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Storwick JA, Tam H, Rosenbaum DG, Houghton K. Checkpoint inhibitor immunotherapy induced inflammatory arthritis secondary to Nivolumab and Ipilimumab: a pediatric first. Pediatr Rheumatol Online J 2024; 22:49. [PMID: 38685034 PMCID: PMC11059652 DOI: 10.1186/s12969-024-00983-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/09/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have expanded the arsenal of cancer therapeutics over the last decade but are associated with a spectrum of immune-related adverse events (irAEs), including inflammatory arthritis. While these complications are increasingly recognized in the adult population, no cases of inflammatory arthritis irAEs have been reported in the pediatric literature. CASE PRESENTATION A 14-year-old female with metastatic epithelioid mesothelioma was referred to the pediatric rheumatology clinic after developing progressive inflammatory joint pain in her bilateral shoulders, hips, and small joints of hands following the second cycle of Nivolumab and Ipilimumab. Initial examinations showed bilateral shoulder joint line tenderness, positive FABERs test bilaterally, tenderness over bilateral greater trochanters, and bilateral second PIP effusions. Her serological profile was notable for positive HLA-B27, positive anti-CCP, negative Rheumatoid Factor, and negative ANA. PET-CT scan performed for disease response following immunotherapy showed symmetric increased metabolic activity primarily involving the supraspinatus, gluteus medius and minimus, and semimembranosus tendon insertions. Her presentation was consistent with a grade 1 irAE that worsened to a grade 2 irAE despite NSAID therapy, prompting a short course of oral prednisolone. She achieved clinical remission of her mesothelioma following six cycles of Nivolumab and Ipilimumab and her inflammatory arthritis was controlled on Celebrex monotherapy. CONCLUSIONS To our knowledge, this is the first pediatric case of ICI-induced inflammatory arthritis and enthesitis. This case highlights the importance of increasing awareness of diagnosis and management of irAEs in children.
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Affiliation(s)
- John A Storwick
- Division of Pediatric Rheumatology, Department of Radiology, British Columbia Children's Hospital, The University of British Columbia, Vancouver, Canada.
| | - Herman Tam
- Division of Pediatric Rheumatology, Department of Radiology, British Columbia Children's Hospital, The University of British Columbia, Vancouver, Canada
| | - Daniel G Rosenbaum
- Division of Pediatric Rheumatology, Department of Radiology, British Columbia Children's Hospital, The University of British Columbia, Vancouver, Canada
| | - Kristin Houghton
- Division of Pediatric Rheumatology, Department of Radiology, British Columbia Children's Hospital, The University of British Columbia, Vancouver, Canada
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Semalulu T, Berard R, Beattie K, Basodan D, Boire G, Bolaria R, Cabral D, Chhabra A, Gerschman T, Johnson N, Herrington J, Houghton K, Lim L, Miettunen PMH, Park J, Proulx-Gauthier JP, Schmeling H, Scuccimarri R, Tam H, Tucker L, Guzman J, Batthish M. Clinical Characteristics of Adolescents With Juvenile Idiopathic Arthritis Transitioning to Adult Rheumatology Care in Canada: Results From the CAPRI Registry. J Rheumatol 2024; 51:403-407. [PMID: 38302168 DOI: 10.3899/jrheum.2023-0783] [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] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE Using Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) juvenile idiopathic arthritis (JIA) registry data, we describe (1) clinical characteristics of patients with JIA transitioning to adult care, (2) prevalence of disease-related damage and complications, and (3) changes in disease activity during the final year prior to transfer. METHODS Registry participants who turned 17 years between February 2017 and November 2021 were included. Clinical characteristics and patient-reported outcomes (PROs) at the last recorded pediatric rheumatology visit, and changes observed in the year prior to that visit were analyzed. Physicians completed an additional questionnaire characterizing cumulative disease-related damage and adverse events by age 17 years. RESULTS At their last visit, 88 of 131 participants (67%) had inactive and 42 (32%) had active disease. Overall, 96 (73%) were on medications and 41 (31%) were on biologic disease-modifying antirheumatic drugs. Among 80 participants for whom the additional questionnaire was completed, 26% had clinically detected joint damage, 31% had joint damage on imaging, 14% had uveitis, and 7.5% had experienced at least 1 serious adverse event. During the final year, 44.2% of patients were in remission, 28.4% attained inactive disease, and 27.4% became or remained active. Mean scores of PROs were stable overall during that last year, but a minority reported marked worsening. CONCLUSION A substantial proportion of youth with JIA transitioning to adult care in Canada had a high disease burden, which was reflected by their degree of disease activity, joint damage, or ongoing medication use. These results will inform pediatric and adult providers of anticipated needs during transition of care.
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Affiliation(s)
- Teresa Semalulu
- T. Semalulu, MD, Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario
| | - Roberta Berard
- R. Berard, MD, MSc, J. Park, MD, Division of Rheumatology, Department of Pediatrics, Western University, London, Ontario
| | - Karen Beattie
- K. Beattie, PhD, J. Herrington, PT, MSc, M. Batthish, MD, MSc, Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario
| | - Daniah Basodan
- D. Basodan, MBBS, L. Lim, MD, MPH, Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Gilles Boire
- G. Boire, MD, MSc, Division of Rheumatology, Department of Medicine, Sherbrooke University, Sherbrooke, Quebec
| | - Roxana Bolaria
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - David Cabral
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Amieleena Chhabra
- A. Chhabra, MD, Interior Health Authority, Mary Pack Arthritis Society, University of British Columbia, Vancouver, British Columbia
| | - Tommy Gerschman
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Nicole Johnson
- N. Johnson, MD, MSc, P.M.H. Miettunen, MD, H. Schmeling, MD, Division of Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta
| | - Julie Herrington
- K. Beattie, PhD, J. Herrington, PT, MSc, M. Batthish, MD, MSc, Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario
| | - Kristin Houghton
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Lillian Lim
- D. Basodan, MBBS, L. Lim, MD, MPH, Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Paivi Maria Hannele Miettunen
- N. Johnson, MD, MSc, P.M.H. Miettunen, MD, H. Schmeling, MD, Division of Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta
| | - Jonathan Park
- R. Berard, MD, MSc, J. Park, MD, Division of Rheumatology, Department of Pediatrics, Western University, London, Ontario
| | - Jean-Philippe Proulx-Gauthier
- J.P. Proulx-Gauthier, MD, Division of Rheumatology, Department of Pediatrics, CHU de Québec-Université Laval, Quebec City, Quebec
| | - Heinrike Schmeling
- N. Johnson, MD, MSc, P.M.H. Miettunen, MD, H. Schmeling, MD, Division of Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta
| | - Rosie Scuccimarri
- R. Scuccimarri, MD, Division of Rheumatology, Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Herman Tam
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Lori Tucker
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Jaime Guzman
- R. Bolaria, MD, D. Cabral, MD, T. Gerschman, MD, MSc, K. Houghton, MD, H. Tam, MBBS, MSc, L. Tucker, MD, J. Guzman, MD, Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
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3
