1
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Kleiman NS, Van Mieghem NM, Reardon MJ, Gada H, Mumtaz M, Olsen PS, Heiser J, Merhi W, Chetcuti S, Deeb GM, Chawla A, Kiaii B, Teefy P, Chu MWA, Yakubov SJ, Windecker S, Althouse AD, Baron SJ. Quality of Life 5 Years Following Transfemoral TAVR or SAVR in Intermediate Risk Patients. JACC Cardiovasc Interv 2024; 17:979-988. [PMID: 38658126 DOI: 10.1016/j.jcin.2024.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 01/12/2024] [Accepted: 02/04/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Symptomatic patients with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR) sustain comparable improvements in health status over 5 years after transcatheter aortic valve replacement (TAVR) or SAVR. Whether a similar long-term benefit is observed among intermediate-risk AS patients is unknown. OBJECTIVES The purpose of this study was to assess health status outcomes through 5 years in intermediate risk patients treated with a self-expanding TAVR prosthesis or SAVR using data from the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial. METHODS Intermediate-risk patients randomized to transfemoral TAVR or SAVR in the SURTAVI trial had disease-specific health status assessed at baseline, 30 days, and annually to 5 years using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Health status was compared between groups using fixed effects repeated measures modelling. RESULTS Of the 1,584 patients (TAVR, n = 805; SAVR, n = 779) included in the analysis, health status improved more rapidly after TAVR compared with SAVR. However, by 1 year, both groups experienced large health status benefits (mean change in KCCQ-Overall Summary Score (KCCQ-OS) from baseline: TAVR: 20.5 ± 22.4; SAVR: 20.5 ± 22.2). This benefit was sustained, albeit modestly attenuated, at 5 years (mean change in KCCQ-OS from baseline: TAVR: 15.4 ± 25.1; SAVR: 14.3 ± 24.2). There were no significant differences in health status between the cohorts at 1 year or beyond. Similar findings were observed in the KCCQ subscales, although a substantial attenuation of benefit was noted in the physical limitation subscale over time in both groups. CONCLUSIONS In intermediate-risk AS patients, both transfemoral TAVR and SAVR resulted in comparable and durable health status benefits to 5 years. Further research is necessary to elucidate the mechanisms for the small decline in health status noted at 5 years compared with 1 year in both groups. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI]; NCT01586910).
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Affiliation(s)
- Neal S Kleiman
- Department of Interventional Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
| | | | - Michael J Reardon
- Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Hemal Gada
- Department of Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle, Wormleysburg, Pennsylvania, USA
| | - Mubashir Mumtaz
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center Pinnacle Health, Harrisburg, Pennsylvania, USA
| | - Peter Skov Olsen
- Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - John Heiser
- Department of Interventional Cardiology, Corewell Health, Grand Rapids, Michigan, USA
| | - William Merhi
- Department of Cardiothoracic Surgery, Corewell Health, Grand Rapids, Michigan, USA
| | - Stanley Chetcuti
- Interventional Cardiology, University of Michigan, Ann Arbor, Michigan, USA
| | - G Michael Deeb
- Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Atul Chawla
- Department of Cardiology, Iowa Heart Center, Des Moines, Iowa, USA
| | - Bob Kiaii
- Division of Cardiac Surgery, University of California-Davis Health, Sacramento, California, USA
| | - Patrick Teefy
- Divisions of Cardiology and Cardiac Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Michael W A Chu
- Divisions of Cardiology and Cardiac Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Steven J Yakubov
- Interventional Cardiology, OhioHealth Riverside Methodist Hospital, Columbus, Ohio, USA
| | - Stephan Windecker
- Department of Cardiology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Suzanne J Baron
- Massachusetts General Hospital, Boston, Massachusetts, USA; Baim Institute for Clinical Research, Boston, Massachusetts, USA
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2
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Panca M, Blackstone J, Stirrup O, Cutino-Moguel MT, Thomson E, Peters C, Snell LB, Nebbia G, Holmes A, Chawla A, Machin N, Taha Y, Mahungu T, Saluja T, de Silva TI, Saeed K, Pope C, Shin GY, Williams R, Darby A, Smith DL, Loose M, Robson SC, Laing K, Partridge DG, Price JR, Breuer J. Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals. J Hosp Infect 2023; 139:23-32. [PMID: 37308063 PMCID: PMC10257337 DOI: 10.1016/j.jhin.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The COG-UK hospital-onset COVID-19 infection (HOCI) trial evaluated the impact of SARS-CoV-2 whole-genome sequencing (WGS) on acute infection, prevention, and control (IPC) investigation of nosocomial transmission within hospitals. AIM To estimate the cost implications of using the information from the sequencing reporting tool (SRT), used to determine likelihood of nosocomial infection in IPC practice. METHODS A micro-costing approach for SARS-CoV-2 WGS was conducted. Data on IPC management resource use and costs were collected from interviews with IPC teams from 14 participating sites and used to assign cost estimates for IPC activities as collected in the trial. Activities included IPC-specific actions following a suspicion of healthcare-associated infection (HAI) or outbreak, as well as changes to practice following the return of data via SRT. FINDINGS The mean per-sample costs of SARS-CoV-2 sequencing were estimated at £77.10 for rapid and £66.94 for longer turnaround phases. Over the three-month interventional phases, the total management costs of IPC-defined HAIs and outbreak events across the sites were estimated at £225,070 and £416,447, respectively. The main cost drivers were bed-days lost due to ward closures because of outbreaks, followed by outbreak meetings and bed-days lost due to cohorting contacts. Actioning SRTs, the cost of HAIs increased by £5,178 due to unidentified cases and the cost of outbreaks decreased by £11,246 as SRTs excluded hospital outbreaks. CONCLUSION Although SARS-CoV-2 WGS adds to the total IPC management cost, additional information provided could balance out the additional cost, depending on identified design improvements and effective deployment.
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Affiliation(s)
- M Panca
- Comprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, UCL, London, UK.
| | - J Blackstone
- Comprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - O Stirrup
- Institute for Global Health, UCL, London, UK
| | | | - E Thomson
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - C Peters
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - L B Snell
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - G Nebbia
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - A Holmes
- Imperial College Healthcare NHS Trust, London, UK
| | - A Chawla
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - N Machin
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Y Taha
- Departments of Virology and Infectious Diseases, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - T Mahungu
- Royal Free NHS Foundation Trust, London, UK
| | - T Saluja
- Sandwell and West Birmingham NHS Trust, UK
| | - T I de Silva
- Department of Infection, Immunity and Cardiovascular Disease, Medical School, The University of Sheffield, Sheffield, UK
| | - K Saeed
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Pope
- St George's University Hospitals NHS Foundation Trust, London, UK; Institute for Infection and Immunity, St George's University of London, London, UK
| | - G Y Shin
- University College London Hospitals NHS Foundation Trust, London, UK
| | - R Williams
- Department of Genetics & Genomic Medicine, UCL Great Ormond Street Institute of Child Health, UCL, London, UK
| | - A Darby
- Centre for Genomic Research, University of Liverpool, Liverpool, UK
| | - D L Smith
- Department of Applied Sciences, Northumbria University, Newcastle, UK
| | - M Loose
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - S C Robson
- Centre for Enzyme Innovation & School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - K Laing
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - D G Partridge
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J R Price
- Imperial College Healthcare NHS Trust, London, UK
| | - J Breuer
- Department of Infection, Immunity and Inflammation, Great Ormond Street Institute of Child Health, UCL, London, UK
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3
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Aalbers J, Akerib DS, Akerlof CW, Al Musalhi AK, Alder F, Alqahtani A, Alsum SK, Amarasinghe CS, Ames A, Anderson TJ, Angelides N, Araújo HM, Armstrong JE, Arthurs M, Azadi S, Bailey AJ, Baker A, Balajthy J, Balashov S, Bang J, Bargemann JW, Barry MJ, Barthel J, Bauer D, Baxter A, Beattie K, Belle J, Beltrame P, Bensinger J, Benson T, Bernard EP, Bhatti A, Biekert A, Biesiadzinski TP, Birch HJ, Birrittella B, Blockinger GM, Boast KE, Boxer B, Bramante R, Brew CAJ, Brás P, Buckley JH, Bugaev VV, Burdin S, Busenitz JK, Buuck M, Cabrita R, Carels C, Carlsmith DL, Carlson B, Carmona-Benitez MC, Cascella M, Chan C, Chawla A, Chen H, Cherwinka JJ, Chott NI, Cole A, Coleman J, Converse MV, Cottle A, Cox G, Craddock WW, Creaner O, Curran D, Currie A, Cutter JE, Dahl CE, David A, Davis J, Davison TJR, Delgaudio J, Dey S, de Viveiros L, Dobi A, Dobson JEY, Druszkiewicz E, Dushkin A, Edberg TK, Edwards WR, Elnimr MM, Emmet WT, Eriksen SR, Faham CH, Fan A, Fayer S, Fearon NM, Fiorucci S, Flaecher H, Ford P, Francis VB, Fraser ED, Fruth T, Gaitskell RJ, Gantos NJ, Garcia D, Geffre A, Gehman VM, Genovesi J, Ghag C, Gibbons R, Gibson E, Gilchriese MGD, Gokhale S, Gomber B, Green J, Greenall A, Greenwood S, van der Grinten MGD, Gwilliam CB, Hall CR, Hans S, Hanzel K, Harrison A, Hartigan-O'Connor E, Haselschwardt SJ, Hernandez MA, Hertel SA, Heuermann G, Hjemfelt C, Hoff MD, Holtom E, Hor JYK, Horn M, Huang DQ, Hunt D, Ignarra CM, Jacobsen RG, Jahangir O, James RS, Jeffery SN, Ji W, Johnson J, Kaboth AC, Kamaha AC, Kamdin K, Kasey V, Kazkaz K, Keefner J, Khaitan D, Khaleeq M, Khazov A, Khurana I, Kim YD, Kocher CD, Kodroff D, Korley L, Korolkova EV, Kras J, Kraus H, Kravitz S, Krebs HJ, Kreczko L, Krikler B, Kudryavtsev VA, Kyre S, Landerud B, Leason EA, Lee C, Lee J, Leonard DS, Leonard R, Lesko KT, Levy C, Li J, Liao FT, Liao J, Lin J, Lindote A, Linehan R, Lippincott WH, Liu R, Liu X, Liu Y, Loniewski C, Lopes MI, Lopez Asamar E, López Paredes B, Lorenzon W, Lucero D, Luitz S, Lyle JM, Majewski PA, Makkinje J, Malling DC, Manalaysay A, Manenti L, Mannino RL, Marangou N, Marzioni MF, Maupin C, McCarthy ME, McConnell CT, McKinsey DN, McLaughlin J, Meng Y, Migneault J, Miller EH, Mizrachi E, Mock JA, Monte A, Monzani ME, Morad JA, Morales Mendoza JD, Morrison E, Mount BJ, Murdy M, Murphy ASJ, Naim D, Naylor A, Nedlik C, Nehrkorn C, Neves F, Nguyen A, Nikoleyczik JA, Nilima A, O'Dell J, O'Neill FG, O'Sullivan K, Olcina I, Olevitch MA, Oliver-Mallory KC, Orpwood J, Pagenkopf D, Pal S, Palladino KJ, Palmer J, Pangilinan M, Parveen N, Patton SJ, Pease EK, Penning B, Pereira C, Pereira G, Perry E, Pershing T, Peterson IB, Piepke A, Podczerwinski J, Porzio D, Powell S, Preece RM, Pushkin K, Qie Y, Ratcliff BN, Reichenbacher J, Reichhart L, Rhyne CA, Richards A, Riffard Q, Rischbieter GRC, Rodrigues JP, Rodriguez A, Rose HJ, Rosero R, Rossiter P, Rushton T, Rutherford G, Rynders D, Saba JS, Santone D, Sazzad ABMR, Schnee RW, Scovell PR, Seymour D, Shaw S, Shutt T, Silk JJ, Silva C, Sinev G, Skarpaas K, Skulski W, Smith R, Solmaz M, Solovov VN, Sorensen P, Soria J, Stancu I, Stark MR, Stevens A, Stiegler TM, Stifter K, Studley R, Suerfu B, Sumner TJ, Sutcliffe P, Swanson N, Szydagis M, Tan M, Taylor DJ, Taylor R, Taylor WC, Temples DJ, Tennyson BP, Terman PA, Thomas KJ, Tiedt DR, Timalsina M, To WH, Tomás A, Tong Z, Tovey DR, Tranter J, Trask M, Tripathi M, Tronstad DR, Tull CE, Turner W, Tvrznikova L, Utku U, Va'vra J, Vacheret A, Vaitkus AC, Verbus JR, Voirin E, Waldron WL, Wang A, Wang B, Wang JJ, Wang W, Wang Y, Watson JR, Webb RC, White A, White DT, White JT, White RG, Whitis TJ, Williams M, Wisniewski WJ, Witherell MS, Wolfs FLH, Wolfs JD, Woodford S, Woodward D, Worm SD, Wright CJ, Xia Q, Xiang X, Xiao Q, Xu J, Yeh M, Yin J, Young I, Zarzhitsky P, Zuckerman A, Zweig EA. First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment. Phys Rev Lett 2023; 131:041002. [PMID: 37566836 DOI: 10.1103/physrevlett.131.041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 08/13/2023]
Abstract
The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
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Affiliation(s)
- J Aalbers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - D S Akerib
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C W Akerlof
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A K Al Musalhi
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - F Alder
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - A Alqahtani
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S K Alsum
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C S Amarasinghe
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A Ames
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Anderson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - N Angelides
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - H M Araújo
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Armstrong
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - M Arthurs
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S Azadi
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - A J Bailey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baker
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J Balajthy
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - S Balashov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Bang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J W Bargemann
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M J Barry
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Barthel
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Bauer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baxter
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - K Beattie
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Belle
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Beltrame
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Bensinger
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T Benson
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E P Bernard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Bhatti
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - A Biekert
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T P Biesiadzinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - H J Birch
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - B Birrittella
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - G M Blockinger
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - K E Boast
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - B Boxer
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Bramante
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C A J Brew
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - P Brás
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J H Buckley
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - V V Bugaev
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - S Burdin
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - J K Busenitz
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Buuck
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R Cabrita
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - C Carels
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D L Carlsmith
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - B Carlson
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - M Cascella
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C Chan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Chawla
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - H Chen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J J Cherwinka
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N I Chott
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Cole
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Coleman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M V Converse
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Cottle
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - G Cox
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - W W Craddock
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - O Creaner
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Curran
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - A Currie
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Cutter
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - C E Dahl
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - A David
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Davis
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - T J R Davison
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Delgaudio
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Dey
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - L de Viveiros
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - A Dobi
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J E Y Dobson
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Dushkin
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T K Edberg
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - W R Edwards
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M M Elnimr
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W T Emmet
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - S R Eriksen
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - C H Faham
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Fan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - S Fayer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - N M Fearon
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Fiorucci
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H Flaecher
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - P Ford
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - V B Francis
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - E D Fraser
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - T Fruth
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R J Gaitskell
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N J Gantos
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Garcia
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Geffre
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Genovesi
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C Ghag
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R Gibbons
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - E Gibson
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - S Gokhale
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Gomber
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Green
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - A Greenall
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - S Greenwood
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | | | - C B Gwilliam
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - S Hans
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - K Hanzel
