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Wang Q, Zhang Y, Tan C, Ni SJ, Huang D, Chang B, Sheng WQ, Wang L. [Colorectal adenocarcinoma with enteroblastic differentiation: a clinicopathological analysis of eight cases]. Zhonghua Bing Li Xue Za Zhi 2024; 53:370-376. [PMID: 38556821 DOI: 10.3760/cma.j.cn112151-20231025-00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Objective: To investigate the clinicopathological features of colorectal adenocarcinoma with enteroblastic differentiation (CAED). Methods: Eight cases of CAED diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China from January 2017 to August 2023 were collected. The histopathological, immunohistochemical, molecular and prognostic features of 8 CAED cases were analyzed. The relevant studies were also reviewed. Results: Among the eight patients, there were six males and two females, with an average age of 58 years (range: 29-77 years, median age: 61.5 years). Preoperative serum alpha-fetoprotein levels were elevated in five patients (14.0-286.6 μg/L). Four tumors were located in the colon, and four tumors in the rectum. Two patients were clinically staged as advanced stage (stage Ⅳ), and distant metastasis occurred at the initial diagnosis (one case had liver metastasis, and the other had lung, bone and multiple lymph nodes metastases). Six patients were clinically staged as locally-advanced stage (Stage Ⅱ-Ⅲ). Three of them developed distant metastases after surgery (one case had liver metastasis, one case had lung metastasis, and one case had peritoneal metastasis). Additionally, two patients died at 9 months and 24 months after surgery, respectively. The tumors were composed of various proportions of adenocarcinoma components with enteroblastic differentiation (30%-100%) and classical tubular adenocarcinoma components. The component with enteroblastic differentiation exhibited morphology similar to embryonic intestinal epithelium: cuboidal or columnar tumor cells arranged in tubular, papillary, cribriform, or solid nest patterns, with clear cytoplasm. Immunohistochemical studies showed that tumor cells expressed at least one oncofetal protein (SALL4, Glypican-3, and AFP). In addition, focal squamous differentiation was observed in 3 cases (3/8). Compared to the primary tumor, both CAED and squamous differentiation components were increased in the metastatic tumors. Based on the sequencing results of KRAS, NRAS and BRAF of the primary and/or metastatic tumors, 5 cases were wild-type, while KRAS exon 2 (G13D) mutations were identified in 2 cases. Conclusions: CAED is a rare colorectal malignancy with a dismal prognosis. Accurate pathological diagnosis is prognostically valuable. The histological features of enteroblastic differentiation, elevated serum AFP levels, and the expression of oncofetal proteins play an important role in the tumor diagnosis.
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Affiliation(s)
- Q Wang
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - Y Zhang
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - C Tan
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - S J Ni
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - D Huang
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - B Chang
- Department of Pathology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - W Q Sheng
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - L Wang
- Department of Pathology, Fudan University Shanghai Cancer Center/Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
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Liu F, Wang H, Jiang C, He L, Xiao S, Yan O, Wu X, Liu W, Ye X, Fan C, Li Y, Zhao Q, Wu W, Tan C. Efficacy and Toxicity of Different Target Volume Delineations of Radiotherapy Based on the Updated RTOG/NRG and EORTC Guidelines in Patients with High Grade Glioma: A Randomized, Controlled Clinical Trial. Int J Radiat Oncol Biol Phys 2023; 117:S84-S85. [PMID: 37784587 DOI: 10.1016/j.ijrobp.2023.06.406] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Postoperative radiotherapy with concomitant and adjuvant temozolomide (TMZ) is the standard of care for newly diagnosed high grade glioma, but the optimal method for target volume delineations for intensity modulated radiation therapy (IMRT) is still unclear. We hypothesized that compared with the EORTC guidelines, IMRT based on the updated RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. The purpose of this randomized phase 2 study was to compare the efficacy and toxicity of IMRT based on different target volume delineations (updated RTOG/NRG versus EORTC guidelines) with concomitant and adjuvant TMZ for patients with high grade glioma. MATERIALS/METHODS A total of 302 patients with newly diagnosed high-grade glioma (WHO grade 3-4) were randomly assigned (1:1) to receive postoperative IMRT based on either updated RTOG/NRG guidelines (RTOG/NRG group, n = 151) or EORTC guideline (EORTC group, n = 151), with concomitant and adjuvant TMZ. In the RTOG/NRG group, an initial volume consisting of enhancement, postoperative cavity, plus surrounding edema (or fluid-attenuated inversion recovery [FLAIR] abnormality defined by magnetic resonance imaging [MRI]) and a 2-cm margin received 46 Gy in 23 fractions followed by a boost of 14 Gy in 7 fractions to the area of enhancement plus the cavity and a 2-cm margin. In the EORTC group, a single planning volume was used to deliver 60 Gy in 30 fractions to the area of enhancement and the cavity with a 2-cm margin. The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS) and toxicities associated with each treatment. RESULTS No statistically significant differences were observed between groups for 1-year OS (71.8% for RTOG/NRG group and 69.9% for EORTC group, respectively; P = 0.759) or 1-year PFS (46.7% for RTOG/NRG group and 43.6% for EORTC group, respectively; P = 0.674). Efficacy did not differ by MGMT methylation status. There were no differences in grade 3-4 toxicities (leukopenia, lymphopenia, neutropenia, thrombocytopenia, fatigue, nausea and vomiting) between the two groups. No grade 5 toxicities were observed in both groups. Multivariate analyses showed that tumor MGMT status (methylated vs unmethylated) and WHO grade (grade 3 vs grade 4) were associated with OS and PFS. However, radiation type (RTOG/NRG group vs EORTC), sex, age, and Karnofsky scale did not significantly influence OS or PFS. CONCLUSION Compared with EORTC guidelines for postoperative radiotherapy, IMRT based on RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. This trial is registered with chictr.org.cn, number ChiCTR2100046667.
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Affiliation(s)
- F Liu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - H Wang
- Department of Radiation Oncology, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - C Jiang
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - L He
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - S Xiao
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - O Yan
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - X Wu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - W Liu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - X Ye
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - C Fan
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - Y Li
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Q Zhao
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - W Wu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, Changsha, China
| | - C Tan
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Ng WZ, Ariffin K, Tay PKC, Prasad M, Tan C, Kwok C, Tan RKJ. Prevalence and risk factors for alcohol use disorders, substance use disorders, and depression anxiety and stress among users of sexual health services in Singapore: a cross-sectional survey study. Sex Health 2023; 20:363-365. [PMID: 37088547 DOI: 10.1071/sh23023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023]
Abstract
Syndemics of poor mental health also drive poorer sexual health outcomes. This study used three scales, the Alcohol Use Disorders Identification Test (AUDIT), the Drug Abuse Screening Test (DAST-10), and the Depression Anxiety Stress Scale (DASS-21) among beneficiaries of sexual health services in Singapore (n =975), respectively. We found that a prevalence of 20.4% and 18.6% of hazardous and moderate-severe alcohol use disorders and substance use risks, respectively. About 13.7%, 18.1% and 10.5% of participants reported severe to extremely severe symptoms of depression, anxiety, and stress, respectively. Further investigation and integrated interventions for mental health in sexual health settings are warranted.
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Affiliation(s)
- Wen Zhi Ng
- Action for AIDS Singapore, Singapore, Singapore
| | | | - Peter Kay Chai Tay
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | | | - Calvin Tan
- Action for AIDS Singapore, Singapore, Singapore
| | | | - Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore; and University of North Carolina Project-China, Guangzhou, China
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Heenan TMM, Mombrini I, Llewellyn A, Checchia S, Tan C, Johnson MJ, Jnawali A, Garbarino G, Jervis R, Brett DJL, Di Michiel M, Shearing PR. Mapping internal temperatures during high-rate battery applications. Nature 2023; 617:507-512. [PMID: 37198308 DOI: 10.1038/s41586-023-05913-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/02/2023] [Indexed: 05/19/2023]
Abstract
Electric vehicles demand high charge and discharge rates creating potentially dangerous temperature rises. Lithium-ion cells are sealed during their manufacture, making internal temperatures challenging to probe1. Tracking current collector expansion using X-ray diffraction (XRD) permits non-destructive internal temperature measurements2; however, cylindrical cells are known to experience complex internal strain3,4. Here, we characterize the state of charge, mechanical strain and temperature within lithium-ion 18650 cells operated at high rates (above 3C) by means of two advanced synchrotron XRD methods: first, as entire cross-sectional temperature maps during open-circuit cooling and second, single-point temperatures during charge-discharge cycling. We observed that a 20-minute discharge on an energy-optimized cell (3.5 Ah) resulted in internal temperatures above 70 °C, whereas a faster 12-minute discharge on a power-optimized cell (1.5 Ah) resulted in substantially lower temperatures (below 50 °C). However, when comparing the two cells under the same electrical current, the peak temperatures were similar, for example, a 6 A discharge resulted in 40 °C peak temperatures for both cell types. We observe that the operando temperature rise is due to heat accumulation, strongly influenced by the charging protocol, for example, constant current and/or constant voltage; mechanisms that worsen with cycling because degradation increases the cell resistance. Design mitigations for temperature-related battery issues should now be explored using this new methodology to provide opportunities for improved thermal management during high-rate electric vehicle applications.
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Affiliation(s)
- T M M Heenan
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
- The Faraday Institution, Harwell Science and Innovation Campus, Didcot, UK
| | - I Mombrini
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
- The European Synchrotron, Grenoble, France
| | - A Llewellyn
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
| | - S Checchia
- The European Synchrotron, Grenoble, France
| | - C Tan
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
- The Faraday Institution, Harwell Science and Innovation Campus, Didcot, UK
| | - M J Johnson
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
| | - A Jnawali
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
| | | | - R Jervis
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
- The Faraday Institution, Harwell Science and Innovation Campus, Didcot, UK
| | - D J L Brett
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK
- The Faraday Institution, Harwell Science and Innovation Campus, Didcot, UK
| | | | - P R Shearing
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College of London, London, UK.
- The Faraday Institution, Harwell Science and Innovation Campus, Didcot, UK.