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Nguyen K, Barsalou J, Basodan D, Batthish M, Benseler SM, Berard RA, Blanchette N, Boire G, Bolaria R, Bruns A, Cabral DA, Cameron B, Campillo S, Cellucci T, Chan M, Chédeville G, Chetaille AL, Chhabra A, Couture J, Dancey P, De Bruycker JJ, Demirkaya E, Dhalla M, Duffy CM, Feldman BM, Feldman DE, Gerschman T, Haddad E, Heale L, Herrington J, Houghton K, Huber AM, Human A, Johnson N, Jurencak R, Lang B, Larché M, Laxer RM, LeBlanc CM, Lee JJY, Levy DM, Lim L, Lim LSH, Luca N, McGrath T, McMillan T, Miettunen PM, Morishita KA, Ng HY, Oen K, Park J, Petty RE, Proulx-Gauthier JP, Ramsey S, Roth J, Rosenberg AM, Rozenblyum E, Rumsey DG, Schmeling H, Schneider R, Scuccimarri R, Shiff NJ, Silverman E, Soon G, Spiegel L, Stringer E, Tam H, Tse SM, Tucker L, Turvey S, Twilt M, Duffy KW, Yeung RSM, Guzman J. A decade of progress in juvenile idiopathic athritis treatments and outcomes in Canada: results from ReACCh-Out and the CAPRI registry. Rheumatology (Oxford) 2023:kead560. [PMID: 37851400 DOI: 10.1093/rheumatology/kead560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE To assess changes in juvenile idiopathic arthritis (JIA) treatments and outcomes in Canada, comparing a 2005-2010 and a 2017-2021 inception cohorts. METHODS Patients enrolled within three months of diagnosis in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) and the Canadian Alliance of Pediatric Rheumatology Investigators Registry (CAPRI) cohorts were included. Cumulative incidences of drug starts and outcome attainment within 70 weeks of diagnosis were compared with Kaplan Meier survival analysis and multivariable Cox regression. RESULTS The 2005-2010 and 2017-2021 cohorts included 1128 and 721 patients, respectively. JIA category distribution and baseline clinical juvenile idiopathic arthritis disease activity (cJADAS10) scores at enrolment were comparable. By 70 weeks, 6% of patients (95% CI 5, 7) in the 2005-2010 and 26% (23, 30) in the 2017-2021 cohort had started a biologic DMARD (bDMARD), and 43% (40, 47) and 60% (56, 64) had started a conventional DMARD (cDMARD), respectively. Outcome attainment was 64% (61, 67) and 83% (80, 86) for Inactive disease (Wallace criteria), 69% (66, 72) and 84% (81, 87) for minimally active disease (cJADAS10 criteria), 57% (54, 61) and 63% (59, 68) for pain control (<1/10), and 52% (47, 56) and 54% (48, 60) for a good health-related quality of life. CONCLUSION Although baseline disease characteristics were comparable in the 2005-2010 and 2017-2021 cohorts, cDMARD and bDMARD use increased with a concurrent increase in minimally active and inactive disease. Improvements in parent and patient reported outcomes were smaller than improvements in disease activity.
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Affiliation(s)
- Kelly Nguyen
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | - Gilles Boire
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Roxana Bolaria
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - David A Cabral
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Mercedes Chan
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | - Paul Dancey
- Memorial University, St. John's, Newfoundland and Labrador, Canada
| | | | | | | | | | | | | | - Tommy Gerschman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Elie Haddad
- Université de Montréal, Montréal, Quebec, Canada
| | - Liane Heale
- McMaster University, Hamilton, Ontario, Canada
| | | | - Kristin Houghton
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam M Huber
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrea Human
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Bianca Lang
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Lillian Lim
- University of Alberta, Edmonton, Alberta, Canada
| | - Lily S H Lim
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nadia Luca
- University of Ottawa, Ottawa, Ontario, Canada
| | - Tara McGrath
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | - Hon Yan Ng
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kiem Oen
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Ross E Petty
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | - Dax G Rumsey
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | | - Gordon Soon
- Health Sciences North, Sudbury, Ontario, Canada
- North York General Hospital, North York, Toronto, Ontario, Canada
| | | | | | - Herman Tam
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Lori Tucker
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stuart Turvey
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Jaime Guzman
- University of British Columbia, Vancouver, British Columbia, Canada
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4
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Bass AR, Chakravarty E, Akl EA, Bingham CO, Calabrese L, Cappelli LC, Johnson SR, Imundo LF, Winthrop KL, Arasaratnam RJ, Baden LR, Berard R, Bridges SL, Cheah JTL, Curtis JR, Ferguson PJ, Hakkarinen I, Onel KB, Schultz G, Sivaraman V, Smith BJ, Sparks JA, Vogel TP, Williams EA, Calabrese C, Cunha JS, Fontanarosa J, Gillispie-Taylor MC, Gkrouzman E, Iyer P, Lakin KS, Legge A, Lo MS, Lockwood MM, Sadun RE, Singh N, Sullivan N, Tam H, Turgunbaev M, Turner AS, Reston J. 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol 2023; 75:333-348. [PMID: 36597810 DOI: 10.1002/art.42386.10.1002/art.42386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs). METHODS This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation. RESULTS This guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence. CONCLUSION Application of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.
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Affiliation(s)
- Anne R Bass
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Elie A Akl
- American University of Beirut, Beirut, Lebanon
| | | | | | | | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Lisa F Imundo
- Columbia University Irving Medical Center, New York, New York
| | | | - Reuben J Arasaratnam
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas
| | - Lindsey R Baden
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roberta Berard
- Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - S Louis Bridges
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | | | | | | | - Karen B Onel
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Vidya Sivaraman
- The Ohio State University and Nationwide Children's Hospital, Columbus
| | | | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Joanne S Cunha
- Brown University, Brown Physicians Inc., and Providence Veterans Affairs Medical Center, East Providence, Rhode Island
| | | | | | | | - Priyanka Iyer
- University of California Irvine Medical Center, Orange
| | - Kimberly S Lakin
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | - Alexandra Legge
- Dalhousie University and QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Mindy S Lo
- Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - Herman Tam
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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5
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Bass AR, Chakravarty E, Akl EA, Bingham CO, Calabrese L, Cappelli LC, Johnson SR, Imundo LF, Winthrop KL, Arasaratnam RJ, Baden LR, Berard R, Bridges SL, Cheah JTL, Curtis JR, Ferguson PJ, Hakkarinen I, Onel KB, Schultz G, Sivaraman V, Smith BJ, Sparks JA, Vogel TP, Williams EA, Calabrese C, Cunha JS, Fontanarosa J, Gillispie-Taylor MC, Gkrouzman E, Iyer P, Lakin KS, Legge A, Lo MS, Lockwood MM, Sadun RE, Singh N, Sullivan N, Tam H, Turgunbaev M, Turner AS, Reston J. 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol 2023; 75:333-348. [PMID: 36597810 DOI: 10.1002/art.42386] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs). METHODS This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation. RESULTS This guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence. CONCLUSION Application of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.
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Affiliation(s)
- Anne R Bass
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Elie A Akl
- American University of Beirut, Beirut, Lebanon
| | | | | | | | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Lisa F Imundo
- Columbia University Irving Medical Center, New York, New York
| | | | - Reuben J Arasaratnam
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas
| | - Lindsey R Baden
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roberta Berard
- Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - S Louis Bridges
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | | | | | | | - Karen B Onel
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Vidya Sivaraman
- The Ohio State University and Nationwide Children's Hospital, Columbus
| | | | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Joanne S Cunha
- Brown University, Brown Physicians Inc., and Providence Veterans Affairs Medical Center, East Providence, Rhode Island
| | | | | | | | - Priyanka Iyer
- University of California Irvine Medical Center, Orange
| | - Kimberly S Lakin
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | - Alexandra Legge
- Dalhousie University and QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Mindy S Lo
- Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - Herman Tam
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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6
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Bass AR, Chakravarty E, Akl EA, Bingham CO, Calabrese L, Cappelli LC, Johnson SR, Imundo LF, Winthrop KL, Arasaratnam RJ, Baden LR, Berard R, Bridges SL, Cheah JTL, Curtis JR, Ferguson PJ, Hakkarinen I, Onel KB, Schultz G, Sivaraman V, Smith BJ, Sparks JA, Vogel TP, Williams EA, Calabrese C, Cunha JS, Fontanarosa J, Gillispie-Taylor MC, Gkrouzman E, Iyer P, Lakin KS, Legge A, Lo MS, Lockwood MM, Sadun RE, Singh N, Sullivan N, Tam H, Turgunbaev M, Turner AS, Reston J. 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases. Arthritis Care Res (Hoboken) 2023; 75:449-464. [PMID: 36597813 DOI: 10.1002/acr.25045] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs). METHODS This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation. RESULTS This guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence. CONCLUSION Application of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.