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Harrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Hartigan-O'Connor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S J Haselschwardt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M A Hernandez
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - G Heuermann
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - C Hjemfelt
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M D Hoff
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E Holtom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Y-K Hor
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Horn
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Q Huang
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Hunt
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - C M Ignarra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R G Jacobsen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - O Jahangir
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R S James
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - S N Jeffery
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - W Ji
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Johnson
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A C Kaboth
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A C Kamaha
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| | - K Kamdin
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - V Kasey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - K Kazkaz
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J Keefner
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M Khaleeq
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Khazov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - I Khurana
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - Y D Kim
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - C D Kocher
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Kodroff
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - L Korley
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - E V Korolkova
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Kras
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - H Kraus
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Kravitz
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H J Krebs
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - L Kreczko
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Krikler
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - V A Kudryavtsev
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - S Kyre
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - B Landerud
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E A Leason
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Lee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Lee
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - D S Leonard
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - R Leonard
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - C Levy
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J Li
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - F-T Liao
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - J Liao
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J Lin
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Lindote
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Linehan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - W H Lippincott
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Liu
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - X Liu
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - Y Liu
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C Loniewski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M I Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Lopez Asamar
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - B López Paredes
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W Lorenzon
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - D Lucero
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Luitz
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J M Lyle
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - P A Majewski
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Makkinje
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D C Malling
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Manalaysay
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - L Manenti
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R L Mannino
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N Marangou
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - M F Marzioni
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Maupin
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M E McCarthy
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - C T McConnell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D N McKinsey
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J McLaughlin
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - Y Meng
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Migneault
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E H Miller
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Mizrachi
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J A Mock
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - A Monte
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - M E Monzani
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Vatican Observatory, Castel Gandolfo, V-00120, Vatican City State
| | - J A Morad
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - J D Morales Mendoza
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - E Morrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - B J Mount
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - M Murdy
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - A St J Murphy
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - D Naim
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A Naylor
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - C Nedlik
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - C Nehrkorn
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - F Neves
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Nguyen
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J A Nikoleyczik
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - A Nilima
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J O'Dell
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - F G O'Neill
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - K O'Sullivan
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Olcina
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M A Olevitch
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - K C Oliver-Mallory
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J Orpwood
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - D Pagenkopf
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - S Pal
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - K J Palladino
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Palmer
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - M Pangilinan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N Parveen
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - S J Patton
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E K Pease
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - B Penning
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - C Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Perry
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - T Pershing
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - I B Peterson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Piepke
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Podczerwinski
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - D Porzio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - S Powell
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R M Preece
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - K Pushkin
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - Y Qie
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - B N Ratcliff
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J Reichenbacher
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - L Reichhart
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C A Rhyne
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Richards
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Q Riffard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - G R C Rischbieter
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J P Rodrigues
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Rodriguez
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - H J Rose
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Rosero
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - P Rossiter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - T Rushton
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - G Rutherford
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Rynders
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - J S Saba
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Santone
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A B M R Sazzad
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - R W Schnee
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - P R Scovell
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - D Seymour
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S Shaw
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - T Shutt
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J J Silk
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - C Silva
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Sinev
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - W Skulski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - R Smith
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M Solmaz
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - V N Solovov
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Soria
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Stancu
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M R Stark
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Stevens
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - T M Stiegler
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K Stifter
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Studley
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - B Suerfu
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T J Sumner
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - P Sutcliffe
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - N Swanson
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - M Szydagis
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - M Tan
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D J Taylor
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - R Taylor
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W C Taylor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D J Temples
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - B P Tennyson
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - P A Terman
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K J Thomas
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D R Tiedt
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M Timalsina
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - W H To
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - A Tomás
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Z Tong
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - D R Tovey
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Tranter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - M Trask
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Tripathi
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - D R Tronstad
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C E Tull
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - W Turner
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - L Tvrznikova
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - U Utku
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Va'vra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - A Vacheret
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A C Vaitkus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J R Verbus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E Voirin
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - W L Waldron
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Wang
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - B Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J J Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W Wang
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - Y Wang
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J R Watson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - R C Webb
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - A White
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D T White
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - J T White
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - R G White
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Whitis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Williams
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - W J Wisniewski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - J D Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - S Woodford
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - D Woodward
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - S D Worm
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - C J Wright
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xia
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - X Xiang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xiao
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Xu
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - M Yeh
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - J Yin
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - I Young
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Zarzhitsky
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - A Zuckerman
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E A Zweig
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
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Forrest JK, Deeb GM, Yakubov SJ, Gada H, Mumtaz MA, Ramlawi B, Bajwa T, Teirstein PS, DeFrain M, Muppala M, Rutkin BJ, Chawla A, Jenson B, Chetcuti SJ, Stoler RC, Poulin MF, Khabbaz K, Levack M, Goel K, Tchétché D, Lam KY, Tonino PAL, Ito S, Oh JK, Huang J, Popma JJ, Kleiman N, Reardon MJ. 3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis. J Am Coll Cardiol 2023; 81:1663-1674. [PMID: 36882136 DOI: 10.1016/j.jacc.2023.02.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [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: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process. OBJECTIVES The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial. METHODS Low-risk patients were randomized to TAVR with a self-expanding, supra-annular valve or surgery. The primary endpoint of all-cause mortality or disabling stroke and several secondary endpoints were assessed at 3 years. RESULTS There were 1,414 attempted implantations (730 TAVR; 684 surgery). Patients had a mean age of 74 years and 35% were women. At 3 years, the primary endpoint occurred in 7.4% of TAVR patients and 10.4% of surgery patients (HR: 0.70; 95% CI: 0.49-1.00; P = 0.051). The difference between treatment arms for all-cause mortality or disabling stroke remained broadly consistent over time: -1.8% at year 1; -2.0% at year 2; and -2.9% at year 3. The incidence of mild paravalvular regurgitation (20.3% TAVR vs 2.5% surgery) and pacemaker placement (23.2% TAVR vs 9.1% surgery; P < 0.001) were lower in the surgery group. Rates of moderate or greater paravalvular regurgitation for both groups were <1% and not significantly different. Patients who underwent TAVR had significantly improved valve hemodynamics (mean gradient 9.1 mm Hg TAVR vs 12.1 mm Hg surgery; P < 0.001) at 3 years. CONCLUSIONS Within the Evolut Low Risk study, TAVR at 3 years showed durable benefits compared with surgery with respect to all-cause mortality or disabling stroke. (Medtronic Evolut Transcatheter Aortic Valve Replacement in Low Risk Patients; NCT02701283).
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Affiliation(s)
- John K Forrest
- Yale University School of Medicine, New Haven, Connecticut, USA.
| | - G Michael Deeb
- University of Michigan Health Systems University Hospital, Ann Arbor, Michigan, USA
| | | | - Hemal Gada
- University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, USA
| | - Mubashir A Mumtaz
- University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, USA
| | - Basel Ramlawi
- Lankenau Heart Institute, Philadelphia, Pennsylvania, USA
| | - Tanvir Bajwa
- Aurora St Luke's Medical Center, Milwaukee, Wisconsin, USA
| | | | | | | | - Bruce J Rutkin
- North Shore University Hospital, Manhasset, New York, USA
| | - Atul Chawla
- Mercy Medical Center, Iowa Heart, Des Moines, Iowa, USA
| | - Bart Jenson
- Mercy Medical Center, Iowa Heart, Des Moines, Iowa, USA
| | - Stanley J Chetcuti
- University of Michigan Health Systems University Hospital, Ann Arbor, Michigan, USA
| | | | | | - Kamal Khabbaz
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Melissa Levack
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kashish Goel
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Ka Yan Lam
- Catharina Ziekenhuis, Eindhoven, the Netherlands
| | | | - Saki Ito
- Echocardiography Core Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Jae K Oh
- Echocardiography Core Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Neal Kleiman
- Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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Ito S, Laham R, Nkomo VT, Forrest JK, Reardon MJ, Little SH, Mumtaz M, Gada H, Bajwa T, Langholz D, Heiser J, Chawla A, Jenson B, Attizanni G, Markowitz AH, Huang J, Oh JK. Impact of aortic valve replacement in symptomatic low-risk patients with less than severe aortic stenosis. Open Heart 2023; 10:e002297. [PMID: 37173100 PMCID: PMC10186477 DOI: 10.1136/openhrt-2023-002297] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE To evaluate whether transcatheter or surgical aortic valve replacement (TAVR or SAVR) affects clinical and haemodynamic outcomes in symptomatic patients with moderately-severe aortic stenosis (AS). METHODS Echocardiographic evidence of severe AS for enrolment in the Evolut Low Risk trial was based on site-reported measurements. For this post hoc analysis, core laboratory measurements identified patients with symptomatic moderately-severe AS (1.0 RESULTS Moderately-severe AS was identified in 113 out of 1414 patients (8%). Baseline AVA was 1.1±0.1 cm2, peak velocity 3.7±0.2 m/s, MG 32.7±4.8 mm Hg and aortic valve calcium volume 588 (364, 815) mm3. Valve haemodynamics improved following TAVR (AVA 2.5±0.7 cm2, peak velocity 1.9±0.5 m/s and MG 8.4±4.8 mm Hg; p<0.001 for all) and SAVR (AVA 2.0±0.6 cm2, peak velocity 2.1±0.4 m/s and MG 10.0±3.4 mm Hg; p<0.001 for all). At 24 months, the rates of death or disabling stroke were similar (TAVR 7.7% vs SAVR 6.5%; p=0.82). Kansas City Cardiomyopathy Questionnaire overall summary score assessing quality of life improved from baseline to 30 days after TAVR (67.0±20.6 to 89.3±13.4; p<0.001) and SAVR (67.5±19.6 to 78.3±22.3; p=0.001). CONCLUSIONS In symptomatic patients with moderately-severe AS, AVR appears to be beneficial. Determination of the clinical and haemodynamic profile of patients who can benefit from earlier isolated AVR needs further investigation in randomised clinical trials.
