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Bommireddipally J, Broussard K, Osman H, Uhlhorn A, Loganantharaj N. Gastrointestinal: A rare case of concurrent vulvar Crohn's disease and pyoderma gangrenosum. J Gastroenterol Hepatol 2024; 39:417-419. [PMID: 38030955 DOI: 10.1111/jgh.16393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Affiliation(s)
- J Bommireddipally
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - K Broussard
- Division of Gastroenterology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
| | - H Osman
- Department of Pathology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - A Uhlhorn
- Division of Gastroenterology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
| | - N Loganantharaj
- Division of Gastroenterology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
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Zghouzi M, Osman H, Erdem S, Ullah W, Patel N, Sattar Y, Aronow H, Paul T, Aggarwal V, Licha H, Gurm H, Fischman D, Mamas M, AlJaroudi W, Alraies MC. In-Hospital Outcomes of Combined Coronary Revascularization and Transcatheter Aortic Valve Implantation in Inpatient Nationwide Analysis. Curr Probl Cardiol 2024; 49:101913. [PMID: 37557942 DOI: 10.1016/j.cpcardiol.2023.101913] [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: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 08/11/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) is accepted as an alternative to surgery, but data on combined percutaneous coronary interventions (PCI) and TAVI during the same in-hospital stay are still lacking. Using the national inpatient sample (NIS) database, we identified all TAVI encounters and compared in-hospital outcomes of patients who had TAVI only to patients who had TAVI and PCI. We used multivariable logistic regression analysis to calculate the adjusted odds ratio (aOR). Of 291,810 patient encounters with TAVI, 13,114 (4.5%) had combined PCI during the same index admission. The average age was 79.61 ± 8.61 years in the TAVI-only vs 80.25 ± 8.73 years in the combined TAVI-PCI group. Combined TAVI and PCI was associated with higher in-hospital mortality (4.5% vs 1.8%, aOR: 2.3), stroke (4.7% vs 2.9%, aOR: 1.4), net adverse events (NAE) (20.2% vs 5.7%, aOR: 3.6), major bleeding (40.1% vs 24.3%, aOR: 1.8), vascular complications (10.6% vs 2.5%, aOR: 3.9), acute kidney injury (AKI) (23.3% vs 11.7%, aOR: 2.1), hemodialysis (HD) (4.2% vs 2.4%, aOR: 1.4), postoperative cardiogenic shock (1.2% vs 0.4%, aOR: 2.8), need for mechanical circulatory support (6.9% vs 1%, aOR: 7); p-value < 0.001 for all. The utilization of permanent pacemakers was similar between the groups (9.8% vs 9.2%, aOR: 1; p = 0.6). Combining TAVI and PCI during the same index admission is associated with worse outcomes. The decision to do PCI for patients undergoing TAVI should be individualized and tailored based on the patient's clinical conditions.
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Affiliation(s)
| | | | | | - Waqas Ullah
- Thomas Jefferson University, Philadelphia, PA
| | - Neel Patel
- New York Medical College/Landmark Medical Center, Woonsocket, RI
| | | | | | | | | | | | | | | | - Mamas Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK
| | - Wael AlJaroudi
- Medical College of Georgia at Augusta University, Augusta, GA
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Ullah W, Suleiman ARM, Osman H, Bodempudi S, Muhammadzai HZU, Zahid S, Zghouzi M, Sattar Y, Virani SS, Fischman DL, Alraies MC. Trends and Outcomes of Transcatheter Aortic Valve Implantation in Aortic Insufficiency: A Nationwide Readmission Database Analysis. Curr Probl Cardiol 2024; 49:102012. [PMID: 37549814 DOI: 10.1016/j.cpcardiol.2023.102012] [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: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) has increasingly been utilized in patients with aortic insufficiency (AI) with insufficient data on its safety. The Nationwide Readmissions Database (NRD) was queried to identify patients undergoing TAVI for AI. Net clinical events (composite of in-hospital mortality, stroke, major bleeding) and procedural complications were assessed using a propensity-score matched (PSM) analysis to calculate adjusted odds ratios (OR). A total of 185,703 (AI 3873, aortic stenosis [AS] 181,830) patients were included in the analysis. Due to a significant difference in the baseline characteristics, a matched sample of 7929 patients (AI 3873, AS 4056) was selected. At index admission, the adjusted odds of in-hospital NACE (aOR 2.0, 95% CI 1.59-2.51), mortality (aOR 3.06, 95% CI 2.38-5.47), major bleeding (aOR 1.53, 95% CI 1.13-2.06) and valvular complications (aOR 9.48, 95% CI 6.73-13.38) were significantly higher in patients undergoing TAVI for AI compared with those undergoing TAVI for AS. However, there was no significant difference in the incidence of NACE, mortality, stroke, major bleeding, and need for permanent pacemaker implantation at 30- and 180-days follow-up. TAVI in AI was associated with a higher risk of periprocedural NACE, mortality, and major bleeding. The risk of these complications attenuated at 30- and 180-day readmission.
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Affiliation(s)
- Waqas Ullah
- Thomas Jefferson University Hospital, Philadelphia, PA.
| | - Abdul-Rahman M Suleiman
- University of Tennessee Health Sceince Center, Nashville, TN and Ascenstion St. Thomas Hospital, Nashville, TN
| | - Heba Osman
- Wayne State University/Detroit Medical Center, Detroit, MI
| | | | | | - Salman Zahid
- Oregan Health and Science University, Portland, OR
| | - Mohamed Zghouzi
- University of Tennessee Health Sceince Center, Nashville, TN and Ascenstion St. Thomas Hospital, Nashville, TN
| | | | | | | | - M Chadi Alraies
- University of Tennessee Health Sceince Center, Nashville, TN and Ascenstion St. Thomas Hospital, Nashville, TN
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Benhabib H, Crivellaro PS, Osman H, Gunaseelan S, Chung A, Lee JY, Colak E, Leung V, O'Sullivan J, Walsh C, Kielar A. Standardized Reporting on the Preoperative CT Assessment of Potential Living Renal Transplant Donors: Can We Create a Universal Report Standard to Meet the Needs of Transplant Urologists? Can Assoc Radiol J 2023; 74:629-634. [PMID: 36718778 DOI: 10.1177/08465371231153828] [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: 02/01/2023] Open
Abstract
Purpose: Determine whether standardized template reporting for the preoperative assessment of potential living renal transplant donors improves the comprehensiveness of radiology reports to meet the needs of urologists performing renal transplants. Methods: Urologist and radiologist stakeholders from renal transplant centres in our province ratified a standardized reporting template for evaluation of potential renal donors. Three centres (A, B, and C) were designated "intervention" groups. Centre D was the control group, given employment of a site-specific standardized template prior to study commencement. Up to 100 consecutive CT scan reports per centre, pre- and post-implementation of standardized reporting, were evaluated for reporting specific outcome measures. Results: At baseline, all intervention groups demonstrated poor reporting of urologist-desired outcome measures. Centre A discussed 5/13 variables (38%), Centre B discussed 6/13 variables (46%), and Centre C only discussed 1/13 variables (8%) with ≥90% reliability. The control group exhibited consistent reporting, with 11/13 variables (85%) reported at ≥90% reliability. All institutions in the intervention group exhibited excellent compliance to structured reporting post-template implementation (Centres A = 95%, B = 100%, and C = 77%, respectively). Additionally, all intervention centres demonstrated a significant improvement in the comprehensiveness of reports post-template implementation, with statistically significant increases in the reporting of all variables under-reported at baseline (P > .01). Conclusion: Standardized templates across our province for CT scans of potential renal donors promote completeness of reports. Radiologists can reliably provide our surgical colleagues with needed preoperative anatomy and incidental findings, helping to determine suitable transplant donors and reduce potential complications associated with organ retrieval.
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Affiliation(s)
- Hadas Benhabib
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Priscila Sacilotto Crivellaro
- Department of Medical Imaging, London Health Sciences Centre, University Hospital, Western University, London, ON, Canada
| | - Heba Osman
- Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - Senthujan Gunaseelan
- Department of Radiology, Health Sciences Centre (HSC - 3N26), McMaster University, Hamilton, ON, Canada
| | - Andrew Chung
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Jason Y Lee
- Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Errol Colak
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Vincent Leung
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Joseph O'Sullivan
- Department of Medical Imaging, London Health Sciences Centre, University Hospital, Western University, London, ON, Canada
| | - Cynthia Walsh
- Department of Medical Imaging, London Health Sciences Centre, University Hospital, Western University, London, ON, Canada
| | - Ania Kielar
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Almaasfeh S, Abukonna A, Omer S, Osman H. Evaluation of Forced Expiratory Volume in One Second and Forced Vital Capacity from Age and Height for Pulmonary Function Test. West Afr J Med 2023; 40:1029-1034. [PMID: 37906250] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND Lung function tests (LFTs) are a collection of clinical examinations used to assess lung function and monitor potential declines in the lungs, respiratory muscles, and chest wall's mechanical performance. This cross-sectional study aimed to identify the relation of age and height to lung function. MATERIAL AND METHODS The study was conducted at AlHussein Medical City, 70 adult male subjects were enrolled in the study. All subjects were screened physically to ensure that they were normal and there were no respiratory disorders that could affect the lung function. Age and height were taken for these subjects, forced vital capacity (FVC), FEV1 (Forced expiratory volume in first second) as well as FEV1 /FVC ratio were measured. RESULTS The results of the study showed that the average values of FVC and FEV1 were 4.75 and 3.88 respectively. There was a significant negative correlation observed between age and FVC (r=0.48), FEV1 (r= 0.6). Also there was a significant positive correlation noticed between Height and FVC (r = 0.62), FEV1 (r =0.69). There was a very high correlation evidenced between FEV1 and FVC, the relation between FEV1 and FVC is practically height and age-independent. CONCLUSION Our study highlights a great interest in the study of the relation between age, height, and lung function. The study also creates simple and convenience equations that can be used for reference standards in clinical practice to give reasonable theoretical values for a large sector of the population.