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Affiliation(s)
- Anne R Bass
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Elie A Akl
- American University of Beirut, Beirut, Lebanon
| | | | | | | | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Lisa F Imundo
- Columbia University Irving Medical Center, New York, New York
| | | | - Reuben J Arasaratnam
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas
| | - Lindsey R Baden
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roberta Berard
- Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - S Louis Bridges
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | | | | | | | - Karen B Onel
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | - Vidya Sivaraman
- The Ohio State University and Nationwide Children's Hospital, Columbus
| | | | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Joanne S Cunha
- Brown University, Brown Physicians Inc., and Providence Veterans Affairs Medical Center, East Providence, Rhode Island
| | | | | | | | - Priyanka Iyer
- University of California Irvine Medical Center, Orange
| | - Kimberly S Lakin
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | - Alexandra Legge
- Dalhousie University and QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Mindy S Lo
- Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - Herman Tam
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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Bass E, Connor M, Adzawoloo-Andersson I, Bertonelli Tanaka M, Bhola-Stewart H, Brown D, Eldred-Evans D, Hosking-Jervis F, Jaipuria J, Mendoza R, Pegers E, Leelamany D, Powell L, Ahmad S, Wong K, Tam H, Gordon S, Qazi H, Hrouda D, Mccracken S, Winkler M, Ahmed H. Can we predict when non-targeted systematic prostate biopsies need to be performed? Outcomes from the multicentre RAPIDOnline 3,853 patient cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00227-0] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Houghton K, McPherson M, Surjanovic N, Loughin T, Berard R, Proulx-Gauthier JP, Chédeville G, Rumsey D, Schmeling H, Luca N, Johnson N, Gerschman T, Miettunen P, Tam H, Lim L, Morishita K, Scuccimarri R, Roth J, Duffy C, Tucker L, Feldman BM, Guzman J. Development and validation of the Kids Disability Screen for children with juvenile idiopathic arthritis: results from the CAPRI Registry. Rheumatology (Oxford) 2022; 61:4835-4844. [PMID: 35438140 DOI: 10.1093/rheumatology/keac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/01/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to develop and validate a brief disability screen for children with JIA, the Kids Disability Screen (KDS). METHODS A total of 216 children enrolled in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry in 2017-2018 formed a development cohort, and 220 children enrolled in 2019-2020 formed a validation cohort. At every clinic visit, parents answered two questions derived from the Childhood Health Assessment Questionnaire (CHAQ): 'Is it hard for your child to run and play BECAUSE OF ARTHRITIS?' ('Hard' 0-10), and 'Does your child usually need help from you or another person BECAUSE OF ARTHRITIS?' ('Help', 0-10). We used 36-fold cross-validation and tested nine different mathematical methods to combine the answers and optimize psychometric properties. The results were confirmed in the validation cohort. RESULTS Expressed as the mean of the two answers, KDS best balanced ease of use and psychometric properties, while a LASSO regression model combining the two answers with other patient characteristics [estimated CHAQ [eCHAQ]) had the highest responsiveness. In the validation cohort, 22.7%, 25.9% and 28.6% of patients had a score of 0 at enrolment for the KDS, eCHAQ and CHAQ, respectively. Responsiveness was 0.67, 0.74 and 0.62, respectively. Sensitivity to detect a CHAQ > 0 was 0.90 and specificity 0.56, KDS detecting some disability in 44% of children with a CHAQ = 0. CONCLUSION This simple KDS has psychometric properties comparable with those of a full CHAQ and may be used at every clinic visit to identify those children who need a full disability assessment.
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Affiliation(s)
- Kristin Houghton
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Meghan McPherson
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | | | | | - Roberta Berard
- London Health Sciences Centre and Western University, London
| | | | | | - Dax Rumsey
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | | | - Nadia Luca
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Nicole Johnson
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Tommy Gerschman
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Paivi Miettunen
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Herman Tam
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | - Lillian Lim
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | - Kimberly Morishita
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | | | - Johannes Roth
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa
| | - Ciaran Duffy
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa
| | - Lori Tucker
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Brian M Feldman
- Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Jaime Guzman
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
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Lopez AA, Patel M, Rayment JH, Tam H, Roberts A, Laskin S, Tucker L, Biggs CM. Tout le monde sur le pont : une approche multidisciplinaire du SRAS-CoV-2 associé au SIME. Paediatr Child Health 2022; 27:S136-S142. [PMID: 36092300 PMCID: PMC9455652 DOI: 10.1093/pch/pxac018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Historique Le syndrome inflammatoire multisystémique de l’enfant (SIME) est une complication postinfectieuse de la COVID-19 qui combine des manifestations de la maladie de Kawasaki et du syndrome de choc toxique. En mai 2020, un groupe de travail multidisciplinaire provincial a été mis sur pied en prévision des cas émergents après la première vague de COVID-19. Méthodologie Le centre des auteurs a créé un groupe multidisciplinaire pour les cas de SIME en Colombie-Britannique, qui a préparé des lignes directrices inspirées de la définition de cas de SIME de l’Organisation mondiale de la Santé. Il a mis les lignes directrices à jour au moyen de méthodes d’amélioration de la qualité en fonction de la publication de nouveaux rapports et de l’évolution de l’expérience locale. Il a inclus tous les enfants évalués en personne ou dont les échantillons avaient été envoyés au centre afin de confirmer la présence du syndrome entre mai 2020 et avril 2021. Il a procédé à la collecte prospective des caractéristiques démographiques et cliniques, des caractéristiques de laboratoire et des traitements des patients. Résultats Au total, 52 enfants ont été évalués, et 11 ont reçu un diagnostic de SIME confirmé. Dix de ces 11 cas ont souffert d’un choc, et les atteintes gastro-intestinales et mucocutanées étaient également courantes. Les résultats de laboratoire fréquents incluaient une élévation de la protéine C-réactive, des D-dimères, de la troponine et du peptide cérébral natriurétique. Quatre des 11 cas (36 %) ont souffert d’un dysfonctionnement myocardique et trois (27 %), d’anomalies des artères coronaires. Les 11 patients ont obtenu des résultats démontrant une infection par le SRAS-CoV-2, et dix d’entre eux (91 %) ont reçu des immunoglobulines et des corticostéroïdes par voie intraveineuse. Conclusion La cohorte provinciale de patients atteints d’un SIME confirmé était plus susceptible de présenter un état de choc et un dysfonctionnement cardiaque, d’être admise en soins intensifs et de recevoir un traitement aux corticostéroïdes que les cas écartés. Grâce au processus évolutif privilégié par le groupe de travail, les enfants de la province possédant des caractéristiques du syndrome étaient rapidement dépistés, soumis à une évaluation standardisée et traités de manière appropriée.
