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Javed A, Qadir MO, Lee S, Mitra A, Tyagi A, Sharma A, Lett K, Ch'ng S. Rethinking the urgency priority system in round hole detachments, which should be done first? Macula on or macula off. Eye (Lond) 2024:10.1038/s41433-024-02930-8. [PMID: 38279039 DOI: 10.1038/s41433-024-02930-8] [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: 12/15/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024] Open
Affiliation(s)
- A Javed
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK.
| | - M O Qadir
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Lee
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Mitra
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Tyagi
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Sharma
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - K Lett
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Ch'ng
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
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Shousha T, Javed A, Bekhet A, Jahan AM, Alayat M, Alshehri M, Moustafa I. Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study. Heliyon 2023; 9:e22951. [PMID: 38144339 PMCID: PMC10746425 DOI: 10.1016/j.heliyon.2023.e22951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/02/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Few studies exist regarding the attitudes and behaviours of Egyptian physiotherapists in relation to the use of evidence in practice (EBP). The purpose of this study was to describe the beliefs, attitudes, knowledge, and behaviours of Egyptian physical therapists as they relate to evidence-based practice. It also explores their perception of possible barriers to implement EBP. Four hundred and seventy Egyptian therapists responded to our questionnaire with results revealing participants' awareness towards EBP was quite diverse. Only terms of systematic review and randomized controlled trial were well understood while remaining terms showed various level of comprehension which were rather low. Results also revealed significant correlations between attitudes towards EBP and overall awareness as well as attitudes and knowledge (r = 0.270 and 0.107) respectively. In addition, a significant relationship was also found between EBP awareness and knowledge with (r = 0.219). With regards to the barriers, insufficient teaching in previous education was identified as the primary barrier (34.4 %), followed by lack of funding and resources (31.1 %), while lack of time (10.2 %) was reported as the least. These barriers highlight the need to enhance implementation of EBP within Egyptian Physiotherapists. Findings of this study can be used as a foundation for the implementation of EBP in various clinical settings by understanding the limitations and barriers reported. Our study concluded that despite Egyptian physiotherapists declare their awareness of EBP, nevertheless, knowledge is restricted to a small number of terms. More focus is required to enhance the knowledge and practice of EBP. Focusing on adjustable factors, including increasing the awareness of value of research would help reduce time and resource demands for physiotherapists when implementing EBP.
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Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS – Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
| | - Asma Javed
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
| | - Amira Bekhet
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Alhadi M. Jahan
- School of Rehabilitation Sciences, University of Ottawa, Canada
- Physiotherapy Department, College of Medical Technology, Misrata, Libya
| | - Mohamed Alayat
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mansour Alshehri
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury& Health, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS – Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
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Smida K, Adnan, Sohail MU, Tlili I, Javed A. Numerical thermal study of ternary nanofluid influenced by thermal radiation towards convectively heated sinusoidal cylinder. Heliyon 2023; 9:e20057. [PMID: 37810123 PMCID: PMC10559828 DOI: 10.1016/j.heliyon.2023.e20057] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/05/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
Applications The heat transfer remains a huge problem for industrialists and engineers because many production processes required considerable amount of heat to finish the process successfully. Although, conventional fluids have large scale industrial applications but unable to provide huge amount of heat transfer. Therefore, the study is organized to propose a new ternary heat transfer model using different physical constraints. The key applications area of nanofluid heat transfer are chemical, applied thermal and food processing engineering. Purpose and Methodology: The key purpose of this research is introduce a new ternary nanofluid model using the impressive effects of thermal radiations, surface convection and saddle/nodal points. The results simulated via RKF-45 and discussed in detail. Core findings The strength of Al2O3 nanoparticles form 1%-7% (keeping fixed CuO and Cu as 4% and 6%) and s1 = -0.2,-0.4,-0.6,-0.8 controlled the fluid movement while s1 = 0.2,0.4,0.6,0.8 boosted the velocity. Increasing the convection process Bi = 0.1,0.2,0.3,0.4 increased the temperature significantly. Further, shear drag is maximum for ternary nanofluid and thermal radiations Rd = 0.1,0.2,0.3,0.4 enhances the heat transfer rate.
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Affiliation(s)
- Kamel Smida
- Department of General Science and English Language, College of Applied Sciences, AlMaarefa University, Diriyah, 13713, Riyadh, Saudi Arabia
| | - Adnan
- Departmment of Mathematics, Mohi-ud-Din Islamic University, Nerian Sharif, AJ&K, 12080, Pakistan
| | - Muhammad Umer Sohail
- Department of Aeronautics & Astronautics Engineering, Institute of Space Technology, Islamabad, 46000, Pakistan
| | - Iskander Tlili
- Department of Physics, College of Science Al-Zulfi, Majmaah University, Al-Majmaah, 11952, Saudi Arabia
| | - Asma Javed
- Department of Computer Science, University of Huddersfield, UK
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Arumugam A, Murat D, Javed A, Ali SA, Mahmoud I, Trabelsi K, Ammar A. Association of Sociodemographic Factors with Physical Activity and Sleep Quality in Arab and Non-Arab Individuals of Both Sexes during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2200. [PMID: 37570440 PMCID: PMC10418443 DOI: 10.3390/healthcare11152200] [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: 07/01/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
We explored the association of sociodemographic and anthropometric factors with self-reported physical activity (PA) and sleep quality in Arab and non-Arab individuals of both sexes during the COVID-19 pandemic. In this cross-sectional study, 638 participants (those recovered from COVID-19 = 149, and non-infected = 489) of both sexes aged 18-55 years were recruited. Their sociodemographic and anthropometric information, PA (self-reported using the International Physical Activity Questionnaire Short-form [IPAQ-SF)]) and sleep quality (self-reported using the Pittsburgh Sleep Quality Index [PSQI]) were documented. The association between participants' characteristics, PA levels, and sleep quality were determined using the chi-squared test. Variables significantly associated with IPAQ and PSQI in bivariate analyses were included in a multivariate binary logistic regression model. Men were more active than women (odds ratio [OR] = 1.66, p = 0.010), and non-Arab participants were more active than Arab ones (OR = 1.49, p = 0.037). Participants ≥40 years, men, non-Arab participants, and those who were working were more likely to have a good sleep quality than those ≤40 years (OR 1.70, p = 0.048), women (OR 1.10, p = 0.725), Arab individuals (OR 1.95, p = 0.002), and unemployed people (OR 2.76, p = 0.007). Male and non-Arab participants seemed to have a better self-reported PA and sleep quality compared to female and Arab participants, during the pandemic.
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Affiliation(s)
- Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (A.A.)
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS—Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE—Research Institute of Sciences and Engineering, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Danya Murat
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (A.A.)
| | - Asma Javed
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (A.A.)
| | - Sara Atef Ali
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (A.A.)
| | - Ibrahim Mahmoud
- Department of Family Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
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Khalid A, Rehman FU, Javed A. Evaluation of Serum Vitamin-D Levels in Patients with Alopecia Areata. PAFMJ 2023. [DOI: 10.51253/pafmj.v72i6.7227] [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: 02/05/2023] Open
Abstract
Objective: To evaluate serum vitamin-D levels in patients with Alopecia areata compared to healthy controls.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Dermatology Outpatient Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Nov 2019 to Apr 2020.
Methodology: The study included 70 patients with Alopecia areata (Group-1) and 70 healthy controls (Group-2). Complete blood count, TSH, urea and creatinine, fasting plasma glucose, liver function tests, serum Calcium and vitamin-D levels were performed.
Results: The mean vitamin-D levels of Group-1 were 38.28±22.07ng/mL, and the mean vitamin-D levels of Group-2 were 39.61±18.36ng/mL. In Group-1, deficient vitamin-D levels were seen in 14(20.0%) of Group-1, and insufficient in 19(27.1%) and 37(52.9%) had normal levels. In Group-2, 10(14.3%) had deficient levels, 16(25.0%) had insufficient levels and 44(62.9%) had normal levels. No statistically significant difference seen between Group-1 and Group-2.
Conclusion: There is no association between vitamin D level and Alopecia Areata.
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Khalid A, Rehman FU, Javed A. Evaluation of Serum Vitamin D Levels in Patients with Vitiligo. PAFMJ 2023. [DOI: 10.51253/pafmj.v72i6.7239] [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: 02/05/2023] Open
Abstract
Objective: To evaluate serum vitamin D levels in patients with vitiligo and compare them to the healthy controls.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Dermatology Outpatient Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Nov 2019 to Apr 2020.
Methodology: The study included 75 patients with vitiligo (Group-1) and 75 healthy controls (Group-2). Complete blood count, urea and creatinine, liver function tests, TSH, fasting plasma glucose, vitamin B12 levels, serum calcium and vitamin D levels were performed. In addition, vitamin D levels were compared in both groups.
Results: The mean age of Group-1 was 32.81±20.59 years, and Group- 2 was 40.13±16.09 years. In Group-1, deficient vitamin D levels were seen in 17(22.7%) of cases, insufficient in 25(33.3%) and 33(44.0%) had normal levels. In Group-2, 10(13.3%) had deficient levels, 10(13.3%) had insufficient levels and 55(77.3%) had normal levels. Patients with vitiligo had low serum 25(OH)D levels compared to controls, and this difference was statistically significant (p=0.001).
Conclusion: Low serum vitamin D levels are seen in patients with vitiligo compared to controls.
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Shaikh S, Anwar K, Javed A, Khatoon Z. Color Doppler and Ankle-brachial Index in the Diagnosis of Peripheral Artery Disease in Type II Diabetic Subject. JPRI 2022. [DOI: 10.9734/jpri/2022/v34i42b36315] [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: 11/09/2022]
Abstract
Objective: To determine the association of color doppler and ankle-brachial index (ABI) in the diagnosis of peripheral artery disease in type ii diabetic subject.