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Affiliation(s)
- S Almaasfeh
- Al - Hussein bin Talal University, Princess Aisha Bint Al- Hussein College of Nursing and Health Science- Ma'an Jordan
| | - A Abukonna
- Sudan University of Science and Technology, College of Medical Radiologic Science - Khartoum Sudan
| | - S Omer
- Sudan University of Science and Technology, College of Medical Radiologic Science - Khartoum Sudan
| | - H Osman
- College of Applied Medical Science, Taif University, Taif, Saudi Arabia
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Shafi I, Patel DA, Osman H, Patel N, Ramaseshan K, Goel M, Alraies MC. Outcomes of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention Among Patients With Acute Coronary Syndrome. Am J Cardiol 2023; 204:115-121. [PMID: 37541147 DOI: 10.1016/j.amjcard.2023.07.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 08/06/2023]
Abstract
Intravascular ultrasound (IVUS) use in percutaneous coronary intervention (PCI) improves outcomes. However, data on outcomes of IVUS-guided PCI in patients presenting with acute coronary syndrome (ACS) is scarce. Therefore, we sought to study the utilization rate and outcomes of IVUS-guided PCI in patients with ACS. Using the National Readmission database, we identified all patients with ACS who underwent PCI from 2016 to 2019. We used a 1:1 propensity-matched analysis to compare the outcome of patients with ACS who underwent PCI with and without IVUS. In 1,263,997 patients with ACS, 563,521 (44.6%) underwent PCI without IVUS and 40,095 (3.17%) underwent IVUS-guided PCI. A Propensity scored matched comparison of PCI with and without IVUS showed IVUS-guided PCI was associated with a lower risk of in-hospital mortality (odds ratio 0.74, 95% confidence interval 0.64 to 0.85, p <0.01) compared with PCI without IVUS. The utilization of IVUS increased from 2.64% in 2016 to 4.10% in 2019, p <0.001. In conclusion, IVUS-guided PCI is associated with lower in-hospital mortality in patients with ACS, yet the current utilization of IVUS-guided PCI remains low across the United States.
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Affiliation(s)
| | | | - Heba Osman
- Department of Internal Medicine - Pediatrics
| | - Neel Patel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan; Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, Rhode Island
| | - Karthik Ramaseshan
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan
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Osman H, Shaik AN, Nguyen PL, Cantor Z, Kaafarani M, Soubani AO. The Clinical Significance of Aspergillus Detected in Lower-Respiratory-Tract Samples of Critically Ill COVID-19-Positive Patients. Adv Respir Med 2023; 91:337-349. [PMID: 37736973 PMCID: PMC10514834 DOI: 10.3390/arm91050027] [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] [Received: 04/28/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
Objective: Critically ill patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications, including invasive aspergillosis. Our study aimed to characterize the clinical significance and outcome of Aspergillus species isolated from lower-respiratory-tract samples of critically ill OVID-19 patients at a single center. Design: We conducted a retrospective cohort study to evaluate the characteristics of patients with COVID-19 and aspergillus isolated from the lower respiratory tract and to identify predictors of outcomes in this population. Setting: The setting was a single-center hospital system within the metropolitan Detroit region. Results: The prevalence of Aspergillus isolated in hospitalized COVID-19 patients was 1.18% (30/2461 patients), and it was 4.6% in critically ill ICU patients with COVID-19. Probable COVID-19-associated invasive pulmonary aspergillosis (CAPA) was found in 21 critically ill patients, and 9 cases were classified as colonization. The in-hospital mortality of critically ill patients with CAPA and those with aspergillus colonization were high but not significantly different (76% vs. 67%, p = 1.00). Furthermore, the in-hospital mortality for ICU patients with or without Aspergillus isolated was not significantly different 73.3% vs. 64.5%, respectively (OR 1.53, CI 0.64-4.06, p = 0.43). In patients in whom Aspergillus was isolated, antifungal therapy (p = 0.035, OR 12.3, CI 1.74-252); vasopressors (0.016, OR 10.6, CI 1.75-81.8); and a higher mSOFA score (p = 0.043, OR 1.29 CI 1.03-1.72) were associated with a worse outcome. In a multivariable model adjusting for other significant variables, FiO2 was the only variable associated with in-hospital mortality in patients in whom Aspergillus was isolated (OR 1.07, 95% CI 1.01-1.27). Conclusions: The isolation of Aspergillus from lower-respiratory-tract samples of critically ill patients with COVID-19 is associated with high mortality. It is important to have a low threshold for superimposed infections such as CAPA in critically ill patients with COVID-19.
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Affiliation(s)
- Heba Osman
- Department of Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Asra N. Shaik
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Paul L. Nguyen
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Zachary Cantor
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Mirna Kaafarani
- Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, 3990 John R-3 Hudson, Detroit, MI 48201, USA
| | - Ayman O. Soubani
- Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, 3990 John R-3 Hudson, Detroit, MI 48201, USA
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Alhusain R, Patel D, Osman H, Subahi A, Ahmed AK, Shaikheldin A, Hussein S, Abdelrahim A, Dandu C, Chalek A, Patel N, Elhussein M, Hamza M, Alamzaib SM, Sattar Y, Alraies MC. Coronary Intra-orbital Atherectomy Complications and Procedural Failure: Insight From the Manufacturer and User Facility Device Experience (MAUDE) Database. Cureus 2023; 15:e40817. [PMID: 37485105 PMCID: PMC10362969 DOI: 10.7759/cureus.40817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND The Diamondback 360® Coronary Orbital Atherectomy System (Cardiovascular Systems Inc., St. Paul, MN) is the first and only orbital atherectomy system approved by the US FDA for the treatment of severely calcified lesions. While the device has proven to be safe in clinical trials, real-world data are minimal. METHODS The Manufacturer and User Facility Device Experience (MAUDE) database was queried for reports on the Diamondback 360® Coronary from January 2019 to January 2022. RESULTS A total of 566 events were reported during the study period. After the exclusion of duplicate reports, the final cohort included 547 reports. The most common mode of failure was break or separation of a device part (40.4%, n = 221) mainly due to breaking in the tip of the ViperWire (66.1%), driveshaft (22.7%), or crown (12.2%). The most common vessel associated with events was the left anterior descending artery (31.4%), followed by the right coronary artery (26.9%), left circumflex (21.6%), and left main coronary artery (6.4%). The most common clinical adverse outcome was perforation (33.0%, n = 181) with 23.7% resulting in cardiac tamponade. Most perforation cases were treated by covered stent (44.2%), surgery (30.5%), stent (98%), and balloon angioplasty (9%). There were 89 (16.3%) events of death with 67% due to perforation (p < 0.001). CONCLUSION Our study provided a glimpse of real-world adverse outcomes and common modes of failure due to orbital atherectomy. The most common mode of failure was the break or separation of a device part and the most common complication was perforation according to the MAUDE database. It will help physicians to anticipate complications and escalate care appropriately.
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Affiliation(s)
| | - Dhruvil Patel
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Heba Osman
- Internal Medicine/Pediatrics, Wayne State University Detroit Medical Center, Detroit, USA
| | - Ahmed Subahi
- Internal Medicine, Beaumont Hospital, Detroit, USA
| | | | | | - Sami Hussein
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | | | - Chaitu Dandu
- Vascular Surgery, Wayne State University School of Medicine, Detroit, USA
| | - Adam Chalek
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Neel Patel
- Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, USA
| | | | | | - Sardar Muhammad Alamzaib
- Cardiovascular Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Yasar Sattar
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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Dayco JS, Osman H, Almas T, Manasrah N, Saleem A, Alhusain R, Awadelkarim A, Dirani K, Sokolowski C, Lakkis N, Alraies MC. Major Complications and Failure Modes of the Angiosculpt Scoring Balloon Catheter: Analysis of the MAUDE Database. Curr Probl Cardiol 2023; 48:101557. [PMID: 36528205 DOI: 10.1016/j.cpcardiol.2022.101557] [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: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Since its Food and Drug Administration approval in January 2007, the Angiosculpt scoring balloon catheter has been widely utilized in severely calcified stenotic vascular lesions. We sought to characterize the complication rates, failure modes, and outcomes associated with the Angiosculpt catheter. Using queried events from October 2013 to December 2020 from the Food and Drug Administration Manufacturer and User Facility Device Experience database, we analyzed the Angiosculpt scoring balloon catheter complication rates and mode of failure. A total of 248 complications were reported. Most reported complications occurred in the superficial femoral artery (SFA) (19.4%, n = 48), followed by the left anterior descending artery (8.1%, n = 20). Severe vessel calcifications were reported in (26.6%, n = 66) of the complications. Most complications occurred with damage to the device, such as tip break (44.8%, n = 111) and balloon rupture (26.6%, n = 66). Some complications were due to difficulties in the withdrawal of the catheter (23.8%, n = 59). Balloon rupture is observed at a significantly higher rate amongst calcified vessels (60.6% vs 14.8%), P = < 0.001, and in cases involving the SFA (39.4% vs 11.3%), P = < 0.001. All-cause complications in calcified vessels are associated with the SFA (39.4% vs 12.5%), P = < 0.001, and left anterior descending artery (16.7% vs 5.1%), P = < 0.001. The Angiosculpt scoring balloon catheter has a relatively low complication rate. Most complications were associated with a device tip break, balloon rupture, and difficulties in withdrawal in severely calcified vessels.