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5
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Wu B, Luo H, Tan C, Qi X, Sloan FA, Kamer AR, Schwartz MD, Martinez M, Plassman BL. Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis. J Dent Res 2023:220345231155825. [PMID: 36908186 PMCID: PMC10399080 DOI: 10.1177/00220345231155825] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Diabetes mellitus (DM) is a recognized risk factor for dementia, and increasing evidence shows that tooth loss is associated with cognitive impairment and dementia. However, the effect of the co-occurrence of DM and edentulism on cognitive decline is understudied. This 12-y cohort study aimed to assess the effect of the co-occurrence of DM and edentulism on cognitive decline and examine whether the effect differs by age group. Data were drawn from the 2006 to 2018 Health and Retirement Study. The study sample included 5,440 older adults aged 65 to 74 y, 3,300 aged 75 to 84 y, and 1,208 aged 85 y or older. Linear mixed-effect regression was employed to model the rates of cognitive decline stratified by age cohorts. Compared with their counterparts with neither DM nor edentulism at baseline, older adults aged 65 to 74 y (β = -1.12; 95% confidence interval [CI], -1.56 to -0.65; P < 0.001) and those aged 75 to 84 y with both conditions (β = -1.35; 95% CI, -2.09 to -0.61; P < 0.001) had a worse cognitive function. For the rate of cognitive decline, compared to those with neither condition from the same age cohort, older adults aged 65 to 74 y with both conditions declined at a higher rate (β = -0.15; 95% CI, -0.20 to -0.10; P < 0.001). Having DM alone led to an accelerated cognitive decline in older adults aged 65 to 74 y (β = -0.09; 95% CI, -0.13 to -0.05; P < 0.001); having edentulism alone led to an accelerated decline in older adults aged 65 to 74 y (β = -0.13; 95% CI, -0.17 to -0.08; P < 0.001) and older adults aged 75 to 84 (β = -0.10; 95% CI, -0.17 to -0.03; P < 0.01). Our study finds the co-occurrence of DM and edentulism led to a worse cognitive function and a faster cognitive decline in older adults aged 65 to 74 y.
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Affiliation(s)
- B Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - H Luo
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - C Tan
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - X Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - F A Sloan
- Department of Economics, Duke University, Durham, NC, USA
| | - A R Kamer
- College of Dentistry, New York University, New York, NY, USA
| | - M D Schwartz
- Grossman School of Medicine, New York University, New York, NY, USA
| | - M Martinez
- Department of Biology, Duke University, Durham, NC, USA
| | - B L Plassman
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
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6
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Walcott S, Tan C, Wicker J, Litovsky S. Subclinical maternal autoimmune disease leading to congenital high degree atrioventricular heart block. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00348-8] [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: 01/28/2023]
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Alenchery AJ, Yeaney NK, Chen CB, Talati R, Vogelius E, Tan C, Radhakrishnan K. A rare case of hepatic sinusoidal occlusive syndrome in a premature neonate with trisomy 21. J Neonatal Perinatal Med 2023; 16:735-740. [PMID: 38073401 DOI: 10.3233/npm-230094] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Trisomy 21 (Down Syndrome) may lead to multiple hematological and hepatobiliary manifestations including the development of transient abnormal myelopoiesis. While many cases resolve, transient abnormal myelopoiesis may lead to significant morbidity and mortality in a small percentage of patients. This condition may present a diagnostic challenge for physicians and currently there is only limited data on effective treatments, particularly with low blast percent transient abnormal myelopoiesis. We present a case of a neonate with trisomy 21 and multiple congenital anomalies who consequently developed hepatic failure with evidence of non-cirrhotic portal hypertension likely due to transient abnormal myelopoiesis. This clinical scenario highlights the need for additional evaluation for transient abnormal myelopoiesis associated hepatic disorder and possibly hepatic sinusoidal occlusive syndrome among trisomy 21 neonates particularly with low blast percentage.
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Affiliation(s)
- A J Alenchery
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's, Cleveland, OH, USA
| | - N K Yeaney
- Neonatal Director, Fetal Care Center, Cleveland Clinic Children's, Cleveland, OH, USA
| | - C B Chen
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's, Cleveland, OH, USA
| | - R Talati
- Department of Pediatric Hematology/Oncology/Bone Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | - E Vogelius
- Section Head, Pediatric Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - C Tan
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - K Radhakrishnan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Children's, Cleveland, OH, USA
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He KD, Davis C, Ahn J, Gilligan HM, Tan C. 1465. A Randomized Double-Blinded Placebo-Controlled Study to Determine Efficacy of Immunoglobulin Therapy to Treat BK Viremia in Renal Transplant Recipients. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1292] [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: 12/23/2022] Open
Abstract
Abstract
Background
BK viremia in renal transplant recipients increases risk of BK virus-associated nephropathy (BKVAN), posing a threat to allograft function. Up to 30% of all renal transplant recipients develop BK viremia and 1-10% will develop BKVAN. With no effective antiviral, the mainstay of therapy to prevent BKVAN is immunosuppression reduction (IR). Case series showed potential efficacy of using intravenous immunoglobulins (IVIG) to treat BK viremia. However, a randomized placebo-controlled study is needed.
Methods
A multicenter prospective double-blinded randomized placebo-controlled proof-of-concept study was conducted at three transplant institutions. 14 adult renal transplant recipients diagnosed with BK viremia were randomized (1:1) to receive IVIG and IR versus placebo and IR and were followed for 12 months, with the primary endpoint defined as resolution of BK viremia by month 3. Samples were collected at 1, 2, 3, 6, and 12 months for viral load quantification and immunological assays.
Results
At enrollment, clinical characteristics of the IVIG group (n = 5) were similar to the control group (n = 9), except that a larger number of participants in the control group had delayed graft function (0% vs. 77.8%, p = 0.02) and a higher baseline BK viral load (11300 vs 99300 copies/mL, p = 0.04). At 3 months, 2 out of 5 patients in the treatment group and 4 out of 9 patients in the control group cleared their viremia (40% vs 44.4%, RR 0.89, 95% CI 0.21 – 3.35, p > 0.99). Patients who received IVIG and IR had reduction in viral load at 6 months only (11300 vs 141 copies/mL, p = 0.008). Those who received IR alone had continued reduction in viral load starting at 2 months (99300 vs 4700, 1542, 906, 278 copies/mL; p < 0.05). No participant progressed to BKVAN. Immunological profiles of each participant will be correlated to the viral load.
Serum BK viral loads were higher in the placebo group than the IVIG group at enrollment, but not significantly different between the two groups at any of the follow-up time points. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04. Bar – median (Mann-Whitney between group comparisons).
Median serum BK viral loads of the IVIG group decreased at the 6 months follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. ** p = 0.008 (Mann-Whitney comparing enrollment to each follow-up time point).
Median serum BK viral loads of the placebo group continued to decrease at each follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04; ** p = 0.006; *** p = 0.0008, 0.0003 (Mann-Whitney comparing enrollment to each follow-up time point).
Conclusion
This proof-of-concept study illustrates that a clinical trial of IVIG versus placebo for the treatment of BK viremia in renal transplant recipients is feasible. IVIG may not be more effective than IR alone; its immunosuppressive effect may even limit BK clearance. A larger sample is needed to attenuate baseline differences between groups and to provide a higher level of evidence on IVIG therapy in BK viremia.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Kevin D He
- Beth Israel Deaconess Medical Center , Boston, Massachusetts
| | - Caitlin Davis
- Beth Israel Deaconess Medical Center , Boston, Massachusetts
| | - Jenny Ahn
- Beth Israel Deaconess Medical Center , Boston, Massachusetts
| | | | - C Tan
- Beth Israel Deaconess Medical Center , Boston, Massachusetts
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9
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Tan C, Hou Y, Qiao YS, Chen JY, Sun XH. [The study of the correlation between age and the pathogenic factors of primary glaucoma: a review]. Zhonghua Yan Ke Za Zhi 2022; 58:1106-1110. [PMID: 36480899 DOI: 10.3760/cma.j.cn112142-20220616-00297] [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: 06/17/2023]
Abstract
Age is an important risk factor for primary glaucoma. While the specific mechanism of primary glaucoma remained unclear, the change of ocular anatomy, the disturbance of aqueous humor balance, the change of ocular biomechanics and the disorder of neurometabolism contribute to the occurrence and development of primary glaucoma. This paper reviewes the latest studies on the correlation between age and the risk factors of glaucoma in the above four aspects, so as to provide some references for the in-depth discussion of the pathophysiology of primary glaucoma, and advancement on diagnosis, treatment and research of primary glaucoma.
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Affiliation(s)
- C Tan
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - Y Hou
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - Y S Qiao
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - J Y Chen
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - X H Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
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Chew N, Teo V, Tan C, Kong G, Chin YH, Ambhore A, Low A, Lee CH, Chan MY, Tan HC, Ph LOH. A 10-year cohort on prognostic outcomes in patients presenting with acute myocardial infarction complicated by cardiogenic shock and/or cardiac arrest. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1496] [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: 11/13/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) and cardiac arrest (CA) complicating acute myocardial infarction (AMI) portend unfavourable outcomes. This study examined the prognosis of patients presenting with AMI complicated by CS and/or CA.
Methods
Consecutive patients presented with AMI to a percutaneous coronary intervention-capable tertiary institution between 2011 and 2021 were studied. Patients were stratified based on the presence or absence of CS (CS+ or CS−) and CA (CA+ or CA−). The primary outcome was 30-day cardiovascular-related mortality. Subgroup analyses based on AMI-type and sex were conducted. Kaplan-Meier curves for cardiovascular-related mortality based on the AMI-type and sex were constructed.