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Affiliation(s)
- Saki Ito
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Roger Laham
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Vuyisile T Nkomo
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - John K Forrest
- Department of Internal Medicine (Cardiology), Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Michael J Reardon
- Departments of Cardiology and Cardiothoracic Surgery, Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA
| | - Stephen H Little
- Departments of Cardiology and Cardiothoracic Surgery, Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA
| | - Mubashir Mumtaz
- Departments of Cardiothoracic Surgery and Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle Health, Wormsleyburg, Pennsylvania, USA
| | - Hemal Gada
- Departments of Cardiothoracic Surgery and Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle Health, Wormsleyburg, Pennsylvania, USA
| | - Tanvir Bajwa
- Aurora Cardiovascular and Thoracic Services, Aurora Saint Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - David Langholz
- Department of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, Michigan, USA
| | - John Heiser
- Department of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, Michigan, USA
| | - Atul Chawla
- Department of Cardiology, Mercy Medical Center, IA, Mercy Medical Center, Des Moines, Iowa, USA
| | - Bart Jenson
- Department of Cardiology, Mercy Medical Center, IA, Mercy Medical Center, Des Moines, Iowa, USA
| | - Guilherme Attizanni
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Alan H Markowitz
- Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Jian Huang
- Structural Heart and Aortic, Medtronic Inc, Mounds View, Minnesota, USA
| | - Jae K Oh
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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Ahsan M, Taskesen T, Ahmad S, Putz J, Sulaiman S, Shivapour DM, Chawla A, McAllister DW, Sigurdsson G, Ardhanari S, Goldsweig AM, Martin EL. AORTIC VALVE CALCIUM SCORE PREDICTS NEED FOR PERMANENT PACEMAKER AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01810-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Ugwu JK, Kandah DR, Ndulue JK, Ebiem OP, Ugwu-Erugo JN, Hamilton R, Osei K, Taskesen T, Shivapour DM, Chawla A, Marcus RH. Comparative Outcomes of TAVR in Mixed Aortic Valve Disease and Aortic Stenosis: A Meta-analysis. Cardiol Ther 2023; 12:143-157. [PMID: 36567395 PMCID: PMC9986165 DOI: 10.1007/s40119-022-00293-3] [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: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Transcatheter aortic valve replacement (TAVR) has become a suitable alternative to surgical aortic valve replacement (SAVR) for the treatment of symptomatic severe aortic stenosis (AS). A high proportion of patients with AS have mixed aortic valve disease (MAVD) with mild or more concurrent aortic regurgitation (AR). Differential outcomes of TAVR among patients with AS and MAVD have not been well characterized. We compared 1-year mortalities following TAVR among patients with MAVD and AS. METHODS We conducted a meta-analysis of studies published in PubMed/Medline. The primary outcome was 1-year all-cause mortality following TAVR among patients with MAVD vs. AS. Secondary endpoints were: (1) incidence of AR within 30 days following TAVR (post TAVR AR); and (2) 1-year all-cause mortality within each group stratified according to severity of post TAVR AR. RESULTS Nine studies involving 9505 participants were included in the analysis. At 1 year following TAVR, mortality was lower in MAVD than in AS; HR 0.89, 95% CI 0.81-0.98. The mortality advantage increased when pre-TAVR AR was moderate or more; HR 0.84, 95% CI 0.72-0.99. The mortality advantage was attenuated after correction for publication bias. There was a higher risk of post TAVR AR in the MAVD group; OR 1.51, 95% CI 1.20-1.90 but the impact on mortality of moderate vs. mild post TAVR AR was greater among patients with AS than in patients with MAVD HR 1.67 95% CI 0.89-3.14 vs. 0.93 95% CI 0.47-1.85. CONCLUSIONS Patients with MAVD have similar or improved survival 1 year after TAVR compared to those with AS.
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Affiliation(s)
- Justin K Ugwu
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.
| | - Daniel R Kandah
- Internal Medicine Residency, MercyOne Des Moines Medical Center, Des Moines, IA, United States of America
| | - Jideofor K Ndulue
- Providence Medical Group, Chehalis Family Medicine, Chehalis, WA, United States of America
| | - Okechukwu P Ebiem
- Department of Hospital Medicine, Miami Valley Hospital, Dayton, OH, United States of America
| | | | - Russell Hamilton
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
| | - Kofi Osei
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
| | - Tuncay Taskesen
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
| | - Daniel M Shivapour
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
| | - Atul Chawla
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
| | - Richard H Marcus
- Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America
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Gauhar V, Kocak M, Dasgupta R, Ganpule A, Chawla A, Lim E, De La Rosette J. Does gender influence Extracorporeal Shock Wave Lithotripsy practice (ESWL)? Results form a global survey. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01123-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
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Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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Taskesen T, Ahsan M, Putz J, Park A, De Santis T, Latif A, Ugwu J, Ellerman M, Shivapour D, Chawla A, McAllister D, Sigurdsson G, Martin E. Predictive Role of Aortic Valve Calcium score on post-procedural outcomes and mortality after Transcatheter aortic valve replacement. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Extent of aortic valve (AV) calcium increases as degenerative aortic valve stenosis progresses. Initial studies postulated AV calcium (AVC) score to be a predictor of complications such as need for pacemaker implantation, paravalvular regurgitation and mortality after Trans-catheter Aortic valve Replacement (TAVR). However, evidence regarding the impact of AVC score as a predictor of post-procedural complications and mortality has been conflicting.
Objective
This study aimed to determine the prognostic impact of AVC as predictor of post-procedural outcomes and mortality in patients with severe aortic stenosis (AS) who underwent TAVR.
Methods
We retrospectively abstracted the records of 497 patients with severe AS who underwent TAVR between January 2016 and July 2019 at our institution. All patients underwent a non-contrast cardiac CT scan on a Siemens Somatom Definition Flash 128 slice scanner. AVC score using the Agatston method was obtained retrospectively. Patients were divided into two groups: 1) Non-severe AVC score group [women <1200 Agatston unit (AU) and men <2000 AU]; 2) Severe AV Calcium Score group [women >1200 AU and men >2000 AU]. Primary outcome was 1-year mortality.
Results
Among 466 patients included in the analysis, 352 patients were included severe AVC group while 114 patients were in the non-severe AVC group. Patients in the severe AVC group were older (81±8 vs 79±8 years), were predominantly males (79% vs 71%), and had less diabetes mellitus (31% vs 42%, p=0.02). Post-TAVR AV dimensionless index (0.58±0.13 vs 0.58±0.12, p=0.8) and AV mean gradient (9.5±4.9 vs 9.2±5.4 mmHg) were not statistically different between both groups. There was no statistical difference in the need for PPM (12% vs 7%, p=0.16), post-TAVR stroke (1.5% vs 0%), post-TAVR major complications (17.4% vs 10%, p=0.07), 30 day (3.7% vs 4.4%), and 1-year mortality (13.6 vs 11.4, p=0.6) between both groups.
Conclusion
Our study report that the severity of AVC score does not have a prognostic impact on major post-procedural outcomes and mortality after TAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Taskesen
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - M Ahsan
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - J Putz
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - A Park
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - T De Santis
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - A Latif
- Creighton University Medical Centre, Internal Medicine , Omaha , United States of America
| | - J Ugwu
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - M Ellerman
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - D Shivapour
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - A Chawla
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - D McAllister
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - G Sigurdsson
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - E Martin
- Iowa Heart Center Inc , West Des Moines , United States of America
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11
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Ahsan M, Taskesen T, Putz J, Ugwu J, Latif A, Park A, De Santis T, Sigurdsson G, Shivapour D, McAllister D, Chawla A, Bhatt D, Mamas M, Velagapudi P, Martin E. Sex-based differences of the impact of aortic valve calcium score on mortality and post-procedural outcomes after trans-catheter aortic valve replacement. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sex based differences exist in the presentation, outcomes, and management of cardiovascular diseases. Although aortic valve calcium (AVC) score has been postulated to be associated with post-procedural outcomes after transcatheter aortic valve replacement (TAVR), data on the impact of AVC score on procedural outcomes after TAVR based on sex have been scarce.
Objective
The aim of the present study was to elucidate sex related differences in the prognostic impact of AVC score as a predictor of post-procedural outcomes and mortality in patients with severe aortic stenosis (AS) who underwent TAVR.
Methods
We retrospectively abstracted the records of 497 patients with severe AS who underwent TAVR between January 2016 and July 2019 at our institution. All patients underwent a non-contrast cardiac CT scan on a Siemens Somatom Definition Flash 128 slice scanner. AVC score using the Agatston method was calculated retrospectively. Primary outcome was 1-year mortality. Patients were divided into two groups: 1) Non-severe AVC score group [women <1200 Agatston unit (AU) and men <2000 AU]; 2) Severe AVC Score group [women >1200 AU and men >2000 AU]. Cox-regression model was used to predict effect of variables on 1-year mortality in male and female patients.
Results
Among 466 patients included, 268 patients were male and 198 were female (57.5% vs 42.5%). When compared with males, female patients had significantly lower AVC score (p<0.001), aortic valve area (AVA) (p<0.001), obstructive CAD (p<0.001), and history of previous PCI (p<0.004), and CABG (<0.001) but had a significantly higher STS score (6.7±3.2 vs 5.8±3.3 P=0.01). There was no difference between need for permanent pacemaker (PPM) implantation (11% vs 9.6%, p=0.4), major complications (16% vs 15%, p=0.9), stroke (0.8% vs 1.6%, p=0.7), 30-day (3.7% vs 4%, p=0.9), and 1-year mortality (14% vs 12%, p=0.6) between males and females, respectively. Female patients required smaller bio-prosthetic valves compared with males (26±3.2 vs 30±3, p<0.001). Cox regression analysis for female patients showed BMI, hemoglobin level, and AVA independently predicted 1-year mortality, while there was no impact of severe AVC score (>1200 AU) on 1-year mortality in females. Similarly, Cox regression analysis for male patients showed there was no impact of severe AVC score (>2000 AU) on 1-year mortality in males. When males in the severe AVC group were compared with female patients in the severe AVC group, there was no difference in 30 day (4.3% vs 3.3%, p=0.82) and 1-year mortality (14.2% vs 13.3%, p=0.77). Similarly, in the severe AVC group there was no difference between need for PPM implantation (12.8% vs 12.1%, p=0.9), major complications (19.7% vs 15.8%, p=0.4), and stroke (2.2% vs 1%, p=0.6) between males and females, respectively.