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Affiliation(s)
- John S Dayco
- Wayne State University, Detroit Medical Center, MI
| | - Heba Osman
- Wayne State University, Detroit Medical Center, MI
| | | | | | | | | | | | - Karim Dirani
- Wayne State University, Detroit Medical Center, MI
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10
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Manasrah N, Zghouzi M, Naughton R, Patel D, Osman H, Abdelrahman AK, Halboni A, Deschamps R, Sattar Y, Alraies MC. Outcomes of Orbital Atherectomy for the Treatment of Severely Calcified Coronary Artery Lesions. Cureus 2023; 15:e37651. [PMID: 37200667 PMCID: PMC10188128 DOI: 10.7759/cureus.37651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
Background Orbital atherectomy (OA) is used to prepare severely calcified coronary artery lesions before percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) is used to determine the plaque volume and degree of stenosis within the arterial vessel. This study evaluated the safety and efficacy of OA for treating severely calcified coronary lesions and determined if IVUS impacted these outcomes. Methods We retrospectively collected data from a single center of patients with severe coronary artery calcification who underwent OA. The data on baseline characteristics and procedural and clinical outcomes were collected and analyzed. Results A total of 374 patients underwent OA. The mean age was 69 ± 12.7; 53.6% were Black, and 38% were female. Hypertension was present in 96% of the patients, followed by hyperlipidemia in 79.4%, diabetes mellitus in 53.7%, and chronic kidney disease (CKD) in 22.7%. More patients had presented with a non-ST-elevation myocardial infarction (NSTEMI) compared to ST-elevation myocardial infarction (STEMI) at 36.3% versus 4.3%, respectively. The radial artery was used in 35.4% of the cases, and the left anterior descending artery (LAD) was the most commonly treated vessel with OA at 61%, followed by the right coronary artery (RCA) at 30.7%. IVUS was utilized in 63.4% of cases. The most common complication of the procedure was perforation and dissection at an equal proportion of 1.3% among all patients. The no-reflow rate was 0.5%, and 0.5% developed post-procedural myocardial infarction (MI). The average length of stay was 4.7 days, while a marginal proportion, at 10.5%, had same-day discharge with no recorded complications. Conclusion In this analysis of patients with severely calcified coronary lesions, OA had low rates of major adverse cardiovascular events (MACE) and was considered a safe and effective treatment for complex coronary lesions.
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Affiliation(s)
- Nouraldeen Manasrah
- Internal Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA
| | | | - Ryan Naughton
- Internal Medicine, Wayne State University, Detroit, USA
| | - Dhruvil Patel
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Heba Osman
- Internal Medicine/Pediatrics, Wayne State University-Detroit Medical Center, Detroit, USA
| | - Ahmad K Abdelrahman
- Internal Medicine, Wayne State University-Detroit Medical Center, Detroit, USA
| | - Adnan Halboni
- Internal Medicine, Wayne State University-Detroit Medical Center, Detroit, USA
| | - Raegan Deschamps
- Cardiology, Wayne State University-Detroit Medical Center, Detroit, USA
| | - Yasar Sattar
- Cardiology, West Virginia University, Morgantown, USA
| | - M Chadi Alraies
- Cardiology, Wayne State University-Detroit Medical Center, Detroit, USA
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Zghouzi M, Osman H, Erdem S, Ullah W, Sattar Y, Alraies MC. IN-HOSPITAL OUTCOMES OF COMBINED CORONARY REVASCULARIZATIONAND TRANSCATHETER AORTIC VALVE IMPLANTATION IN INPATIENT NATIONWIDE ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01536-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Osman H, Mishra T, Aslam A, Kang W, Elmoghrabi A, Yassin A, Afonso LC. THE RAVAGES OF INFECTIVE ENDOCARDITIS: INTRAMYOCARDIAL ABSCESS AND ACUTE MYOCARDIAL INFARCTION FROM SEPTIC EMBOLIZATION. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03785-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Elmoghrabi A, Shafi I, Abdelrahman A, Osman H, Manasrah N, Zghouzi M, Halboni A, Patino S, Patel NN, Hakim Z, Gardi D, Lakkis N, Alraies MC. Outcomes of Catheter-Based Pulmonary Artery Embolectomy in Patients With Sub-Massive to Massive Pulmonary Embolism. Cureus 2023; 15:e34877. [PMID: 36925989 PMCID: PMC10013309 DOI: 10.7759/cureus.34877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2023] [Indexed: 02/13/2023] Open
Abstract
Background Pulmonary embolism (PE) is the third leading cause of cardiovascular death after myocardial infarction and stroke. The ideal therapeutic approach for these patients remains undetermined. We report our single-center outcome data for using a catheter-based pulmonary artery thrombectomy using the FlowTriever (Inari Medical, Irvine, CA) device as management for patients with submassive PE. Methods We retrospectively collected data from a single center of patients who underwent thrombectomy using INARI FlowTriever device. The data on baseline characteristics, procedural and clinical outcomes was collected and analysed Results A total of 38 patients with PE treated endovascularly with the FlowTriever device were identified: 33 with submassive PE and five with massive PE. The mean age was 65.9 years (95% CI 61.9 - 69.8), and most patients were male (73.7%). All patients had right heart strain as the main indication for thrombectomy. Four patients (10.53%) required pressor support before the procedure. In 31 patients, pre- and post-thrombectomy average mean pulmonary artery pressure (mPAP) was improved significantly by 22% (p < 0.01). Two patients had significant adverse events at 48 hours (5.26%). One patient experienced procedure-related access site hematoma and life-threatening bleeding, while another developed intraprocedural-related massive hemoptysis and cardiopulmonary arrest. Overall post-procedural length of stay was 7.7 ± 5.6 days; 52.63% of patients (n = 20) required intensive care. Three patients (7.89%) required pressor support before the procedure, and 78.9% of patients (n = 30 of 38) survived hospital discharge. Thirty patients who survived were discharged with oral anticoagulation. There were no device-related complications. Conclusion Randomized trials of interventional devices for submassive PE are warranted to either support or alert the medical community of the safety and efficacy of their use for patients with submassive and massive PE. In time, pulmonary embolism response team (PERT) may generate outcome data that better inform treatment decisions.
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Affiliation(s)
- Adel Elmoghrabi
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Irfan Shafi
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Ahmed Abdelrahman
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Heba Osman
- Internal Medicine/Pediatrics, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Nouraldeen Manasrah
- Internal Medicine, Detroit Medical Center, Sinai Grace Hospital - Wayne State University, Detroit, USA
| | - Mohamed Zghouzi
- Internal Medicine, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Adnan Halboni
- Internal Medicine, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Skarlet Patino
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Neel N Patel
- Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, USA.,Graduate Medical Education, B J Medical College, Ahmedabad, IND
| | - Zaher Hakim
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Delair Gardi
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - Nasser Lakkis
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
| | - M Chadi Alraies
- Cardiology, Detroit Medical Center - Wayne State University, Detroit, USA
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Azmi MN, Hasmaruddin NS, Mat Ali NA, Osman H, Mohamad S, Parumasivam T, Hassan MZ, Abd Ghani MS, Awang K. Synthesis, characterization, anti-mycobacterial activity and in silico study of new 2,5-disubstituted-1,3,4-oxadiazole derivatives. Trop Biomed 2022; 39:467-475. [PMID: 36214446 DOI: 10.47665/tb.39.3.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value -8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.
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Affiliation(s)
- M N Azmi
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - N S Hasmaruddin
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - N A Mat Ali
- School of Biological Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - H Osman
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - S Mohamad
- School of Biological Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - T Parumasivam
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - M Z Hassan
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha, 62529, Saudi Arabia
| | - M S Abd Ghani
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - K Awang
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Awadelkarim A, Shafi I, Elmoghrabi A, Kang W, Alhusain R, Osman H, Idris I, Dawdy J, Alraies MC, Lakkis N. TCT-555 Gender Differences in the Outcomes of Transcatheter Mitral Valve Repair: An Insight From the Nationwide Readmissions Database. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Zghouzi M, Osman H, Ullah W, Suleiman AR, Razvi P, Abdalrazzak M, Rabbat F, Alraiyes M, Sattar Y, Bagur R, Paul T, Matetic A, Mamas MA, Lakkis N, Alraies MC. Safety and efficacy of transcatheter aortic valve implantation in stenotic bicuspid aortic valve compared to tricuspid aortic valve: a systematic review and meta-analysis. Expert Rev Cardiovasc Ther 2022; 20:581-588. [PMID: 35770517 DOI: 10.1080/14779072.2022.2094368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective alternative to surgical replacement for tricuspid aortic valve (TAV) stenosis. However, utilization of TAVI for aortic stenosis in bicuspid aortic valve (BAV) compared to TAV remains controversial. METHODS We queried online databases with various keywords to identify relevant articles. We compared major cardiovascular events and procedural outcomes using a random effect model to calculate odds ratios (OR). RESULTS We included a total of 22 studies comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled analysis, there were no difference in TAVI for BAV vs. TAV for all-cause mortality, cardiovascular mortality, myocardial infarction (MI), vascular complications, acute kidney injury (AKI), coronary occlusion, annulus rupture, and reintervention/reoperation between the groups. The incidence of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42; 95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26) was less in the TAV group compared to the BAV group, while incidence of life-threatening bleeding was higher in the TAV group. Subgroup analysis mirrored pooled outcomes except for all-cause mortality. CONCLUSION The use of TAVI for the treatment of aortic stenosis in selective BAV appears to be safe and effective.