Results
The study included 11,608 AMI patients, 283 of whom had CS+/CA+, 1,068 had CS+/CA−, 54 had CS−/CA+ and 10,203 had CS−/CA−. Cardiovascular-related mortality was significantly higher for CS+/CA+ (57.6%), followed by CS+/CA− (41.6%), CS−/CA+ (20.4%) and CS−/CA− (2.4%). Kaplan-Meier curves demonstrated CS+/CA+ group had the highest mortality (HR=36.26; 95% CI: 29.71–44.25, p<0.001), followed by CS+/CA− (HR=21.59; 95% CI: 18.47–25.24, p<0.001) and CS−/CA+ (HR=9.18; 95% CI: 5.02–16.80, p<0.001), with CS−/CA− as the reference. Those with NSTEMI had consistently higher cardiovascular-related mortality rates than their STEMI counterparts for all groups, apart from the CS+/CA+ group. The sex-specific analysis demonstrated that the survival curves for females with CS+/CA+, CS+/CA− and CS−/CA+ converged, whilst the survival curves for males diverged over time. The multivariable Cox regression revealed the presence of CS and CA are independent predictors of cardiovascular-related mortality, but not NSTEMI, when adjusted for age, gender, diabetes, left ventricular ejection fraction, chronic renal failure, and culprit vessel.
Conclusions
AMI associated with CA and CS portends the least favourable survival, followed by those with CS or CA alone. Excess mortality was observed in the traditionally perceived lower-risk groups, particularly in women. This calls for increased awareness amongst clinicians when managing this subset of high-risk patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Chew
- National University Heart Centre , Singapore , Singapore
| | - V Teo
- National University of Singapore , Singapore , Singapore
| | - C Tan
- National University of Singapore , Singapore , Singapore
| | - G Kong
- National University of Singapore , Singapore , Singapore
| | - Y H Chin
- National University of Singapore , Singapore , Singapore
| | - A Ambhore
- National University Heart Centre , Singapore , Singapore
| | - A Low
- National University Heart Centre , Singapore , Singapore
| | - C H Lee
- National University Heart Centre , Singapore , Singapore
| | - M Y Chan
- National University Heart Centre , Singapore , Singapore
| | - H C Tan
- National University Heart Centre , Singapore , Singapore
| | - L O H Ph
- National University Heart Centre , Singapore , Singapore
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11
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Chua M, Sim A, Hakansson A, Ong E, Low K, Tan C, Tan J, Lau A, Tuan J, Tan T, Wang M, Yeong J, Tan M, Lee L, Kanesvaran R, Tay K, Liu S, Khor L, Davicioni E. 1408P Comparative transcriptomic analyses of 100,691 primary tumors from East Asian (EA) and North American (NA) men with prostate cancer (PCa). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1894] [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: 11/01/2022] Open
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12
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Toh H, Yang MH, Wang HM, Hsieh CY, Chitapanarux I, Ho K, Hong RL, Ang MK, Colevas D, Sirachainan E, Lertbutsayanukul C, Ho G, Samol J, Huang Z, Tan C, Ding C, Myo A. 652O Randomized phase III VANCE study: Gemcitabine and carboplatin (GC) followed by Epstein Barr virus-specific autologous cytotoxic T lymphocytes (EBV-CTL) versus the same chemotherapy as first-line treatment for advanced nasopharyngeal carcinoma (NPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Li JL, Su YJ, Dong BQ, Wu QJ, Yang QL, Chen QY, Chen SY, Tan C, Ju Y, Li H. [Association of DNA methylation of IFNG gene with no/low response to hepatitis B vaccine in children]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:926-931. [PMID: 35899344 DOI: 10.3760/cma.j.cn112150-20220125-00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province. Methods: A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti-HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results: There were 104 children in the case group and 159 in the control group. The median (Q1, Q3) level of anti-HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group (P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 (OR=1.18, 95%CI: 1.03-1.35) and 93 (OR=1.21, 95%CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion: The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.
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Affiliation(s)
- J L Li
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China Guangxi Key Laboratory of Translational Medicine for Treating High-incidence Infectious Diseases with Integrative Medicine, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Y J Su
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China Guangxi Key Laboratory of Translational Medicine for Treating High-incidence Infectious Diseases with Integrative Medicine, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - B Q Dong
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
| | - Q J Wu
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
| | - Q L Yang
- Guangxi Key Laboratory of Translational Medicine for Treating High-incidence Infectious Diseases with Integrative Medicine, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Q Y Chen
- Guangxi Key Laboratory for Control and Prevention of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - S Y Chen
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
| | - C Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical College, Guilin 541000, China
| | - Y Ju
- Department of Emergent Infectious Disease Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H Li
- Department of epidemiology, School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China Guangxi Key Laboratory of Translational Medicine for Treating High-incidence Infectious Diseases with Integrative Medicine, Guangxi University of Chinese Medicine, Nanning 530200, China
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14
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Hu T, Meng L, Tan C, Luo C, He WB, Tu C, Zhang H, Du J, Nie H, Lu GX, Lin G, Tan YQ. P-524 Bi-allelic CFAP61 variants cause male infertility in humans and mice with severe oligoasthenoteratozoospermia. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Are mutations in cilia and flagella-associated protein 61 (CFAP61) associated with human male infertility?
Summary answer
Bi-allelic variants ([NM_015585.4: c.1654C>T (p.R552C) and c.2911G>A (p.D971N), c.144-2A>G and c.1666G>A (p.G556R)] in CFAP61 were identified as contributory genetics factor in severe oligoasthenoteratozoospermia (OAT).
What is known already
Cfap61 knockout mice were infertile due to multiple morphological abnormalities of the sperm flagella (MMAF). However, so far there is no direct evidence that mutations of CFAP61 cause OAT and male infertility.
Study design, size, duration
Variant screening was performed by whole-exome sequencing (WES) from 325 infertile patients with OAT and 392 fertile individuals. A knockout mouse model was generate to confirm the candidate disease-causing gene, intracytoplasmic sperm injection (ICSI) was used to evaluate the efficiency of clinical treatment.
Participants/materials, setting, methods
A total 325 OAT-affected patients and 392 men with normal fertility were recruited from China. WES was performed, followed by Sanger sequencing validation. In silico bioinformatics predictions and in vitro functional analyses were performed to evaluate the impacts of candidate disease-causing variants. Hematoxylin and eosin (H&E) staining, electron microscopy, and immunofluorescence assays were performed to evaluate the sperm morphology. Two OAT-affected men with CFAP61 variants were treated by ICSI, and pregnancy outcomes were followed.
Main results and the role of chance
We identified bi-allelic CFAP61 variants [NM_015585.4: c.1654C>T (p.R552C) and c.2911G>A (p.D971N), c.144-2A>G and c.1666G>A (p.G556R)] in two (0.62%) of the 325 OAT-affected men. In silico bioinformatics analysis predicted that all four variants were deleterious, and in vitro functional analysis confirmed the deleterious effects of the mutants. Notably, H&E staining and electron microscopy analyses of the spermatozoa revealed multiple morphological abnormalities of sperm flagella, the absence of central pair microtubules, and mitochondrial sheath malformation in sperm flagella from man with CFAP61 variants. Further immunofluorescence assays revealed markedly reduced CFAP61 staining in the sperm flagella. In addition, Cfap61-deficient mice showed the OAT phenotype, suggesting that loss of function of CFAP61 was the cause of OAT. Two individuals accepted ICSI therapy using their own ejaculated sperm, and one of them succeeded in fathering a healthy baby.
Limitations, reasons for caution
Limitations include the lack of in vivo data from the one of patients, and the exact molecular mechanism should be further investigated.
Wider implications of the findings
Our findings indicate that CFAP61 is essential for spermatogenesis and that bi-allelic CFAP61 variants lead to OAT and male infertility in humans and mice. In addition, our results show that ICSI treatment can be recommended for CFAP61-related OAT.
Trial registration number
not applicable
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Affiliation(s)
- T Hu
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
| | - L Meng
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - C Tan
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
| | - C Luo
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
| | - W B He
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - C Tu
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
| | - H Zhang
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - J Du
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - H Nie
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - G X Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - G Lin
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
| | - Y Q Tan
- Central South University, Institute of Reproduction and Stem Cell Engineering- School of Basic Medical Science , Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province , Changsha, China
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15
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Mosallaei D, Hao M, Antaya RJ, Levian B, Kwong A, Cogan J, Hamilton C, Schwieger-Briel A, Tan C, Tang X, Woodley DT, Chen M. Molecular and Clinical Outcomes After Intravenous Gentamicin Treatment for Patients With Junctional Epidermolysis Bullosa Caused by Nonsense Variants. JAMA Dermatol 2022; 158:366-374. [PMID: 35234826 PMCID: PMC8892363 DOI: 10.1001/jamadermatol.2021.5992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Junctional epidermolysis bullosa (JEB) is an incurable blistering skin disorder with high infant mortality often caused by nonsense variants in the genes that encode laminin 332. OBJECTIVE To evaluate the safety and outcomes following intravenous gentamicin readthrough therapy and subsequent laminin 332 expression in patients with JEB. DESIGN, SETTING, AND PARTICIPANTS This open-label, pilot nonrandomized clinical trial assessed 1 course of low- or high-dose intravenous gentamicin, including follow-up at 30 and 90 days after treatment. Five pediatric patients with JEB (2 with intermediate JEB and 3 with severe JEB) and confirmed nonsense variants in LAMA3 or LAMB3 in 1 or 2 alleles and decreased expression of laminin 332 at the dermal-epidermal junction of their skin participated in the study, which was performed at a single institution in collaboration with physicians and home infusion services near the patients from April 1, 2019, to February 28, 2021, with follow-up until May 31, 2021. INTERVENTIONS Three patients received gentamicin at 7.5 mg/kg daily for 14 days, and 2 patients received gentamicin at 10 mg/kg daily for 24 days. MAIN OUTCOMES AND MEASURES Primary outcomes were change in expression of laminin 332 in patients' skin and assessments for safety (ototoxic effects, nephrotoxic effects, and autoimmune response). Secondary outcomes included wound healing in monitored wounds and Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) score. RESULTS After gentamicin treatment, all 5 patients (age range, 3 months to 10 years, 4 [80%] female) exhibited increased laminin 332 in the dermal-epidermal junction. By 1 month, 7 of 9 wounds in patients receiving low-dose intravenous gentamicin and all wounds in patients receiving high-dose intravenous gentamicin exhibited at least 50% wound closure. By 3 months, 8 of 9 wounds in patients receiving low-dose gentamicin and all wounds in patients receiving high-dose intravenous gentamicin exhibited greater than 85% closure. All 3 patients who were evaluated with EBDASI showed a decrease in total activity scores that met minimal clinically important differences 1 month after treatment. All 5 patients completed the study, and no ototoxic effects, nephrotoxic effects, or anti-laminin 332 antibodies were detected. CONCLUSIONS AND RELEVANCE In this nonrandomized clinical trial, intravenous gentamicin therapy was associated with induced readthrough of nonsense variants in patients with JEB, restored functional laminin 332 in their skin, and wound closure during the 3-month study period. Although long-term safety and efficacy requires further evaluation, a single cycle of intravenous gentamicin may be a safe and readily available therapy in the short term for this population of patients with JEB. TRIAL REGISTRATION ClinicalTrials.gov Identifiers: NCT03526159 and NCT04140786.