Methods: The study was carried out at ultrasound department of Advanced Radiology Clinic (ARC), Karachi, from January 2020 to December 2020. Patients of diagnosed diabetes mellitus for at least 4 years of either gender between 30-70 years of age were included. All patients were instructed to avoid heavy exercise, smoking and caffeinated beverages before the examination for at the minimum of two hours. All the cases underwent Standard Doppler examination of lower limb peripheral arteries performed by radiologist having experience of more than 10 years. Spectral waveform analysis was evaluated and presence of Biphasic flow or monophasic flow on color Doppler was labelled as peripheral artery disease. The ABI was computed for each patient by measuring the systolic blood pressure in supine position starting with the right arm then proceeding towards right leg, left leg, and finally for the left arm. ABI is a ratio obtained from dividing the higher of the ankle blood pressures for each leg by the highest of the right and left arm’s brachial systolic blood pressures. It was labelled as peripheral artery disease if the value was <0.9. This information along with the demographics was entered in the Performa by the researcher. Data was analyzed by using SPSS Version 26.
Result: Mean age of enrolled participants was 58.21±6.74 year. There were 78.6% were males and 21.4% were females; mean duration of diabetes was 11.24±5.62 years. Out of all 121 cases were diagnosed color doppler and 118 cases found positive on ABI. Although ankle-brachial index shows almost similar diagnosis like color doppler ultrasound in the assessment of peripheral arterial disease (P-0.649).
Conclusion: This study concludes that ankle-brachial index is a feasible, non-invasive technique almost similar to color Doppler ultrasound method for the detection of peripheral arterial disease. The ankle-brachial index technique is most important in periphery areas where color Doppler ultrasound is not available.
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Javed A, Das D. Suicide in patients under care of first‐episode psychosis service. Prog Neurol Psychiatry 2022. [DOI: 10.1002/pnp.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Asma Javed
- Dr Javed previously ST5 in General Adult Psychiatry, Leicestershire Partnership NHS Trust, now working as Consultant Psychiatrist in Liaison Services at Black Country Healthcare NHS Foundation Trust
| | - Debasis Das
- Dr Das is a Consultant Psychiatrist in Psychosis Intervention and Early Recovery Services at Leicestershire Partnership NHS Trust
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Misra S, Sakhuja P, Agarwal AK, Javed A. Fulminant amebic colitis: An unusual postoperative complication of intraabdominal malignancy. J Postgrad Med 2020; 66:99-101. [PMID: 32134005 PMCID: PMC7239400 DOI: 10.4103/jpgm.jpgm_605_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Amebiasis caused by protozoa Entamoeba histolytica (EH) is the third leading parasitic cause of human mortality. Although amebiasis is endemic in India, only about 10% of the infected individuals manifest disease. Clinical spectrum of amebiasis ranges from asymptomatic colonization to amebic colitis to hemorrhagic and fulminant colitis. Factors causing an invasive infection are not completely understood. Pathogen virulence, host immunity, and ability of the pathogen to evade host immune response play vital role in determining the disease course. Host factors such as immunocompromised states may make an individual susceptible to develop symptomatic infection. Malignancies usually result in chronic debilitation which may make the individual prone to develop invasive amebiasis with rapid progression. We report two cases of invasive amebiasis which developed a fulminant course in the immediate postoperative period after abdominal surgeries for visceral malignancies.
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Affiliation(s)
- S Misra
- Department of Pathology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - P Sakhuja
- Department of Pathology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - A K Agarwal
- Department of Gastrointestinal Surgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - A Javed
- Department of Gastrointestinal Surgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Ahmad J, Larijani H, Emmanuel R, Mannion M, Javed A. Occupancy detection in non-residential buildings – A survey and novel privacy preserved occupancy monitoring solution. ACI 2020. [DOI: 10.1016/j.aci.2018.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Buildings use approximately 40% of global energy and are responsible for almost a third of the worldwide greenhouse gas emissions. They also utilise about 60% of the world’s electricity. In the last decade, stringent building regulations have led to significant improvements in the quality of the thermal characteristics of many building envelopes. However, similar considerations have not been paid to the number and activities of occupants in a building, which play an increasingly important role in energy consumption, optimisation processes, and indoor air quality. More than 50% of the energy consumption could be saved in Demand Controlled Ventilation (DCV) if accurate information about the number of occupants is readily available (Mysen et al., 2005). But due to privacy concerns, designing a precise occupancy sensing/counting system is a highly challenging task. While several studies count the number of occupants in rooms/zones for the optimisation of energy consumption, insufficient information is available on the comparison, analysis and pros and cons of these occupancy estimation techniques. This paper provides a review of occupancy measurement techniques and also discusses research trends and challenges. Additionally, a novel privacy preserved occupancy monitoring solution is also proposed in this paper. Security analyses of the proposed scheme reveal that the new occupancy monitoring system is privacy preserved compared to other traditional schemes.
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McAllister-Williams RH, Arango C, Blier P, Demyttenaere K, Falkai P, Gorwood P, Hopwood M, Javed A, Kasper S, Malhi GS, Soares JC, Vieta E, Young AH, Papadopoulos A, Rush AJ. The identification, assessment and management of difficult-to-treat depression: An international consensus statement. J Affect Disord 2020; 267:264-282. [PMID: 32217227 DOI: 10.1016/j.jad.2020.02.023] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/07/2020] [Accepted: 02/06/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Many depressed patients are not able to achieve or sustain symptom remission despite serial treatment trials - often termed "treatment resistant depression". A broader, perhaps more empathic concept of "difficult-to-treat depression" (DTD) was considered. METHODS A consensus group discussed the definition, clinical recognition, assessment and management implications of the DTD heuristic. RESULTS The group proposed that DTD be defined as "depression that continues to cause significant burden despite usual treatment efforts". All depression management should include a thorough initial assessment. When DTD is recognized, a regular reassessment that employs a multi-dimensional framework to identify addressable barriers to successful treatment (including patient-, illness- and treatment-related factors) is advised, along with specific recommendations for addressing these factors. The emphasis of treatment, in the first instance, shifts from a goal of remission to optimal symptom control, daily psychosocial functional and quality of life, based on a patient-centred approach with shared decision-making to enhance the timely consideration of all treatment options (including pharmacotherapy, psychotherapy, neurostimulation, etc.) to optimize outcomes when sustained remission is elusive. LIMITATIONS The recommended definition and management of DTD is based largely on expert consensus. While DTD would seem to have clinical utility, its specificity and objectivity may be insufficient to define clinical populations for regulatory trial purposes, though DTD could define populations for service provision or phase 4 trials. CONCLUSIONS DTD provides a clinically useful conceptualization that implies a search for and remediation of specific patient-, illness- and treatment obstacles to optimizing outcomes of relevance to patients.
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Affiliation(s)
- R H McAllister-Williams
- Northern Centre for Mood Disorders, Newcastle University, UK; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - C Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - P Blier
- Royal Ottawa Institute of Mental Health Research, University of Ottawa, Canada
| | - K Demyttenaere
- University Psychiatric Center KU Leuven, Faculty of Medicine KU Leuven, Belgium
| | - P Falkai
- Clinic for Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - P Gorwood
- CMME, Hopital Sainte-Anne (GHU Paris et Neurosciences). Paris-Descartes University, INSERM U1266, Paris, France
| | - M Hopwood
- University of Melbourne, Melbourne, Australia
| | - A Javed
- Faculty of the University of Warwick, UK
| | - S Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - G S Malhi
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia; Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia
| | - J C Soares
- University of Texas Health Science Center, Houston, TX, USA
| | - E Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, UK
| | | | - A J Rush
- Duke University School of Medicine, Durham, NC, USA; Texas Tech University Health Sciences Center, Permian Basin, Midland, TX, USA; Duke-NUS Medical School, Singapore
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Donkervoort S, Sabouny R, Yun P, Gauquelin L, Chao KR, Hu Y, Al Khatib I, Töpf A, Mohassel P, Cummings BB, Kaur R, Saade D, Moore SA, Waddell LB, Farrar MA, Goodrich JK, Uapinyoying P, Chan SS, Javed A, Leach ME, Karachunski P, Dalton J, Medne L, Harper A, Thompson C, Thiffault I, Specht S, Lamont RE, Saunders C, Racher H, Bernier FP, Mowat D, Witting N, Vissing J, Hanson R, Coffman KA, Hainlen M, Parboosingh JS, Carnevale A, Yoon G, Schnur RE, Boycott KM, Mah JK, Straub V, Foley AR, Innes AM, Bönnemann CG, Shutt TE. MSTO1 mutations cause mtDNA depletion, manifesting as muscular dystrophy with cerebellar involvement. Acta Neuropathol 2019; 138:1013-1031. [PMID: 31463572 PMCID: PMC6851037 DOI: 10.1007/s00401-019-02059-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/25/2019] [Accepted: 08/08/2019] [Indexed: 01/12/2023]
Abstract
MSTO1 encodes a cytosolic mitochondrial fusion protein, misato homolog 1 or MSTO1. While the full genotype–phenotype spectrum remains to be explored, pathogenic variants in MSTO1 have recently been reported in a small number of patients presenting with a phenotype of cerebellar ataxia, congenital muscle involvement with histologic findings ranging from myopathic to dystrophic and pigmentary retinopathy. The proposed underlying pathogenic mechanism of MSTO1-related disease is suggestive of impaired mitochondrial fusion secondary to a loss of function of MSTO1. Disorders of mitochondrial fusion and fission have been shown to also lead to mitochondrial DNA (mtDNA) depletion, linking them to the mtDNA depletion syndromes, a clinically and genetically diverse class of mitochondrial diseases characterized by a reduction of cellular mtDNA content. However, the consequences of pathogenic variants in MSTO1 on mtDNA maintenance remain poorly understood. We present extensive phenotypic and genetic data from 12 independent families, including 15 new patients harbouring a broad array of bi-allelic MSTO1 pathogenic variants, and we provide functional characterization from seven MSTO1-related disease patient fibroblasts. Bi-allelic loss-of-function variants in MSTO1 manifest clinically with a remarkably consistent phenotype of childhood-onset muscular dystrophy, corticospinal tract dysfunction and early-onset non-progressive cerebellar atrophy. MSTO1 protein was not detectable in the cultured fibroblasts of all seven patients evaluated, suggesting that pathogenic variants result in a loss of protein expression and/or affect protein stability. Consistent with impaired mitochondrial fusion, mitochondrial networks in fibroblasts were found to be fragmented. Furthermore, all fibroblasts were found to have depletion of mtDNA ranging from 30 to 70% along with alterations to mtDNA nucleoids. Our data corroborate the role of MSTO1 as a mitochondrial fusion protein and highlight a previously unrecognized link to mtDNA regulation. As impaired mitochondrial fusion is a recognized cause of mtDNA depletion syndromes, this novel link to mtDNA depletion in patient fibroblasts suggests that MSTO1-deficiency should also be considered a mtDNA depletion syndrome. Thus, we provide mechanistic insight into the disease pathogenesis associated with MSTO1 mutations and further define the clinical spectrum and the natural history of MSTO1-related disease.