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Affiliation(s)
- Alison A Lopez
- Service d’infectiologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Mona Patel
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service de soins intensifs, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Jonathan H Rayment
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service de pneumologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Herman Tam
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service de rhumatologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Ashley Roberts
- Service d’infectiologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
| | - Samara Laskin
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service de pédiatrie générale, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Lori Tucker
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service de rhumatologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
| | - Catherine M Biggs
- Département de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
- Service d’allergies et d’immunologie, BC Children’s Hospital, Vancouver (Colombie-Britannique)Canada
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10
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Lopez AA, Patel M, Rayment JH, Tam H, Roberts A, Laskin S, Tucker L, Biggs CM. All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C. Paediatr Child Health 2022; 27:S53-S58. [PMID: 35620558 PMCID: PMC9126281 DOI: 10.1093/pch/pxab110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/24/2022] [Indexed: 11/14/2022] Open
Abstract
Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of SARS-CoV-2 infection with overlapping features of Kawasaki disease and toxic shock syndrome. In May 2020, a provincial multidisciplinary working group was established in anticipation of emerging cases following the first wave of SARS-CoV-2 infections. Methodology Our centre established a multidisciplinary working group for MIS-C cases in British Columbia. The group developed guidelines using the World Health Organization MIS-C case definition. Guidelines were updated using quality improvement methods as new reports and our local experience evolved. We included all children who were evaluated in person or had samples sent to our centre for MIS-C evaluation from May 2020 to April 2021. We prospectively collected patient demographics, clinical and laboratory characteristics, and treatment. Results Fifty-two children were included. Eleven were diagnosed as confirmed MIS-C. Ten of the 11 MIS-C cases presented with shock. Gastrointestinal and mucocutaneous involvement were also prominent. Common laboratory features included elevated C-reactive protein, D-dimer, troponin, and brain natriuretic peptide. Four out of 11 (36%) had myocardial dysfunction and 3/11 (27%) had coronary artery abnormalities. All 11 patients had evidence of SARS-CoV-2 infection. Ten out of 11 (91%) received intravenous (IV) immunoglobulin and IV corticosteroids. Conclusion Our provincial cohort of MIS-C patients were more likely to present with shock and cardiac dysfunction, require ICU admission, and be treated with corticosteroids compared to ruled out cases. Our working group’s evolving process ensured children with features of MIS-C were rapidly identified, had standardized evaluation, and received appropriate treatment in our province.
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Affiliation(s)
- Alison A Lopez
- Division of Infectious Diseases, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Mona Patel
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Critical Care, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Jonathan H Rayment
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Respiratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Herman Tam
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Rheumatology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Ashley Roberts
- Division of Infectious Diseases, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samara Laskin
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of General Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Lori Tucker
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Rheumatology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Catherine M Biggs
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Allergy and Immunology, BC Children's Hospital, Vancouver, British Columbia, Canada
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Peters M, Eldred-Evans D, Connor M, Bertoncelli Tanaka M, Bhola-Stewart H, T Shah T, Ahmad S, Noureldin M, Wong K, Tam H, Hrouda D, Winkler M, van Rossum P, Kurver P, Gordon S, Qazi H, Ahmed H, Giovanni Falagario U, Jambor I, Briganti A, Nordström T, Carrieri G, Powell L, Joshi S, Pegers E. PD-0416 Derivation and external validation of a RAPID Risk score for predicting significant prostate cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02851-1] [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: 10/18/2022]
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12
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Bass E, Bertonelli Tanaka M, Connor M, Walters U, Eldred-Evans D, Sarkar P, Hosking-Jervis F, Bhola-Stewart H, Pegers E, Powell L, Leelamany D, Wong K, Ahmad S, Tam H, Gordon S, Hrouda D, Mccracken S, Winkler M, Ahmed H. Identifying men affected by changes in PSA screening in the COVID-19 pandemic. Eur Urol 2022. [PMCID: PMC9155264 DOI: 10.1016/s0302-2838(22)00455-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Reddy D, Eldred-Evans D, Connor M, Hosking-Jervis F, Bertoncelli Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Bass E, Lee H, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Assessing the regional variability of a pre-biopsy mpMRI and targeted prostate cancer diagnostic pathway. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Conway R, Grimshaw AA, Konig MF, Putman M, Duarte-García A, Tseng LY, Cabrera DM, Chock YPE, Degirmenci HB, Duff E, Egeli BH, Graef ER, Gupta A, Harkins P, Hoyer BF, Jayatilleke A, Jin S, Kasia C, Khilnani A, Kilian A, Kim AH, Lin CMA, Low C, Proulx L, Sattui SE, Singh N, Sparks JA, Tam H, Ugarte-Gil MF, Ung N, Wang K, Wise LM, Yang Z, Young KJ, Liew JW, Grainger R, Wallace ZS, Hsieh E. SARS-CoV-2 Infection and COVID-19 Outcomes in Rheumatic Disease: A Systematic Literature Review And Meta-Analysis. Arthritis Rheumatol 2021; 74:766-775. [PMID: 34807517 PMCID: PMC9011807 DOI: 10.1002/art.42030] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/22/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022]
Abstract
Objective The relative risk of SARS–CoV‐2 infection and COVID‐19 disease severity among people with rheumatic and musculoskeletal diseases (RMDs) compared to those without RMDs is unclear. This study was undertaken to quantify the risk of SARS–CoV‐2 infection in those with RMDs and describe clinical outcomes of COVID‐19 in these patients. Methods We conducted a systematic literature review using 14 databases from January 1, 2019 to February 13, 2021. We included observational studies and experimental trials in RMD patients that described comparative rates of SARS–CoV‐2 infection, hospitalization, oxygen supplementation/intensive care unit (ICU) admission/mechanical ventilation, or death attributed to COVID‐19. Methodologic quality was evaluated using the Joanna Briggs Institute critical appraisal tools or the Newcastle‐Ottawa scale. Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated, as applicable for each outcome, using the Mantel‐Haenszel formula with random effects models. Results Of the 5,799 abstracts screened, 100 studies met the criteria for inclusion in the systematic review, and 54 of 100 had a low risk of bias. Among the studies included in the meta‐analyses, we identified an increased prevalence of SARS–CoV‐2 infection in patients with an RMD (RR 1.53 [95% CI 1.16–2.01]) compared to the general population. The odds of hospitalization, ICU admission, and mechanical ventilation were similar in patients with and those without an RMD, whereas the mortality rate was increased in patients with RMDs (OR 1.74 [95% CI 1.08–2.80]). In a smaller number of studies, the adjusted risk of outcomes related to COVID‐19 was assessed, and the results varied; some studies demonstrated an increased risk while other studies showed no difference in risk in patients with an RMD compared to those without an RMD. Conclusion Patients with RMDs have higher rates of SARS–CoV‐2 infection and an increased mortality rate.