Conclusion
There were no sex differences in the impact of AVC score on mortality and post-procedural outcomes after TAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ahsan
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - T Taskesen
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - J Putz
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - J Ugwu
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - A Latif
- Creighton University Medical Centre, Internal Medicine , Omaha , United States of America
| | - A Park
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - T De Santis
- Mercy Medical Center, Internal Medicine , Des Moines , United States of America
| | - G Sigurdsson
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - D Shivapour
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - D McAllister
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - A Chawla
- Iowa Heart Center Inc , West Des Moines , United States of America
| | - D Bhatt
- Brigham and Women's Hospital, Heart and Vascular Center, Cardiovascular Diseases , Boston , United States of America
| | - M Mamas
- Keele University, Cardiovascular Diseases , Keele , United Kingdom
| | - P Velagapudi
- University of Nebraska Medical Center, Cardiovascular Diseases , Omaha , United States of America
| | - E Martin
- Iowa Heart Center Inc , West Des Moines , United States of America
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12
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Tuttle MK, Kiaii B, Van Mieghem NM, Laham RJ, Deeb GM, Windecker S, Chetcuti S, Yakubov SJ, Chawla A, Hockmuth D, Teefy P, Li S, Reardon MJ. Functional Status After Transcatheter and Surgical Aortic Valve Replacement: 2-Year Analysis From the SURTAVI Trial. JACC Cardiovasc Interv 2022; 15:728-738. [PMID: 35393106 DOI: 10.1016/j.jcin.2022.01.284] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/03/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study sought to evaluate patient-centered metrics in intermediate-surgical-risk aortic stenosis patients enrolled in the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial treated with self-expanding transcatheter aortic valve replacement (TAVR) or surgery. BACKGROUND Studies have shown TAVR to be an alternative to surgery in patients with severe symptomatic aortic stenosis but have focused on "hard endpoints," including all-cause mortality and stroke, rather than on comparative patient-centered metrics, such as functional status and symptom burden. METHODS The study analyzed functional status (6-minute walk test [6MWT]) and symptom burden (Kansas City Cardiomyopathy Questionnaire) in 1,492 patients from the SURTAVI trial at baseline, 30 days, 1 year, and 2 years. Patients were categorized by baseline functional status into tertiles of slow, medium, and fast walkers. RESULTS Patients with lowest capacity baseline functional status were commonly women, had higher Society of Thoracic Surgeons scores, and had more New York Heart Association functional class III or IV symptoms; reduced baseline functional status was associated with higher aortic valve- and heart failure-related hospitalization at 2 years. There was greater improvement in 6MWT distance in TAVR compared with surgery patients at 30 days (P < 0.001) and 1 year (P = 0.012), but at 2 years, both groups had similar improvement (P = 0.091). The percentage of patients with large improvement in 6MWT was greatest in patients categorized as slow walkers and lowest in fast walkers. Symptom burden improved after TAVR at 30 days and after both procedures at 1 and 2 years. CONCLUSIONS In this substudy of patients from the SURTAVI trial, patients receiving TAVR demonstrated a more rapid improvement in functional status and symptom burden compared with patients undergoing surgery; however, both groups had similar improvements in long-term follow-up. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI]; NCT01586910).
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Affiliation(s)
- Mark K Tuttle
- CardioVascular Institute of North Colorado, Banner Health, Greeley, Colorado, USA.
| | - Bob Kiaii
- Department of Cardiothoracic Surgery, University of California Davis Medical Center, Sacramento, California, USA
| | - Nicolas M Van Mieghem
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Roger J Laham
- CardioVascular Institute of North Colorado, Banner Health, Greeley, Colorado, USA
| | - G Michael Deeb
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Stanley Chetcuti
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven J Yakubov
- Department of Cardiac Surgery, Riverside Methodist Hospital, Columbus, Ohio, USA; Department of Interventional Cardiology, Riverside Methodist Hospital, Columbus, Ohio, USA
| | - Atul Chawla
- Department of Cardiology, Iowa Heart Center, Des Moines, Iowa, USA
| | - David Hockmuth
- Department of Cardiology, Iowa Heart Center, Des Moines, Iowa, USA
| | - Patrick Teefy
- Department of Medicine, Cardiology Division, London Health Sciences Centre, London, Ontario, Canada
| | - Shuzhen Li
- Coronary and Structural Heart, Medtronic, Minneapolis, Minnesota, USA
| | - Michael J Reardon
- Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA; Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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13
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Chawla A, Byrne H, Rao M. 1544 The Doctor Will Call You Now – Patients’ Perspective of The Implementation of Telephone Clinics in the COVID-19 Era. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
During the first wave of the COVID-19 pandemic, clinical guidelines advised the implementation of remote consultations with the aim of preventing viral transmission. Guidance included the introduction of telephone clinics and in March 2020, these were initiated for General Surgery at our rural DGH. The aim of this study was to review patients’ perspectives of these remote consultations.
Method
Using telephone clinic schedules, the first 100 patients of the telephone clinics were retrospectively identified. A survey was created using Google forms and questions covered patient demographics, as well as patients’ opinions on the organisation and efficacy of the clinic. The survey was completed via a telephone conversation with each patient between June to August 2020.
Results
72 patients consented to participate (age range: 24-80 years; 65% female). 44% of consultations were follow up, with 23% of patients having their initial appointment remotely. Although 82% of patients were able to discuss all concerns, nearly half of patients (43%) felt not having a face-to-face appointment affected their consultation. 78% of patients preferred remote consultations during the pandemic, but beyond this specific situation, 53% felt that in the future they would still prefer a face-to-face consultation. 57.6% of patients rated the newly implemented telephone consultations as 10/10.
Conclusions
The majority of patient feedback was positive. However, outside of the COVID-19 pandemic, our patients would prefer the traditional face-to-face consultation format. This outcome has been demonstrated in other similar studies worldwide, as it enables patients to be examined by and meet their surgeon prior to potential surgery.
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Affiliation(s)
- A Chawla
- Queen's Medical Centre, Nottingham, United Kingdom
| | - H Byrne
- Northampton General Hospital, Northampton, United Kingdom
| | - M Rao
- Pilgrim Hospital, Boston, United Kingdom
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14
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Chawla A, Gill S, Sharma S, Kumar V, Logani A. Endodontic implications of a patient with arteriovenous malformation: a case report and literature review. Int Endod J 2021; 54:975-987. [PMID: 33410128 DOI: 10.1111/iej.13473] [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: 04/24/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
AIM To present the endodontic management of a patient diagnosed with a high-flow arteriovenous malformation (AVM) requiring root canal treatment and to discuss the relevant endodontic literature for this rare but significant problem. SUMMARY AVM is a complex communication of an artery and a vein in which the oxygenated blood is forced away from the intended tissue. The incidence of its occurrence in the face and neck is rare, and when present, the most common sign is gingival bleeding. Arteriovenous malformation is both a diagnostic and therapeutic challenge for dentists. Also, there is ambiguity regarding the precautions to be taken whilst doing endodontic procedures in such cases. Hence, there is a need to understand the disease process and its implications in order to prevent life-threatening complications during treatment. This case report highlights the successful endodontic management of a cariously exposed right maxillary second premolar in a patient diagnosed with high-flow AVM. On an orthopantomogram, the AVM was spreading in the left submandibular space involving the left ramus area. The clinical findings of limited mouth opening with inter-appointment swelling and trismus during treatment made the case unusual and challenging. This paper addresses the current understanding of the classification, diagnosis, clinical features and endodontic management, together with specific guidelines and recommendations whilst performing endodontic procedures in AVM cases. KEY LEARNING POINTS The classification and oral manifestations of AVM must be known and understood. Practitioners should be aware of the radiographic appearance of AVM. Recommended precautions should be taken when carrying out restorative and endodontic procedures in a patient with AVM. Antibiotic prophylaxis may be considered before endodontic treatment in a patient with AVM. Multidisciplinary treatment planning may be required.
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Affiliation(s)
- A Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - S Gill
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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15
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Sharma R, Kumar V, Logani A, Chawla A, Mir RA, Sharma S, Kalaivani M. Association between concentration of active MMP-9 in pulpal blood and pulpotomy outcome in permanent mature teeth with irreversible pulpitis - a preliminary study. Int Endod J 2020; 54:479-489. [PMID: 33128238 DOI: 10.1111/iej.13437] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 08/07/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
AIM To investigate the correlation between the concentration of active-matrix metalloproteinases-9 (aMMP-9) in pulpal blood and the outcome of pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis (SIP). METHODOLOGY Forty permanent molar teeth with a clinical diagnosis of SIP and normal apical tissues with periapical index (PAI) score ≤ 2 and ten permanent teeth (8 molars and two premolars) with a diagnosis of normal pulp that required root canal treatment for prosthetic reasons from patients between the ages of 15-35 years were recruited. All clinical procedures were performed under local anaesthesia and rubber dam isolation. After access opening, the coronal pulp tissue was amputated up to the canal orifice. A 100 μL volume of the pulpal blood was collected using a micropipette and transported to the laboratory. Sodium hypochlorite (2.5 %) was used as a haemostatic agent, and mineral trioxide aggregate (MTA) was used as the pulp capping material. The tooth was restored with composite at the same visit. Teeth with normal pulps were treated with single-visit root canal treatment. Patients with pulpotomy were recalled at 6 and 12 months. Outcome assessment of teeth with pulpotomy was carried out at 12 months and was categorized as success (asymptomatic patients with PAI score ≤ 2) or failure (symptomatic patients or PAI score ≥ 3). Quantification of aMMP-9 in pulpal blood was achieved using a fluorometric assay. The following statistical analyses were performed to assess the data: t-test, Fisher's exact test, kappa coefficient, non-parametric test, Wilcoxon rank-sum test, Spearman rank correlation test and receiver operating characteristic curve (ROC). RESULT The success rate of pulpotomy was 88 % at 12-months. There was a significant difference between the median concentrations of aMMP-9 in pulpal blood of teeth with normal pulps (52 (12-96) ng mL-1 :) and SIP (193.3 (25.8-607.7) ng mL-1 :) (P = 0.0003) and successful (132.3 (25.8-548.3) ng mL-1 :) and failed cases (512.4 (334.8-607.7 ng mL-1 :) (P = 0.0015) of MTA pulpotomy. A significant association was established between aMMP-9 concentration and outcome of pulpotomy. The area under the receiver operating characteristics curve (0.9484, 95%CI) suggested excellent discriminatory power of aMMP-9 concentration in pulpal blood to predict the pulpotomy outcome. CONCLUSION The pulpal blood concentration of aMMP-9 was significantly associated with the outcome of pulpotomy in teeth with symptomatic irreversible pulpitis, where it may be used as a potential prognostic biomarker.
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Affiliation(s)
- R Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - R A Mir
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - M Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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16
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Mumtaz M, Wyler von Ballmoos MC, Deeb GM, Popma JJ, Van Mieghem NM, Kleiman NS, Gleason TG, Chawla A, Hockmuth D, Zorn GL, Tadros P, Li S, Reardon MJ. The Impact of Transfusions on Mortality After Transcatheter or Surgical Aortic Valve Replacement. Ann Thorac Surg 2020; 112:778-785. [PMID: 33217396 DOI: 10.1016/j.athoracsur.2020.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND An increasing body of evidence suggests that packed red blood cell (PRBC) transfusion may be associated with increased morbidity and mortality after transcatheter and surgical aortic valve replacement. It remains unclear whether PRBC transfusion is a surrogate marker or truly an independent risk factor for mortality after aortic valve replacement in different populations. METHODS The Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial randomized 1660 patients with symptomatic, severe aortic stenosis at intermediate risk for operative death to transcatheter aortic valve replacement or surgical aortic valve replacement. Baseline characteristics and outcomes including all-cause and cardiovascular mortality at 30 days and thereafter were compared between participants with and participants without PRBC transfusion. Cox proportional hazards models with time-varying covariates were fitted to estimate the effect of PRBC transfusion on mortality after adjustment for comorbidities and procedural complications. RESULTS Patients receiving PRBC were older, more commonly female and frail, with more comorbidities. The Society of Thoracic Surgeons Predicted Risk of Mortality baseline score was higher in the transfused group. After adjustment for these differences, PRBC transfusion was associated with mortality at 30 days, but not thereafter. The effect of PRBC on mortality (hazard ratio 1.04; 95% confidence interval, 0.96 to 1.11; P = .304) at 30 days was not independent of procedural complications (hazard ratio 21.04; 95% CI, 7.26 to 60.95; P < .001). CONCLUSIONS Poor health status, procedural complications, PRBC transfusion, and mortality are correlated with each other. Transfusion of PRBC did not independently increase risk for mortality. In this intermediate-risk population, transfusion appears to be a risk marker of chronic conditions and periprocedural complications as opposed to a risk factor for postprocedural mortality. (Clinical trial registration: www.clinicaltrials.gov NCT01586910.).
