD mice.
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Affiliation(s)
- Kwangwon Lee
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Andrew Haddad
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Abdullah Osme
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Chunki Kim
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Ahmad Borzou
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas 77555
| | - Sergei Ilchenko
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Daniela Allende
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio 44195
| | | | - Arthur McCullough
- Department of Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio 44195
| | - Rovshan G Sadygov
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas 77555
| | - Takhar Kasumov
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, Ohio 44272; Department of Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
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