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Javed A, Jenkins SM, Labow B, Boughey JC, Lemaine V, Neal L, Shah SS, Pruthi S. Intermediate and long‐term outcomes of fibroadenoma excision in adolescent and young adult patients. Breast J 2019; 25:91-95. [DOI: 10.1111/tbj.13159] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Asma Javed
- Division of Pediatric and Adolescent Gynecology Mayo Clinic Rochester Minnesota
| | - Sarah M. Jenkins
- Division of Biomedical Statistics and Informatics Mayo Clinic Rochester Minnesota
| | - Brian Labow
- Department of Plastic and Oral Surgery Boston Children’s Hospital Boston Massachusetts
| | | | | | - Lonzetta Neal
- Division of General Internal Medicine Mayo Clinic Rochester Minnesota
| | - Sejal S. Shah
- Division of Anatomic Pathology Mayo Clinic Rochester Minnesota
| | - Sandhya Pruthi
- Division of General Internal Medicine Mayo Clinic Rochester Minnesota
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Javed A, Mahreen S, Faiq SM. Penile Hemangioma in a Prostate Cancer Patient; A case report. J Dow Univ Health Sci 2018. [DOI: 10.36570/jduhs.2018.3.589] [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: 11/20/2022] Open
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15
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Smith BM, Duncan FE, Ataman L, Smith K, Quinn GP, Chang RJ, Finlayson C, Orwig K, Valli-Pulaski H, Moravek MB, Zelinski MB, Irene Su H, Vitek W, Smith JF, Jeruss JS, Gracia C, Coutifaris C, Shah D, Nahata L, Gomez-Lobo V, Appiah LC, Brannigan RE, Gillis V, Gradishar W, Javed A, Rhoton-Vlasak AS, Kondapalli LA, Neuber E, Ginsberg JP, Muller CH, Hirshfeld-Cytron J, Kutteh WH, Lindheim SR, Cherven B, Meacham LR, Rao P, Torno L, Sender LS, Vadaparampil ST, Skiles JL, Schafer-Kalkhoff T, Frias OJ, Byrne J, Westphal LM, Schust DJ, Klosky JL, McCracken KA, Ting A, Khan Z, Granberg C, Lockart B, Scoccia B, Laronda MM, Mersereau JE, Marsh C, Pavone ME, Woodruff TK. The National Physicians Cooperative: transforming fertility management in the cancer setting and beyond. Future Oncol 2018; 14:3059-3072. [PMID: 30474429 PMCID: PMC6331694 DOI: 10.2217/fon-2018-0278] [Citation(s) in RCA: 24] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Once unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have made it possible for men, women and children to be connected with an oncofertility specialist or offered fertility preservation soon after a cancer diagnosis. The Oncofertility Consortium's National Physicians Cooperative is a large-scale effort to engage physicians across disciplines – oncology, urology, obstetrics and gynecology, reproductive endocrinology, and behavioral health – in clinical and research activities to enable significant progress in providing fertility preservation options to children and adults. Here, we review the structure and function of the National Physicians Cooperative and identify next steps.
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Affiliation(s)
- Brigid M Smith
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Francesca E Duncan
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Lauren Ataman
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Kristin Smith
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.,Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL 60611, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics & Gynecology, New York University School of Medicine, New York, NY 10016, USA
| | - R Jeffrey Chang
- Department of OB/GYN & Reproductive Sciences, Division of Reproductive Endocrinology & Infertility, University of California San Diego, La Jolla, CA 92093, USA
| | - Courtney Finlayson
- Division of Endocrinology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611 USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Kyle Orwig
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.,Magee-Womens Research Institute, Pittsburgh, PA 15213, USA
| | - Hanna Valli-Pulaski
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.,Magee-Womens Research Institute, Pittsburgh, PA 15213, USA
| | - Molly B Moravek
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mary B Zelinski
- Division of Reproductive & Developmental Science, Oregon National Primate Research Center, Beaverton, OR 97006, USA.,Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, OR 97239, USA
| | - H Irene Su
- Department of Reproductive Medicine & Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
| | - Wendy Vitek
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642, USA
| | - James F Smith
- Department of Urology, University of California San Francisco, San Francisco, CA 94110, USA
| | - Jacqueline S Jeruss
- Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Clarisa Gracia
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christos Coutifaris
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Divya Shah
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Leena Nahata
- Department of Pediatrics, Division of Endocrinology, The Ohio State University College of Medicine/Nationwide Children's Hospital, Columbus, OH 43210, USA.,Center for Behavioral Health, the Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Veronica Gomez-Lobo
- Division of Pediatric & Adolescent Gynecology, MedStar Washington Hospital Center, Children's National Health System, Washington, DC 20010, USA
| | - Leslie Coker Appiah
- The James Cancer Center, Nationwide Children's Hospital, The Ohio State University, Columbus, OH 43210, USA
| | - Robert E Brannigan
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Valerie Gillis
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - William Gradishar
- Department of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Asma Javed
- Department of Pediatric & Adolescent Medicine, Division of Pediatric & Adolescent Gynecology, Mayo Clinic, Rochester, MN 55905, USA
| | - Alice S Rhoton-Vlasak
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Florida, Gainesville, FL 32608, USA
| | | | - Evelyn Neuber
- Center for Advanced Reproductive Services, University of Connecticut, Farmington, CT 06032, USA
| | - Jill P Ginsberg
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Charles H Muller
- Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | | | - William H Kutteh
- Division of Reproductive Endocrinology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.,Department of Surgery, St Jude Children's Research Hospital, Memphis, TN 38105, USA.,Fertility Associates of Memphis, Memphis, TN 38120, USA
| | - Steven R Lindheim
- Department of Obstetrics & Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH 45435, USA
| | - Brooke Cherven
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Lillian R Meacham
- Aflac Cancer & Blood Disorders Center & Department of Pediatrics, Division of Hematology/Oncology & Division of Endocrinology, Emory University, Atlanta, GA 30322, USA
| | - Pooja Rao
- Division of Pediatric Hematology/Oncology, Penn State Health Children's Hospital, Hershey, PA 17033, USA
| | - Lilibeth Torno
- Division of Oncology, CHOC Children's Hospital, Orange, CA 92868, USA
| | - Leonard S Sender
- Division of Oncology, CHOC Children's Hospital, Orange, CA 92868, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.,Department of Health Outcomes and Behaviors, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Jodi L Skiles
- Department of Pediatrics, Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Riley Hospital for Children at IU Health, Indianapolis, IN 46202, USA
| | - Tara Schafer-Kalkhoff
- Division of Pediatric & Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Oliva J Frias
- Division of Pediatric & Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Julia Byrne
- Children's Research Center, Mayo Clinic, Rochester, MN 55905, USA
| | - Lynn M Westphal
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Danny J Schust
- Department of Obstetrics, Gynecology & Women's Health, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - James L Klosky
- Aflac Cancer & Blood Disorders Center & Department of Pediatrics, Division of Hematology/Oncology & Division of Endocrinology, Emory University, Atlanta, GA 30322, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Kate A McCracken
- Section of Pediatric & Adolescent Gynecology, Nationwide Children's Hospital, Columbus, OH 43205, USA.,Department of Obstetrics & Gynecology, The Ohio State University, Columbus, OH 43210, USA
| | - Alison Ting
- Division of Reproductive & Developmental Science, Oregon National Primate Research Center, Beaverton, OR 97006, USA.,21st Century Medicine, Inc., Fontana, CA 92336, USA
| | - Zaraq Khan
- Division of Reproductive Endocrinology & Infertility, Mayo Clinic, Rochester, MN 55905, USA.,Division of Minimally Invasive Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Barbara Lockart
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.,Division of General Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Bert Scoccia
- Department of Obstetrics & Gynecology, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Monica M Laronda
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.,Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Jennifer E Mersereau
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, University of North Carolina, Raleigh, NC 27599, USA
| | - Courtney Marsh
- Department of Obstetrics & Gynecology, University of Kansas Health System, Kansas City, KS 66160, USA
| | - Mary Ellen Pavone
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL 60611, USA
| | - Teresa K Woodruff
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Brutocao C, Zaiem F, Alsawas M, Morrow AS, Murad MH, Javed A. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine 2018; 62:318-325. [PMID: 30066285 DOI: 10.1007/s12020-018-1692-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 07/21/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is a common disorder affecting up to 15% of women in the reproductive age. Prior studies suggest that PCOS can be associated with mood and psychiatric disorders. The purpose of this study is to examine the prevalence of any psychiatric disorder in women with PCOS. METHODS We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through February 08, 2017 for studies that examined the prevalence of any psychiatric disorder in adolescents or adults with a clinical or biochemical diagnosis of PCOS. We used a random-effects model to generate pooled estimates and 95% confidence intervals (CI). RESULTS We included 57 studies reporting on 172,040 patients. The majority of studies addressed depression and anxiety. Studies had fair methodological quality although most estimates were unadjusted. Women with PCOS were more likely to have a clinical diagnosis of depression (odds ratio (OR), 2.79; 95% CI, 2.23-3.50), anxiety (OR, 2.75; 95% CI, 2.10-3.60), bipolar disorder (OR, 1.78; 95% CI, 1.43-2.23) and obsessive compulsive disorder (OCD) (OR, 1.37; 95% CI 1.22-1.55), but not social phobia or panic disorder. Using various scales, the severity of symptoms of depression, anxiety, obsessive compulsive disorder, and somatization disorders were higher compared to women without PCOS. CONCLUSIONS PCOS is associated with an increased risk of diagnosis of depression, anxiety, bipolar disorder, and obsessive compulsive disorder. It is associated with worse symptoms of depression, anxiety, OCD, and somatization. Screening for these disorders to allow early intervention may be warranted.