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Affiliation(s)
- Mubashir Mumtaz
- Department of Cardiovascular and Thoracic Surgery, University of Pittsburgh Medical Center, Pinnacle Heath, Harrisburg, Pennsylvania.
| | | | - G Michael Deeb
- Department of Cardiac Surgery, University of Michigan Hospitals, Ann Arbor, Michigan
| | - Jeffrey J Popma
- Department of Interventional Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nicolas M Van Mieghem
- Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Neal S Kleiman
- Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Thomas G Gleason
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | - George L Zorn
- University of Kansas Medical Center, Kansas City, Kansas
| | - Peter Tadros
- University of Kansas Medical Center, Kansas City, Kansas
| | - Shuzhen Li
- Department of Statistics, Medtronic, Mounds View, Minnesota
| | - Michael J Reardon
- Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
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17
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Amaresh M, Hegde P, Chawla A, de la Rosette JJMCH, Laguna MP, Kriplani A. Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study. World J Urol 2020; 39:2155-2161. [PMID: 32865690 PMCID: PMC8216999 DOI: 10.1007/s00345-020-03409-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/11/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones. Methods Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (p value < 0.05). Results Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (p = 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (p = 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (p = 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (p = 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (p = 0.243).Post operatively blood transfusion was required in two patients in group 2 (p = 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (p = 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (p = 0.046). Conclusions Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications. Study registration Clinical trials registry – INDIA; CTRI/2018/07/014,687.
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Affiliation(s)
- M Amaresh
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
| | - P Hegde
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
| | - A Chawla
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India.
| | | | - M P Laguna
- Department of Urology, Istanbul Medipol University Hospital, Istanbul, Turkey
| | - A Kriplani
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India
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18
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Reardon MJ, Heijmen RH, Van Mieghem NM, Williams MR, Yakubov SJ, Watson D, Kleiman NS, Conte J, Chawla A, Hockmuth D, Petrossian G, Robinson N, Kappetein AP, Li S, Popma JJ. Comparison of Outcomes After Transcatheter vs Surgical Aortic Valve Replacement Among Patients at Intermediate Operative Risk With a History of Coronary Artery Bypass Graft Surgery: A Post Hoc Analysis of the SURTAVI Randomized Clinical Trial. JAMA Cardiol 2020; 4:810-814. [PMID: 31215985 DOI: 10.1001/jamacardio.2019.1856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Surgical aortic valve replacement (SAVR) has increased risk for patients with aortic stenosis (AS) and a history of coronary artery bypass graft (CABG) surgery. Transcatheter aortic valve replacement (TAVR) may be an alternative. Objective To compare TAVR with SAVR outcomes in patients at intermediate operative risk with prior CABG surgery. Design, Setting, and Participants In this post hoc analysis of the Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) noninferiority randomized clinical trial, patients with severe, symptomatic AS at intermediate operative risk were enrolled from 87 centers across the United States, Europe, and Canada from June 2012 to June 2016 and followed-up with up to July 2017. Those with a history of CABG surgery were considered for analysis. Data were analyzed from September to December 2017. Interventions A total of 1746 patients were enrolled and randomized 1:1 to self-expanding TAVR or SAVR. An implant was attempted in 1660 patients, of whom 273 had prior CABG surgery, including 136 who underwent attempted TAVR and 137 who underwent attempted SAVR. Main Outcomes and Measures The primary outcome was all-cause mortality or disabling stroke at 1-year follow-up. Efficacy outcomes included quality of life, measured using the Kansas City Cardiomyopathy Questionnaire at 30 days, 6 months, and 1 year, and distance walked in 6 minutes, measured using the 6-minute walk test at 30 days and 1 year. Results Of the 136 patients in the TAVR cohort, 111 (81.6%) were male, and the mean (SD) age was 76.9 (6.5) years; of the 137 in the SAVR cohort, 117 (85.4%) were male, and the mean (SD) age was 76.6 (6.5) years. The mean (SD) Society of Thoracic Surgeons Predicted Risk of Mortality score was 5.0% (1.6%) in the TAVR cohort and 5.2% (1.7%) in the SAVR cohort. All-cause mortality or disabling stroke at 1-year follow-up was 8.9% (95% CI, 5.2-15.2) in the TAVR cohort and 6.7% (95% CI, 3.5-12.8) in the SAVR cohort (log-rank P = .53). Compared with patients receiving SAVR, the mean (SD) Kansas City Cardiomyopathy Questionnaire summary score was significantly better among patients receiving TAVR at 30 days (81.4 [19.2] vs 69.7 [22.6]; P < .001); treatments were similar at 1 year (85.7 [14.6] vs 82.8 [18.4]; P = .19). Compared with patients in the SAVR cohort, those in the TAVR cohort showed greater mean (SD) improvement in distance walked at 1 year (48.3 [120.6] m vs 16.8 [88.7] m; P = .04). Conclusions and Relevance Both TAVR and SAVR were safe for intermediate-risk patients with AS and prior CABG surgery. The transcatheter approach facilitated faster improvement in quality of life and better exercise capacity at 1-year follow-up. Trial Registration ClinicalTrials.gov identifier: NCT01586910.
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Affiliation(s)
| | | | | | | | | | - Daniel Watson
- OhioHeath Riverside Methodist Hospital, Columbus, Ohio
| | - Neal S Kleiman
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - John Conte
- The Johns Hopkins University, Baltimore, Maryland
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Taori R, Chawla A, Kapadia A. Modified Visual Prostate Symptom Score (M-VPSS) – a new tool for evaluation of lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) in men. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34050-7] [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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Shah M, Hameed B, Chawla A. Urostentz: World’s first comprehensive ureteral stent and symptom tracking smartphone application. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33391-7] [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: 11/16/2022] Open
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Shenoi S, Nayak S, Munoli R, Chawla A. P-02-77 Clinical Profile of Patients Attending a Multidisciplinary Sexual Dysfunction Clinic at a Tertiary Care Hospital. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sharma S, Kumar V, Chawla A, Logani A. Rapid detection of SARS-CoV-2 in saliva: can an endodontist take the lead in point-of-care COVID-19 testing? Int Endod J 2020; 53:1017-1019. [PMID: 32344452 PMCID: PMC7267301 DOI: 10.1111/iej.13317] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- S Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Søndergaard L, Popma JJ, Reardon MJ, Van Mieghem NM, Deeb GM, Kodali S, George I, Williams MR, Yakubov SJ, Kappetein AP, Serruys PW, Grube E, Schiltgen MB, Chang Y, Engstrøm T, Sorajja P, Sun B, Agarwal H, Langdon T, den Heijer P, Bentala M, O’Hair D, Bajwa T, Byrne T, Caskey M, Paulus B, Garrett E, Stoler R, Hebeler R, Khabbaz K, Scott Lim D, Bladergroen M, Fail P, Feinberg E, Rinaldi M, Skipper E, Chawla A, Hockmuth D, Makkar R, Cheng W, Aji J, Bowen F, Schreiber T, Henry S, Hengstenberg C, Bleiziffer S, Harrison JK, Hughes C, Joye J, Gaudiani V, Babaliaros V, Thourani V, Dauerman H, Schmoker J, Skelding K, Casale A, Kovac J, Spyt T, Seshiah P, Smith JM, McKay R, Hagberg R, Matthews R, Starnes V, O’Neill W, Paone G, García JMH, Such M, de la Tassa CM, Cortina JCL, Windecker S, Carrel T, Whisenant B, Doty J, Resar J, Conte J, Aharonian V, Pfeffer T, Rück A, Corbascio M, Blackman D, Kaul P, Kliger C, Brinster D, Teefy P, Kiaii B, Leya F, Bakhos M, Sandhu G, Pochettino A, Piazza N, de Varennes B, van Boven A, Boonstra P, Waksman R, Bafi A, Asgar A, Cartier R, Kipperman R, Brown J, Lin L, Rovin J, Sharma S, Adams D, Katz S, Hartman A, Al-Jilaihawi H, Crestanello J, Lilly S, Ghani M, Bodenhamer RM, Rajagopal V, Kauten J, Mumtaz M, Bachinsky W, Nickenig G, Welz A, Olsen P, Watson D, Chhatriwalla A, Allen K, Teirstein P, Tyner J, Mahoney P, Newton J, Merhi W, Keiser J, Yeung A, Miller C, Berg JT, Heijmen R, Petrossian G, Robinson N, Brecker S, Jahangiri M, Davis T, Batra S, Hermiller J, Heimansohn D, Radhakrishnan S, Fremes S, Maini B, Bethea B, Brown D, Ryan W, Kleiman N, Spies C, Lau J, Herrmann H, Bavaria J, Horlick E, Feindel C, Neumann FJ, Beyersdorf F, Binder R, Maisano F, Costa M, Markowitz A, Tadros P, Zorn G, de Marchena E, Salerno T, Chetcuti S, Labinz M, Ruel M, Lee JS, Gleason T, Ling F, Knight P, Robbins M, Ball S, Giacomini J, Burdon T, Applegate R, Kon N, Schwartz R, Schubach S, Forrest J, Mangi A. Comparison of a Complete Percutaneous Versus Surgical Approach to Aortic Valve Replacement and Revascularization in Patients at Intermediate Surgical Risk: Results From the Randomized SURTAVI Trial. Circulation 2019; 140:1296-1305. [PMID: 31476897 DOI: 10.1161/circulationaha.118.039564] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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] [Indexed: 01/06/2023]
Abstract
BACKGROUND For patients with severe aortic stenosis and coronary artery disease, the completely percutaneous approach to aortic valve replacement and revascularization has not been compared with the standard surgical approach. METHODS The prospective SURTAVI trial (Safety and Efficiency Study of the Medtronic CoreValve System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement) enrolled intermediate-risk patients with severe aortic stenosis from 87 centers in the United States, Canada, and Europe between June 2012 and June 2016. Complex coronary artery disease with SYNTAX score (Synergy Between PCI with Taxus and Cardiac Surgery Trial) >22 was an exclusion criterion. Patients were stratified according to the need for revascularization and then randomly assigned to treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Patients assigned to revascularization in the TAVR group underwent percutaneous coronary intervention, whereas those in the SAVR group had coronary artery bypass grafting. The primary end point was the rate of all-cause mortality or disabling stroke at 2 years. RESULTS Of 1660 subjects with attempted aortic valve implants, 332 (20%) were assigned to revascularization. They had a higher Society of Thoracic Surgeons risk score for mortality (4.8±1.7% versus 4.4±1.5%; P<0.01) and were more likely to be male (65.1% versus 54.2%; P<0.01) than the 1328 patients not assigned to revascularization. After randomization to treatment, there were 169 patients undergoing TAVR and percutaneous coronary intervention, 163 patients undergoing SAVR and coronary artery bypass grafting, 695 patients undergoing TAVR, and 633 patients undergoing SAVR. No significant difference in the rate of the primary end point was found between TAVR and percutaneous coronary intervention and SAVR and coronary artery bypass grafting (16.0%; 95% CI, 11.1-22.9 versus 14.0%; 95% CI, 9.2-21.1; P=0.62), or between TAVR and SAVR (11.9%; 95% CI, 9.5-14.7 versus 12.3%; 95% CI, 9.8-15.4; P=0.76). CONCLUSIONS For patients at intermediate surgical risk with severe aortic stenosis and noncomplex coronary artery disease (SYNTAX score ≤22), a complete percutaneous approach of TAVR and percutaneous coronary intervention is a reasonable alternative to SAVR and coronary artery bypass grafting. CLINICAL TRIAL REGISTRATION URL: https://www. CLINICALTRIALS gov. Unique identifier: NCT01586910.
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Affiliation(s)
- Lars Søndergaard
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark (L.S., T.E.)
| | - Jeffrey J. Popma
- Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Michael J. Reardon
- Department of Cardiovascular Surgery, Methodist DeBakey Heart and Vascular Center, Houston, TX (M.J.R.)
| | - Nicolas M. Van Mieghem
- Departments of Cardiology and Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands (N.M.V.M., A.P.K.)
| | - G. Michael Deeb
- Department of Cardiac Surgery, University of Michigan, Ann Arbor (G.M.D.)
| | - Susheel Kodali
- Department of Surgery, Columbia University Medical Center, New York (S.K., I.G.)
| | - Isaac George
- Department of Surgery, Columbia University Medical Center, New York (S.K., I.G.)
| | - Mathew R. Williams
- Departments of Medicine (Cardiology) and Cardiothoracic Surgery, NYU-Langone Medical Center, New York (M.R.W.)
| | - Steven J. Yakubov
- Department of Cardiology, OhioHealth Riverside Methodist Hospital, Columbus (S.J.Y.)
| | - Arie P. Kappetein
- Departments of Cardiology and Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands (N.M.V.M., A.P.K.)