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Affiliation(s)
- Mohamed Zghouzi
- Department of Internal Medicine, Detroit Medical Center, Detroit, MI, USA
| | - Heba Osman
- Department of Internal Medicine, Detroit Medical Center, Detroit, MI, USA
| | - Waqas Ullah
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Parveen Razvi
- Department of Internal Medicine, Detroit Medical Center, Detroit, MI, USA
| | - Mukhlis Abdalrazzak
- Division of Cardiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Firas Rabbat
- Division of Cardiolog, Internal medicine, Baptist hospital, Miami, FL, USA
| | - Mowaffak Alraiyes
- Division of Cardiology, Vernon Hills High School, Vernon Hills, IL, USA
| | - Yasar Sattar
- Division of cardiology, West Virginia University, Morgantown, WV, USA
| | - Rodrigo Bagur
- Division of Cardiology, London Health Sciences Centre, Western University, London, ON, Canada
| | - Timir Paul
- Department of Medical Education, University of Tennessee at Nashville, Nashville, TN, USA
| | - Andrija Matetic
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - Nasser Lakkis
- Division of cardiology, Wayne State University/Detroit Medical Center, Detroit, MI, USA
| | - M Chadi Alraies
- Division of cardiology, Wayne State University/Detroit Medical Center, Detroit, MI, USA
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Al-abcha A, Osman H, Oladeji A, Boumegouas M, Abela G, Wang E. The Effect of Estrogen and Testosterone on Cholesterol Crystallization. J Clin Lipidol 2022. [DOI: 10.1016/j.jacl.2022.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Osman H, Tran J, McGowan R, Haidar-El-Atrache S. Nausea and Vomiting in an Adolescent Female. Clin Pediatr (Phila) 2022; 61:381-383. [PMID: 35156415 DOI: 10.1177/00099228221078680] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Heba Osman
- Wayne State University, Detroit, MI, USA
| | - Jennifer Tran
- Central Michigan University, Mount Pleasant, MI, USA
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Suleiman ARM, Osman H, Chalek A, Dandu C, Zghouzi M, Ullah W, Razvi P, Sattar Y, Oveido C, Elmakshbr N, Alhusain R, Lakkis NM, Alraies MC. PREDICTORS OF OUTCOMES OF TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH AORTIC INSUFFICIENCY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Osman H, Ullah W, Suleiman ARM, ZahidUllah H, Zahid S, Zghouzi M, Sattar Y, Prasad A, Bagur R, Shafi I, Kapadia SR, Mamas M, Virani SS, Fischman DL, Alraies MC. TRENDS OF TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH AORTIC INSUFFICIENCY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Osman H, Elmoghrabi A, Ali M, Afonso LC. RARE MASS IN THE ASCENDING AORTA. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)04301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Frank RA, Fabiano N, Hallgrimson Z, Korevaar DA, Cohen JF, Bossuyt PM, Leeflang MMG, Moher D, McInnes MDF, Treanor L, Salameh JP, McGrath TA, Sharifabadi AD, Atyani A, Kazi S, Choo-Foo J, Asraoui N, Alabousi M, Ha W, Prager R, Rooprai P, Pozdnyakov A, John S, Osman H, Islam N, Li N, Gauthier ID, Absi M, Kraaijpoel N, Ebrahimzadeh S, Port JD, Stoker J, Klein JS, Schweitzer M. Association of Accuracy, Conclusions, and Reporting Completeness With Acceptance by Radiology Conferences and Journals. J Magn Reson Imaging 2022; 56:380-390. [PMID: 34997786 DOI: 10.1002/jmri.28046] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/29/2021] [Accepted: 12/16/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Preferential publication of studies with positive findings can lead to overestimation of diagnostic test accuracy (i.e. publication bias). Understanding the contribution of the editorial process to publication bias could inform interventions to optimize the evidence guiding clinical decisions. PURPOSE/HYPOTHESIS To evaluate whether accuracy estimates, abstract conclusion positivity, and completeness of abstract reporting are associated with acceptance to radiology conferences and journals. STUDY TYPE Meta-research. POPULATION Abstracts submitted to radiology conferences (European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and International Society for Magnetic Resonance in Medicine (ISMRM)) from 2008 to 2018 and manuscripts submitted to radiology journals (Radiology, Journal of Magnetic Resonance Imaging [JMRI]) from 2017 to 2018. Primary clinical studies evaluating sensitivity and specificity of a diagnostic imaging test in humans with available editorial decisions were included. ASSESSMENT Primary variables (Youden's index [YI > 0.8 vs. <0.8], abstract conclusion positivity [positive vs. neutral/negative], number of reported items on the Standards for Reporting of Diagnostic Accuracy Studies [STARD] for Abstract guideline) and confounding variables (prospective vs. retrospective/unreported, sample size, study duration, interobserver agreement assessment, subspecialty, modality) were extracted. STATISTICAL TESTS Multivariable logistic regression to obtain adjusted odds ratio (OR) as a measure of the association between the primary variables and acceptance by radiology conferences and journals; 95% confidence intervals (CIs) and P-values were obtained; the threshold for statistical significance was P < 0.05. RESULTS A total of 1000 conference abstracts (500 ESGAR and 500 ISMRM) and 1000 journal manuscripts (505 Radiology and 495 JMRI) were included. Conference abstract acceptance was not significantly associated with YI (adjusted OR = 0.97 for YI > 0.8; CI = 0.70-1.35), conclusion positivity (OR = 1.21 for positive conclusions; CI = 0.75-1.90) or STARD for Abstracts adherence (OR = 0.96 per unit increase in reported items; CI = 0.82-1.18). Manuscripts with positive abstract conclusions were less likely to be accepted by radiology journals (OR = 0.45; CI = 0.24-0.86), while YI (OR = 0.85; CI = 0.56-1.29) and STARD for Abstracts adherence (OR = 1.06; CI = 0.87-1.30) showed no significant association. Positive conclusions were present in 86.7% of submitted conference abstracts and 90.2% of journal manuscripts. DATA CONCLUSION Diagnostic test accuracy studies with positive findings were not preferentially accepted by the evaluated radiology conferences or journals. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Robert A Frank
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Nicholas Fabiano
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Zachary Hallgrimson
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Jérémie F Cohen
- Department of Pediatrics and Inserm UMR 1153 (Centre of Research in Epidemiology and Statistics), Necker - Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Patrick M Bossuyt
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariska M G Leeflang
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Matthew D F McInnes
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | | | - Lee Treanor
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Jean-Paul Salameh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.,Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Trevor A McGrath
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Almohannad Atyani
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sakib Kazi
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Jade Choo-Foo
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Nabil Asraoui
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Winston Ha
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Ross Prager
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Paul Rooprai
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Alex Pozdnyakov
- Department of Radiology, McMaster University, Hamilton, Canada
| | - Susan John
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heba Osman
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Nayaar Islam
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Nicole Li
- Department of Radiology, McMaster University, Hamilton, Canada
| | - Isabelle D Gauthier
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Marissa Absi
- Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Noëmie Kraaijpoel
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sanam Ebrahimzadeh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - John D Port
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeffrey S Klein
- Department of Radiology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Mark Schweitzer
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Chan J, Yan JH, Munir J, Osman H, Alrasheed S, McGrath T, Flood T, Schieda N. Comparison of Bosniak Classification of cystic renal masses version 2019 assessed by CT and MRI. Abdom Radiol (NY) 2021; 46:5268-5276. [PMID: 34390368 DOI: 10.1007/s00261-021-03236-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare imaging features in cystic masses imaged with both CT and MRI using Bosniak Classification version 2019 (Bosniak.v2019) and original Bosniak Classification (Bosniak.original). MATERIALS AND METHODS This IRB-approved, retrospective, cross-sectional study evaluated sixty-five consecutively identified cystic (≤ 25% enhancing) masses imaged by CT and MRI between 2009 and 2019: 35 with histologic diagnosis and 30 Bosniak.v2019 Class 2 and Class 2F cystic masses verified by an expert radiologist (R1) with minimum 5-year stability. Three radiologists (R2, R3, R4) independently evaluated CT, followed by MRI and assigned Bosniak.original and Bosniak.v2019 class in two sessions separated by ≥ 1 month and assessed the following: septa number, septa/wall thickness, and protrusions. Discrepancies were resolved by consensus with R1. RESULTS There was 70.8% agreement (kappa = 0.60, p = 0.0146) in class assigned by CT versus MRI for Bosniak.original and 72.3% agreement (kappa = 0.63, p = 0.006) for Bosniak.v2019. Increased septa number (p < 0.001) and more protrusions (p = 0.034) were identified on MRI, with no differences in septal/wall thickness (p = 0.067, 0.855) or protrusion size (p = 0.467). For both CT and MRI, Bosniak.v2019 improved specificity (79.0% [95% confidence interval 71.0-87.0%] CT, 70% [62.0-77.0%] MRI) compared to Bosniak.original (63.0% [56.0-69.0%] CT, 66.0% [58.0-74.0%] MRI) with maintained sensitivity and higher overall accuracy. Inter-observer agreement was similar-to-slightly higher for Bosniak.v2019 (K = 0.44 CT, 0.39 MRI) versus Bosniak.original (K = 0.35 CT, 0.37 MRI). CONCLUSION Class assignment differs in cystic masses evaluated by CT versus MRI for original and v2019 Bosniak Classification with similar-to-slightly higher agreement and improved specificity and higher overall accuracy on both CT and MRI with Bosniak version 2019.
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Zghouzi M, Ullah W, Osman H, Abdalrazzak M, Suleiman AR, Ahmad B, Rabbat F, Chalek A, Dandu C, Razvi P, Sattar Y, Alraies MC. TCT-356 Safety and Efficacy of Transcatheter Aortic Valve Implantation in Stenotic Bicuspid Aortic Valve: A Meta-Analysis. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Osman H, Ullah W, Suleiman AR, Zghouzi M, Sattar Y, Zahid S, Dandu C, Chalek A, Fischman D, Alraies MC. TCT-181 Trends, Predictors, and Outcomes of Transcatheter Aortic Valve Implantation in Patients With Aortic Insufficiency: A National Inpatient Sample Database Analysis. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tag-Adeen M, Yousef M, Osman H, Abdel-Gawad M, Elsayed M, Ozawa E, Sapra A. Impact of COVID-19 pandemic on endoscopic retrograde cholangiopancreatography; a single center experience. Rev Esp Enferm Dig 2021; 114:455-460. [PMID: 34696594 DOI: 10.17235/reed.2021.8229/2021] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background COVID-19 pandemic has impacted several aspects of health care services worldwide. Our aim was to study its influence on the case volume, success rate and complication rate of ERCP. Method All patients who underwent ERCP one-year before and after applying COVID-19 safety measures at Qena university hospital were included. Data were collected from the patients' records, analyzed and compared. Result A total of 250 patients were subjected to ERCP between April 1, 2019 and March 31, 2021, mean age 52±18. There was 5% increase in case volume after applying COVID-19 safety measures than before (128 vs 122) and the total procedure time was significantly shorter (42 versus 46 minutes, p=0.04). The overall success rate and complication rate showed no significant difference. Procedure success significantly corelated to cannulation attempts and total procedure time in both groups, and serum bilirubin and cannulation time in patients before COVID-19, and ALP in patients after. ERCP related complications significantly correlated with cannulation attempts in both groups, and ALP, INR, cannulation time and total procedure time in patients before COVID-19, and platelets count and amylase after. Two patients were confirmed COVID-19 cases at the time of ERCP, therapeutic targets were achieved in both with smooth post-ERCP recovery. Three out of 9 ERCP team members have caught mild to moderate COVID-19 infection and recovered after receiving proper management. Conclusion Our result showed no negative impact of using COVID-19 safety measures and precautions on the case-volume, indications, overall outcome or complication rate of ERCP.