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Affiliation(s)
- Claire Brutocao
- Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Feras Zaiem
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mouaz Alsawas
- Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Allison S Morrow
- Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Asma Javed
- Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Kumar S, Hossain J, Javed A, Kullo I, Balagopal PB. Relationship of circulating spexin with markers of cardiovascular disease: a pilot study in adolescents with obesity. Pediatr Obes 2018; 13:374-380. [PMID: 29045048 PMCID: PMC5906205 DOI: 10.1111/ijpo.12249] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/18/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE Spexin, a novel peptide, has potential implications in obesity, satiety and energy homeostasis. The current study examined the relationship of spexin with various biomarkers of cardiovascular disease and endothelial function in adolescents with obesity. METHODS Nineteen adolescents with obesity (age, 15.8 ± 1.7 years) were studied. Spexin, leptin and various cardiovascular disease biomarkers were measured. Endothelial function was assessed by high-resolution Doppler ultrasonography of the right brachial artery. RESULTS Spexin concentration (median [interquartile range] 0.38 ng/mL [0.29-0.59 ng/mL]) was inversely correlated (r = -0.50, P = 0.03) with leptin. When participants were clustered into two groups ('high spexin and low leptin' vs. 'low spexin and high leptin'), the odds of having 'low spexin and high leptin' in participants with higher hs-CRP (≥ 3 mg/L) were 12.25 times (95 per cent CI -1 to139, P = 0.026) higher than those of participants with lower hs-CRP (<3 mg/L). Spexin levels, however, were not associated with measures of endothelial function. CONCLUSIONS The inverse association between spexin and leptin and the presence of higher concentrations of hs-CRP in adolescents with obesity in the setting of 'low spexin and high leptin' suggest a potential role for spexin in the regulation of satiety and certain cardiovascular risk factors in children with obesity.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jobayer Hossain
- Biostatistics Core, Nemours Biomedical Research, Wilmington, DE, USA
| | - Asma Javed
- Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Iftikhar Kullo
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - P. Babu Balagopal
- Nemours Children's Specialty Care, Division of Biomedical Research, Jacksonville, FL, USA and Mayo Clinic College of Medicine, Jacksonville, FL,USA
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Abstract
INTRODUCTION Steroid and local anaesthetic injection to the acromioclavicular joint (ACJ) is a very common diagnostic and therapeutic procedure, which is often performed in the outpatient department. However, it can be difficult to localize this joint because of its small size, presence of osteophytes and variable morphology in the population. We performed a study to determine whether the use of an image intensifier (X-ray guidance), in theatre, improves the accuracy of this injection. METHODS This was a prospective study carried out between March 2014 and March 2015. The injections were performed by two senior orthopaedic surgeons. First, we clinically palpated the ACJ and marked the area over this point as A. Then, with the use of a needle and an image intensifier in a single plane, we identified the actual location of the ACJ and marked this point as B. We measured the distance between A and B in millimetres (mm) and determined the accuracy of the injections. Further analysis taking into account the ACJ capsular attachments was also performed. RESULTS In total, 45 patients and 50 injections were included in the study; five patients had repeated injections at different times. We found that only 12 injections (24%) were palpated to be correct with no discrepancies between A and B (95% confidence interval: 14-37%). For the remaining 38 injections (76%), the use of an image intensifier had significantly improved the accuracy of ACJ location ( p < 0.05). Taking the capsular attachments of the ACJ into consideration reduced the number of inaccurate injections to 27 (54%). CONCLUSION We recommend the use of an image intensifier (or ultrasound guidance) to accurately determine the location of the ACJ for steroid and local anaesthetic injections. This prevents an injection into the wrong place, which can lead to wrong diagnosis and/or suboptimal treatment.
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Affiliation(s)
- S Javed
- Trauma and Orthopaedic Department, Royal Blackburn Hospital, Blackburn, UK
| | - Z Sadozai
- Trauma and Orthopaedic Department, Royal Blackburn Hospital, Blackburn, UK
| | - A Javed
- Trauma and Orthopaedic Department, Royal Blackburn Hospital, Blackburn, UK
| | - A Din
- Trauma and Orthopaedic Department, Royal Blackburn Hospital, Blackburn, UK
| | - G Schmitgen
- Trauma and Orthopaedic Department, Royal Blackburn Hospital, Blackburn, UK
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Abstract
Fertility preservation therapies can conserve future reproductive potential for persons facing serious medical diagnoses. With cure rates for childhood cancer reaching almost 80%, quality-of-life concerns for long-term survivors, including future parenting, are becoming more pertinent. Late effects of childhood cancer can be divided into physical, social, psychological, and spiritual domains. Potential loss of fertility threatens the well-being of these children in all these domains. Providers often hesitate to discuss fertility preservation with the patients. However, parental attitudes toward discussion of fertility preservation have been found to be open to such conversations for both prepubertal and postpubertal children who have a cancer diagnosis. Multiple national and international organizations recommend discussion with all persons having gonadotoxic therapy, including children, regarding the effect of planned treatment on future fertility and their options for fertility preservation. Renal or rheumatologic disease treated with high-dose cyclophosphamide and chromosomal anomalies such as Turner or Klinefelter syndrome may be amenable to fertility preservation. This essay reviews fertility preservation options available to children, as well as the expanding list of indications for fertility preservation.
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Affiliation(s)
- Asma Javed
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Zaraq Khan
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Siobhan T Pittock
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jani R Jensen
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
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Arora C, Byrnes J, Javed A, Singh R, Klingele C, Gebhart J. 77: Long-term psychological and physical impacts of McIndoe reconstruction in Mayer-Rokitansky-Küster-Hauser syndrome. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.096] [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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Abstract
In this study, we demonstrated an association between adrenal hyperandrogenism, as determined by dehydroepiandrostenedione-to-free testosterone (DHEA-S/FT) ratio, and metabolic phenotype in obese and lean adolescents with polycystic ovary syndrome (PCOS). We compared 64 overweight/obese adolescents with PCOS (PCOS-O) with 18 lean (PCOS-L) adolescents. We analyzed the association between DHEA-S/FT ratios and metabolic parameters. Patients in the PCOS-O group were younger (median [interquartile range]) than those in the PCOS-L group (15 [15-17] vs. 16 [16-17] years; p = .04). The median DHEA-S/FT ratio and total testosterone concentrations did not differ. However, androstenedione concentrations were higher in the PCOS-L group (p = .02) and free testosterone levels lower in the PCOS-L group compared with the PCOS-O group (p = .02). Insulin resistance was present in 30 of 64 (46.9%) adolescents with PCOS-O compared with 1 of 18 (5.6%) with PCOS-L (p = .001). A significant negative correlation between DHEA-S/FT ratios and insulin concentrations in PCOS-O (p = .03) and PCOS-L (p = .04) groups was noted. In the PCOS-O group, the DHEA-S/FT ratio was negatively associated with serum triglyceride (p = .03) and total cholesterol concentrations (p = .02). We conclude that in adolescents with PCOS, a higher ratio of adrenal to ovarian androgens, signified by DHEA-S/FT, may be associated with a more favorable metabolic phenotype.
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Affiliation(s)
| | - Lyndsay D Viers
- b Department of Radiology , Mayo Clinic , Rochester , MN , USA
| | - Asma Javed
- c Division of Pediatric and Adolescent Gynecology , Mayo Clinic , Rochester , MN , USA
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Al-Hilli Z, Javed A, Boughey JC, Lemaine V, Visscher DW, Pruthi S. Breast cysts rapidly enlarging with replacement of breast parenchyma and asymmetry. Breast J 2017; 24:83-85. [PMID: 28590556 DOI: 10.1111/tbj.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Zahraa Al-Hilli
- Department of General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Asma Javed
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - Judy C Boughey
- Department of General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Valerie Lemaine
- Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Sandhya Pruthi
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Javed A, Kumar S, Simmons PS, Lteif AN. Phenotypic Characterization of Polycystic Ovary Syndrome in Adolescents Based on Menstrual Irregularity. Horm Res Paediatr 2016; 84:223-30. [PMID: 26184981 DOI: 10.1159/000435883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/10/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) in adolescents is associated with adverse metabolic outcomes. The association of menstrual irregularity with metabolic risk among adolescents with PCOS was assessed. METHOD A retrospective medical record review of 366 adolescents with PCOS aged 13-18 years was conducted, from which 265 girls newly diagnosed with PCOS were included and divided into those presenting with primary amenorrhea (PA), secondary amenorrhea (SA) and oligomenorrhea (OM). Androgen concentrations and markers of metabolic risk were compared among the groups. RESULTS Most subjects presented with OM (PA = 17, SA = 30 and OM = 218). Subjects with PA were younger than those with OM but not different from those with SA. Mean BMI was not different between groups. Total testosterone and insulin levels were higher in PA than SA and OM (p < 0.01 and 0.02, respectively). Fasting glucose was higher in PA than OM (p = 0.048) but not different from SA. Triglyceride levels were higher in PA than SA and OM (p < 0.001 each). More subjects with PA and SA had metabolic syndrome (52%) than those with OM (29.1%) (p = 0.027). The differences in triglycerides and glucose persisted despite BMI adjustment in multivariate regression models. CONCLUSION Adolescents with PCOS presenting with PA are at risk of metabolic disease beyond expected based on BMI.