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Affiliation(s)
- Richard Conway
- Department of Rheumatology, St. James's Hospital, Dublin, Ireland and Clinical Lecturer Trinity College Dublin, Ireland
| | - Alyssa A Grimshaw
- Cushing/Whitney Medical Library, Yale University New Haven, Connecticut, USA
| | - Maximilian F Konig
- Division of Rheumatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Diego M Cabrera
- Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA
| | - Yu Pei Eugenia Chock
- Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA
| | | | - Eimear Duff
- Department of Rheumatology, St. James's Hospital, Dublin, Ireland
| | - Bugra Han Egeli
- Graduate Medical Sciences, Boston University School of Medicine, 72 E Concord St L-317, 02118, Boston, MA, USA and Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth R Graef
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Akash Gupta
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Patricia Harkins
- Department of Rheumatology, St. James's Hospital, Dublin, Ireland
| | - Bimba F Hoyer
- Department of Rheumatology and Clinical Immunology, Clinic for Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | | - Shangyi Jin
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID),, Beijing, 100730, China
| | | | - Aneka Khilnani
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Adam Kilian
- Division of Rheumatology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Alfred Hj Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Chung Mun Alice Lin
- National Institute of Health Research, Newcastle Biomedical Research Centre and the Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Candice Low
- St. Vincent's University Hospital, Dublin, Ireland
| | - Laurie Proulx
- Patient Author, Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Sebastian E Sattui
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Namrata Singh
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Herman Tam
- Division of Rheumatology, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada
| | - Manuel F Ugarte-Gil
- Lima, Peru and Hospital Guillermo Almenara Irigoyen, EsSalud, Universidad Cientifica del Sur, Lima, Peru
| | - Natasha Ung
- Campbelltown Hospital, Campbelltown, New South Wales, Australia and University of Western Sydney, New South Wales, Australia
| | - Kaicheng Wang
- Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA and Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Leanna M Wise
- Division of Rheumatology, University of Southern California; Los Angeles, CA, USA
| | - Ziyi Yang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID),, Beijing, 100730, China
| | - Kristen J Young
- Division of Rheumatic Diseases, University of Texas Southwestern, Dallas, TX, USA
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Zachary S Wallace
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Evelyn Hsieh
- Section of Rheumatology, VA Connecticut Healthcare System, West Haven, CT, USA
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Dushnicky MJ, Campbell C, Beattie KA, Berard R, Cellucci T, Chan M, Gerschman T, Johnson N, Lim L, Luca N, Miettunen P, Morishita KA, Proulx-Gauthier JP, Rumsey DG, Schmeling H, Scuccimarri R, Tam H, Guzman J, Batthish M. Impact of the COVID-19 Pandemic on Juvenile Idiopathic Arthritis Presentation and Research Recruitment: Results from the CAPRI Registry. Rheumatology (Oxford) 2021; 61:SI157-SI162. [PMID: 34726738 PMCID: PMC8689883 DOI: 10.1093/rheumatology/keab812] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has disrupted healthcare delivery and clinical research worldwide, with data from areas most affected demonstrating an impact on rheumatology care. This study aimed to characterize the impact of the pandemic on the initial presentation of JIA and JIA-related research in Canada. METHODS Data collected from the Canadian Alliance of Pediatric Rheumatology Investigators JIA Registry from the year pre-pandemic (March 11, 2019-March 10, 2020) was compared with data collected during the first year of the pandemic (March 11, 2020-March 10, 2021). Outcomes included time from symptom onset to first assessment, disease severity at presentation and registry recruitment. Proportions and medians were used to describe categorical and continuous variables, respectively. RESULTS The median time from symptom onset to first assessment was 138 days (IQR 64-365) pre-pandemic vs 146 days (IQR 83-359) during the pandemic. The JIA category frequencies remained overall stable, (44% oligoarticular JIA pre-pandemic, 46.8% pandemic), except for systemic JIA (12 cases pre-pandemic, 1 pandemic). Clinical features, disease activity (cJADAS10), disability (CHAQ) and quality of life (JAQQ) scores were similar between the two cohorts. Pre-pandemic, 225 patients were enrolled, compared with 111 in the pandemic year, with the greatest decrease from March to June 2020. CONCLUSIONS We did not observe the anticipated delay in time to presentation or increased severity at presentation, suggesting that, within Canada, care adapted well to provide support to new patient consults without negative impacts. The COVID-19 pandemic was associated with an initial 50% decrease in registry enrolment but has since improved.
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Affiliation(s)
- Molly J Dushnicky
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Catherine Campbell
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Karen A Beattie
- Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Roberta Berard
- Division of Rheumatology, Department of Pediatrics, Western University, London, Ontario, Canada
| | - Tania Cellucci
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mercedes Chan
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tommy Gerschman
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Johnson
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lillian Lim
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Luca
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paivi Miettunen
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kimberly A Morishita
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Dax G Rumsey
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Heinrike Schmeling
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rosie Scuccimarri
- Division of Rheumatology, Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Herman Tam
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jaime Guzman
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle Batthish
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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16
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Bass EJ, Pantovic A, Connor M, Gabe R, Padhani AR, Rockall A, Sokhi H, Tam H, Winkler M, Ahmed HU. A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk. Prostate Cancer Prostatic Dis 2021; 24:596-611. [PMID: 33219368 DOI: 10.1038/s41391-020-00298-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Multiparametric magnetic resonance imaging (mpMRI), the use of three multiple imaging sequences, typically T2-weighted, diffusion weighted (DWI) and dynamic contrast enhanced (DCE) images, has a high sensitivity and specificity for detecting significant cancer. Current guidance now recommends its use prior to biopsy. However, the impact of DCE is currently under debate regarding test accuracy. Biparametric MRI (bpMRI), using only T2 and DWI has been proposed as a viable alternative. We conducted a contemporary systematic review and meta-analysis to further examine the diagnostic performance of bpMRI in the diagnosis of any and clinically significant prostate cancer. METHODS A systematic review of the literature from 01/01/2017 to 06/07/2019 was performed by two independent reviewers using predefined search criteria. The index test was biparametric MRI and the reference standard whole-mount prostatectomy or prostate biopsy. Quality of included studies was assessed by the QUADAS-2 tool. Statistical analysis included pooled diagnostic performance (sensitivity; specificity; AUC), meta-regression of possible covariates and head-to-head comparisons of bpMRI and mpMRI where both were performed in the same study. RESULTS Forty-four articles were included in the analysis. The pooled sensitivity for any cancer detection was 0.84 (95% CI, 0.80-0.88), specificity 0.75 (95% CI, 0.68-0.81) for bpMRI. The summary ROC curve yielded a high AUC value (AUC = 0.86). The pooled sensitivity for clinically significant prostate cancer was 0.87 (95% CI, 0.78-0.93), specificity 0.72 (95% CI, 0.56-0.84) and the AUC value was 0.87. Meta-regression analysis revealed no difference in the pooled diagnostic estimates between bpMRI and mpMRI. CONCLUSIONS This meta-analysis on contemporary studies shows that bpMRI offers comparable test accuracies to mpMRI in detecting prostate cancer. These data are broadly supportive of the bpMRI approach but heterogeneity does not allow definitive recommendations to be made. There is a need for prospective multicentre studies of bpMRI in biopsy naïve men.
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Affiliation(s)
- E J Bass
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK. .,Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK.