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Affiliation(s)
- Mohammed Tag-Adeen
- Internal Medicine, Qena University Hospital, Qena Faculty of Medicine, South Valley University, Egypt
| | - Mohamed Yousef
- General Surgery , Qena University Hospital, Qena Faculty of Medicine, South Valley University
| | - Heba Osman
- Tropical Medicine and Gastroenterology, Qena University Hospital, Qena Faculty of Medicine, South Valley University
| | - Muhammad Abdel-Gawad
- Hepatogastroenterology and Infectious Diseases, Al-Azhar University Hospital, Al-Azhar Faculty of Medicine
| | - Marwa Elsayed
- Medical Microbiology and Immunology, Qena University Hospital, Qena Faculty of Medicine, South Valley University
| | - Eisuke Ozawa
- Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki
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Beattie E, Dowling J, Chardon JW, Kothary R, Lintern S, Amin R, Buffone T, Brais B, Campbell C, Gagnon C, Gonorazky H, Karamchandani J, Korngut L, McMillan H, Oskoui M, Osman H, Selby K, Wojtal D, Worsfold N, Lochmüller H. REGISTRIES AND CARE OF NMD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.367] [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]
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Hodgkinson-Brechenmacher V, McCormick A, Sheriko J, Lounsberry J, Osman H, Worsfold N, Campbell C, Mah J, McAdam L, Selby K, Korngut L, N. CNDR Investigator Network. DMD/BMD – OUTCOME MEASURES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nguyen PL, Osman H, Watza D, Khicher S, Sharma A, Dyson G, Saydain G, Soubani A. High-flow nasal cannula therapy in a predominantly African American population with COVID-19 associated acute respiratory failure. BMJ Open Respir Res 2021; 8:8/1/e000875. [PMID: 34551962 PMCID: PMC8457999 DOI: 10.1136/bmjresp-2021-000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/07/2021] [Indexed: 01/08/2023] Open
Abstract
Importance Use of non-invasive respiratory modalities in COVID-19 has the potential to reduce rates of intubation and mortality in severe disease however data regarding the use of high-flow nasal cannula (HFNC) in this population is limited. Objective To interrogate clinical and laboratory features of SARS-CoV-2 infection associated with high-flow failure. Design We conducted a retrospective cohort study to evaluate characteristics of high-flow therapy use early in the pandemic and interrogate factors associated with respiratory therapy failure. Setting Multisite single centre hospital system within the metropolitan Detroit region. Participants Patients from within the Detroit Medical Center (n=104, 89% African American) who received HFNC therapy during a COVID-19 admission between March and May of 2020. Primary outcome HFNC failure is defined as death or intubation while on therapy. Results Therapy failure occurred in 57% of the patient population, factors significantly associated with failure centred around markers of multiorgan failure including hepatic dysfunction/transaminitis (OR=6.1, 95% CI 1.9 to 19.4, p<0.01), kidney injury (OR=7.0, 95% CI 2.7 to 17.8, p<0.01) and coagulation dysfunction (OR=4.5, 95% CI 1.2 to 17.1, p=0.03). Conversely, comorbidities, admission characteristics, early oxygen requirements and evaluation just prior to HFNC therapy initiation were not significantly associated with success or failure of therapy. Conclusions In a population disproportionately affected by COVID-19, we present key indicators of likely HFNC failure and highlight a patient population in which aggressive monitoring and intervention are warranted.
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Affiliation(s)
- Paul L Nguyen
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Heba Osman
- Department of Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Donovan Watza
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Suman Khicher
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Aditi Sharma
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Greg Dyson
- Department of Oncology, Bioinformatics and Biostatistics Core, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ghulam Saydain
- Division of Pulmonary and Critical Care, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ayman Soubani
- Division of Pulmonary and Critical Care, Wayne State University School of Medicine, Detroit, Michigan, USA
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Al Hosani H, Salah M, Saade D, Osman H, Al Zahid J. United Arab Emirates National Newborn Screening Programme:an evaluation 1998-2000. East Mediterr Health J 2021. [DOI: 10.26719/2003.9.3.324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To evaluate the United Arab Emirate National Newborn Screening Programme we compared coverage, timeliness of programme indicators [age at sampling, recall and treatment initiation, timing of specimen delivery and laboratory results] and specimen quality with international st and ards. Recall rate, sensitivity, specificity, positive predictive values and relative incidence rates for phenylketonuria [PKU] and congenital hypothyroidism [CH] were calculated. Investigations for hypothyroidism included thyroid function studies [T3, T4, fT4 and TSH], technetium-99m thyroid scan when possible and thyroglobulin and thyroid antibodies when indicated. PKU investigations included plasma amino acids and measurement of biopterin defects. In the 6 years before December 2000, 138, 718 neonates were screened. Relative incidences for CH and for classic PKU were 1: 1570 and 1: 20, 050 respectively
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Abstract
BACKGROUND Knowledge of the factors that predispose to postdural puncture headache in children may help reduce the occurrence of this complication. MATERIALS AND METHODS A retrospective cohort study of children who presented to the study institution between 2010 and 2018 was conducted. Children were divided into 2 groups: those who experienced postdural puncture headache and those who did not. The 2 groups were compared with respect to certain demographic, technical, and personnel-related factors. Only children who had opening pressure documented during the procedure were included in the core study group. RESULTS In univariate analysis, children aged ≥10 years, female gender, children with higher body mass index, standard blinded lumbar puncture procedure, use of sedation, higher opening pressure, and presence of pseudotumor cerebri increased the probability of postdural puncture headache. In multivariable logistic regression analysis, presence of pseudotumor cerebri was the only factor that attained statistical significance when the opening pressure was measured and documented. CONCLUSIONS The risk factors for postdural puncture headache in a pediatric cohort varied from risk factors that are classically implicated in adults.
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Affiliation(s)
- Madhav Bandatmakur
- Department of Pediatric Neurology, 2969Children's Hospital of MI, Detroit, MI, USA
| | - Carter Bench
- 12267Wayne State University School of Medicine, Detroit, MI, USA
| | - Ngum Ngwa
- Department of Pediatrics, 2969Children's Hospital of MI, Detroit, MI, USA
| | - Heba Osman
- Department of Anesthesia, Detroit Medical Center, Detroit, MI, USA
| | - Pooja Dave
- Department of Pediatrics, 2969Children's Hospital of MI, Detroit, MI, USA
| | - Ahmad Farooqi
- Department of Biostatistics, Children's Hospital of MI, Detroit, MI, USA
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Sathiadoss P, Haroon M, Osman H, Ahmad F, Papadatos P, Schieda N. Comparison of 5 Rectal Preparation Strategies for Prostate MRI and Impact on Image Quality. Can Assoc Radiol J 2021; 73:346-354. [PMID: 34404240 DOI: 10.1177/08465371211033753] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To compare 5 different rectal preparation strategies for prostate MRI. METHODS This 5-arm quality-assurance study evaluated 56 patients per arm (280 patients) including: no preparation, clear-fluids diet (CFD) beginning at 00:00 hours on the day of MRI, Fleet®-enema, enema + CFD, enema + CFD + IV-antispasmodic agent. The study was powered to 0.80 with alpha-error of 0.05. Three blinded radiologists independently evaluated T2-Weighted (T2W) and Diffusion Weighed Imaging (DWI) for: rectal diameter (maximal AP diameter), rectal content (stool, fluid, gas), rectal motion, T2W/DWI image quality, T2W image sharpness and DWI susceptibility artifact using 5-point Likert scales. Overall comparisons were performed using analysis of variance (ANOVA) and Kruskal-Wallis, with pair-wise comparisons using paired t-tests and Wilcoxon sign-rank tests. RESULTS Rectal diameter and amount of gas were lower in enema compared to non-enema groups (p < 0.001), with smallest diameter and least gas in the enema + CFD + IV-antispasmodic group (p = 0.022-<0.001). T2W image quality and sharpness were highest in the enema + CFD groups (p < 0.001) with no difference comparing enema + CFD with/without IV-antispasmodic (p = 0.064, 0.084). Motion artifact was least in enema + CFD + IV-antispasmodic group compared to all other groups (p < 0.001), followed by the enema + CFD group (p = 0.008-<0.001). DWI image quality was highest (p < 0.001) and DWI susceptibility artifact lowest (p < 0.001) in the enema + CFD groups (p < 0.001) and did not differ comparing enema + CFD with/without anti-spasmodic (p = 0.058-0.202). CONCLUSIONS Use of enema + clear-fluids diet before prostate MRI yields the highest T2W and DWI image quality with the least DWI artifact. IV-antispasmodic use reduces motion on T2W but does not improve image quality on T2W or DWI, or lessen DWI artifact compared to enema + clear-fluids diet.