- Structural Heart, Medtronic plc, Minneapolis, MN (A.P.K., M.B.S., Y.C.)
| | - Patrick W. Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Eberhard Grube
- Department of Medicine II, Heart Center Bonn, Germany (E.G.)
| | | | - Yanping Chang
- Structural Heart, Medtronic plc, Minneapolis, MN (A.P.K., M.B.S., Y.C.)
| | - Thomas Engstrøm
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark (L.S., T.E.)
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Chawla A, Shikhare S, Singh D. IgG4 disease diagnosed on computed tomography-magnetic resonance imaging. Indian J Nephrol 2018. [PMID: 29515308 PMCID: PMC5830816 DOI: 10.4103/ijn.ijn_15_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- P Mukherjee
- Khoo Teck Puat Hospital, Department of Diagnostic Radiology, 90 Yishun Central, Singapore 768828
| | - A Chawla
- Khoo Teck Puat Hospital, Department of Diagnostic Radiology, 90 Yishun Central, Singapore 768828
| | - S Swarup
- Khoo Teck Puat Hospital, Department of Accident and Emergency, 90 Yishun Central, Singapore 768828
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Kleiman NS, Maini BJ, Reardon MJ, Conte J, Katz S, Rajagopal V, Kauten J, Hartman A, McKay R, Hagberg R, Huang J, Popma J, Ad N, Aharonian V, Anderson WD, Applegate R, Bafi A, Bajwa T, Bakhos M, Ball S, Batra S, Beohar N, Brachinsky W, Brinster D, Brown J, Byrne J, Byrne T, Casale A, Caskey M, Chawla A, Cohen H, Coselli J, Costa M, Cheatham J, Chetcuti SJ, Crestanello J, Davis T, Michael Deeb G, Diez J, Dauerman H, Elefteriades J, Fail P, Feinberg E, Fontana G, Forrest JL, Galloway A, Giacomini J, Gleason TG, Guadiani V, Harrison JK, Hebeler R, Heimansohn D, Heiser J, Heller L, Henry S, Hermiller J, Hockmuth D, Hughes GC, Joye J, Kafi A, Kar B, Khabbaz K, Kipperman R, Kliger C, Kon N, Lamelas J, Lee JS, Leya F, Londono JC, Macheers S, Mangi A, de Marchena E, Markowitz A, Matthews R, Merhi W, Mumtaz M, O’Hair D, Petrossian G, Pfeffer T, Raybuck B, Resar J, Robbins M, Robbins R, Robinson N, Ring M, Salerno T, Schreiber T, Schmoker J, Sharma S, Siwek L, Skelding K, Slater J, Starnes V, Stoler R, Subramanian V, Tadros P, Thompson C, Waksman R, Watson D, Yakubov S, Zhao D, Zorn GL. Neurological Events Following Transcatheter Aortic Valve Replacement and Their Predictors: A Report From the CoreValve Trials. Circ Cardiovasc Interv 2017; 9:CIRCINTERVENTIONS.115.003551. [PMID: 27601429 DOI: 10.1161/circinterventions.115.003551] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [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: 09/09/2015] [Accepted: 07/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The risk for stroke after transcatheter aortic valve replacement (TAVR) is an important concern. Identification of predictors for stroke is likely to be a critical factor aiding patient selection and management as TAVR use becomes widespread. METHODS AND RESULTS Patients enrolled in the CoreValve US Extreme Risk and High Risk Pivotal Trials or Continued Access Study treated with the self-expanding CoreValve bioprosthesis were included in this analysis. The 1-year stroke rate after TAVR was 8.4%. Analysis of the stroke hazard rate identified an early phase (0-10 days; 4.1% of strokes) and a late phase (11-365 days; 4.3% of strokes). Baseline predictors of early stroke included National Institutes of Health stroke scale score >0, prior stroke, prior transient ischemic attack, peripheral vascular disease, absence of prior coronary artery bypass surgery, angina, low body mass index (<21 kg/m(2)), and falls within the past 6 months. Significant procedural predictors were total time in the catheterization laboratory or operating room, delivery catheter in the body time, rapid pacing used during valvuloplasty, and repositioning of the prosthesis. Predictors of stroke between 11 and 365 days were small body surface area, severe aortic calcification, and falls within the past 6 months. There were no significant imaging predictors of early or late stroke. CONCLUSIONS Predictors of early stroke after TAVR included clinical and procedural factors; predictors of later stroke were limited to patient but not anatomic characteristics. These findings indicate that further refinement of imaging to identify anatomic factors predisposing to embolization may help improve stroke prediction in patients undergoing TAVR. CLINICAL TRIAL REGISTRATIONS URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01240902, NCT01531374.
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Affiliation(s)
- Neal S Kleiman
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.).
| | - Brijeshwar J Maini
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Michael J Reardon
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - John Conte
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Stanley Katz
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Vivek Rajagopal
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - James Kauten
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Alan Hartman
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Raymond McKay
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Robert Hagberg
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Jian Huang
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Jeffrey Popma
- From the Houston Methodist DeBakey Heart and Vascular Institute, TX (N.S.K., M.J.R.); Tenet Healthcare Corporation, Delray Beach, FL (B.J.M.); Johns Hopkins University, Baltimore, MD (J.C.); Hofstra North Shore University Hospital, New Hyde Park, NY (S.K., A.H.); Hartford Hospital, CT (R.M., R. H.); Piedmont Heart Institute, Atlanta, GA (V.R., J.K.); Medtronic, Minneapolis, MN (J.H.); and Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | | | | | | | | | | | - Amar Bafi
- Washington Hospital Center/Georgetown Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joseph Coselli
- Texas Heart Institute at St Lukes Episcopal Hospital/Baylor College of Medicine
| | | | | | | | | | | | | | - Jose Diez
- Texas Heart Institute at St Lukes Episcopal Hospital/Baylor College of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Scott Henry
- Detroit Medical Center Cardiovascular Institute
| | | | | | | | | | - Ali Kafi
- Detroit Medical Center Cardiovascular Institute
| | - Biswajit Kar
- Texas Heart Institute at St Lukes Episcopal Hospital/Baylor College of Medicine
| | | | | | | | - Neal Kon
- Wake Forest University Baptist Medical Center
| | | | | | | | | | | | | | | | | | - Ray Matthews
- University of Southern California University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lee Siwek
- Providence Sacred Heart Medical Center
| | | | | | | | | | | | | | | | - Ron Waksman
- Washington Hospital Center/Georgetown Hospital
| | - Daniel Watson
- Riverside Methodist Hospital/Ohio Health Research Institute
| | - Steven Yakubov
- Riverside Methodist Hospital/Ohio Health Research Institute
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Pankaj A, Mittal A, Chawla A. The validity and reproducibility of cross table radiographs compared with CT scans for the measurement of anteversion of the acetabular component after total hip arthroplasty. Bone Joint J 2017; 99-B:1006-1011. [DOI: 10.1302/0301-620x.99b8.bjj-2016-1158.r2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 12/04/2016] [Accepted: 03/24/2017] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to assess the reproducibility and validity of cross table radiographs for measuring the anteversion of the acetabular component after total hip arthroplasty (THA) and to compare it with measurements using CT scans. Patients and Methods A total of 29 patients who underwent THA between June 2010 and January 2016 were included. There were 17 men and 12 women. Their mean age was 43 years (26 to 65). Seven patients underwent a bilateral procedure. Thus, 36 THAs were included in the study. Lateral radiographs and CT scans were obtained post-operatively and radiographs repeated three weeks later. The anteversion of the acetabular component was measured using the method described by Woo and Morrey and the ischiolateral method described by Pulos et al and these were compared with the results obtained from CT scans. Results The mean anteversion was 18.35° (3° to 38°) using Woo and Morrey’s method, 51.45° (30° to 85°) using the ischiolateral method and 21.22° (2° to 48°) using CT scans. The Pearson correlation coefficient was 0.754 for Woo and Morrey’s method and 0.925 for the ischiolateral method. There was a linear correlation between the measurements using the ischiolateral method and those using CT scans. We derived a simple linear equation between the value of the CT scan and that of ischiolateral method to deduce the CT scan value from that of ischiolateral method and vice versa. Conclusion The anteversion of the acetabular component measured using both plain radiographic methods was consistently valid with good interobserver reproducibility, but the ischiolateral method which is independent of pelvic tilt was more accurate. As CT is costly, associated with a high dose of radiation and not readily available, the ischiolateral method can be used for assessing the anteversion of the acetabular component. Cite this article: Bone Joint J 2017;99-B:1006–11.
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Affiliation(s)
- A. Pankaj
- Fortis Hospital, A
Block, Shalimar Bagh, Opposite
Kela Godam, New Delhi, Delhi 110088, India
| | - A. Mittal
- Guru Teg Bahadur Hospital, House
No. S4, Block 2, Type
2, Kalyan Vas, Delhi, 110091, India
| | - A. Chawla
- Fortis Hospital, A
Block, Shalimar Bagh, Opposite
Kela Godam, New Delhi, Delhi 110088, India
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Krishna R, Gheyas F, Liu Y, Hagen DR, Walker B, Chawla A, Cote J, Blaustein RO, Gutstein DE. Chronic Administration of Anacetrapib Is Associated With Accumulation in Adipose and Slow Elimination. Clin Pharmacol Ther 2017; 102:832-840. [DOI: 10.1002/cpt.700] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/14/2017] [Accepted: 03/28/2017] [Indexed: 11/07/2022]
Affiliation(s)
- R Krishna
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - F Gheyas
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - Y Liu
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - DR Hagen
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - B Walker
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - A Chawla
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - J Cote
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | | | - DE Gutstein
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
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Alexander T, Maxim E, Cardwell L, Chawla A, Feldman S. 702 Prescriptions for atopic dermatitis: Oral corticosteroids remain commonplace. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zacharias R, Belcher S, Rodway-Norman M, Guller D, Chawla A, Hough P, Smith WG. Exploration of a new model of care in a psychiatry unit. Healthc Manage Forum 2017; 30:107-110. [PMID: 28929892 DOI: 10.1177/0840470416658906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The model established at Orillia Soldiers Memorial Hospital involves family physicians as the most responsible physician. They act as "admission gatekeeper" for all unattached patients who are admitted to the psychiatry in-patient unit. A PubMed, EBSCO, OVID Medline, Embase, CINAHL, and Web of Science database review of the last 10 years (2006-2016) was undertaken. A satisfaction survey was undertaken. An intensive literature review found this model to be unique. The model has proved to be extremely efficient and cost-effective.