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Affiliation(s)
- Daniel Mosallaei
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Michelle Hao
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Richard J. Antaya
- Department of Dermatology and Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Brandon Levian
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Andrew Kwong
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Jon Cogan
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Claire Hamilton
- Department of Dermatology and Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Agnes Schwieger-Briel
- Pediatric Skin Center, Division of Pediatric Dermatology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Calvin Tan
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Xin Tang
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - David T. Woodley
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
| | - Mei Chen
- Department of Dermatology, The Keck School of Medicine, University of Southern California, Los Angeles
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16
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Bolten J, Tan C. The challenge of creating procedure-specific (PROSPECT) recommendations for postoperative pain management after video-assisted thoracoscopic surgery. Anaesthesia 2022; 77:936. [PMID: 35319777 DOI: 10.1111/anae.15721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 12/01/2022]
Affiliation(s)
- J Bolten
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - C Tan
- St George's University Hospitals NHS Foundation Trust, London, UK
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17
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Chieng D, Sugumar H, Segan L, Tan C, Vizi D, Al-Kaisey A, Hawson J, Prabhu S, Voskoboinik A, Morton J, Lee G, Mariani J, Le Gerche A, Kistler P, Kalman J, Kaye D, Ling L. Catheter Ablation in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction Improves Peak Pulmonary Capillary Wedge Pressure, Exercise Capacity and Quality of Life. A Prospective Randomised Controlled Trial (RCT-STALL HFpEF). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.021] [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: 11/27/2022]
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18
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Chng JK, Mihir G, Lee Y, Tan C, Mansor S. To evaluate if ultrasound gel or water-based media affects ER/PR staining patterns on breast core biopsy specimens. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
IHC staining for biomarkers ER, PR and HER-2 (CerB2) forms an essential component of breast cancer management and prognostication. Staining for these biomarkers is dependent on optimal fixation of the specimen in formalin. Scoring systems employed for ER and PR grade the intensity of the nuclear staining along with the percentage of the cells stained. This study aims to determine if ultrasound gel used during core biopsy as opposed to water affects immunohistochemical staining of biomarkers ER and PR in breast cancer specimens, following an observation that ultrasound gel assisted core biopsies may affect ER/PR nuclear staining scores through excess cytoplasmic staining.
Methods/Case Report
We included a total of 50 cases of invasive breast carcinoma diagnosed on core biopsy from KK Women’s and Children’s Hospital from February 2019 to July 2020. These included 25 cases with gel and 25 cases with water applied to the breast prior to the procedure. All biopsies were optimally fixed in formalin as per recommended latest ASCO/CAP guidelines. The control group included 25 resection cases of invasive breast carcinoma which had neither gel nor water and had been optimally fixed in formalin. Cytoplasmic staining for ER and PR was graded as being present or absent and was compared against the excision specimens (control group) to determine if using the gel was significant in producing cytoplasmic staining. The data was analyzed on SPSS using multiple logistic regression.
Results (if a Case Study enter NA)
Using the gel appeared to be statistically significant in producing cytoplasmic staining for ER (p=0.042) as opposed to using water (p=0.274). For PR staining, both gel-based (p=0.250) and water-based media (p=0.286) were not statistically significant in causing cytoplasmic staining.
Conclusion
The preliminary findings of this small retrospective case-control study gives an insight that gel-based media may have a role in causing cytoplasmic staining for oestrogen receptor in breast cancer biopsy specimens which may interfere with accurate scoring and impact results of external quality assurance schemes to which laboratories subscribe to. However the study is limited by the small sample size and exclusion of any other pre- analytical factors like needle bore or number of cores taken which may have had an impact on the staining.
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Affiliation(s)
- J K Chng
- Pathology, Singapore General Hospital, Singapore, SINGAPORE
| | - G Mihir
- KK Women’s and Children’s Hospital, Singapore, SINGAPORE
| | - Y Lee
- KK Women’s and Children’s Hospital, Singapore, SINGAPORE
| | - C Tan
- KK Women’s and Children’s Hospital, Singapore, SINGAPORE
| | - S Mansor
- KK Women’s and Children’s Hospital, Singapore, SINGAPORE
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Darbyshire A, Miles J, Towers A, Tan C, Toh S. 889 Management of Paediatric Appendicitis During the First Wave of COVID-19: Comparison of Our Centre to National Practice. Br J Surg 2021. [PMCID: PMC8524615 DOI: 10.1093/bjs/znab259.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim Our hospital took part in a multi-centre prospective cohort study “the CASCADE study” investigating the management and early outcomes of children with appendicitis in the UK and Ireland during the first wave of the COVID-19 pandemic (1). The aim of this study was to compare our local outcomes to those at a national level. Method This was a prospective cohort study with data collected from 01/04/2020 to 31/05/2020. Primary outcome was treatment strategy for appendicitis. Secondary outcomes were duration of symptoms, ultrasound findings, rate of simple vs perforated appendicitis and complications. Results Overall, only a minority (2/24 [8%]) were initially treated non-operatively, with both proceeding to appendicectomy due to pain. Remaining children (24/26 [92%]) were primarily treated with appendicectomy. All were performed laparoscopically with no conversions to open. Ultrasound was performed for most children (23/26 [88%]) which accurately identified appendicitis (22/23 [95%]) and negative appendicectomy rate of zero. Rates of complex appendicitis were not higher than expected (10/26 [38%]) but had a longer duration of symptoms (median 66.0h [IQR21.5] vs 30.0h [27.2], p = 0.008) and more complications (4 vs 1). Post-operative length of stay was significantly shorter for simple appendicitis than complicated (median 1.0d [IQR0.0] vs 4.0 [IQR2.8], p = 0.001). Conclusions Practice in our centre contrasts with the CASCADE study's National findings where 39% were treated non-operatively, only 48% of appendicectomies were performed laparoscopically, only 53% of children had diagnostic imaging and negative appendicectomy rate was 4.5%. Rates of complications for simple and complex appendicitis were similar, but post-operative length of stay shorter in our centre.
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Affiliation(s)
- A Darbyshire
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - J Miles
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - A Towers
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - C Tan
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - S Toh
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
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Liu M, Xie J, Tan C, Ruan X, Wang Z, Luo X, Lin J, Xiang L, Li A, Han Z, Liu S. [Japan narrow-band imaging Expert Team type 2B colorectal cancer: consistency between endoscopic prediction and pathological diagnosis]. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41:942-946. [PMID: 34238749 DOI: 10.12122/j.issn.1673-4254.2021.06.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the potential factors that affect the accuracy of endoscopic diagnosis for Japan narrow-band imaging (NBI) Expert Team (JNET) type 2B colorectal lesions. OBJECTIVE The clinical data were collected from 261 patients with JNET type 2B colorectal lesions diagnosed in Nanfang Hospital between July, 2018 and July, 2021. We analyzed the macroscopic type, size, location or pit pattern classification of the lesions for their potential influence of the diagnostic accuracy of JNET type 2B lesions. OBJECTIVE The 261 lesions included 91 low-grade intramucosal neoplasia lesions (34.9%), 132 high-grade intramucosal neoplasia lesions (50.6%), 13 submucosal invasive cancer lesions (5.0%), and 25 deep submucosal invasive cancer lesions (9.6%). The coincidence rate between endoscopic prediction and pathological diagnosis of these lesions was 55.6% (145/ 261). The macroscopic type and size of the lesions were significantly associated with the diagnostic accuracy of JNET type 2B lesions (P < 0.001). There was a significant difference in the diagnostic accuracy among the lesions with different pit pattern types (P < 0.001). OBJECTIVE Both the macroscopic type and size affect the accuracy of endoscopic diagnosis of JNET type 2B colorectal lesions. JNET classification combined with pit pattern types can have better accuracy in predicting the pathological diagnosis of these lesions.