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Affiliation(s)
- Asma Javed
- Division of Pediatric and Adolescent Gynecology, Mayo Clinic, Rochester, Minn., USA
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Javed A, Kullo IJ, Balagopal PB, Kumar S. Effect of vitamin D3 treatment on endothelial function in obese adolescents. Pediatr Obes 2016; 11:279-84. [PMID: 26273791 PMCID: PMC4753130 DOI: 10.1111/ijpo.12059] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/11/2015] [Accepted: 07/06/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity in children is associated with vitamin D deficiency and endothelial dysfunction. It is not known if treatment with vitamin D improves endothelial function in obese adolescents. OBJECTIVE This study aimed to determine whether treatment with vitamin D3 improves endothelial function in obese adolescents. METHODS Nineteen obese adolescents, 13-18 years of age, with 25-hydroxy vitamin D (25[OH]D) levels <75 nmol L(-1) were treated with 100 000 IU vitamin D3 orally once a month for 3 months in an open-label, single-centre prospective trial. Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery at study entry and 1 month after the third dose of vitamin D3 . Biochemical parameters, including calcium, fasting lipids, glucose, insulin and high-sensitivity C-reactive protein, were also obtained. RESULTS Mean 25(OH)D levels increased from 55.9 ± 12.2 to 86.9 ± 16.7 nmol L(-1) (P < 0.01). There was no correlation between 25(OH)D levels and brachial artery FMD. The brachial artery FMD (%) did not change significantly following vitamin D3 treatment (9.5 ± 3.53 vs. 10.3 ± 3.83, P = 0.83). Serum parathyroid hormone declined from 3.8 ± 1.5 to 3.1 ± 1 pmol L(-1) (P = 0.01). The remainder of biochemical measurements did not show a significant change. CONCLUSIONS Treatment with vitamin D3 , 100 000 IU once a month for 3 months was effective in increasing 25(OH)D levels in obese adolescents but did not impact endothelial function.
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Affiliation(s)
- A Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - I. J. Kullo
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - P. Babu Balagopal
- Nemours Children’s Clinic, Division of Biomedical Research, Jacksonville, FL, USA
| | - S Kumar
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Al Nofal A, Gionfriddo MR, Javed A, Haydour Q, Brito JP, Prokop LJ, Pittock ST, Murad MH. Accuracy of thyroid nodule sonography for the detection of thyroid cancer in children: systematic review and meta-analysis. Clin Endocrinol (Oxf) 2016; 84:423-30. [PMID: 25845503 DOI: 10.1111/cen.12786] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 02/24/2015] [Accepted: 03/27/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Thyroid ultrasound (US) is a widely used tool for evaluating thyroid nodules. Various US features have been suggested as predictors of thyroid cancer in children. OBJECTIVE To conduct a systematic review and meta-analysis to assess the diagnostic accuracy of different thyroid US features in detecting thyroid cancer in children. METHODS We searched multiple online databases for cohort studies that enrolled paediatric patients with thyroid nodules (age <21 years) and evaluated the accuracy of 12 relevant ultrasound features. Diagnostic measures were pooled across studies using a random effects model. RESULTS The search strategy yielded 1199 citations, of which 12 studies met the predefined inclusion criteria (750 nodules). The prevalence of thyroid cancer was 27·2% (40·8% in patients with a history of radiation exposure and 23·2% in patients without a history of exposure to radiation). The most common cancer was papillary thyroid cancer (86·7%). The presence of internal calcifications and enlarged cervical lymph nodes were the US features with the highest likelihood ratio [4·46 (95% CI: 1·87-10·64) and 4·96 (95% CI: 2·01-12·24), respectively] for thyroid cancer. A cystic nodule was the feature with highest likelihood ratio for benign nodules [1·96 (95% CI: 0·87-4·43)]. CONCLUSION Thyroid US features are not highly accurate predictors of benign or malignant aetiology of thyroid nodules in children. Internal calcification may predict malignancy, and cystic appearance may suggest benign aetiology.
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Affiliation(s)
- Alaa Al Nofal
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN, USA
| | - Michael R Gionfriddo
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Mayo Graduate School, Rochester, MN, USA
| | - Asma Javed
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Qusay Haydour
- Internal Medicine Program, Georgia Regents University, Augusta, GA, USA
| | - Juan P Brito
- Division of Diabetes, Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Larry J Prokop
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Siobhan T Pittock
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Mohammad Hassan Murad
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN, USA
- Division of Preventive Medicine, Mayo Clinic, Rochester, MN, USA
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Ospina NS, Al Nofal A, Bancos I, Javed A, Benkhadra K, Kapoor E, Lteif AN, Natt N, Murad MH. ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2016; 101:427-34. [PMID: 26649617 DOI: 10.1210/jc.2015-1700] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
CONTEXT The diagnosis of adrenal insufficiency is clinically challenging and often requires ACTH stimulation tests. OBJECTIVE To determine the diagnostic accuracy of the high- (250 mcg) and low- (1 mcg) dose ACTH stimulation tests in the diagnosis of adrenal insufficiency. METHODS We searched six databases through February 2014. Pairs of independent reviewers selected studies and appraised the risk of bias. Diagnostic association measures were pooled across studies using a bivariate model. DATA SYNTHESIS For secondary adrenal insufficiency, we included 30 studies enrolling 1209 adults and 228 children. High- and low-dose ACTH stimulation tests had similar diagnostic accuracy in adults and children using different peak serum cortisol cutoffs. In general, both tests had low sensitivity and high specificity resulting in reasonable likelihood ratios for a positive test (adults: high dose, 9.1; low dose, 5.9; children: high dose, 43.5; low dose, 7.7), but a fairly suboptimal likelihood ratio for a negative test (adults: high dose, 0.39; low dose, 0.19; children: high dose, 0.65; low dose, 0.34). For primary adrenal insufficiency, we included five studies enrolling 100 patients. Data were only available to estimate the sensitivity of high dose ACTH stimulation test (92%; 95% confidence interval, 81-97%). CONCLUSION Both high- and low-dose ACTH stimulation tests had similar diagnostic accuracy. Both tests are adequate to rule in, but not rule out, secondary adrenal insufficiency. Our confidence in these estimates is low to moderate because of the likely risk of bias, heterogeneity, and imprecision.
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Affiliation(s)
- Naykky Singh Ospina
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Alaa Al Nofal
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Irina Bancos
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Asma Javed
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Khalid Benkhadra
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Ekta Kapoor
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Aida N Lteif
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - Neena Natt
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
| | - M Hassan Murad
- Evidence-Based Practice Research Program (N.S.O., A.A.N., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Knowledge and Evaluation Research Unit (N.S.O., K.B., M.H.M.), Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition (N.S.O., N.N., I.B.), Mayo Clinic, Rochester, Minnesota; Division of Pediatric Endocrinology and Metabolism (A.A.N., A.J., A.N.L.), Mayo Clinic, Rochester, Minnesota; Division of General Internal Medicine (E.K.), Mayo Clinic, Rochester, Minnesota 55905
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Javed A, Lteif AN, Kumar S, Simmons PS, Chang AY. Fasting Glucose Changes in Adolescents with Polycystic Ovary Syndrome Compared with Obese Controls: A Retrospective Cohort Study. J Pediatr Adolesc Gynecol 2015; 28:451-6. [PMID: 26238569 PMCID: PMC4526446 DOI: 10.1016/j.jpag.2015.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 12/30/2014] [Accepted: 01/02/2015] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE To compare changes in fasting glucose among adolescents with polycystic ovary syndrome (PCOS) with those in obese adolescents without PCOS. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of 310 adolescents with PCOS and 250 obese adolescents (age range 13 to 18 years) seen at Mayo Clinic, Rochester, MN, from 1996 to 2012. METHODS Included for analysis were 98 adolescents with PCOS and 150 obese adolescents who had 2 or more fasting glucose measurements separated by at least 6 months. Adolescents with impaired fasting glucose (IFG) or diabetes were excluded. Multivariate models were used to assess predictors of change in fasting glucose. RESULTS At diagnosis, adolescents with PCOS had lower body mass index (BMI) (kg/m(2)) and older age than obese adolescents (P < .001). Adolescents with PCOS had shorter follow-up (P = .02). Baseline fasting glucose was not different between groups. Mean change in fasting glucose was 2.4 ± 9.4 mg/dL per year for PCOS and 2.2 ± 6.2 mg/dL per year for obese adolescents (P = .83). Significant predictors for change in fasting glucose were BMI and fasting glucose at diagnosis (P < .01). Within the PCOS cohort, BMI was a significant predictor for development of IFG (P = .003). Prevalence of hypertension increased in the PCOS cohort from baseline to follow-up (P = .02). PCOS and BMI were significantly associated with development of HTN in the entire cohort. CONCLUSION Adolescent girls with PCOS do not show a significant change in fasting glucose or an increased risk for the development of IFG compared with obese adolescents. BMI, not PCOS status, was the strongest predictor for changes in fasting glucose and development of IFG over time.