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Affiliation(s)
- R Zacharias
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - S Belcher
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - M Rodway-Norman
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - D Guller
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - A Chawla
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - P Hough
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
| | - W G Smith
- 1 Mental Health and Addictions Program, Orillia Soldiers Memorial Hospital (OSMH), Orillia, Ontario, Canada
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Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, Rai V, Hung NV, Kanj SS, Salama MF, Salgado-Yepez E, Elahi N, Morfin Otero R, Apisarnthanarak A, De Carvalho BM, Ider BE, Fisher D, Buenaflor MCS, Petrov MM, Quesada-Mora AM, Zand F, Gurskis V, Anguseva T, Ikram A, Aguilar de Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di Silvestre G, Furova K, Ramos-Ortiz GY, Gamar Elanbya MO, Satari HI, Gupta U, Dendane T, Raka L, Guanche-Garcell H, Hu B, Padgett D, Jayatilleke K, Ben Jaballah N, Apostolopoulou E, Prudencio Leon WE, Sepulveda-Chavez A, Telechea HM, Trotter A, Alvarez-Moreno C, Kushner-Davalos L, Desse J, Maurizi D, Montanini A, Chaparro G, Stagnaro J, Romani A, Bianchi A, Álvarez G, Palaoro A, Bernan M, Cabrera-Montesino R, Domínguez C, Rodríguez C, Silva C, Bogdanowicz E, Riera F, Benchetrit G, Perez I, Vimercati J, Marcos L, Ramasco L, Caridi M, Oyola M, Rodríguez M, Spadaro M, Olivieri M, Saul P, Juarez P, Pérez R, Botta P, Quintana D, Ríos A, Stagnaro J, Chediack V, Chilon W, Alsayegh AI, Yaseen FH, Hani LF, Sowar SF, Magray TA, Medeiros E, Alves De Oliveira A, Romario-Mendes A, Fernandes-Valente C, Santos C, Escudeiro D, Azevedo-Ferreira Lima D, Azevedo-Pereira D, Onzi-Siliprandi E, Serpa-Maia F, Aguiar-Leitao F, Assuncao-Ponte G, Dos Anjos-Lima J, Olszewski J, Harten Pinto Coelho K, Alves De Lima L, Mendonca M, Maciel-Canuto Amaral M, Tenorio M, Gerah S, Andrade-Oliveira-Reis M, Moreira M, Ximenes-Rocha Batista M, Campos-Uchoa R, Rocha-Vasconcelos Carneiro R, Amaral De Moraes R, Do Nascimento S, Moreira-Matos T, Lima-De Barros Araujo T, De Jesus Pinheiro-Bandeira T, Machado-Silva V, Santos Monteiro W, Hristozova E, Kostadinov E, Angelova K, Velinova V, Dicheva V, Guo X, Ye G, Li R, Song L, Liu K, Liu T, Song G, Wang C, Yang X, Yu H, Yang Y, Martínez A, Vargas-García A, Lagares-Guzmán A, González A, Linares C, Ávila-Acosta C, Santofimio D, Yepes-Gomez D, Marin-Tobar D, Mazo-Elorza D, Chapeta-Parada E, Camacho-Moreno G, Roncancio-Vill G, Valderrama-Marquez I, Ruiz-Gallardo J, Ospina-Martínez J, Osorio J, Marín-Uribe J, López J, Gualtero S, Rojas J, Gomez-Nieto K, Rincon L, Meneses-Ovallos L, Canas-Giraldo L, Burgos-Florez L, Amaral-Almeida Costa M, Rodriguez M, Barahona-Guzmán N, Mancera-Paez O, Rios-Arana P, Ortega R, Romero-Torres S, Pulido-Leon S, Valderrama S, Moreno-Mejia V, Raigoza-Martinez W, Villamil-Gomez W, Pardo-Lopez Y, Argüello-Ruiz A, Solano-Chinchilla A, Muñoz-Gutierrez G, Calvo-Hernández I, Maroto-Vargas L, Zuniga M, Valverde-Hernandez M, Chavarria-Ugalde O, Herrera B, Díaz C, Bovera M, Cevallos C, Pelaez C, Jara E, Delgado V, Coello-Gordon E, Picoita F, Guerrero-Toapant F, Valencia F, Santacruz G, Gonzalez H, Pazmino L, Garcia M, Arboleda M, Lascano M, Alquinga N, Ramírez V, Yousef RH, Moustafa AEM, Ahmed A, Elansary A, Ali AM, Hasanin A, Messih AA, Ramadan A, El Awady B, Hassan D, Abd El Aziz D, Hamza H, Agha HM, Ghazi IA, ElKholy J, Fattah MA, Elanany M, Mansour M, Haleim M, Fouda R, El-Sherif RH, Bekeit S, Bayani V, Elkholy Y, Abdelhamid Y, Salah Z, Rivera D, Chawla A, Manked A, Azim A, Mubarak A, Thakur A, Dharan A, Patil A, Sasidharan A, Bilolikar AK, Anirban Karmakar A, Mathew A, Kulkarni A, Agarwal A, Sriram A, Dwivedy A, Dasgupta A, Bhakta A, Suganya AR, Poojary A, Mani AK, Sakle A, Abraham BK, Padmini B, Ramachandran B, Ray B, Pati BK, Chaudhury BN, Mishra BM, Biswas S, Saibala MB, Jawadwala BQ, Rodrigues C, Modi C, Patel C, Khanna D, Devaprasad D, Divekar D, Aggarwal DG, Divatia J, Zala D, Pathrose E, Abubakar F, Chacko F, Gehlot G, Khanna G, Sale H, Roy I, Shelgaonkar J, Sorabjee J, Eappen J, Mathew J, Pal J, Varma K, Joshi KL, Sandhu K, Kelkar R, Ranganathan L, Pushparaj L, Lavate M, Latha M, Suryawanshi M, Bhattacharyya M, Kavathekar M, Agarwal MK, Patel M, Shah M, Sivakumar M, Kharbanda M, Bej M, Potdar M, Chakravarthy M, Karpagam M, Myatra S, Gita N, Rao N, Sen N, Ramakrishnan N, Jaggi N, Saini N, Pawar N, Modi N, Pandya N, Mohanty N, Thakkar P, Joshi P, Sahoo PK, Nair PK, Kumar PS, Patil P, Mukherjee P, Mathur P, Shah P, Sukanya R, Arjun R, Chawla R, Gopalakrishnan R, Venkataraman R, Raut S, Krupanandan R, Tejam R, Misra R, Debroy R, Saranya S, Narayanan S, Mishra S, Saseedharan S, Sengupta S, Patnaik S, Sinha S, Blessymole S, Rohra S, Rajagopal S, Mukherjee S, Sengupta S, John S, Bhattacharya S, Sijo, Bhattacharyya S, Singh S, Sohanlal T, Vadi S, Dalal S, Todi S, Kumar S, Kansal S, Misra S, Bhattacharyya S, Nirkhiwale S, Purkayastha SK, Mukherjee S, Singh S, Sahu S, Sharma S, Kumar S, Basu S, Shetty S, Shah S, Singhal T, Francis T, Anand T, Venkateshwar V, Thomas V, Kothari V, Velupandi, Kantroo V, Sitohang G, Kadarsih R, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Alebouyeh M, Sherafat SJ, Mohamed YK, Al Khamis A, Alsaadi AS, Al-Jarie AA, Mutwalli AH, Rillorta A, Thomas A, Kelany A, Manao A, Alamri DM, Santiago E, Cruzpero E, Sawan FA, Al Qasmah FA, Alabdaly H, Al-Dossary HA, Ahmed H, Roshdi H, Al-Alkami HY, Hanafi H, Ammari HE, Hani HMA, Asiri IAA, Mendoza JA, Philipose J, Selga JO, Kehkashan, Ghalilah KM, Redito LS, Josph L, Al-Alawi M, Al-Gethamy MM, Madco M, Manuel M, Girvan M, Aldalaton M, De Guzman M, Alkhamaly M, Masfar M, Karrar MAA, Al Azmi MM, Quisai ML, Torres MM, Al-Abdullah N, Tawfic NA, Elsayed N, Abdulkhalik NS, Bugis NA, Ariola NC, Gad N, Alghosn N, Tashkandi N, Zharani NA, De Vera P, Krishnan R, Al Shehri RH, Jaha RNA, Thomas R, Cresencia RL, Penuliar R, Lozada R, Al Qahtani S, Twfik S, Al Faraj SH, El-Sherbiny S, Alih SJB, Briones S, Bukhari SZ, Alotaibi TSA, Gopal U, Nair U, Abdulatif WA, Hussain WM, Demotica WM, Spahija G, Baftiu N, Gashi A, Omar AA, Mohamed A, Rebello F, Almousa HH, Abdo NM, George S, Khamis S, Thomas S, Ahmad Zaatari A, Anwar Al Souheil A, Ayash H, Zeid I, Tannous J, Zahreddine N, Ahmadieh R, Mahfouz T, Kardas T, Tanzi V, Kanafani Z, Hammoud Z, Dagys A, Grinkeviciute D, Kevalas R, Kondratas T, Petrovska M, Popovska K, Mitrev Z, Miteva ZB, Jankovska K, Guroska ST, Gan CS, Othman AA, Yusof AM, Abidin ASZ, Aziz FA, Weng FK, Zainol H, Bakar KBA, Lum LCS, Mansor M, Zaman MK, Jamaluddin MFH, Hasan MS, Rahman RA, Zaini RHM, Zhazali R, Sri Ponnampala SSL, Chuah SL, Shukeri WFWM, Hassan WNW, Yusoff WNW, Mat WRW, Cureno-Diaz M, Aguirre-Avalos G, Flores-Alvarado A, Cerero-Gudino A, Zamores-Pedroza A, Cano-Munoz B, Hernandez-Chena B, Carreon-Martinez C, Coronado-Magana H, Corona-Jimenez F, Rodriguez-Noriega E, Alcala-Martinez E, Gonzalez-Diaz E, Guerra-Infante F, Arteaga-Troncoso G, Martinez-Falcon G, Leon-Garnica G, Delgado-Aguirre H, Perez-Gomez H, Sosa-Gonzalez I, Galindo-Olmeda J, Ayala-Gaytan J, Rodriguez-Pacheco J, Zamorano-Flores L, Lopez-Pulgarin J, Miranda-Novales M, Ramírez M, Lopez-Hurtado M, Lozano M, Gomez M, Sanchez-Castuera M, Kasten-Monges M, Gonzalez-Martinez M, Sanchez-Vargas M, Culebro-Burguet M, Altuzar-Figueroa M, Mijangos-Mendez J, Ramires O, Espinosa O, De Leon-Escobedo R, Salas-Flores R, Ruiz-Rendon R, Petersen-Morfin S, Aguirre-Diaz S, Esparza-Ahumada S, Vega-Gonzalez S, Gaona-Flores V, Monroy-Colin V, Cruz-Rivera Z, Bat-Erdene A, Narankhuu B, Choijamts B, Tuvdennyam B, Batkhuu B, Chuluunchimeg K, Enkhtsetseg D, Batjargal G, Bayasgalan G, Dorj M, Mendsaikhan N, Baatar O, Suvderdene P, Baigalmaa S, Khajidmaa T, Begzjav T, Tsuyanga, Ariyasuren Z, Zeggwagh A, Berechid K, Abidi K, Madani N, Abouqal R, Koirala A, Giri R, Sainju S, Acharya SP, Ahmed A, Raza A, Parveen A, Sultan F, Khan M, Paul N, Daud N, Yusuf S, Nizamuddin S, Garcia-Mayorca E, Castaño E, Moreno-Castillo J, Ballinas-Aquino J, Lara L, Vargas M, Rojas-Bonilla M, Ramos S, Mapp T, De Iturrado V, La Hoz Vergara C, Linares-Calderon C, Moreno D, Ramirez E, Ramírez Wong F, Montenegro-Orrego G, Sandoval-Castillo H, Pichilingue-Chagray J, Mueras-Quevedo J, Aibar-Yaranga K, Castillo-Bravo L, Santivanez-Monge L, Mayorga-Espichan M, Rosario-Tueros M, Changano-Rodriguez M, Salazar-Ramirez N, Marquez-Mondalgo V, Tajanlangit ALN, Tamayo AS, Llames CMJP, Labro E, Dy AP, Fortin J, Bergosa L, Salvio L, Bermudez V, Sg-Buenaflor M, Trajano M, Mendoza M, Javellana O, Maglente R, Arreza-Galapia Y, Navoa-Ng J, Kubler A, Barteczko-Grajek B, Dragan B, Zurawska M, Mikaszewska-Sokolewicz M, Zielinska M, Ramos-Ortiz G, Florin-Rogobete A, Vlad CD, Muntean D, Sandesc D, Papurica M, Licker M, Bedreag OH, Popescu R, Grecu S, Dumitrascu V, Molkov A, Galishevskiy D, Furman M, Simic A, Lekic D, Ristic G, Eremija J, Kojovic J, Nikolic L, Bjelovic M, Lesnakova A, Hlinkova S, Gamar-Elanbya M, Supa N, Prasan P, Pimathai R, Wanitanukool S, Somabutr S, Ben-Jaballah N, Borgi A, Bouziri A, Dilek A, Oncul A, Kaya A, Demiroz AP, Gunduz A, Ozgultekin A, Inan A, Yalcin A, Ramazanoglu A, Engin A, Willke A, Meco BC, Aygun C, Bulut C, Uzun C, Becerik C, Hatipoglu CA, Guclu CY, Ozdemir D, Yildizdas D, Ugurcan D, Azak E, Guclu E, Yilmaz EM, Sebnem-Erdinc F, Sirmatel F, Ulger F, Sari F, Kizilates F, Usluer G, Ceylan G, Ersoz G, Kaya G, Ertem GT, Senol G, Agin H, Cabadak H, Yilmaz H, Sungurtekin H, Zengin H, Turgut H, Ozgunes I, Devrim I, Erdem I, Işcanlı IGE, Bakir MM, Geyik M, Oral M, Meric M, Cengiz M, Ozcelik M, Altindis M, Sunbul M, Elaldi N, Kuyucu N, Unal N, Oztoprak N, Yasar N, Erben N, Bayram N, Dursun O, Karabay O, Coskun O, Horoz OO, Turhan O, Sandal OS, Tekin R, Esen S, Erdogan SY, Unal S, Karacorlu S, Sen S, Sen S, Sacar S, Yarar V, Oruc Y, Sahip Y, Kaya Z, Philip A, Elhoufi A, Alrahma H, Sachez E, Perez F, Empaire G, Vidal H, Montes-Bravo L, Guzman Siritt M, Orozco N, Navarrete N, Ruiz Y, De Anez ZDG, Van Trang DT, Minh DQ, Co DX, Anh DPP, Thu LTA, Tuyet LTD, Nguyet LTT, Chau NU, Binh NG, Tien NP, Anh NQ, Hang PT, Hanh TTM, Hang TTT, Thu TA, Thoa VTH. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am J Infect Control 2016; 44:1495-1504. [PMID: 27742143 DOI: 10.1016/j.ajic.2016.08.007] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. CONCLUSIONS Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically.