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Affiliation(s)
- M Liu
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Xie
- First Clinical Medical College of Southern Medical University, Guangzhou 510515, China
| | - C Tan
- Department of Endoscopy, First Hospital of Hunan University of Chinese Medicine, Changsha 410208, China
| | - X Ruan
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Wang
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Luo
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Lin
- Department of Gastroenterology, Longgang District People's Hospital, Shenzhen 518172, China
| | - L Xiang
- Department of Gastroenterology, Longgang District People's Hospital, Shenzhen 518172, China
| | - A Li
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Han
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - S Liu
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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21
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Tan RKJ, Low TQY, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Cook AR, Wong ML. Experienced Homophobia and Suicide Among Young Gay, Bisexual, Transgender, and Queer Men in Singapore: Exploring the Mediating Role of Depression Severity, Self-Esteem, and Outness in the Pink Carpet Y Cohort Study. LGBT Health 2021; 8:349-358. [PMID: 34142861 PMCID: PMC8252908 DOI: 10.1089/lgbt.2020.0323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore. Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men 18 to 25 years of age who were HIV negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable logistic regression, and structural equation modeling techniques. Results: Of 570 participants, 58.9% (n = 308) reported ever contemplating suicide, whereas 14.2% (n = 76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, whereas depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts. Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Timothy Qing Ying Low
- Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Daniel Le
- Action for AIDS Singapore, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, Singapore, Singapore
| | | | - Calvin Tan
- Action for AIDS Singapore, Singapore, Singapore
| | | | | | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Dang J, Lin M, Tan C, Pham CH, Huang S, Hulsebos IF, Yenikomshian H, Gillenwater J. Use of Infrared Thermography for Assessment of Burn Depth and Healing Potential: A Systematic Review. J Burn Care Res 2021; 42:irab108. [PMID: 34120173 DOI: 10.1093/jbcr/irab108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Burn wound depth assessments are an important component of determining patient prognosis and making appropriate management decisions. Clinical appraisal of the burn wound by an experienced burn surgeon is standard of care but has limitations. IR thermography is a technology in burn care that can provide a non-invasive, quantitative method of evaluating burn wound depth. IR thermography utilizes a specialized camera that can capture the infrared emissivity of the skin, and the resulting images can be analyzed to determine burn depth and healing potential of a burn wound. Though IR thermography has great potential for burn wound assessment, its use for this has not been well documented. Thus, we have conducted a systematic review of the current use of IR thermography to assess burn depth and healing potential. METHODS A systematic review and meta-analysis of the literature was performed on PubMed and Google Scholar between June 2020-December 2020 using the following keywords: FLIR, FLIR ONE, thermography, forward looking infrared, thermal imaging + burn*, burn wound assessment, burn depth, burn wound depth, burn depth assessment, healing potential, burn healing potential. A meta-analysis was performed on the mean sensitivity and specificity of the ability of IR thermography for predicting healing potential. Inclusion criteria were articles investigating the use of IR thermography for burn wound assessments in adults and pediatric patients. Reviews and non-English articles were excluded. RESULTS A total of 19 articles were included in the final review. Statistically significant correlations were found between IR thermography and laser doppler imaging (LDI) in 4/4 clinical studies. A case report of a single patient found that IR thermography was more accurate than LDI for assessing burn depth. Five articles investigated the ability of IR thermography to predict healing time, with four reporting statistically significant results. Temperature differences between burnt and unburnt skin were found in 2/2 articles. IR thermography was compared to clinical assessment in five articles, with varying results regarding accuracy of clinical assessment compared to thermography. Mean sensitivity and specificity of the ability of IR thermography to determine healing potential <15 days was 44.5 and 98.8 respectively. Mean sensitivity and specificity of the ability of FLIR to determine healing potential <21 days was 51.2 and 77.9 respectively. CONCLUSION IR thermography is an accurate, simple, and cost-effective method of burn wound assessment. FLIR has been demonstrated to have significant correlations with other methods of assessing burns such as LDI and can be utilized to accurately assess burn depth and healing potential.
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Affiliation(s)
- Justin Dang
- Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Matthew Lin
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Calvin Tan
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Christopher H Pham
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Samantha Huang
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ian F Hulsebos
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Haig Yenikomshian
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Wang L, Tan C, Ni SJ, Jiang WH, Xu J, Cai X, Huang D, Sheng WQ, Chang B. [Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma: a clinicopathological study]. Zhonghua Bing Li Xue Za Zhi 2021; 50:632-637. [PMID: 34078052 DOI: 10.3760/cma.j.cn112151-20201224-00963] [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: 11/05/2022]
Abstract
Objective: To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas. Methods: Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Hematoxylin and eosin, and immunohistochemical stains were performed, and the relevant literatures were reviewed. Results: The two patients were both male, aged 60 and 74 years, respectively. Their symptoms were both abdominal pain. The tumor arose in the esophagogastric junction in case 1, and the cardia to the fundus and the posterior wall of the upper part of gastric body in case 2. Both tumors were present as an ulcerative mass. The patients died of tumor 11 months and 8 months after surgery, respectively. Histologically, the tumor cells arranged in sheets, nests, cords or trabecular patterns, and pseudoavleolar structure. The tumor cells were epithelioid with uniform morphology, while the tumors showed scant stroma and massive necrosis. Variable rhabdoid cells and multinucleated giant cells were seen in both cases. SMARCA4 encoding protein BRG1 was undetectable in both tumors, while SMARCB1 encoding protein INI1 was detected. The tumor cells were diffusely positive for vimentin and negative for epithelial marker (CKpan), gastrointestinal stromal tumor markers (CD117 and DOG1), myogenic markers (desmin and myogenin), melanoma markers (S-100 protein, SOX10 and HMB45), and lymphohematopoietic markers (LCA and CD20). Conclusions: Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma is a rare and highly aggressive tumor with poor prognosis. The detection of subunits protein expression of SWI/SNF complex is important for diagnosis of the tumor.
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Affiliation(s)
- L Wang
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - C Tan
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - S J Ni
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - W H Jiang
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - J Xu
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - X Cai
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - D Huang
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - W Q Sheng
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
| | - B Chang
- Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China
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Fanshawe J, Warren H, Clark C, Kum F, Smekal M, Masiha E, Saada L, Tan C, Deen S, Farooq O, Siddiqi M, Apata-Omisore J, Stroman L, Rusere J, Tasleem A, Nkwam N, Brown C, Elhage O, Cathcart P, Challacombe B, Popert R, Di Benedetto E, Hadjipavlou M. The role of psa density in decision making to perform transperineal prostate biopsy in men with multi-parametric MRI Likert 2 or 3 scores: A retrospective analysis from a multi-centre cancer network study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01312-9] [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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Tan RKJ, O'Hara CA, Koh WL, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Wong ML. Delineating patterns of sexualized substance use and its association with sexual and mental health outcomes among young gay, bisexual and other men who have sex with men in Singapore: a latent class analysis. BMC Public Health 2021; 21:1026. [PMID: 34059021 PMCID: PMC8166008 DOI: 10.1186/s12889-021-11056-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young gay, bisexual, and other men who have sex with men (YMSM) are vulnerable to the risks associated with sexualized substance use. This is a novel study in Singapore that aims to classify patterns of sexualized substance use among YMSM, and investigate its association with sexual and mental health outcomes. METHODS In this cross-sectional study among 570 YMSM aged 18 to 25 years old, latent class analysis (LCA) conducted to identify classes with similar patterns of sexualized substance use, across which measures of inconsistent condom use, recent STI diagnoses, past suicide ideation and depression severity were compared. RESULTS LCA revealed three classes of YMSM based on types of substances ever used in sexualized contexts, which we labelled as 'substance-naive', 'substance-novice', and 'chemsex'. Substance-naive participants (n = 404) had only ever used alcohol, while substance-novice participants (n = 143) were primarily amyl nitrite users with a small proportion who reported using chemsex-related drugs. Chemsex participants (n = 23) comprised individuals who had mostly used such drugs. Those in the chemsex group were more likely to report recent unprotected anal sex with casual partners (aPR = 3.28, 95%CI [1.85, 5.79]), depression severity (aβ = 3.69, 95%CI [0.87, 6.51]) and a history of suicide ideation (aPR = 1.64, 95%CI [1.33, 2.03]). CONCLUSIONS Findings of this study highlight how the use of varying substances in sexualized contexts may be classified and characterized by different sexual and mental health outcomes. Health promotion efforts should be differentiated accordingly to address the risks associated with sexualized substance use among YMSM.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore.
| | - Caitlin Alsandria O'Hara
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore
| | - Wee Ling Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
| | - Daniel Le
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore.,National University Hospital, National University Health System, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Adrian Tyler
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Calvin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Chronos Kwok
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Sumita Banerjee
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
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Ong C, Tan RKJ, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Wong ML. Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore. BMC Public Health 2021; 21:971. [PMID: 34022843 PMCID: PMC8141135 DOI: 10.1186/s12889-021-10992-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 05/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background Gay, bisexual and queer (GBQ) men are frequently subjected to minority stressors that have negative impacts on their health. Milestones that include the acceptance and disclosure of sexual identity amongst GBQ men are hence key instruments in understanding the prevalence of internalised homophobia and predicting health outcomes. As such, this work takes a novel approach to deduce the correlates of delayed acceptance of sexual orientation in young GBQ men as a measure of internalised homophobia through retrospective self-reporting and age-based analysis. Methods Participants were recruited as part of a cohort study exploring the syndemic risks associated with HIV acquisition among young GBQ men in Singapore. We examined their levels of internalised, perceived, experienced homophobia, as well as their health behaviours and suicidal tendencies. Two separate variables were also self-reported by the participants – the age of questioning of sexual orientation and the age of acceptance of sexual orientation. We subsequently recoded a new variable, delayed acceptance of sexual orientation, by taking the difference between these two variables, regressing it as an independent and dependent variable to deduce its psychosocial correlates, as well as its association with other measured instruments of health. Results As a dependent variable, delayed acceptance of sexual orientation is positively associated with an increase of age and internalised homophobia, while being negatively associated with reporting as being gay, compared to being bisexual or queer. As an independent variable, delayed acceptance of sexual orientation was associated with a delayed age of coming out to siblings and parents, suicide ideation, historical use of substances including smoking tobacco cigarettes and consuming marijuana, as well as reporting higher levels of experienced, internalised and perceived homophobia. Conclusion Greater levels of early intervention and efforts are required to reduce the heightened experience of minority stress resulting from communal and institutional hostilities. Areas of improvement may include community-based counselling and psychological support for GBQ men, while not forsaking greater education of the social and healthcare sectors. Most importantly, disrupting the stigma narrative of a GBQ ‘lifestyle’ is paramount in establishing an accepting social environment that reduces the health disparity faced by GBQ men. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10992-6.