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Affiliation(s)
- Asma Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Aida N Lteif
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
| | - Seema Kumar
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Patricia S Simmons
- Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alice Y Chang
- Division of Endocrinology, Department of Internal Medicine, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota
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Dwyer JP, Javed A, Hair CS, Moore GT. Venous thromboembolism and underutilisation of anticoagulant thromboprophylaxis in hospitalised patients with inflammatory bowel disease. Intern Med J 2015; 44:779-84. [PMID: 24893756 DOI: 10.1111/imj.12488] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 11/10/2013] [Accepted: 05/25/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a well-recognised extra-intestinal manifestation of inflammatory bowel disease (IBD). Despite the widespread support for anticoagulant prophylaxis in hospitalised IBD patients, the utilisation and efficacy in clinical practice are unknown. AIMS The aim of this study was to assess the prevalence and clinical features of VTE among hospitalised IBD patients and ascertain whether appropriate thromboprophylaxis had been administered. METHODS All patients with a discharge diagnosis of Crohn disease or ulcerative colitis and VTE were retrospectively identified using International Classification of Diseases, tenth revision codes from medical records at our institution from July 1998 to December 2009. Medical records were then reviewed for clinical history and utilisation of thromboprophylaxis. Statistical analysis was performed by Mann-Whitney test and either χ(2) tests or Fisher's exact tests. RESULTS Twenty-nine of 3758 (0.8%) IBD admissions suffered VTE, 13 preadmission and 16 during admission. Of these 29 admissions (in 25 patients), 24% required intensive care unit and 10% died. Of the 16 venous thrombotic events that occurred during an admission, eight (50%) did not receive anticoagulant thromboprophylaxis and eight (50%) occurred despite thromboprophylaxis. Most thromboembolism despite prophylaxis occurred post-intestinal resection (n = 5, 63%). CONCLUSION Thromboprophylaxis is underutilised in half of IBD patients suffering VTE. Prescription of thromboprophylaxis for all hospitalised IBD patients, including dual pharmacological and mechanical prophylaxis in postoperative patients, may lead to a reduction in this preventable complication of IBD.
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Affiliation(s)
- J P Dwyer
- Gastroenterology and Hepatology Unit, Monash Medical Centre, Melbourne, Victoria, Australia
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Mariam J, Titirez V, Javed A, Kasem A. P29. An audit of a single practice of immediate and delayed breast reconstruction in a district general hospital. Eur J Surg Oncol 2015. [DOI: 10.1016/j.ejso.2015.08.134] [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: 11/25/2022] Open
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Wang X, Liu X, Javed A, Zhu C, Liang G. Phase transition behavior of yttria-stabilized zirconia from tetragonal to monoclinic in the lanthanum zirconate/yttria-stabilized zirconia coupled-system using molecular dynamics simulation. J Mol Liq 2015. [DOI: 10.1016/j.molliq.2015.03.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Javed A, Jumean M, Murad MH, Okorodudu D, Kumar S, Somers VK, Sochor O, Lopez-Jimenez F. Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatr Obes 2015; 10:234-44. [PMID: 24961794 DOI: 10.1111/ijpo.242] [Citation(s) in RCA: 278] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/07/2013] [Accepted: 11/19/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND The ideal means of identifying obesity in children and adolescents has not been determined although body mass index (BMI) is the most widely used screening tool. OBJECTIVE We performed a systematic review and meta-analysis of studies assessing the diagnostic performance of BMI to detect adiposity in children up to 18 years. METHODS Data sources were EMBASE, MEDLINE, Cochrane, Database of Systematic Reviews Cochrane CENTRAL, Web of Science and SCOPUS up to March 2013. Studies providing measures of diagnostic performance of BMI and using body composition technique for body fat percentage measurement were included. RESULTS Thirty-seven eligible studies that evaluated 53 521 patients, with mean age ranging from 4 to 18 years were included in the meta-analysis. Commonly used BMI cut-offs for obesity showed pooled sensitivity to detect high adiposity of 0.73 (confidence interval [CI] 0.67-0.79), specificity of 0.93 (CI 0.88-0.96) and diagnostic odds ratio of 36.93 (CI 20.75-65.71). Males had lower sensitivity. Moderate heterogeneity was observed (I(2) = 48%) explained in meta-regression by differences across studies in race, BMI cut-off, BMI reference criteria (Center for Disease Control vs. International Obesity Task Force) and reference standard method assessing adiposity. CONCLUSION BMI has high specificity but low sensitivity to detect excess adiposity and fails to identify over a quarter of children with excess body fat percentage.
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Affiliation(s)
- A Javed
- Department of Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
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Javed A, Balagopal PB, Vella A, Fischer PR, Piccinini F, Dalla Man C, Cobelli C, Giesler PD, Laugen JM, Kumar S. Association between thyrotropin levels and insulin sensitivity in euthyroid obese adolescents. Thyroid 2015; 25:478-84. [PMID: 25777801 PMCID: PMC4426325 DOI: 10.1089/thy.2015.0005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Thyrotropin (TSH) levels display a positive association with body mass index (BMI), and the prevalence of isolated hyperthyrotropinemia is higher in obese adolescents compared to their normal weight controls. However, the metabolic significance of the higher TSH in obese adolescents is less clear. The objective of this study was to determine the relationship between TSH concentrations and insulin sensitivity, lipids, and adipokines in euthyroid, non-diabetic, obese adolescents. METHODS Thirty-six euthyroid, non-diabetic, obese adolescents between the ages of 12 and 18 years underwent a 75 g oral glucose tolerance test. Insulin sensitivity (Si) and pancreatic β-cell function as assessed by disposition index (DI) were measured using the oral glucose minimal model approach. Cholesterol (total, low-density lipoprotein [LDL-C], and high-density lipoprotein [HDL-C]), triglycerides (TG), interleukin-6 (IL-6), total and high molecular weight (HMW) adiponectin, and retinol binding protein-4 (RBP4) were also determined. Associations between measures of thyroid function and Si, DI, lipids, and adipokines were computed using Pearson's correlation coefficient and multiple regression analysis. RESULTS The mean age of the subjects was 14.3±1.88 years, and the mean BMI was 32.5±4.65 kg/m2; 97% were non-Hispanic white and 47% were male. The mean TSH was 2.7±1.2 mIU/L. Increasing serum TSH was correlated with decreasing Si (log Si) in the entire cohort (p=0.03), but this relationship persisted only in males (p=0.02). The correlation between TSH and Si in males remained significant after adjusting for BMI (p=0.02). There was no correlation between TSH and pancreatic β-cell function as assessed by DI (p=0.48). TSH correlated positively with LDL-C (p=0.04) and IL-6 (p=0.03), but these associations vanished or weakened after adjusting for BMI (LDL-C p-value=0.44; IL-6 p-value=0.07). CONCLUSIONS This study suggests a sex-specific association between TSH and insulin sensitivity in euthyroid, non-diabetic, obese adolescent males. Prospective studies are warranted to explore further this sexual dimorphism in the relationship between thyroid function and insulin sensitivity and to determine if obese adolescents with insulin resistance receiving thyroid supplements for hypothyroidism would benefit from targeting TSH levels in the lower half of normal range.
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Affiliation(s)
- Asma Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Adrian Vella
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Philip R. Fischer
- Division of General Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Chiara Dalla Man
- Department of Information Engineering, University of Padua, Padua, Italy
| | - Claudio Cobelli
- Department of Information Engineering, University of Padua, Padua, Italy
| | - Paula D. Giesler
- Endocrine Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jeanette M. Laugen
- Endocrine Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Seema Kumar
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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Javed A, Vella A, Balagopal PB, Fischer PR, Weaver AL, Piccinini F, Dalla Man C, Cobelli C, Giesler PD, Laugen JM, Kumar S. Cholecalciferol supplementation does not influence β-cell function and insulin action in obese adolescents: a prospective double-blind randomized trial. J Nutr 2015; 145:284-90. [PMID: 25644349 PMCID: PMC6619681 DOI: 10.3945/jn.114.202010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 12/15/2022] Open
Abstract
BACKGROUND There is increasing interest in the extraskeletal effects of vitamin D, particularly in the obese state with regard to the development of insulin resistance and diabetes. OBJECTIVE The objective of the study was to determine the effect of 2 doses of cholecalciferol (vitamin D3) supplementation on insulin action (Si) and pancreatic β-cell function in obese adolescents. METHODS We performed a 12-wk double-blind, randomized comparison of the effect of vitamin D3 supplementation on Si and β-cell function in obese Caucasian adolescents (body mass index > 95(th) percentile). The subjects were randomly assigned to receive either 400 IU/d (n = 25) or 2000 IU/d (n = 26) of vitamin D3. Each subject underwent a 7-sample 75 g oral glucose tolerance test, with glucose, insulin, and C-peptide measurements, to calculate Si and β-cell function as assessed by the disposition index (DI), with use of the oral minimal model before and after supplementation. A total of 51 subjects aged 15.0 ± 1.9 y were enrolled. Included for analysis at follow-up were a total of 46 subjects (20 male and 26 female adolescents), 23 in each group. RESULTS Initial serum 25-hydroxyvitamin D [25(OH)D] was 24.0 ± 8.1 μg/L. There was no correlation between 25(OH)D concentrations and Si or DI. There was a modest but significant increase in 25(OH)D concentration in the 2000 IU/d group (3.1 ± 6.5 μg/L, P = 0.04) but not in the 400 IU/d group (P = 0.39). There was no change in Si or DI following vitamin D3 supplementation in either of the treatment groups (all P > 0.10). CONCLUSIONS The current study shows no effect from vitamin D3 supplementation, irrespective of its dose, on β-cell function or insulin action in obese nondiabetic adolescents with relatively good vitamin D status. Whether obese adolescents with vitamin D deficiency and impaired glucose metabolism would respond differently to vitamin D3 supplementation remains unclear and warrants further studies. This trial was registered at clinicaltrials.gov as NCT00858247.