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LogithKumar R, KeshavNarayan A, Dhivya S, Chawla A, Saravanan S, Selvamurugan N. A review of chitosan and its derivatives in bone tissue engineering. Carbohydr Polym 2016; 151:172-188. [DOI: 10.1016/j.carbpol.2016.05.049] [Citation(s) in RCA: 328] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/24/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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Affiliation(s)
- A Chawla
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun 768828, Singapore
| | - D Chinchure
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun 768828, Singapore
| | - M Subramanian
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun 768828, Singapore
| | - D Singh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun 768828, Singapore
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Bhirud BG, Chandan LM, Chawla A. Do Congenitally Blind Individuals have Better Haptic Object Perception Compared to Blindfolded Sighted Individuals? Indian J Physiol Pharmacol 2016; 60:230-234. [PMID: 29957910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: Haptic perceptual enhancement in congenitally blind people is a subject of intense debate. There is no consensus whether the congenitally blind get the benefit of their haptic experience or the sighted get the benefit of previous visual experience when it comes to recognizing objects by manual exploration using different constraints. The present study compared haptic object perception between congenitally blind and blindfolded sighted participants in a situation where manual exploration of objects was constrained. Methods: Thirty congenitally blind braille readers and 30 age and gender matched controls were studied. All participants were required to identify the objects haptically, without the aid of vision. Manual exploration of the objects was constrained by permitting touching of the object with only the exposed tip of the index finger with the aim to limit cues about material information. Performance was evaluated in terms of speed and accuracy with which objects were identified. Result: The recognition time analysis showed that congenitally blind participants recognize objects much faster than blindfolded sighted participants. The analysis of haptic recognition rates showed that congenitally blind participants identified the objects more accurately compared to blindfolded normal sighted individuals. Conclusion: Congenitally blind individuals appear to possess a definite enhanced haptic perceptual ability allowing for faster and more accurate recognition of objects even when manual exploration is constrained.
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Chawla A, Swarup S, Gaikwad V. Electrocardiogram: the saviour for this patient. Neth Heart J 2015; 24:366-7. [PMID: 26645714 PMCID: PMC4840108 DOI: 10.1007/s12471-015-0794-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- A Chawla
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Yishun, Singapore.
| | - S Swarup
- Department of Accident and Emergency, Khoo Teck Puat Hospital, Yishun, Singapore
| | - V Gaikwad
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Yishun, Singapore
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Chawla A, Gaikwad V, Swarup S. Electrocardiogram: the saviour for this patient. Neth Heart J 2015; 24:363. [PMID: 26645712 PMCID: PMC4840117 DOI: 10.1007/s12471-015-0793-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- A Chawla
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Yishun, Singapore.
| | - V Gaikwad
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Yishun, Singapore
| | - S Swarup
- Department of Accident and Emergency, Khoo Teck Puat Hospital, Yishun, Singapore
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Sikri G, Srinivasa AB, Chawla A. Acute mountain sickness and obesity. Eur Rev Med Pharmacol Sci 2015; 19:4086. [PMID: 26592831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- G Sikri
- Department of Physiology, Armed Forces Medical College, Pune, India.
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Shimpi T, Chawla A, Shikhare S. Tell tale of tablets in bronchus. Med J Malaysia 2015; 70:36-37. [PMID: 26032528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Foreign body (FB) aspiration is an emergency of concern at all ages. However, in adults, it can present with atypical symptoms such as shortness of breath, wheezing or rarely cyanosis. Aspiration of oral medications is seen in the elderly population with impairment of protective airway mechanism. Treatment of choice is endoscopic removal of the foreign body. We report such a case of foreign body aspiration (potassium chloride tablet), diagnosed on imaging and subsequently developed bronchostenosis. There are a very few reported cases of oral potassium supplement aspiration and associated complications in the literature.
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Affiliation(s)
- T Shimpi
- Khoo Teck Puat Hospital, Department of Diagnostic Radiology, 90 Yishun Central, Singapore 768828, Republic of Singapore.
| | - A Chawla
- Khoo Teck Puat Hospital, Department of Diagnostic Radiology, 90 Yishun Central, Singapore 768828, Republic of Singapore
| | - S Shikhare
- Khoo Teck Puat Hospital, Department of Diagnostic Radiology, 90 Yishun Central, Singapore 768828, Republic of Singapore
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Chawla A, Bosco JIE, Shenoy JN, Chinchure D. Giant renal angiomyolipomas in a patient with tuberous sclerosis. Indian J Nephrol 2015. [PMID: 26199482 PMCID: PMC4495485 DOI: 10.4103/0971-4065.150729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Chawla A. SP0193 Physiologic Functions of Innate Immunity in Metabolic Homeostasis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.6271] [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: 11/03/2022]
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Jhaveri KD, Chawla A, Xu C, Hazzan A. Intravenous albumin infusion is an effective therapy for hyponatremia in patient with malignant ascites. Indian J Nephrol 2014; 24:51-3. [PMID: 24574634 PMCID: PMC3927194 DOI: 10.4103/0971-4065.125116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
There are few reports about the treatment of moderate to severe hyponatremia associated with malignant liver metastasis. Here, we report using intravenous salt poor albumin infusion to treat hypervolemic cirrhosis related hyponatremia. A 58-year-old female with ascites secondary to metastatic breast cancer was referred to our department with symptomatic hyponatremia (serum sodium concentration of 121 mEq/L). The serum sodium level was corrected slowly over 2 days with intravenous albumin infusion and the patient's symptoms – fatigue, nausea, dizziness and headache improved.
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Affiliation(s)
- K D Jhaveri
- Department of Internal Medicine, Division of Kidney Diseases and Hypertension, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA
| | - A Chawla
- Department of Internal Medicine, Division of Kidney Diseases and Hypertension, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA
| | - C Xu
- Department of Internal Medicine, Division of Nephrology, University of Chicago, Illinois
| | - A Hazzan
- Department of Internal Medicine, Division of Kidney Diseases and Hypertension, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, USA
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Chawla A, Mishra D, Sharma P. Renal artery aneurysm with an ovarian vein thrombosis. Case Reports 2013; 2013:bcr-2013-201490. [DOI: 10.1136/bcr-2013-201490] [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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Chawla A, Patel I, Yuen C, Fenerty C. Patterns of adherence to NICE glaucoma guidance in two different service delivery models. Eye (Lond) 2012; 26:1412-7. [PMID: 22935671 PMCID: PMC3496094 DOI: 10.1038/eye.2012.171] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 04/24/2012] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess adherence patterns to the UK National Institute of Health and Clinical Excellence (NICE) guidelines on glaucoma management (2009) in a tertiary referral centre shared care setting and in a district general hospital (DGH) setting. METHOD We performed a retrospective case note analysis of 200 patients from two centres between January and June 2010. The two centres involved were a consultant-guided teaching hospital optometry-led shared care setting (setting 1) and a consultant-led DGH clinic setting (setting 2). The main outcome measures were compliance with eight of the main NICE guidelines on glaucoma diagnosis and management (2009). RESULTS Both centres showed good adherence to the guidelines regarding the choice of initial treatment (96% vs 100%, settings 1 and 2, respectively) and arranging appropriate monitoring intervals (92% vs 86%). However, significant differences were seen when assessing whether an optic disc image was obtained at the initial visit (74% vs 10%), whether an appropriate initial assessment was performed (96% vs 58%), whether patients' review interval complied with the NICE guidance regardless of hospital cancellations (92% vs 66%), and whether concordance with medication was checked (88% vs 24%) (settings 1 and 2, respectively, P<0.01-Fisher's exact test). CONCLUSION Our study provides evidence to suggest that a hospital-based shared care service with trained optometrists using assessment sheets compares favourably to non-specialist glaucoma care delivered by ophthalmologists.
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Affiliation(s)
- A Chawla
- Manchester Royal Eye Hospital and Manchester Academic and Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
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Kapadia A, Samei E, Harrawood B, Sahbaee P, Chawla A, Tan Z, Brady D. SU-E-I-77: X-Ray Coherent Scatter Diffraction Pattern Modeling in GEANT4. Med Phys 2012; 39:3642-3643. [PMID: 28517670 DOI: 10.1118/1.4734794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To model X-ray coherent scatter diffraction patterns in GEANT4 for simulating experiments involving material detection through diffraction pattern measurement. Although coherent scatter cross-sections are modeled accurately in GEANT4, diffraction patterns for crystalline materials are not yet included. Here we describe our modeling of crystalline diffraction patterns in GEANT4 for specific materials and the validation of the results against experimentally measured data. METHODS Coherent scatter in GEANT4 is currently based on Hubbell's non-relativistic form factor tabulations from EPDL97. We modified the form-factors by introducing an interference function that accounts for the angular dependence between the Rayleigh-scattered photons and the photon wavelength. The modified form factors were used to replace the inherent form-factors in GEANT4. The simulation was tested using monochromatic and polychromatic x-ray beams (separately) incident on objects containing one or more elements with modified form-factors. The simulation results were compared against the experimentally measured diffraction images of corresponding objects using an in-house x-ray diffraction imager for validation. The comparison was made using the following metrics: number of diffraction rings, radial distance, absolute intensity, and relative intensity. RESULTS Sharp diffraction pattern rings were observed in the monochromatic simulations at locations consistent with the angular dependence of the photon wavelength. In the polychromatic simulations, the diffraction patterns exhibited a radial blur consistent with the energy spread of the polychromatic spectrum. The simulated and experimentally measured patterns showed identical numbers of rings with close agreement in radial distance, absolute and relative intensities (barring statistical fluctuations). No significant change was observed in the execution time of the simulations. CONCLUSIONS This work demonstrates the ability to model coherent scatter diffraction in GEANT4 in an accurate and efficient manner without compromising the accuracy or runtime of the simulation. This work was supported by the Department of Homeland Security under grant DHS (BAA 10-01 F075), and by the Department of Defense under award W81XWH-09-1-0066.
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Affiliation(s)
- A Kapadia
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - E Samei
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - B Harrawood
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - P Sahbaee
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - A Chawla
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - Z Tan
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
| | - D Brady
- Duke University Medical Center, Durham, NC.,N.C. State University, Raleigh, NC.,Duke University, Durham, NC
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Anderson ER, Taegtmeyer M, Delpech V, Chawla A, Gilbart V. P8 Tests of recent HIV infection in clinical practice: the patient perspective. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chawla A, Marks L, Deasy J, Bradley J, Das S. Testing a Framework to Predict the Risk of Lung Pneumonitis after Thoracic Radiotherapy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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