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Affiliation(s)
- Paul Sathiadoss
- Department of Medical Imaging, The Ottawa Hospital, 6363University of Ottawa, Ottawa, Ontario, Canada
| | - Mohammad Haroon
- Department of Medical Imaging, The Ottawa Hospital, 6363University of Ottawa, Ottawa, Ontario, Canada
| | - Heba Osman
- Department of Medical Imaging, The Ottawa Hospital, 6363University of Ottawa, Ottawa, Ontario, Canada
| | - Faraz Ahmad
- Faculty of Medicine, 6363University of Ottawa, Ottawa, Ontario, Canada
| | - Philip Papadatos
- Department of Medical Imaging, The Ottawa Hospital, 6363University of Ottawa, Ottawa, Ontario, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, 6363University of Ottawa, Ottawa, Ontario, Canada
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Sathiadoss P, Schieda N, Haroon M, Osman H, Alrasheed S, Flood TA, Melkus G. Utility of Quantitative T2-Mapping Compared to Conventional and Advanced Diffusion Weighted Imaging Techniques for Multiparametric Prostate MRI in Men with Hip Prosthesis. J Magn Reson Imaging 2021; 55:265-274. [PMID: 34223675 DOI: 10.1002/jmri.27803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Diffusion weighted imaging (DWI) is fundamental for prostate cancer (PCa) detection with MRI; however, limited by susceptibility artifact from hip prosthesis. PURPOSE To evaluate image quality and ability to detect PCa with quantitative T2-mapping and DWI in men with hip prosthesis undergoing prostate MRI. STUDY TYPE Prospective, cross-sectional study. POPULATION Thirty consecutive men with hip replacement (18 unilateral, 12 bilateral) undergoing prostate MRI from 2019 to 2021. FIELD STRENGTH/SEQUENCE 3-T; multiparametric MRI (T2W, DCE-MRI, echo-planar [EPI]-DWI), T2-mapping (Carr-Purcell-Meiboom-Gill), FOCUS-EPI-DWI, PROPELLER-DWI. ASSESSMENT Five blinded radiologists independently evaluated MRI image quality using a 5-point Likert scale. PI-RADS v2.1 scores were applied in four interpretation strategies: 1) T2W-FSE+DCE-MRI+EPI-DWI, 2) T2W-FSE+DCE-MRI+EPI-DWI+FOCUS-EPI-DWI, 3) T2W-FSE+DCE-MRI+EPI-DWI+PROPELLER-DWI, 4) T2W-FSE+DCE-MRI+EPI-DWI+T2-maps. Five-point confidence scores were recorded. STATISTICAL ANALYSIS ANOVA, Kruskal-Wallis with pair-wise comparisons by Wilcoxon sign-rank, and paired t-tests, P < 0.05 was considered significant. Cohen's Kappa (k) for PI-RADSv2.1 scoring and proportion of correctly classified lesions tabulated for pathology-confirmed cases with 95% confidence intervals (CIs). RESULTS For all radiologists, T2-map image quality was significantly higher than EPI-DWI, FOCUS-EPI-DWI, and PROPELLER-DWI and similar (P = 0.146-0.706) or significantly better (for two readers) than T2W-FSE and DCE-MRI. PI-RADS v2.1 agreement improved comparing strategy A (k = 0.46) to strategy B (k = 0.58) to strategy C (k = 0.58) and was highest with strategy D which included T2-maps (k = 1.00). Radiologists' confidence was significantly highest with strategy D. Strategies B and C had similar confidence (P = 0.051-0.063) both significantly outperforming strategy A. Twelve men with 17 lesions had pathology confirmed diagnoses (13 PCa, 4 benign). Strategy D had the highest proportion of correctly classified lesions (76.5-82.4%) with overlapping 95% confidence intervals. DATA CONCLUSION T2-mapping may be a valuable adjunct to prostate MRI in men with hip replacement resulting in improved image quality, higher reader confidence, interobserver agreement, and accuracy in PI-RADS scoring. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Paul Sathiadoss
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Mohammad Haroon
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Heba Osman
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Sumaya Alrasheed
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Trevor A Flood
- Department of Anatomical Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Gerd Melkus
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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Zghouzi M, Moussa Pacha H, Ullah W, Sattar Y, Ahmad B, Osman H, Mohamed MO, Mir T, Banerjee S, Shishehbor MH, Prasad A, Rits Y, Mamas MA, Alraies MC. In-hospital outcomes of endovascular versus surgical revascularization for chronic total occlusion in peripheral artery disease. Catheter Cardiovasc Interv 2021; 98:E586-E593. [PMID: 34160890 DOI: 10.1002/ccd.29827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/12/2021] [Accepted: 06/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The outcome of endovascular intervention (EVI) compared vs. surgical revascularization in patients with peripheral artery disease (PAD) due to chronic total occlusion (CTO) is unknown. METHODS Using the National Inpatient Sample database between 2007 and 2014, we identified all PAD patients with CTO who had limb revascularization. Multivariate analysis was performed to estimate the odds of in-hospital mortality and adverse outcomes between both groups. RESULTS A total of 168,420 patients who had peripheral CTO and underwent limb revascularization were identified. 99,279 underwent EVI, and 69,141 underwent surgical revascularization. The patients who underwent EVI were younger, more likely to be women and African American, and less likely to be white (p < 0.001 for all). EVI was associated with lower in-hospital mortality (1.2% vs 1.7%, adjusted odds ratio [aOR]: 0.54; 95% confidence interval [CI] 0.50-0.59). The EVI group had higher vascular complications, major bleeding, acute kidney injury (AKI), and major amputation compared with surgical revascularization. A subgroup analysis on patients with critical limb ischemia showed lower mortality in the EVI group (1.4% vs. 1.9, aOR 0.56; 95% CI 0.50-0.63). Although there was no difference in the incidence of AKI or major amputation between the two groups, the EVI group had higher vascular complication rates and major bleeding events. CONCLUSION EVI in PAD with CTO is associated with lower in-hospital mortality, likely due to the procedure's less-invasive nature; however, it is associated with higher postprocedural complications likely due to the CTO's complexity.
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Affiliation(s)
- Mohamed Zghouzi
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
| | - Homam Moussa Pacha
- Cardiology, University of Texas Health Science Center, Houston, Texas, USA
| | - Waqas Ullah
- Internal Medicine, Abington Jefferson Health, Abington, Pennsylvania, USA
| | - Yasar Sattar
- Internal Medicine, Icahn School of Medicine at Mount Sinai Elmhurst Hospital New York, USA
| | - Bachar Ahmad
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
| | - Heba Osman
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
| | - Mohamed O Mohamed
- Keele Cardiovascular Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - Tanveer Mir
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
| | - Subhash Banerjee
- Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mehdi H Shishehbor
- Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Anand Prasad
- Cardiology, UT Health San Antonio, San Antonio, Texas, USA
| | - Yevgeniy Rits
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
| | - Mamas A Mamas
- Keele Cardiovascular Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - M Chadi Alraies
- Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA
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Osman H, Yan JH, Chan J, Munir J, Alrasheed S, Krishna S, Schieda N. Inter-observer and intra-observer agreement of Bosniak classification of cystic renal masses: Comparison between original version to version 2019 and effect of an online support calculator. Can Urol Assoc J 2021; 15:420-422. [PMID: 34171217 DOI: 10.5489/cuaj.7369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Heba Osman
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Jin Hui Yan
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Jason Chan
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Javeria Munir
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Sumaya Alrasheed
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Satheesh Krishna
- Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
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Yan JH, Chan J, Osman H, Munir J, Alrasheed S, Flood TA, Schieda N. Bosniak Classification version 2019: validation and comparison to original classification in pathologically confirmed cystic masses. Eur Radiol 2021; 31:9579-9587. [PMID: 34019130 DOI: 10.1007/s00330-021-08006-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/06/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate Bosniak Classification v2019 definitions in pathologically confirmed cystic renal masses. MATERIALS AND METHODS Seventy-three cystic (≤ 25% solid) masses with histological confirmation (57 malignant, 16 benign) imaged by CT (N = 28) or CT+MRI (N = 56) between 2009 and 2019 were independently evaluated by three blinded radiologists using Bosniak v2019 and original classifications. Discrepancies were resolved by consensus with a fourth blinded radiologist. Overall class and v2019 features were compared to pathology. RESULTS Inter-observer agreement was slightly improved comparing v2019 to Original Bosniak Classification (kappa = 0.26-0.47 versus 0.24-0.34 respectively). v2019 proportion of IIF and III masses (20.5% [15/73, 95% confidence interval (CI) 12.0-31.6%], 38.6% [28/73, 95% CI 27.2-50.5%]) differed from the original classification (6.8% [5/73, 95% CI 2.3-15.3%], 61.6% [45/73, 95% CI 49.5-72.8%]) with overlapping proportion of malignancy in each class. Mean septa number (7 ± 4 [range 1-10]) was not associated with malignancy (p = 0.89). Mean wall and septa thicknesses were 3 ± 3 (1-14) and 3 ± 2 (1-10) mm and higher in malignancies (p = 0.03 and 0.20 respectively). Areas under the receiver-operator-characteristic curve for wall and septa thickness were 0.66 (95% CI 0.54-0.79) and 0.61 (95% CI 0.45-0.78) with an optimal cut point of ≥ 3 mm (sensitivity 33.3%, specificity 86.7% and sensitivity 53%, specificity 73% respectively). Proportion of malignancy occurring in masses with the v2019 features "irregularity" (76.9% [10/13], 95% CI 46.2-94.9%) and "nodule" (89.7% [26/29], 95% CI 72.7-97.8%) overlapped. Angle of "nodule" (p = 0.27) was not associated with malignancy. CONCLUSION Bosniak v2019 definitions for wall/septa thickness and protrusions are associated with malignancy. Overall, Bosniak v2019 categorizes a higher proportion of malignant masses in Class IIF with slight improvement in inter-observer agreement. KEY POINTS • Considering Bosniak v2019 Class IIF cystic masses with many (≥ 4) smooth and thin septa, there was no association between the number of septa and malignancy (p = 0.89) in this study. • Increased cyst wall and septa thickness are associated with malignancy and a lower threshold of ≥ 3 mm maximized overall diagnostic accuracy compared to ≥ 4 mm threshold proposed for Bosniak v2019 Class 3. • An overlapping proportion of malignant masses is noted in Bosniak v2019 Class 3 masses with "irregularity" (76.9% [10/13], 95% CI 46.2-94.9%) compared to Bosniak v2019 Class 4 masses with "nodule" (89.7% [26/29], 95% CI 72.7-97.8%).