| | - A Pantovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, Belgrade, Serbia
| | - M Connor
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.,Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - R Gabe
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - A R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, London, UK
| | - A Rockall
- Division of Cancer, Department of Surgery and Cancer,Faculty of Medicine, Imperial College London, London, UK
| | - H Sokhi
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, London, UK.,Department of Radiology, Hillingdon Hospitals NHS Foundation Trust, London, UK
| | - H Tam
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.,Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - M Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.,Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - H U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.,Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK
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Connor M, Van Son M, Eldred-Evans D, Bass E, Bertoncelli Tanaka M, Walters U, Sakar P, Hosking-Jervis F, Bhola-Stewart H, Pegers E, Powell L, Leelamany D, Wong K, Ahmad S, Tam H, Mccracken S, Hrouda D, Qasi H, Gordon S, Winkler M, Ahmed H. Impact of non-targeted prostate sampling histology on the probability of receiving invasive local treatment in an mpMRI-targeted pathway – analysis of 1,719 men. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01377-4] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Walters U, Connor M, Bass E, Eldred-Evans D, Maynard W, Sarkar P, Bertoncelli Tanaka M, Hosking-Jervis F, Bhola-Stewart H, Pegers E, Powell L, Leelamany D, Wong K, Ahmad S, Tam H, Mccracken S, Gordon S, Hrouda D, Qazi H, Winkler M, Ahmed H. Switching from sedation to local anaesthetic transperineal prostate biopsies: A cost-benefit analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01262-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Connor MJ, Eldred-Evans D, van Son M, Hosking-Jervis F, Bertoncelli Tanaka M, Reddy D, Bass EJ, Powell L, Ahmad S, Pegers E, Joshi S, Sri D, Wong K, Tam H, Hrouda D, Qazi H, Gordon S, Winkler M, Ahmed HU. A Multicenter Study of the Clinical Utility of Nontargeted Systematic Transperineal Prostate Biopsies in Patients Undergoing Pre-Biopsy Multiparametric Magnetic Resonance Imaging. J Urol 2020; 204:1195-1201. [PMID: 32516029 DOI: 10.1097/ju.0000000000001184] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The added value of nontargeted systematic prostate biopsies when performed alongside magnetic resonance imaging targeted biopsies in men referred with a suspicion of prostate cancer is unclear. We aimed to determine the clinical utility of transperineal nontargeted systematic prostate biopsies, when performed alongside targeted systematic prostate biopsies, using pre-biopsy multiparametric magnetic resonance imaging. MATERIALS AND METHODS Consecutive patients referred with a suspicion of prostate cancer (April 2017 to October 2019) underwent pre-biopsy multiparametric magnetic resonance imaging. A transperineal biopsy was advised if multiparametric magnetic resonance imaging PI-RADS® (v.2.0) score was 4 or 5, and score 3 required a prostate specific antigen density 0.12 ng/ml or greater. Primary threshold for clinically significant prostate cancer was defined as any Gleason 3+4 or greater. Multivariable logistic regression analysis identified pre-biopsy predictors of clinically significant prostate cancer in nontargeted systematic prostate biopsies, regardless of targeted pathology (p <0.05, R, version 3.5.1). RESULTS A total of 1,719 men underwent a pre-biopsy multiparametric magnetic resonance imaging, with 679 (39.5%) proceeding to combined targeted systematic prostate biopsies and nontargeted systematic prostate biopsies. In these men clinically significant prostate cancer was detected in 333 (49%) and 139 (20.5%) with targeted systematic prostate biopsies and nontargeted systematic prostate biopsies, respectively. In those men with clinically significant prostate cancer in targeted systematic prostate biopsies, clinically significant prostate cancer was also present in nontargeted systematic prostate biopsies in 117 (17.2%); Gleason 3+3 was present in 50 (7.4%). In 287 men without any cancer in the targeted systematic prostate biopsies, 13 (1.9%) had clinically significant prostate cancer in nontargeted systematic prostate biopsies. In addition 18/679 (2.7%) had Gleason 3+3 disease and no Gleason greater than 4+3 was detected. Predictors associated with clinically significant prostate cancer in nontargeted systematic prostate biopsies were prostate specific antigen 5 ng/ml or greater (OR 2.05, 95% CI 1.13-3.73, p=0.02), PI-RADS score 5 (OR 2.26, 95% CI 1.51-3.38, p <0.001) and prostate volume less than 50 cc (OR 2.47, 95% CI 1.57-3.87, p <0.001). CONCLUSIONS Detection of clinically significant prostate cancer in exclusively nontargeted transperineal systematic biopsies in a pre-biopsy multiparametric magnetic resonance imaging pathway was low (1.9%).
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Affiliation(s)
- M J Connor
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - D Eldred-Evans
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - M van Son
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Hosking-Jervis
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - M Bertoncelli Tanaka
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - D Reddy
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - E J Bass
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - L Powell
- Department of Urology, St. George's Hospital NHS Foundation Trust, London, United Kingdom
| | - S Ahmad
- Department of Urology, Epsom and St. Helier's University Hospital Trust, Surrey, United Kingdom
| | - E Pegers
- RM Partners, West London Cancer Alliance, Royal Marsden Hospital, London, United Kingdom
| | - S Joshi
- RM Partners, West London Cancer Alliance, Royal Marsden Hospital, London, United Kingdom
| | - D Sri
- Department of Urology, St. George's Hospital NHS Foundation Trust, London, United Kingdom
| | - K Wong
- Department of Urology, Epsom and St. Helier's University Hospital Trust, Surrey, United Kingdom
| | - H Tam
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D Hrouda
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H Qazi
- Department of Urology, St. George's Hospital NHS Foundation Trust, London, United Kingdom
| | - S Gordon
- Department of Urology, Epsom and St. Helier's University Hospital Trust, Surrey, United Kingdom
| | - M Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
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Tam H, El Tal T, Go E, Yeung RSM. Le syndrome inflammatoire multisystémique de l’enfant ayant un lien temporel avec la COVID-19 : multiples visages, multiples appellations. CMAJ 2020; 192:E1686-E1690. [DOI: 10.1503/cmaj.201600-f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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21
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Putman M, Chock YPE, Tam H, Kim AHJ, Sattui SE, Berenbaum F, Danila MI, Korsten P, Sanchez-Alvarez C, Sparks JA, Coates LC, Palmerlee C, Peirce A, Jayatilleke A, Johnson SR, Kilian A, Liew J, Prokop LJ, Murad MH, Grainger R, Wallace ZS, Duarte-García A. Antirheumatic Disease Therapies for the Treatment of COVID-19: A Systematic Review and Meta-Analysis. Arthritis Rheumatol 2020; 73:36-47. [PMID: 32741139 PMCID: PMC7435536 DOI: 10.1002/art.41469] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/26/2020] [Indexed: 12/15/2022]
Abstract
Objective Antirheumatic disease therapies have been used to treat coronavirus disease 2019 (COVID‐19) and its complications. We conducted a systematic review and meta‐analysis to describe the current evidence. Methods A search of published and preprint databases in all languages was performed. Included studies described ≥1 relevant clinical outcome for ≥5 patients who were infected with severe acute respiratory syndrome coronavirus 2 and were treated with antirheumatic disease therapy between January 1, 2019 and May 29, 2020. Pairs of reviewers screened articles, extracted data, and assessed risk of bias. A meta‐analysis of effect sizes using random‐effects models was performed when possible. Results The search identified 3,935 articles, of which 45 were included (4 randomized controlled trials, 29 cohort studies, and 12 case series). All studies evaluated hospitalized patients, and 29 of the 45 studies had been published in a peer‐reviewed journal. In a meta‐analysis of 3 cohort studies with a low risk of bias, hydroxychloroquine use was not significantly associated with mortality (pooled hazard ratio [HR] 1.41 [95% confidence interval (95% CI) 0.83, 2.42]). In a meta‐analysis of 2 cohort studies with some concerns/higher risk of bias, anakinra use was associated with lower mortality (pooled HR 0.25 [95% CI 0.12, 0.52]). Evidence was inconclusive with regard to other antirheumatic disease therapies, and the majority of other studies had a high risk of bias. Conclusion In this systematic review and meta‐analysis, hydroxychloroquine use was not associated with benefit or harm regarding COVID‐19 mortality. The evidence supporting the effect of other antirheumatic disease therapies in COVID‐19 is currently inconclusive.
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Affiliation(s)
| | | | - Herman Tam
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alfred H J Kim
- Washington University School of Medicine, Saint Louis, Missouri, United States
| | | | - Francis Berenbaum
- Sorbonne Université, INSERM CRSA, AP-HP Hôpital Saint Antoine, Paris, France
| | | | - Peter Korsten
- University Medical Center Göttingen, Göttingen, Germany
| | | | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | | | | | | | - Arundathi Jayatilleke
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Adam Kilian
- George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | | | | | | | | | - Zachary S Wallace
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
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22
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Tam H, El Tal T, Go E, Yeung RSM. Pediatric inflammatory multisystem syndrome temporally associated with COVID-19: a spectrum of diseases with many names. CMAJ 2020; 192:E1093-E1096. [PMID: 32907819 DOI: 10.1503/cmaj.201600] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Herman Tam
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ont
| | - Tala El Tal
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ont
| | - Ellen Go
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ont
| | - Rae S M Yeung
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ont.