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Affiliation(s)
- Asma Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent
Medicine, Mayo Clinic, Rochester, MN
| | - Adrian Vella
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN
| | | | - Philip R Fischer
- Division of General Pediatric and Adolescent Medicine, Department of
Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Amy L Weaver
- Division of Biomedical Statistics and Informatics, Department of Health
Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Chiara Dalla Man
- Department of Electronics and Informatics, University of Padua, Padua,
Italy
| | - Claudio Cobelli
- Department of Electronics and Informatics, University of Padua, Padua,
Italy
| | - Paula D Giesler
- Endocrine Research Unit, Division of Endocrinology, Diabetes, Metabolism,
and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Jeanette M Laugen
- Endocrine Research Unit, Division of Endocrinology, Diabetes, Metabolism,
and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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Abstract
Objective To compare the reproductive, metabolic, and skeletal profiles of young athletic women with functional hypothalamic amenorrhea (FHA) as well as clinical or biochemical hyperandrogenism (FHA-EX+HA) with body mass index matched women with FHA due to exercise (FHA-EX) or anorexia nervosa (FHA-AN) alone. Design Retrospective cohort study. Setting Tertiary care teaching hospital. Population Adolescents and young women, 15–30 years of age, diagnosed with FHA along with concurrent signs of hyperandrogenism (n=22) and body mass index matched control groups consisting of 22 women in each group of FHA-EX and FHA-AN. Main outcomes 1) Reproductive hormone profile: luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, pelvic ultrasound features. 2) Metabolic function and skeletal health markers: fasting glucose, cholesterol, number of stress fractures and bone mineral density as assessed by spine dual-energy X-ray absorptiometry z scores. Results FHA-EX+HA group was older at diagnosis compared to the other groups with a median (interquartile range [IQR]) age of 22 (18.75–25.25) years versus (vs) 17.5 (15.75–19) for FHA-EX; (P<0.01) and 18 (16–22.25) years for FHA-AN (P=0.01). There were no differences among the groups based on number of hours of exercise per week, type of physical activity or duration of amenorrhea. Median (IQR) LH/FSH ratio was higher in FHA-EX+HA than both other groups, 1.44 (1.03–1.77) vs 0.50 (0.20–0.94) for FHA-EX and 0.67 (0.51–0.87) for FHA-AN (P<0.01 for both). Total testosterone concentrations were not different among the groups. Median (IQR) fasting serum glucose concentration was higher in FHA-EX+HA vs FHA-EX, 88.5 mg/dL (82.8–90 mg/dL) vs 83.5 mg/dL (78.8–86.3 mg/dL) (P=0.01) but not different from FHA-AN (P=0.31). Percentage of women with stress fractures was lower in FHA-EX+HA (4.5%) as compared to both FHA-EX (27.3%) and FHA-AN (50%); P=0.04 and 0.01 respectively. The LH/FSH ratio was weakly positively associated with serum glucose (adjusted r2=0.102; P=0.01) as well as with dual-energy X-ray absorptiometry spine score (adjusted r2=0.191; P=0.04) in the entire cohort. Conclusion In a small cohort of female athletes with hyperandrogenism, a distinct reproductive hormone profile consisting of higher LH to FHS ratio may be associated with adverse metabolic health markers but improved skeletal health.
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Affiliation(s)
- Asma Javed
- Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology Mayo Clinic, Rochester, MN, USA
| | - Rahul Kashyap
- Department of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aida N Lteif
- Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology Mayo Clinic, Rochester, MN, USA
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Chen B, Choi H, Hirsch LJ, Moeller J, Javed A, Kato K, Legge A, Buchsbaum R, Detyniecki K. Cosmetic side effects of antiepileptic drugs in adults with epilepsy. Epilepsy Behav 2015; 42:129-37. [PMID: 25513768 DOI: 10.1016/j.yebeh.2014.10.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Cosmetic side effects (CSEs) such as weight gain and alopecia are common, undesirable effects associated with several AEDs. The objective of the study was to compare the CSE profiles in a large specialty practice-based sample of patients taking both older and newer AEDs. METHODS As part of the Columbia and Yale AED Database Project, we reviewed patient records including demographics, medical history, AED use, and side effects for 1903 adult patients (≥16years of age) newly started on an AED. Cosmetic side effects were determined by patient or physician report in the medical record and included acne, gingival hyperplasia, hair loss, hirsutism, and weight gain. We compared the overall rate of CSEs and intolerable CSEs (ICSEs-CSEs that led to dosage reduction or discontinuation) between different AEDs in both monotherapy and polytherapy. RESULTS Overall, CSEs occurred in 110/1903 (5.8%) patients and led to intolerability in 70/1903 (3.7%) patients. Weight gain was the most commonly reported CSE (68/1903, 3.6%) and led to intolerability in 63 (3.3%) patients. Alopecia was the second most common patient-reported CSE (36/1903, 1.9%) and was intolerable in 33/1903 (1.7%) patients. Risk factors for CSEs included female sex (7.0% vs. 4.3% in males; p<0.05) and any prior CSE (37% vs. 2.9% in patients without prior CSE; p<0.001). Significantly more CSEs were attributed to valproic acid (59/270; 21.9%; p<0.001) and pregabalin (14/143; 9.8%; p<0.001) than to all other AEDs. Significantly less CSEs were attributed to levetiracetam (7/524; 1.3%; p=0.002). Weight gain was most frequently associated with valproic acid (35/270; 13.0%; p<0.001) and pregabalin (12/143; 8.4%; p<0.001). Hair loss was most commonly reported among patients taking valproic acid (24/270; 8.9%; p<0.001). Finally, gingival hyperplasia was most commonly reported in patients taking phenytoin (10/404; 2.5%; p<0.001). Cosmetic side effects leading to dosage change or discontinuation occurred most frequently with pregabalin and valproic acid compared with all other AEDs (13.3 and 5.6% vs. 2.3%; p<0.001). For patients who had been on an AED in monotherapy (n=677), CSEs and ICSEs were still more likely to be attributed to valproic acid (30.2% and 17.1%, respectively) than to any other AED (both p<0.001). SIGNIFICANCE Weight gain and alopecia were the most common patient-reported CSEs in this study, and weight gain was the most likely cosmetic side effect to result in dosage adjustment or medication discontinuation. Particular attention should be paid to pregabalin, phenytoin, and valproic acid when considering cosmetic side effects. Female patients and patients who have had prior CSE(s) to AED(s) were more likely to report CSEs. Knowledge of specific CSE rates for each AED found in this study may be useful in clinical practice.
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Affiliation(s)
- B Chen
- Comprehensive Epilepsy Center, Dept. of Neurology, Yale University, New Haven, CT, USA.
| | - H Choi
- Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY, USA
| | - L J Hirsch
- Comprehensive Epilepsy Center, Dept. of Neurology, Yale University, New Haven, CT, USA
| | - J Moeller
- Comprehensive Epilepsy Center, Dept. of Neurology, Yale University, New Haven, CT, USA
| | - A Javed
- Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY, USA
| | - K Kato
- Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY, USA
| | - A Legge
- Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY, USA
| | - R Buchsbaum
- Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY, USA
| | - K Detyniecki
- Comprehensive Epilepsy Center, Dept. of Neurology, Yale University, New Haven, CT, USA
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Vaught AJ, Ozrazgat-Baslanti T, Javed A, Morgan L, Hobson CE, Bihorac A. Acute kidney injury in major gynaecological surgery: an observational study. BJOG 2014; 122:1340-8. [PMID: 25134440 DOI: 10.1111/1471-0528.13026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 06/25/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the prevalence, outcomes and cost associated with acute kidney injury (AKI) defined by consensus risk, injury, failure, loss, and end-stage kidney (RIFLE) criteria after gynaecologic surgery. DESIGN Retrospective single-centre cohort study. SETTING Academic medical centre. SAMPLE Two thousand three hundred and forty-one adult women undergoing major inpatient gynaecologic surgery between January 2000 and November 2010. METHODS AKI was defined by RIFLE criteria as an increase in serum creatinine greater than or equal to 50% from the reference creatinine. We used multivariable regression analyses to determine the association between perioperative factors, AKI, mortality and cost. MAIN OUTCOME MEASURES AKI, combined major adverse events (hospital mortality, sepsis or mechanical ventilation), 90-day mortality and hospital cost. RESULTS Overall prevalence of AKI was 13%. The prevalence of AKI was associated with the primary diagnosis. Of women with benign tumour surgeries, 5% (43/801) experienced AKI compared with 18% (211/1159) of women with malignant disease (P < 0.001). Only 1.3% of the whole cohort had evidence of urologic mechanical injury. In a multivariable logistic regression analysis, AKI patients had nine times the odds of a major adverse event compared to patients without AKI (adjusted odds ratio 8.95, 95% confidence interval 5.27-15.22). We have identified several readily available perioperative factors that can be used to identify patients at high risk for AKI after in-hospital gynaecologic surgery. CONCLUSIONS AKI is a common complication after major inpatient gynaecologic surgery associated with an increase in resource utilisation and hospital cost, morbidity and mortality.
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Affiliation(s)
- A J Vaught
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
| | | | - A Javed
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
| | - L Morgan
- Department of Gynecology, University of Florida, Gainesville, FL, USA
| | - C E Hobson
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.,Department of Surgery, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA
| | - A Bihorac
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
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Abstract
Mammalia are so named based on the presence of the mammary gland in the breast. The mammary gland is an epidermal appendage, derived from the apocrine glands. The human breast consists of the parenchyma and stroma, originating from ectodermal and mesodermal elements, respectively. Development of the human breast is distinctive for several reasons. The human breast houses the mammary gland that produces and delivers milk through development of an extensive tree-like network of branched ducts. It is also characterized by cellular plasticity, with extensive remodeling in adulthood, a factor that increases its susceptibility to carcinogenesis. Also, breast development occurs in distinct stages via complex epithelial-mesenchymal interactions, orchestrated by signaling pathways under the regulation of systemic hormones. Congenital and acquired disorders of the breast often have a basis in development, making its study essential to understanding breast pathology.