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Affiliation(s)
- Jin Hui Yan
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Jason Chan
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Heba Osman
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Javeria Munir
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Sumaya Alrasheed
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Trevor A Flood
- Department of Anatomical Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
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Osman H, Elmoghrabi A, Othman M, Taha Y. DIFFUSE CORONARY VASOSPASM PRESENTING AS PULSELESS ELECTRICAL ACTIVITY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)03734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Osman H, Panicker A, Nguyen P, Mitry M. Hashimoto's Encephalopathy: A Rare Cause of Seizure-like Activity. Cureus 2021; 13:e14626. [PMID: 34040922 PMCID: PMC8140527 DOI: 10.7759/cureus.14626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hashimoto’s encephalopathy is an uncommon disorder that may present with a wide variety of different neurological signs and symptoms that can include acute altered level of consciousness, psychosis, seizures, ataxia, dementia, myoclonus, and stupor. We present a case of a 60-year-old female patient who was admitted to the internal medicine floor for workup for seizures of unknown etiology. Investigations, including a complete blood count, basic metabolic panel, magnetic resonance imaging (MRI) of the brain, cerebrospinal fluid analysis, and NMDA (N-methyl-D-aspartate) receptor encephalitis screen, were all unremarkable. Thyroid-stimulating hormone levels and anti-thyroid peroxidase antibodies were found to be elevated, suggesting an underlying etiology of Hashimoto’s thyroiditis. Treatment with corticosteroids and levothyroxine can lead to resolution of symptoms. This case report is presented to suggest the importance of serological screening for anti-thyroid antibodies in the workup of all patients with unknown causes of encephalopathy along with providing a review of the literature.
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Affiliation(s)
- Heba Osman
- Department of Internal Medicine-Pediatrics, Wayne State University Detroit Medical Center, Detroit, USA
| | - Aaron Panicker
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Paul Nguyen
- Department of Internal Medicine, Wayne State University Detroit Medical Center, Detroit, USA
| | - Mira Mitry
- Department of Internal Medicine, Wayne State University Detroit Medical Center, Detroit, USA
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Nguyen P, Khicher S, Osman H, Patel N. A Rare Case of Enterococcus gallinarum-Associated Peritonitis and Literature Review. Cureus 2020; 12:e12328. [PMID: 33520526 PMCID: PMC7839278 DOI: 10.7759/cureus.12328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Peritonitis is a well-known complication seen with peritoneal dialysis. Peritonitis is associated with increased mortality risk and is commonly caused by gram-positive and gram-negative bacteria, but it can also be the result of fungal or viral infections. Therefore, it is imperative to obtain a peritoneal fluid sample to send for cell count with differential, gram stain, and culture prior to starting empiric antibiotic therapy. We report a case of peritoneal dialysis-related peritonitis caused by Enterococcus gallinarum, for which there has only been one other reported case in the medical literature. Our patient was initially placed on vancomycin and cefepime but continued to deteriorate until peritoneal fluid cultures revealed E. gallinarum. Based on sensitivities, the patient was treated with daptomycin and cefazolin, which resolved her peritonitis.
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Affiliation(s)
- Paul Nguyen
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Suman Khicher
- Rheumatology, Wayne State University School of Medicine, Detroit, USA
| | - Heba Osman
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Neel Patel
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
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Abstract
Acute respiratory distress syndrome (ARDS) is a clinically and biologically heterogeneous disorder associated with a variety of disease processes that lead to acute lung injury with increased non-hydrostatic extravascular lung water, reduced compliance, and severe hypoxemia. Despite significant advances, mortality associated with this syndrome remains high. Mechanical ventilation remains the most important aspect of managing patients with ARDS. An in-depth knowledge of lung protective ventilation, optimal PEEP strategies, modes of ventilation and recruitment maneuvers are essential for ventilatory management of ARDS. Although, the management of ARDS is constantly evolving as new studies are published and guidelines being updated; we present a detailed review of the literature including the most up-to-date studies and guidelines in the management of ARDS. We believe this review is particularly helpful in the current times where more than half of the acute care hospitals lack in-house intensivists and the burden of ARDS is at large.
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Affiliation(s)
- Harsha Banavasi
- Division of Pulmonary Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Paul Nguyen
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Heba Osman
- Department of Medicine-Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ayman O Soubani
- Division of Pulmonary Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
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Zhao H, ParryFord F, Dabrera G, Sinnathamby M, Ellis J, Dunning J, Osman H, Machin N, Pebody R. Six-year experience of detection and investigation of possible Middle East Respiratory Syndrome coronavirus cases, England, 2012-2018. Public Health 2020; 189:141-143. [PMID: 33227597 PMCID: PMC7574929 DOI: 10.1016/j.puhe.2020.10.007] [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: 08/26/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Surveillance for Middle East Respiratory Syndrome (MERS) has been undertaken in the UK since September 2012. This study describes the surveillance outcomes in England from 2012 to 2018. STUDY DESIGN This was a descriptive study using surveillance data. METHODS Local health protection teams in England report possible MERS cases to the National Infection Service with clinical and laboratory data. RESULTS A total of 1301 possible MERS cases were identified in the study period. Five cases were laboratory-confirmed MERS. The majority of cases had travelled to Saudi Arabia (56.7%) and United Arab Emirates (25.9%). Fifty-four percent of cases were men and 43.7% were women. The majority of cases (65.1%) were aged 45 years or older. The number of tests increased in the period after Hajj each year. Laboratory-confirmed alternative diagnoses were available for 513 (39.4%) cases; influenza was the most common virus detected (n = 255, 52.4%). CONCLUSIONS Our study highlights the importance of differential diagnosis of influenza and other respiratory pathogens and early influenza antiviral treatment.
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Affiliation(s)
- H Zhao
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.
| | - F ParryFord
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - G Dabrera
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - M Sinnathamby
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - J Ellis
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - J Dunning
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - H Osman
- Birmingham Public Health Laboratory, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK
| | - N Machin
- Public Health Laboratory, Manchester, UK
| | - R Pebody
- National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
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Gherardi S, Bovolenta M, Passarelli C, Falzarano MS, Pigini P, Scotton C, Neri M, Armaroli A, Osman H, Selvatici R, Gualandi F, Recchia A, Mora M, Bernasconi P, Maggi L, Morandi L, Ferlini A, Perini G. Corrigendum to: "Transcriptional and epigenetic analyses of the DMD locus reveal novel cis-acting DNA elements that govern muscle dystrophin expression". [Biochim. Biophys. Acta Gene Regul. Mech. 2017 Nov;1860(11):1138-1147.]. Biochim Biophys Acta Gene Regul Mech 2020; 1863:194646. [PMID: 33144059 DOI: 10.1016/j.bbagrm.2020.194646] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- S Gherardi
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy; Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy; CIRI Health Sciences & Technologies (HST), Bologna, Italy
| | - M Bovolenta
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - C Passarelli
- Paediatric Hospital Bambino Gesù, Laboratory of Medical Genetics, Rome, Italy
| | - M S Falzarano
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - P Pigini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - C Scotton
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - M Neri
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - A Armaroli
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - H Osman
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - R Selvatici
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - F Gualandi
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy
| | - A Recchia
- Department of Life Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - M Mora
- Neuromuscular Disease and Immunology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy
| | - P Bernasconi
- Neuromuscular Disease and Immunology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy
| | - L Maggi
- Neuromuscular Disease and Immunology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy
| | - L Morandi
- Neuromuscular Disease and Immunology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy
| | - A Ferlini
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Italy; Neuromuscular Unit, Great Ormond Street Hospital, University College London, UK.
| | - G Perini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy; CIRI Health Sciences & Technologies (HST), Bologna, Italy.
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Amburgey K, Dowling J, Chardon JW, Kothary R, Stead-Coyle B, Brais B, Campbell C, Gagnon C, McMillan H, Selby K, Korngut L, Oskoui M, Amin R, Esler P, Worsfold N, Buffone T, Wojtal D, Osman H, Lochmüller H. REGISTRIES, CARE, QUALITY OF LIFE, MANAGEMENT OF NMD. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.344] [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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Hayes A, Nguyen D, Andersson M, Antón A, Bailly J, Beard S, Benschop KSM, Berginc N, Blomqvist S, Cunningham E, Davis D, Dembinski JL, Diedrich S, Dudman SG, Dyrdak R, Eltringham GJA, Gonzales‐Goggia S, Gunson R, Howson‐Wells HC, Jääskeläinen AJ, López‐Labrador FX, Maier M, Majumdar M, Midgley S, Mirand A, Morley U, Nordbø SA, Oikarinen S, Osman H, Papa A, Pellegrinelli L, Piralla A, Rabella N, Richter J, Smith M, Söderlund Strand A, Templeton K, Vipond B, Vuorinen T, Williams C, Wollants E, Zakikhany K, Fischer TK, Harvala H, Simmonds P. A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. J Med Virol 2020; 92:1065-1074. [PMID: 31883139 PMCID: PMC7496258 DOI: 10.1002/jmv.25659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/24/2019] [Indexed: 12/28/2022]
Abstract
Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10-5 ). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.