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Affiliation(s)
- Clarence Ong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
| | - Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore.
| | - Daniel Le
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore.,National University Hospital, National University Health System, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Adrian Tyler
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Calvin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Chronos Kwok
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Sumita Banerjee
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
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Tan RKJ, O'Hara CA, Koh WL, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Wong ML. Social capital and chemsex initiation in young gay, bisexual, and other men who have sex with men: the pink carpet Y cohort study. Subst Abuse Treat Prev Policy 2021; 16:18. [PMID: 33608005 PMCID: PMC7893730 DOI: 10.1186/s13011-021-00353-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 02/02/2023]
Abstract
Background Young gay, bisexual, and other men who have sex with men (YMSM) are especially vulnerable to the risks associated with sexualized substance use, or ‘chemsex’. Engaging in chemsex established as a major risk factor for Human Immunodeficiency Virus (HIV) acquisition, and is thus a public health issue of increasing urgency. This paper attempts to explore the association between measures of social capital and patterns of sexualized substance use among a sample of YMSM in Singapore. Methods Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study in Singapore, comprising a sample of 570 HIV-negative YMSM aged 18 to 25 years old. Latent class analysis was employed to identify classes with similar patterns of sexualized substance use, and multinomial logistic regression was employed to examine associations between class membership and proxy measures of social capital, including age of sexual debut, bonding and bridging social capital, connectedness to the lesbian, gay, bisexual and transgender community, and outness. Results Latent class analysis revealed three classes of YMSM based on their histories of sexualized substance use, which we labelled as ‘alcohol’, ‘poppers’, and ‘chemsex’. Multivariable analyses revealed that participants who were older (aOR = 1.19, p = 0.002) and who identified as gay (aOR = 2.43, p = 0.002) were more likely to be in the poppers class compared to the alcohol class. Participants with a later age of sexual debut were increasingly less likely to be in the poppers (aOR = 0.93, p = 0.039) and chemsex classes (aOR = 0.85, p = 0.018), compared to the alcohol class. Conclusions Varying measures of social capital such as an earlier age of exposure to sexual networks may predispose YMSM to greater opportunities for sexualized substance use. Future interventions should target YMSM who become sexually active at an earlier age to reduce the risks associated with sexualized substance use.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore.
| | - Caitlin Alsandria O'Hara
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore
| | - Wee Ling Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
| | - Daniel Le
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore.,National University Hospital, National University Health System, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Adrian Tyler
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Calvin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Chronos Kwok
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Sumita Banerjee
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
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Woldendorp K, Tan C, Bannon P, Robinson B. P51 Huge Aortic Root Pseudoaneurysm due to Detachment of Both Coronary Buttons After Modified Mechanical Bentall Procedure. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.254] [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: 11/17/2022]
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Tan C, Woldendorp K, Cao C, Bannon P, Yan T. P55 Novel Staged Method of Managing a Large Right Infected Bullous Cyst Causing Mediastinal Shift. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.258] [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: 11/24/2022]
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Tan C. Outcome of Patients who Have Ventricular Septal Defect (VSD) in Auckland Hospital. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.025] [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: 10/21/2022]
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Tan C. Intrepid Transcatheter Mitral Valve Replacement in a Surgically High-Risk Patient with Previous Mechanical Aortic Valve Replacement. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tan C, Chan D, Grant R, Manganas C. P09 Aortocavitary Fistula: A Rare Complication of Serratia Marcescens Endocarditis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.212] [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: 10/21/2022]
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Tan C. Characteristics and Outcome of Patients who Underwent DC-Cardioversion: An Auckland Hospital Experience. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.039] [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: 10/21/2022]
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Dagan M, Dinh D, Stehli J, Tan C, Brennan A, Ajani A, Freeman M, Reid C, Hiew C, Oqueli E, Kaye D, Clark D, Duffy S. Sex differences in pharmacotherapy and long-term outcomes in patients with ischaemic heart disease and left ventricular dysfunction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1059] [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: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular dysfunction and ischaemic heart disease are common amongst women, however, women tend to present later and are less likely to receive guideline-directed medical therapy compared to their male counterparts.
Purpose
To investigate if a sex discrepancy exists for optimal medical therapy (OMT) and long-term mortality in a cohort of patients with known ischaemic heart disease (IHD) and left ventricular dysfunction.
Methods
We analysed prospectively collected data from a multicentre registry database collected between 2005–2018 on pharmacotherapy 30-days post percutaneous coronary intervention (PCI) in 13,015 patients with left ventricular ejection fraction (LVEF) <50%. OMT at 30-days was defined as beta-blocker (BB), angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB) ± mineralocorticoid receptor antagonist (MRA). Long-term mortality was determined by linkage with the National Death Index, with median follow up of 4.7 (IQR 2.0–8.6) years.
Results
Mean age was 65±12 years; women represented 20.2% (2,634) of the cohort. Women were on average 5 years older, had higher average BMI, higher rates of hypertension, diabetes, renal dysfunction, prior stroke and rheumatoid arthritis. Men were more likely to have sleep apnoea, be current/ex-smokers and to have had prior myocardial infarction, PCI and bypass surgery. Overall, 72.3% (9,411) of patients were on OMT, which was similar between sexes (72.7% in women vs. 72.2% in men, p=0.58). Rates of BB therapy were similar between sexes (85.2% vs. 84.5%, p=0.38), while women were less likely to be on an ACEi/ARB (80.4% vs. 82.4%, p=0.02) and more likely to be on a MRA (12.1% vs. 10.0%, p=0.003). Amongst those with LVEF ≤35% (n=1,652), BB (88.7% vs. 87.3%, p=0.46), ACEi/ARB (83.3% vs. 82.1%, p=0.59) and MRA use (32.5% vs. 33.3%, p=0.78) was comparable. Aspirin use was similar between sexes (95.3% vs. 95.9%, p=0.12), while women were less likely to be on statin therapy (93.5% vs. 95.3%, p<0.001) and a second antiplatelet agent (94.4% vs. 95.6%, p=0.007). On unadjusted analysis women had significantly higher long-term mortality of 25.4% compared to 19.0% for men (p<0.001). Kaplan-Meier analysis out to 14 years demonstrated that men on OMT have the best long-term survival overall and women on sub-OMT have significantly poorer outcomes compared to men on sub-OMT. However, after adjusting for OMT and other comorbidities there was no difference in long-term mortality between sexes (HR 0.99, 95% CI 0.87–1.14, p=0.94).
Conclusion
From this large multicentre registry, we found similar rates of guideline-directed pharmacotherapy for left ventricular dysfunction between sexes, however women were less likely to be on appropriate IHD secondary prevention. The increased unadjusted long-term mortality amongst women is likely due to differing baseline risk, given that adjusted mortality was similar between sexes.
Kaplan-Meier Survival Analysis
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Dagan
- The Alfred Hospital, Melbourne, Australia
| | - D Dinh
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Melbourne, Australia
| | - J Stehli
- The Alfred Hospital, Melbourne, Australia
| | - C Tan
- The Alfred Hospital, Melbourne, Australia
| | - A Brennan
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Melbourne, Australia
| | - A.E Ajani
- Royal Melbourne Hospital, Melbourne, Australia
| | - M Freeman
- Box Hill Hospital, Melbourne, Australia
| | - C.M Reid
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Melbourne, Australia
| | - C Hiew
- Geelong Hospital, Geelong, Australia
| | - E Oqueli
- Deakin University, Melbourne, Australia
| | - D.M Kaye
- The Alfred Hospital, Melbourne, Australia
| | - D.J Clark
- Austin Hospital, Melbourne, Australia
| | - S.J Duffy
- The Alfred Hospital, Melbourne, Australia
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Panelo C, Tan C, Nachura S, Pargas I, Santillan M, Sugay N, Moreno A, Miradora K. PIN44 Benefit Design Considerations during Emergencies: Lessons from Covid 19. Value Health Reg Issues 2020. [PMCID: PMC7487860 DOI: 10.1016/j.vhri.2020.07.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Panelo C, Guerrero M, Genuino A, Moreno A, Nachura S, Tan C. PNS49 Building Capacity for HTA in the Philippines: An Imperative UNDER UHC. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.468] [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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Panelo C, Stein D, Dutta A, Santillan M, Tan C, Moreno A, David Reyes M, Caampued M. PMU13 Defining the ROLL out Strategy for UHC Benefits: Philhealth's Benefit Development PLAN. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.371] [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: 10/23/2022]
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Shen Y, Sun H, Huang C, Zhu X, Xu M, Tan C, Liang F, Zhou J, Fan J. 989P Effects of combination therapy using lenvatinib and anti-pd-1 antibody on liver function in patients with advanced hepatocellar carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1105] [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: 10/23/2022] Open
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Li CH, Kaura A, Tan C, Whitcroft KL, Leung TS, Andrews P. Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study. Laryngoscope Investig Otolaryngol 2020; 5:796-806. [PMID: 32904889 PMCID: PMC7461538 DOI: 10.1002/lio2.445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/06/2020] [Accepted: 07/25/2020] [Indexed: 12/12/2022] Open
Abstract
Objectives There is a need to develop a medical device which can accurately measure normal and abnormal nasal breathing which the patient can better understand in addition to being able to diagnose the cause for their nasal obstruction. The aim is to evaluate the accuracy of the nasal acoustic device (NAD) in diagnosing the common causes for nasal obstruction and diagnosing normal and abnormal (nasal obstruction) nasal breathing. Methods This pilot study recruited 27 patients with allergic rhinitis (AR), chronic rhinosinusitis (CRS), and a deviated nasal septum (DNS) which represents the common causes for NO and 26 controls (with normal nasal breathing). Nasal breathing sounds were recorded by the NAD akin to two small stethoscopes placed over the left and right nasal ala. The novel outcome metrics for the NAD include inspiratory nasal acoustic score (INA) score, expiratory nasal acoustic (ENA) score and the inspiratory nasal obstruction balance index (NOBI). The change in acoustic score following decongestant is key in this diagnostic process. Results Pre‐decongestant ENA score was used to detect the presence of nasal obstruction in patients compared to controls, with a sensitivity of 0.81 (95% CI: 0.66‐0.96) and a specificity of 0.77 (0.54‐1.00). Post‐decongestant percentage change in INA score was used to identify the presence of AR or CRS, with a sensitivity of 0.87 (0.69‐1.00) and specificity of 0.72 (0.55‐0.89) for AR; and a sensitivity of 0.92 (0.75‐1.00) and specificity of 0.69 (0.52‐0.86) for CRS. Post‐decongestant inspiratory NOBI was used to identify DNS, with a sensitivity of 0.77 (0.59‐0.95) and specificity of 0.94 (0.82‐1.00). Conclusion We have demonstrated that the NAD can help distinguish between normal and abnormal nasal breathing and help diagnose AR, CRS, and DNS. Such a device has not been invented and could revolutionize COVID‐19 recovery telemedicine. Level of Evidence Diagnostic accuracy study—Level III.