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Affiliation(s)
- Asma Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Aida Lteif
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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Javed A, Zalawadiya S, Cardozo S, Afonso L. Innocent left ventricular outflow tract membrane masquerading as vegetation. Case Reports 2013; 2013:bcr-2013-201829. [DOI: 10.1136/bcr-2013-201829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhu C, Javed A, Li P, Liang GY, Xiao P. Study of the effect of laser treatment on the initial oxidation behaviour of Al-coated NiCrAlY bond-coat. SURF INTERFACE ANAL 2013. [DOI: 10.1002/sia.5307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C. Zhu
- Science and Technology on Thermostructural Composite Materials Laboratory; Northwestern Polytechnical University; Xi′an Shaanxi 710072 PR China
| | - A. Javed
- Department of Physics; University of the Punjab, Quaid-i-Azam Campus; Lahore 54590 Pakistan
| | - P. Li
- MOE Key Laboratory for Non-equilibrium Synthesis and Modulation of Condensed Matter; School of Science, Xi′an Jiaotong University; Xi′an 710049 Shaanxi PR China
- Northwest Institute for Non-ferrous Metal Research; Xi′an 710016 Shaanxi PR China
| | - G. Y. Liang
- MOE Key Laboratory for Non-equilibrium Synthesis and Modulation of Condensed Matter; School of Science, Xi′an Jiaotong University; Xi′an 710049 Shaanxi PR China
| | - P. Xiao
- Materials Science Centre, School of Materials; University of Manchester; Grosvenor Street Manchester M13 9PL UK
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Javed A, Tebben PJ, Fischer PR, Lteif AN. Female athlete triad and its components: toward improved screening and management. Mayo Clin Proc 2013; 88:996-1009. [PMID: 24001492 DOI: 10.1016/j.mayocp.2013.07.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/25/2013] [Accepted: 07/02/2013] [Indexed: 11/30/2022]
Abstract
As female athletic participation has increased, the positive effects of exercise on health have become evident. However, with this growth in sports activity, a set of health problems unique to the female athlete has emerged. The female athlete triad as first described in 1992 by the American College of Sports Medicine consisted of disordered eating, amenorrhea, and osteoporosis; the definition was updated in 2007 to include a spectrum of dysfunction related to energy availability, menstrual function, and bone mineral density. For this review, a comprehensive search of databases-MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Scopus, from earliest inclusive dates to January 2013-was conducted by an experienced librarian with input from the authors. Controlled vocabulary supplemented with keywords such as female athlete triad, amenorrhea, oligomenorrhea, fracture, osteopenia, osteoporosis, bone disease, anorexia, bulimia, disordered eating, low energy availability was used to search for articles on female athlete triad. Articles addressing the prevalence, screening, and management of the female athlete triad were selected for inclusion in the review. This article reviews the current definitions of the triad components, epidemiology, pathophysiology, and recommended screening and management guidelines. The lack of efficacy of current screening of athletes is highlighted. Low energy availablity, from either dietary restriction or increased expenditure, plays a pivotal role in development of the triad. Athletes involved in "lean sports" (those that emphasize weight categories or aesthetics, such as ballet, gymnastics, or endurance running) are at highest risk. Treatment is centered on restoring energy availability to reverse adverse changes in the metabolic milieu. Prevention and early recognition of triad disorders are crucial to ensure timely intervention. Caregivers and physicians of female athletes must remain vigilant in education, recognition, and treatment of athletes at risk.
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Affiliation(s)
- Asma Javed
- Department of Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology, Mayo Clinic, Rochester MN, USA.
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Nader N, Singhal V, Javed A, Weaver A, Kumar S. Temporal trends in the diagnosis and management of childhood obesity/overweight in primary care. J Prim Care Community Health 2013; 5:44-9. [PMID: 24327587 DOI: 10.1177/2150131913495739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 12/22/2022] Open
Abstract
OBJECTIVE To determine the temporal trends in diagnosis and management of pediatric overweight/obesity by primary care providers at a single medical center. PATIENTS Children 2 to 18 years old undergoing a general medical examination during 3 calendar years (2003, 2006, and 2009). The number of visits for general medical examination were 6390 in 2003, 6646 in 2006, and 7408 in 2009. METHODS We performed a retrospective review of the electronic medical records for weight related diagnostic and/or management terms and laboratory screening in children with body mass index at or greater than the 85th percentile (n = 1630 in 2003, 1495 in 2006, and 1730 in 2009). RESULTS There was a significant increase in the diagnosis of obesity among obese children seen in 2009 (53.3%) compared with 2006 (36%, P < .001) and 2003 (24.3%, P < .001). Weight-related counseling was documented in a higher proportion of obese children in 2009 (49.4%) compared with 2006 (34.8%) and 2003 (26.6%). There was a significant increase in counseling regarding screen time in 2009 compared with 2006. A significant increase in screening for nonalcoholic fatty liver disease was also noted (30.5% in 2009 vs 21.9% in 2006, P = .018). CONCLUSIONS There has been steady improvement in the rates of obesity diagnosis and obesity-related counseling by primary care providers. However, continued efforts to increase awareness of these issues are needed as nearly half of obese children remained undiagnosed and recommended laboratory screening for obesity-related comorbidities was performed in only a third of obese children.
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Abstract
OBJECTIVE To characterize two groups of asthmatics who had achieved remission and those who had not achieved remission of asthma. METHODS The study was a retrospective cohort study based on 117 asthmatic children who participated in a previous study. We categorized the children into two groups: asthmatics with remission versus asthmatics without remission. We defined remission of asthma as lack of symptoms/signs of asthma or asthma-related medications or health care services for at least three consecutive years. Long-term remission was defined by no relapse of asthma after achieving remission. We characterized these groups. RESULTS Of the 117 subjects, 70 (60%) were male, 91 (78%) were Caucasians, and the mean age at index date of asthma was 8.1 years. A total of 59 asthmatic children (50%) achieved remission and 28 asthmatics (24%) achieved long-term remission. Asthmatics with remission were more likely to be Caucasian (87%) compared to those without (69%) (p = .039) There were no differences in the frequency of visits for viral (0.3 vs. 0.4 per person-years, p = .29) or bacterial infections (0.7 vs. 0.5 per person-years, p = .49) between asthmatics with and without remission. Gender, socioeconomic status, smoking exposure, family history of asthma or atopy, breastfeeding history, peak flow meter availability, asthma action plan, and influenza vaccinations were not associated with remission. CONCLUSIONS Only half of asthmatic children accomplished remission of asthma ever and 24% of asthmatic children had long-term remission. Ethnicity may affect remission of asthma but microbial infections may not influence the likelihood of remission of asthma and vice versa.
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Affiliation(s)
- Asma Javed
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Javed A, Leonard JM, Cramer C, Kumar S, Kirmani S, Brands CK. Pseudohypoaldosteronism presenting with thrombocytosis and bilateral pneumothoraces in an infant. J Pediatr Endocrinol Metab 2013; 26:393-5. [PMID: 23327809 DOI: 10.1515/jpem-2012-0334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 12/12/2012] [Indexed: 11/15/2022]
Abstract
Pseudohypoaldosteronism type 1 (PHA-1) is a rare salt-wasting syndrome caused by a peripheral resistance to aldosterone. Here, we describe an unusual presentation of the autosomal dominant PHA-1 featuring bilateral pneumothoraces at birth, thrombocytosis in infancy, and hypercalcemia in addition to the well-described findings of hyponatremia, hyperkalemia, and failure to thrive. These findings contribute to the limited case descriptions of PHA-1 and may suggest additional diagnostic considerations in a neonate presenting with hyperkalemia, hyponatremia, and failure to thrive.
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Affiliation(s)
- Asma Javed
- Mayo Clinic, Pediatric Endocrinology, Rochester, MN 55905, USA.
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Javed A, Lteif A, Kumar S. Update on treatment strategies for optimization of final adult height in children with congenital adrenal hyperplasia. Pediatr Endocrinol Rev 2012; 10:164-173. [PMID: 23469393] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Congenital adrenal hyperplasia (CAH) is one of the most common autosomal recessive disorders, caused by deficiency of an enzyme involved in adrenal synthesis of cortisol. Due to lack of feedback from cortisol, an elevation in ACTH occurs, shifting precursors of steroidogenesis into androgen synthesis. Both the disorder itself due to excess androgens and replacement with glucocorticoids can compromise final adult height. Also, unpredictable progression to precocious puberty in some patients can further compromise height. The achievement of normal growth remains the ultimate goal of treatment. This review will first examine the evidence behind deficits in adult height in CAH and implicated factors behind such compromise. The primary goal of the review is to identify therapies to optimize height in CAH. This will include variations in 'standard' medical therapy and recent single and combination therapies with growth hormone, GnRH analogs, aromatase inhibitors and anti androgens to optimize final height in CAH.
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Affiliation(s)
- Asma Javed
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
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Simpson R, Littlewood S, Cooper S, Cruickshank M, Green C, Derrick E, Yell J, Chiang N, Bell H, Owen C, Javed A, Wilson C, McLelland J, Murphy R. Real-life experience of managing vulval erosive lichen planus: a case-based review and U.K. multicentre case note audit. Br J Dermatol 2012; 167:85-91. [DOI: 10.1111/j.1365-2133.2012.10919.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Williamson E, Javed A. Demyelinating Syndromes Associated with Anti-TNF alpha Agents: Case Series (P06.182). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Stefoski D, Ko M, Javed A, Balabanov R. Novel Interventions with Favorable Resolution of Natalizumab-Induced Progressive Multifocal Leukoencephalopathy (PML) (P07.062). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lee K, McGowan S, Javed A, Bernard J. Optic Nerve and Gray Matter Diffusion Tensor Imaging in CADASIL (S43.001). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s43.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Javed A, Ko M, Balabanov R, Stefoski D. MRI and DTI Characteristics of Natalizumab Associated PML during a Novel Treatment Protocol (P07.061). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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