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Connor M, Eldred-Evans D, Hosking-Jervis F, Bass E, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Khoo C, Maynard W, Shah T, Lee J, Sri D, Powell L, Ahmad S, Joshi S, Pegers E, Kathie W, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Carton J, Ahmed H. Direct and marginal cost analysis of not aiming for the target in a MRI-targeted prostate biopsy pathway. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34162-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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24
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Khoo C, Eldred-Evans D, Peters M, Hosking-Jervis F, Connor M, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Maynard W, Bass E, Shah T, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Man vs machine: Comparative effectiveness of cognitive targeted and image-fusion targeted transperineal prostate biopsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34153-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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25
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Eldred-Evans D, Peters M, Bertoncelli Tanaka M, Hosking-Jervis F, Connor M, Reddy D, Shah T, Khoo C, Maynard W, Bass E, Lee J, Sri D, Bhola-Stewart H, Powell L, Ahmad S, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Qazi H, Gordon S, Ahmed H. The RAPID risk model: A novel risk score to predict significant prostate cancer in men with an mpMRI lesion. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Reddy D, Eldred-Evans D, Connor M, Hosking-Jervis F, Bertoncelli-Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Bass E, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Indeterminate mpMRI lesions: Evaluating the optimal PSA density threshold for prostate biopsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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27
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Connor M, Eldred-Evans D, Hosking-Jervis F, Bass E, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Which men should undergo non-targeted systematic sampling in an mpMRI-targeted pathway – an analysis from 1,719 pre-biopsy mpMRI cases? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32674-4] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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28
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Maynard W, Eldred-Evans D, Connor M, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Khoo C, Bass E, Shah T, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Local anaesthetic transperineal prostate biopsy: Optimising patient selection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Noureldin M, Eldred-Evans D, Khoo CC, Winkler M, Sokhi H, Tam H, Ahmed HU. Review article: MRI-targeted biopsies for prostate cancer diagnosis and management. World J Urol 2020; 39:57-63. [PMID: 32253585 DOI: 10.1007/s00345-020-03182-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/25/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding. METHODS There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis. RESULTS AND CONCLUSION Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.
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Affiliation(s)
- M Noureldin
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK. .,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. .,Urology Department, Ain Shams University Hospitals, Cairo, Egypt.
| | - D Eldred-Evans
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - C C Khoo
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - M Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - H Sokhi
- Department of Radiology, Hillingdon Hospitals NHS Foundation Trust, London, UK.,Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, UK
| | - H Tam
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - H U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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Khoo C, Eldred-Evans D, Jaenicke J, Bertoncelli Tanaka M, Shah T, Miah S, Connor M, Reddy D, Sethi J, Forde A, Bhola-Stewart H, Smith A, Carton J, Lloyd J, Mannion E, Hosking-Jervis F, Cullen E, Cartwright R, Clark M, Arya M, Hrouda D, Winkler M, Tam H, Ahmed H. Likert vs. PI-RADS v2: A comparison of two radiological scoring systems for detection of clinically significant prostate cancer. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)31350-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Powell S, Tam H, Gold A, Marks D, Montalto D. B - 19Septo-Optic Dysplasia (de Morsier syndrome): Neuropsychological Sequelae in a Four-Year-Old. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.95] [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: 11/14/2022] Open
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Tien-Estrada J, Vieira A, Percy V, Millar K, Tam H, Russell K, Crockett M, Dart A, McGavock J. Determinants of scholarly project completion in a paediatric resident program in Canada. Paediatr Child Health 2018; 24:e98-e103. [PMID: 30996614 DOI: 10.1093/pch/pxy089] [Citation(s) in RCA: 4] [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] [Indexed: 11/12/2022] Open
Abstract
Background The primary aims of this study were to: 1) assess barriers and facilitators of completing scholarly projects from residents and faculty mentor perspectives, 2) determine the perceived value of new initiatives designed to support resident scholarly projects and 3) determine if these initiatives led to changes in resident publications. Design and Methods Between June and September 2014, we surveyed 18 paediatric residents and 41 faculty mentors regarding barriers to resident scholarly project completion and the value of new initiatives to support scholarly activity. We also tracked scientific publications by residents before and after implementation of these initiatives. Results The primary perceived barriers to research for residents and faculty were lack of protected time (64.3% versus 68.6%, respectively), lack of resident interest in scholarly activity (50.0% versus 60.0%, respectively) and lack of mentor motivation. Mentors and residents did not agree that lack of proper training in research (29% versus 54%, respectively) and faculty motivation (29% versus 17%, respectively) were barriers to completing a project. A dedicated research coordinator (71.4% versus 70.6%, respectively), a revised research curriculum (71.4% versus 41.2%, respectively) and works in progress sessions (50.0% versus 61.8%, respectively) were perceived as valuable initiatives to the program. These initiatives were not associated with changes in annual resident publication rates. Conclusions Lack of time and competing clinical training are primary barriers to scholarly project completion for residents in addition to a lack of motivation on the part of faculty members. Improving program support was perceived as positive changes to address these barriers but did not increase resident publication rates. The information provided here could be used to tailor future resident research programs and highlight the value of gathering input from resident and faculty when designing initiatives to enhance resident research productivity.
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Affiliation(s)
- Joan Tien-Estrada
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Anajara Vieira
- Resident Scholarly Activity Committee, Department: Resident Scholarly Activity Committee, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba
| | - Vanessa Percy
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Kyle Millar
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Herman Tam
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Kelly Russell
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.,Resident Scholarly Activity Committee, Department: Resident Scholarly Activity Committee, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba
| | - Maryanne Crockett
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.,Resident Scholarly Activity Committee, Department: Resident Scholarly Activity Committee, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba
| | - Allison Dart
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.,Resident Scholarly Activity Committee, Department: Resident Scholarly Activity Committee, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba
| | - Jonathan McGavock
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.,Resident Scholarly Activity Committee, Department: Resident Scholarly Activity Committee, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba
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Tam H, Simons FER, Simons E. Uptake of EpiPen and Allerject (Auvi-Q) epinephrine auto-injectors in Manitoba children. Ann Allergy Asthma Immunol 2017; 119:192-193. [PMID: 28801017 DOI: 10.1016/j.anai.2017.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/13/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Herman Tam