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Affiliation(s)
- A. Hayes
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - D. Nguyen
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - M. Andersson
- Microbiology Laboratory, John Radcliffe Hospital, Headley Way, HeadingtonOxfordUK
| | - A. Antón
- Respiratory Viruses Unit, Virology Section, Microbiology DepartmentHospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig Vall d'HebronBarcelonaSpain
| | - J.‐L. Bailly
- Université Clermont Auvergne, LMGE UMR CNRS, UFR MédecineClermont‐FerrandFrance
- CHU Clermont‐Ferrand, National Reference Center for EV and Parechovirus‐Associated LaboratoryClermont‐FerrandFrance
| | - S. Beard
- Enteric Virus Unit, Virus Reference DepartmentNational Infection Service, Public Health EnglandLondonUK
| | - K. S. M. Benschop
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - N. Berginc
- Department for Public Health VirologyNational Laboratory of Health, Environment and FoodLjubljanaSlovenia
| | - S. Blomqvist
- National Institute for Health and Welfare, MannerheimintieHelsinkiFinland
| | - E. Cunningham
- Viapath Infection Sciences, St. Thomas' HospitalLondonUK
| | - D. Davis
- Microbiology, Virology and infection Prevention & ControlGreat Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - J. L. Dembinski
- Department of VirologyNorwegian Institute of Public HealthOsloNorway
| | - S. Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch InstituteBerlinGermany
| | - S. G. Dudman
- Department of MicrobiologyOslo University Hospital Rikshospitalet, Inst. Clinical Medicine, University of OsloOsloNorway
| | - R. Dyrdak
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstituteStockholmSweden
| | - G. J. A. Eltringham
- Molecular Diagnostics Laboratory, Microbiology, Freeman HospitalNewcastle Upon TyneUK
| | - S. Gonzales‐Goggia
- Public Health England Poliovirus Reference Laboratory, National Infection Service, Public Health EnglandLondonUK
| | - R. Gunson
- West of Scotland Specialist Virology CentreGlasgow Royal InfirmaryGlasgowUK
| | - H. C. Howson‐Wells
- Nottingham University Hospitals NHS Trust, Clinical Microbiology, Queens Medical CentreNottinghamUK
| | - A. J. Jääskeläinen
- University of Helsinki and Helsinki University Hospital, HUSLAB, Virology and ImmunologyHelsinkiFinland
| | - F. X. López‐Labrador
- Virology Laboratory, Joint Units in Genomics and Health and Infection and Health, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO‐Public Health)/Universitat de València, Av. CatalunyaValènciaSpain
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
| | - M. Maier
- Institute of VirologyLeipzig University HospitalLeipzigGermany
| | - M. Majumdar
- The National Institute for Biological Standards and ControlHertfordshireUK
| | - S. Midgley
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - A. Mirand
- CHU Clermont‐Ferrand, Laboratoire de Virologie—Centre National de Référence des Entérovirus et Parechovirus, Laboratoire Associé—Clermont‐FerrandFrance
| | - U. Morley
- UCD National Virus Reference LaboratoryUniversity College Dublin, BelfieldDublinIreland
| | - S. A. Nordbø
- Department of Medical MicrobiologySt. Olavs University HospitalTrondheimNorway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - S. Oikarinen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - H. Osman
- Public Health England Birmingham Public Health Laboratory, Heartlands HospitalBirminghamUK
| | - A. Papa
- Department of MicrobiologyMedical School, Aristotle University of ThessalonikiThessalonikiGreece
| | - L. Pellegrinelli
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - A. Piralla
- Molecular Virology Unit, Microbiology and Virology DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - N. Rabella
- Virology Section, Santa Creu i Sant Pau University HospitalBarcelonaSpain
| | - J. Richter
- Department of Molecular VirologyCyprus Institute of Neurology and GeneticsNicosiaCyprus
| | - M. Smith
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- King's College Hospital, Bessemer Wing, Denmark HillLondonUK
| | - A. Söderlund Strand
- Laboratory Medicine, Department of Clinical MicrobiologyLund University Hospital, SölvegatanLundSweden
| | - K. Templeton
- Edinburgh Specialist Virology, Royal Infirmary of EdinburghEdinburghUK
| | - B. Vipond
- Public Health England, South West Regional Laboratory, Pathology Sciences Building, Science QuarterSouthmead HospitalBristolUK
| | - T. Vuorinen
- Clinical MicrobiologyTurku University Hospital and Institute of Biomedicine University of TurkuTurkuFinland
| | | | - E. Wollants
- Clinical and Epidemiological Virology, KU Leuven, REGA Institute, Clinical and Epidemiological VirologyLeuvenBelgium
| | - K. Zakikhany
- Katherina Zakikhany‐Gilg, Public Health Agency of Sweden, Department of MicrobiologyUnit of Laboratory Surveillance of Viral Pathogens and Vaccine Preventable DiseasesStockholmSweden
| | - T. K. Fischer
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - H. Harvala
- NHS Blood and Transplant, ColindaleLondonUK
| | - P. Simmonds
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
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Shergill R, Osman H, Al-Douri F, Ramonas M, Al Duwaiki S, Alabousi A. The Utility of Short-Interval Follow-Up for Baseline High-Risk Screening Breast MRI. Can Assoc Radiol J 2020; 71:226-230. [PMID: 32063016 DOI: 10.1177/0846537119895752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Patients with a high lifetime risk of developing breast cancer undergo annual screening magnetic resonance imaging (MRI) starting at age 30. A proportion of these patients are subsequently required to undergo short-interval follow-up MRI 6 months after their baseline examination. The purpose of this study was to evaluate the utility and outcome of these short-interval follow-up examinations in this population. METHODS A retrospective review was performed of 523 patients who received their baseline high-risk breast screening MRI at our institution between 2013 and 2017. The proportion of patients who received a short-interval follow-up MRI at 6 months was recorded. The findings at baseline and follow-up MRI were recorded, as well as the outcomes and results of any interventions performed. RESULTS Ninety-six (17.6%) patients (age range: 25-67, mean age: 41) received a short-interval follow-up MRI following their baseline screening examination. Indications for follow-up included moderate to marked background parenchymal enhancement, nonmass enhancement, and likely benign enhancing mass. Of the 92 patients, 5 (5.4%) went on to have a biopsy, with none revealing a malignant pathology. The remainder either returned to routine screening (91.3%) or received further imaging in the form of ultrasound or additional follow-up MRI (3.3%). CONCLUSION Short-interval follow-up breast MRI in high-risk patients after a baseline screening study with likely benign findings is unlikely to yield clinically significant findings. This retrospective study can be considered a starting point for additional future work looking at the rate, indications, and yield of short-interval follow-up following baseline high-risk screening breast MRI studies.
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Affiliation(s)
- Ravi Shergill
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Heba Osman
- Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
| | - Faten Al-Douri
- Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Milita Ramonas
- Department of Radiology, McMaster University, The Juravinski Hospital, Hamilton, Ontario, Canada
| | - Suad Al Duwaiki
- Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Abdullah Alabousi
- Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada
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Li HY, Osman H, Kang CW, Ba T, Lou J. Numerical and experimental studies of water disinfection in UV reactors. Water Sci Technol 2019; 80:1456-1465. [PMID: 31961808 DOI: 10.2166/wst.2019.394] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Performance of UV reactors for water disinfection is investigated in this paper. Both experimental and numerical studies are performed on base reactor LP24. Enterobacteria phage MS2 is chosen as the challenge microorganism in the experiments. Experiments are conducted to evaluate the effect of different parameters, i.e. flow rate and UV transmission, on the reactor performance. Simulation is carried out based on the commercial software ANSYS FLUENT with user defined functions (UDFs) implemented. The UDF is programmed to calculate UV dose absorbed by different microorganisms along their flow trajectories. The effect with boundary layer mesh and without boundary layer mesh for LP24 is studied. The results show that the inclusion of boundary layer mesh does not have much effect on the reactor performance in terms of reduction equivalent dose (RED). The numerical results agree well with the experimental measurements, hence validating the numerical model. With this achieved, the numerical model is applied to study other scaled reactors: LP12, LP40, LP60 and LP80. Comparisons show that LP40 has the highest RED and log inactivation among all the reactors while LP80 has the lowest RED and log inactivation.
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Affiliation(s)
- H Y Li
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, 16-16 Connexis, Singapore 138632, Singapore E-mail:
| | - H Osman
- Research & Development, Sembcorp Marine Ltd, 80 Tuas South Boulevard, Singapore 637051, Singapore
| | - C W Kang
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, 16-16 Connexis, Singapore 138632, Singapore E-mail:
| | - T Ba
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, 16-16 Connexis, Singapore 138632, Singapore E-mail:
| | - J Lou
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, 16-16 Connexis, Singapore 138632, Singapore E-mail:
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Nishimiya K, Sharma G, Singh K, Osman H, Gardecki JA, Tearney GJ. P2772A novel approach for uric acid crystal detection in human coronary arteries with polarization-sensitive micro-OCT. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Nishimiya
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - G Sharma
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - K Singh
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - H Osman
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - J A Gardecki
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - G J Tearney
- Massachusetts General Hospital, Wellman Center for Photomedicine, Department of Pathology, Boston, United States of America
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Nishimiya K, Yin B, Piao Z, Osman H, Ryu J, Leung HM, Sharma G, Gardecki JA, Tearney GJ. P2271Super high-resolution OCT for endothelial cell visualization in the coronary arteries. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2271] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Nishimiya
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - B Yin
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - Z Piao
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - H Osman
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - J Ryu
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - H M Leung
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - G Sharma
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - J A Gardecki
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, United States of America
| | - G J Tearney
- Massachusetts General Hospital, Wellman Center for Photomedicine, Department of Pathology, Boston, United States of America
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Maged A, Amin M, Osman H, Nada LM. Optical absorption spectroscopy of the blackberry dye applied in solar cell sensitizers and gamma radiation effects. Arab Journal of Nuclear Sciences and Applications 2018. [DOI: 10.21608/ajnsa.2018.2686.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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