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Affiliation(s)
- Chia-Hung Li
- Department of Medical Physics and Biomedical Engineering University College London London UK
| | - Anika Kaura
- Department of Rhinology and Facial Plastic Surgery Royal National Throat, Nose and Ear Hospital London UK.,UCL Ear Institute, University College London London UK
| | - Calvin Tan
- Department of Medical Physics and Biomedical Engineering University College London London UK.,UCL Medical School, Faculty of Medical Sciences University College London London UK
| | - Katherine L Whitcroft
- Department of Rhinology and Facial Plastic Surgery Royal National Throat, Nose and Ear Hospital London UK.,UCL Ear Institute, University College London London UK
| | - Terence S Leung
- Department of Medical Physics and Biomedical Engineering University College London London UK
| | - Peter Andrews
- Department of Rhinology and Facial Plastic Surgery Royal National Throat, Nose and Ear Hospital London UK.,UCL Ear Institute, University College London London UK
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Fan X, Wang Q, Zhou M, Liu F, Shen H, Wei Z, Wang F, Tan C, Meng H. Humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer. Opt Express 2020; 28:24682-24692. [PMID: 32907003 DOI: 10.1364/oe.390207] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
A relative humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer (MZI) is proposed in this paper. The MZI was made by splicing a segment of the few-mode fiber (FMF) between two segments of a no-core fiber (NCF) and two segments of a single mode fiber (SMF) located outside the two NCFs. The core and cladding of the FMF acted as interferometric arms, while the NCFs acted as couplers for splitting and recombining light due to mismatch of mode field diameter. The cladding of the FMF was corroded with hydrofluoric acid, and a layer of graphene oxide (GO) film was coated on the corroded cladding of FMF via the natural deposition method. The refractive index of GO varied upon absorption the water molecules. As a result, the phase difference of the MZI varied and the wavelength of the resonant dip shifted with a change in the ambient relative humidity (RH). High humidity sensitivity of 0.191 and 0.061 nm/%RH in the RH range of 30-55% and 55-95%, respectively, were achieved experimentally. The high sensitivity, compact size, and simple manufacturing of the proposed sensor could offer attractive applications in fields of chemical sensors and biochemical detection.
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Heenan TMM, Jnawali A, Kok M, Tranter TG, Tan C, Dimitrijevic A, Jervis R, Brett DJL, Shearing PR. Data for an Advanced Microstructural and Electrochemical Datasheet on 18650 Li-ion Batteries with Nickel-Rich NMC811 Cathodes and Graphite-Silicon Anodes. Data Brief 2020; 32:106033. [PMID: 32775560 PMCID: PMC7394852 DOI: 10.1016/j.dib.2020.106033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 11/23/2022] Open
Abstract
The data presented here were collected from a commercial LG Chem cylindrical INR18650 MJ1 lithium-ion (Li-ion) battery (approximate nominal specifications: 3.5 Ah, 3.6 V, 12.2 Wh). Electrochemical and microstructural information is presented, the latter collected across several length scales using X-ray computed tomography (CT): from cell to particle. One cell-level tomogram, four assembly-level and two electrode/particle-level 3D datasets are available; all data was collected in the pristine state. The electrochemical data consists of the full current and voltage charge-discharge curves for 400 operational cycles. All data has been made freely available via a repository [10.5522/04/c.4994651] in order to aid in the development of improved computational models for commercially-relevant Li-ion battery materials.
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Affiliation(s)
- T M M Heenan
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - A Jnawali
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
| | - M Kok
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - T G Tranter
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - C Tan
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - A Dimitrijevic
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - R Jervis
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - D J L Brett
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - P R Shearing
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK.,The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
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Mosher AA, Tsoulis MW, Lim J, Tan C, Agarwal SK, Leyland NA, Foster WG. Melatonin activity and receptor expression in endometrial tissue and endometriosis. Hum Reprod 2020; 34:1215-1224. [PMID: 31211323 DOI: 10.1093/humrep/dez082] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 01/21/2023] Open
Abstract
STUDY QUESTION Are melatonin receptors (melatonin receptor 1A (MR1A) and melatonin receptor 1B (MR1B)) expressed in human endometrium and endometriotic tissue, and does melatonin affect endometrial cell proliferation? SUMMARY ANSWER Melatonin receptors are expressed in human eutopic endometrium, endometriomas and peritoneal lesions, although to different extents, and melatonin treatment attenuated estradiol-induced endometrial epithelial cell proliferation in culture. WHAT IS KNOWN ALREADY Melatonin decreased endometriotic lesion volume in a rat model of endometriosis. Melatonin treatment reduced pain scores in and analgesic use by women with endometriosis. STUDY DESIGN, SIZE, DURATION Basic science study using human endometrial tissue and an endometrial epithelial cell line. PARTICIPANTS/MATERIALS, SETTING, METHODS Measurement of melatonin receptor expression (mRNA and protein) in women with surgically confirmed endometriosis (endometrioma (n = 20) or peritoneal lesion (n = 11) alone) and women without surgical evidence of endometriosis (control, n = 15). Collection of endometrial and endometriotic tissue samples, gynecologic history and demographic information. Quantification of estradiol (1.0 nM) and melatonin (0.1 nM-1.0 μM) ± estradiol-induced endometrial epithelial cell proliferation in cultures of endometrial epithelial cells (CRL-1671) following 24 and 48 hours of culture. MAIN RESULTS AND THE ROLE OF CHANCE MR1A and MR1B were localized by immunohistochemistry in glandular epithelial cells of endometrial biopsies from women with and without endometriosis. Both receptors were expressed in eutopic and ectopic endometrial tissue. mRNA expression of MR1A and MR1B was significantly greater in peritoneal lesions than in either endometriomas or eutopic endometrium. However, protein expression of MR1A was decreased in peritoneal lesions compared to control eutopic endometrium, whereas MR1B expression did not differ between the groups. Melatonin (0.1 nM-1.0 μM) treatment inhibited estradiol (1.0 nM)-induced endometrial epithelial cell proliferation at 48 hours but not 24 hours of culture. LIMITATIONS, REASONS FOR CAUTION Beneficial effects of melatonin seen in culture have yet to be comprehensively evaluated in women with endometriosis. WIDER IMPLICATIONS OF THE FINDINGS Our data suggest that melatonin may be useful as an adjunct to current endometriosis treatments. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Canadian Institutes of Health Research (grant MOP142230 to W.G.F.). A.A.M. is supported by a resident research grant through the Physicians Services Incorporated Foundation. The authors have no conflicts of interest.
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Affiliation(s)
- A A Mosher
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - M W Tsoulis
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - J Lim
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - C Tan
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - S K Agarwal
- Center for Endometriosis Research and Treatment, University of California San Diego, La Jolla, CA, USA
| | - N A Leyland
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - W G Foster
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.,Center for Endometriosis Research and Treatment, University of California San Diego, La Jolla, CA, USA
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Li S, Li XD, Wang GP, Liang C, Jing JP, Liu MM, Zhang C, Lin T, Zhou YH, Song YZ, Tan C, Wang Q, Fan L. [Consideration of surgeons participating in 2019 coronavirus disease emergency medical rescue]. Zhonghua Wai Ke Za Zhi 2020; 58:404-407. [PMID: 32253891 DOI: 10.3760/cma.j.cn112139-20200317-00226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.
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Affiliation(s)
- S Li
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - X D Li
- Department of Urology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - G P Wang
- Department of Otolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - C Liang
- Department of Neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J P Jing
- Department of Neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - M M Liu
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - C Zhang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - T Lin
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y H Zhou
- Department of Breast Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y Z Song
- Department of Orthopedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - C Tan
- Department of Urology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Q Wang
- Department of Breast Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - L Fan
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
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Tan C, Cheung P, Lahiri M. FRI0530 THE PREVALENCE AND DETERMINANTS OF SLEEP PROBLEMS IN PATIENTS ACROSS RHEUMATIC DISEASES AND THEIR CORRELATION WITH DISEASE INDICES USING THE ROUTINE ASSESSMENT OF PATIENT INDEX DATA 3 (RAPID3) QUESTIONNAIRE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Sleep problems are common in rheumatology patients. RAPID3 is a patient reported outcome measure (PROM) that efficiently screens for problems with sleep, anxiety or depression in routine care.Objectives:To study prevalence and determinants of self-reported sleep problems across rheumatic diseases in Rheumatology clinics in Singapore, and its correlation with disease indices.Methods:RAPID3 questionnaire was filled electronically over 6 months. Demographic data and SNOWMED diagnoses codes were matched through hospital electronic medical records. RAPID3 comprised of 3 questions measuring the extent of difficulty getting a good night’s sleep and dealing with anxiety or depression. Significant problems were considered if they had “much difficulty” or were “unable to do” the component. The relationship of sleep with anxiety, depression, physical function (measured by modified health assessment questionnaire, mdHAQ), pain and patient global assessment (using visual analogue scale, VAS), was evaluated using Pearson’s correlation. Factors associated with significant sleep problems were evaluated by logistic regression.Results:4078 patients [mean (SD) age 55.8 (16.3) years, 67.9% female, 70.6% Chinese] were invited to participate, of which 2625 (64.4%) responded. SNOMED diagnosis codes were available for 1570 (59.8%) patients- majority had inflammatory arthritides (n= 843, 53.7%) (Figure 1).Mean mdHAQ was 0.3 (0.5), pain VAS was 2.4 (2.3) and global VAS was 2.6 (2.2). Data on disease duration, clinical features and medications were not available. 39.3%, 27.5% and 23.8% had problems with sleep, anxiety and depression respectively; and 7.3%, 4.5% and 4.3% had significant problems respectively. Sleep moderately correlated with anxiety (r=0.463, p<0.001) and depression (r=0.436, p<0.001) and weakly correlated with mdHAQ (r= 0.289, p<0.001), global (r=0.339, p<0.001) and pain VAS (r= 0.314, p<0.001).In multivariable logistic regression, significant sleep problems were associated with anxiety (OR 4.733, CI 2.172-10.310, p<0.001), mdHAQ score ≥ 1 (OR 2.920, CI 1.691-5.043, p< 0.001) and pain VAS >3 (OR 1.884, CI 1.093-3.247, p=0.023). Patients with osteoarthritis and fibromyalgia were more likely than those with inflammatory arthritides to have significant sleep problems, though we were unable to adjust for body mass index as data were unavailable (Table 1).Table 1.Determinants of significant disturbances in sleep in patients with rheumatic diseasesVariablesUnivariableMultivariableOdds ratio (95% CI)p-valueOdds ratio (95% CI)p-valueGenderFemale1.79 (1.245-2.57)0.0021.49 (0.86-2.59)0.16EthnicityChineseRefRefMalay1.04 (0.62-1.73)0.890.73 (0.33-1.61)0.43Indian1.59 (1.03-2.44)0.040.97 (0.49-1.90)0.92Others1.05 (0.62-1.77)0.870.92 (0.43-2.00)0.84Age (years)1.00 (1.00-1.01)0.36--mdHAQ ≥16.25 (4.46-8.75)<0.0012.92 (1.69-5.04)0.001Pain VAS >34.15 (3.07-5.61)<0.0011.88 (1.09-3.25)0.02Global VAS > 34.25 (3.13-5.76)<0.0011.63 (0.95-2.80)0.07Significant anxiety15.99 (10.71- 23.89)<0.0014.73 (2.17-10.31)<0.001Significant depression15.58 (10.35-23.45)<0.0013.02 (1.29-7.10)0.11Primary rheuma-tological diagnosisInflammatory arthritidesRefRefConnective tissue diseases1.18 (0.73-1.90)0.510.9 (0.51-1.59)0.71Crystal arthritides1.06 (0.48-2.33)0.880.83 (0.34-2.03)0.68Osteoarthritis3.09 (1.31-7.32)0.012.96 (1.19-7.36)0.02Fibromyalgia9.05 (2.04-40.05)0.0049.62 (2.11-43.84)0.003Others1.63 (0.82-3.29)0.171.20 (0.58-2.47)0.63Conclusion:Sleep problems are common in rheumatology patients and correlate significantly with disease indices and psychological distress. Rheumatologists should routinely screen for sleep difficulties, especially in patients with osteoarthritis and fibromyalgia.References: -Acknowledgments:Nil.Disclosure of Interests:Charlotte Tan: None declared, Peter Cheung: None declared, Manjari Lahiri Grant/research support from: Manjari Lahiri is the site principal investigator for the Singapore National Biologics Register, which is a multi-pharmaceutical funded register, in which industry sponsors provide support through the Chapter of Rheumatologists, Singapore. Dr Lahiri does not personally receive any remuneration.
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Heenan T, Tan C, Wade A, Jervis R, Brett D, Shearing P. Data on the theoretical X-Ray attenuation and transmissions for lithium-ion battery cathodes. Data Brief 2020; 30:105539. [PMID: 32373685 PMCID: PMC7191574 DOI: 10.1016/j.dib.2020.105539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/02/2022] Open
Abstract
This article reports the data required for planning attenuation-based X-ray characterisation e.g. X-ray computed tomography (CT), of lithium-ion (Li-ion) battery cathodes. The data reported here is to accompany a co-submitted manuscript (10.1016/j.matdes.2020.108585 [1]) which compares two well-known X-ray attenuation data sources: Henke et al. and Hubbell et al., and applies methodology reported by Reiter et al. to extend this data towards the practical characterisation of prominent cathode materials. This data may be used to extend beyond the analysis reported in the accompanying manuscript, and may aid in the applications for other materials, not limited to Li-ion batteries.
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Affiliation(s)
- T.M.M. Heenan
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - C. Tan
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - A.J. Wade
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - R. Jervis
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - D.J.L. Brett
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
| | - P.R. Shearing
- Electrochemical Innovation Lab, Department of Chemical Engineering, UCL, London WC1E 7JE, UK
- The Faraday Institution, Quad One, Harwell Science and Innovation Campus, Didcot, OX11 0RA, UK
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Sathiyanathan P, Samsonraj R, Ling L, Tan C, Eio M, Lu X, Lezhava A, Nurcombe V, Stanton L, Cool S. A diagnostic biomarker that predicts human bone marrow-derived mesenchymal stem cell scalability. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.04.064] [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: 10/24/2022]
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Abstract
Summary Hereditary angioedema (HAE) is a primary complement factor deficiency, characterized by recurrent submucosal/subcutaneous swelling episodes. SERPING1 gene defects encoding C1 esterase inhibitor (C1INH) are responsible from the disease. Fifteen patients with HAE are retrospectively evaluated in this study. All patients (n = 15) had HAE type I, 13 were from the same family, other two from two different families. Median age at onset of symptoms was 7 years (2-20); median age on diagnosis, 12 (0,5-41) and median delay in diagnosis, 3 years (0-33). Clinical symptoms were extremity edema(92,3%), facial edema(46%), abdominal pain (46%), genital edema (46%), and laryngeal edema (23%). Some patients suffered from recurrent abdominal pain, had been empirically given colchicine with familial mediterranean fever (FMF) when they admitted. One presented with bullous skin eruption, soon after developed extremity edema. Both resolved spontaneously after C1INH concentrate therapy. Two females suffered from recurrent genital edema after sexual activity. One patient experienced compartment syndrome-like swelling of extremity after playing football. One patient diagnosed with panic attack due to fear of death by asphyxiation, and was diagnosed with HAE disease. A nonsense mutation in exon 8, a missense mutation in exon 2 in SERPING1 gene was present in Family 1 and another patient (P14) from the other family, respectively. Sporadic/autosomal dominant inheritance ratio was 2/3 in the families present in our series. Patients with HAE presents with a large spectrum of symptoms. In mediterranean countries, patients with abdominal attacks may be misdiagnosed with FMF. Thus, health-care professionals should be alert, and put HAE in the first line of differential diagnoses when the disease symptoms are present. Consequently, morbidity/mortality will decrease with effective treatment options.
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Affiliation(s)
- E Soyak Aytekin
- Division of Pediatric Immunology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey
| | - D Çağdaş
- Division of Pediatric Immunology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey.,Institution of Child Health, Division of Pediatric Immunology, Hacettepe University Medical School, Ankara, Turkey
| | - C Tan
- Institution of Child Health, Division of Pediatric Immunology, Hacettepe University Medical School, Ankara, Turkey
| | - İ Tezcan
- Division of Pediatric Immunology, Department of Pediatrics, Hacettepe University Medical School, Ankara, Turkey.,Institution of Child Health, Division of Pediatric Immunology, Hacettepe University Medical School, Ankara, Turkey
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Tan RKJ, Koh WL, Le D, Tan A, Tyler A, Tan C, Banerjee S, Wong CS, Wong ML, Chio MTW, Chen MIC. Effect of a web drama video series on HIV and other sexually transmitted infection testing among gay, bisexual and queer men: study protocol for a community-based, pragmatic randomised controlled trial in Singapore: the People Like Us (PLU) Evaluation Study. BMJ Open 2020; 10:e033855. [PMID: 32269026 PMCID: PMC7170638 DOI: 10.1136/bmjopen-2019-033855] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/07/2020] [Accepted: 03/11/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Gay, bisexual and queer (GBQ) men are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBQ men are increasing worldwide, they remain suboptimal in a variety of settings. METHODS AND ANALYSIS The study is a pragmatic randomised controlled trial designed to evaluate an online video series developed by a community-based organisation in Singapore for GBQ men. A total of 300 HIV-negative GBQ men in Singapore aged 18-29 years old will be recruited for this study. Participants will subsequently be randomised into the intervention arm (n=150) and the control arm (n=150). The intervention arm (n=150) will be assigned the intervention along with sexual health information via a pamphlet, while the control group (n=150) will be assigned only the sexual health information via a pamphlet. Participants should also not have watched the video prior to their participation in this study, which will be ascertained through a questionnaire. Primary outcomes for this evaluation are changes in self-reported intention to test for, actual testing for and regularity of testing for HIV, syphilis, chlamydia and gonorrhoea at the 3 and 6 months after intervention. Secondary outcomes include changes in self-reported risk perception for HIV and other STIs, knowledge of HIV, knowledge of risks associated with acquiring STIs, knowledge of HIV pre-exposure prophylaxis, consistent condom use for anal sex with casual partners, incidence of STIs, connectedness to the lesbian, gay, bisexual and transgender community, self-concealment of sexual orientation, perceived homophobia, internalised homophobia, HIV testing self-efficacy and HIV testing social norms. ETHICS AND DISSEMINATION The study has been approved by the National University of Singapore Institutional Review Board (S-19-059) and registered at ClinicalTrials.gov. The results will be published in peer-reviewed academic journals and disseminated to community-based organisations and policymakers. TRIAL REGISTRATION NUMBER NCT04021953.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Wee Ling Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Daniel Le
- Action for AIDS Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, Singapore
| | | | | | | | - Chen Seong Wong
- National Centre for Infectious Diseases, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mee-Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | | | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- National Centre for Infectious Diseases, Singapore
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Tan Z, Chan S, Bin Abdul Rahman A, Chandramohan S, Damodharan K, Gogna A, Irani F, Leong S, Lo R, Karaddi Venkatanarasimha N, Patel A, Tan B, Too C, Zhuang K, Bin Sulaiman M, Tan C, Tze Tec C, Win H. 3:18 PM Abstract No. 15 Cutting balloon followed by drug-eluting balloon angioplasty for recurrent venous lesions in dialysis access; interim analysis of a single-arm prospective observational study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.035] [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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Steele S, Tan C, Cieslik L, Nanayakkara S, Mariani J, Leet A, Patel H. 307 Comparison of Left Ventriculography and Transthoracic Echocardiography in the Assessment of Left Ventricular Systolic Function Post Myocardial Infarction - A Single Centre Retrospective Analysis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.314] [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: 10/23/2022]
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