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - F Estelle R Simons
- Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elinor Simons
- Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
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Au K, Ngan R, Ng A, Poon D, Ng W, Lee V, Lee A, Cheng A, Tam H. Treatment outcomes of nasopharyngeal carcinoma in modern era after intensity modulated radiotherapy (IMRT) in Hong Kong: A report of 3328 patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx665.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tam H. Updates on early peanut introduction and prevention of peanut allergy. Paediatr Child Health 2017; 22:391-392. [DOI: 10.1093/pch/pxx120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tan B, Ngiam N, Holmin S, Tan D, Chia M, Wong L, Tam H, Sim T, Ooi S, Leong B, Seet R, Teoh H, Chan B, Sharma V, Yeo L. Improvement in door-to-needle times in patients with acute ischaemic stroke via the application of a simple stroke activation protocol. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3122] [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: 10/18/2022]
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Alsayegh MA, Alshamali H, Khadada M, Ciccolini A, Ellis AK, Quint D, Powley W, Lee L, Fiteih Y, Baksh S, Vliagoftis H, Gerega SK, Millson B, Charland K, Barakat S, Sun X, Jimenez R, Waserman S, FitzGerald MJ, Hébert J, Cognet-Sicé J, Renahan KE, Huq S, Chooniedass R, Sawyer S, Pasterkamp H, Becker A, Smith SG, Zhang S, Jayasundara K, Tacon C, Simidchiev A, Nadeau G, Gunsoy N, Mullerova H, Albers F, Kim YW, Shannon CP, Singh A, Neighbour H, Larché M, Tebbutt SJ, Klopp A, Vehling L, Becker AB, Subbarao P, Mandhane PJ, Turvey SE, Sears MR, Azad MB, Loewen K, Monchka B, Mahmud SM, Jong G‘, Longo C, Bartlett G, Ducharme FM, Schuster T, MacGibbon B, Barnett T, North ML, Brook J, Lee E, Omana V, Thiele J, Steacy LM, Evans G, Diamond M, Sussman GL, Amistani Y, Abiteboul K, Tenn MW, Yang C, Carlsten C, Conway EM, Mack D, Othman Y, Barber CM, Kalicinsky C, Burke AE, Messieh M, Nair P, Che CT, Douglas L, Liem J, Duan L, Miller C, Dupuis P, Connors LA, Fein MN, Shuster J, Hadi H, Polk B, Raje N, Labrosse R, Bégin P, Paradis L, Roches AD, Lacombe-Barrios J, Mishra S, Lacuesta G, Chiasson M, Haroon B, Robertson K, Issekutz T, Leddin D, Couban S, Connors L, Roos A, Kanani A, Chan ES, Schellenberg R, Rosenfield L, Cvetkovic A, Woodward K, Quirt J, Watson WTA, Castilho E, Sullivan JA, Temple B, Martin D, Cook VE, Mills C, Portales-Casamar E, Fu LW, Ho A, Zaltzman J, Chen L, Vadas P, Gabrielli S, Clarke A, Eisman H, Morris J, Joseph L, LaVieille S, Ben-Shoshan M, Graham F, Barnes C, Portnoy J, Stagg V, Simons E, Lefebvre D, Dai D, Mandhane P, Sears M, Tam H, Simons FER, Alotaibi D, Dawod B, Tunis MC, Marshall J, Desjardins M, Béland M, Lejtenyi D, Drolet JP, Lemire M, Tsoukas C, Noya FJ, Alizadehfar R, McCusker CT, Mazer BD, Maestre-Batlle D, Gunawan E, Rider CF, Bølling AK, Pena OM, Suez D, Melamed I, Hussain I, Stein M, Gupta S, Paris K, Fritsch S, Bourgeois C, Leibl H, McCoy B, Noel M, Yel L, Scott O, Reid B, Atkinson A, Kim VHD, Roifman CM, Grunebaum E, AlSelahi E, Aleman F, Oberle A, Trus M, Sussman G, Kanani AS, Chambenoi O, Chiva-Razavi S, Grodecki S, Joshi N, Menikefs P, Holt D, Pun T, Tworek D, Hanna R, Heroux D, Rosenberg E, Stiemsma L, Turvey S, Denburg J, Mill C, Teoh T, Zimmer P, Avinashi V, Paina M, Darwish Hassan AA, Oliveria JP, Olesovsky C, Gauvreau G, Pedder L, Keith PK, Plunkett G, Bolner M, Pourshahnazari P, Stark D, Vostretsova K, Moses A, Wakeman A, Singer A, Gerstner T, Abrams E, Johnson SF, Woodgate RL. Canadian Society of Allergy and Clinical Immunology annual scientific meeting 2016. Allergy Asthma Clin Immunol 2017. [PMCID: PMC5390240 DOI: 10.1186/s13223-017-0192-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tam H, Zhang W, Infante D, Parchment N, Sacks M, Vyavahare N. Fixation of Bovine Pericardium-Based Tissue Biomaterial with Irreversible Chemistry Improves Biochemical and Biomechanical Properties. J Cardiovasc Transl Res 2017; 10:194-205. [PMID: 28213846 DOI: 10.1007/s12265-017-9733-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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: 11/30/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
Bioprosthetic heart valves (BHVs), derived from glutaraldehyde crosslinked (GLUT) porcine aortic valve leaflets or bovine pericardium (BP), are used to replace defective heart valves. However, valve failure can occur within 12-15 years due to calcification and/or progressive structural degeneration. We present a novel fabrication method that utilizes carbodiimide, neomycin trisulfate, and pentagalloyl glucose crosslinking chemistry (TRI) to better stabilize the extracellular matrix of BP. We demonstrate that TRI-treated BP is more compliant than GLUT-treated BP. GLUT-treated BP exhibited permanent geometric deformation and complete alteration of apparent mechanical properties when subjected to induced static strain. TRI BP, on the other hand, did not exhibit such permanent geometric deformations or significant alterations of apparent mechanical properties. TRI BP also exhibited better resistance to enzymatic degradation in vitro and calcification in vivo when implanted subcutaneously in juvenile rats for up to 30 days.
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Affiliation(s)
- H Tam
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - W Zhang
- Department of Biomedical Engineering, University of Texas, Austin, TX, USA
| | - D Infante
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - N Parchment
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - M Sacks
- Department of Biomedical Engineering, University of Texas, Austin, TX, USA
| | - N Vyavahare
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA.
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Tam H, Simons FER, Simons E. Dispensing Patterns of Epinephrine Auto-Injectors for Treatment of Anaphylaxis in Manitoba Children and Uptake of Allerject (Auvi-Q). J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tam H, Calderon MA, Manikam L, Nankervis H, García Núñez I, Williams HC, Durham S, Boyle RJ. Specific allergen immunotherapy for the treatment of atopic eczema. Cochrane Database Syst Rev 2016; 2:CD008774. [PMID: 26871981 PMCID: PMC8761476 DOI: 10.1002/14651858.cd008774.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Specific allergen immunotherapy (SIT) is a treatment that may improve disease severity in people with atopic eczema (AE) by inducing immune tolerance to the relevant allergen. A high quality systematic review has not previously assessed the efficacy and safety of this treatment. OBJECTIVES To assess the effects of specific allergen immunotherapy (SIT), including subcutaneous, sublingual, intradermal, and oral routes, compared with placebo or a standard treatment in people with atopic eczema. SEARCH METHODS We searched the following databases up to July 2015: the Cochrane Skin Group Specialised Register, CENTRAL in the Cochrane Library (Issue 7, 2015), MEDLINE (from 1946), EMBASE (from 1974), LILACS (from 1982), Web of Science™ (from 2005), the Global Resource of EczemA Trials (GREAT database), and five trials databases. We searched abstracts from recent European and North American allergy meetings and checked the references of included studies and review articles for further references to relevant trials. SELECTION CRITERIA Randomised controlled trials (RCTs) of specific allergen immunotherapy that used standardised allergen extracts in people with AE. DATA COLLECTION AND ANALYSIS Two authors independently undertook study selection, data extraction (including adverse effects), assessment of risk of bias, and analyses. We used standard methodological procedures expected by Cochrane. MAIN RESULTS We identified 12 RCTs for inclusion in this review; the total number of participants was 733. The interventions included SIT in children and adults allergic to either house dust mite (10 trials), grass pollen, or other inhalant allergens (two trials). They were administered subcutaneously (six trials), sublingually (four trials), orally, or intradermally (two trials). Overall, the risk of bias was moderate, with high loss to follow up and lack of blinding as the main methodological concern.Our primary outcomes were 'Participant- or parent-reported global assessment of disease severity at the end of treatment'; 'Participant- or parent-reported specific symptoms of eczema, by subjective measures'; and 'Adverse events, such as acute episodes of asthma or anaphylaxis'. SCORing Atopic Dermatitis (SCORAD) is a means of measuring the effect of atopic dermatitis by area (A); intensity (B); and subjective measures (C), such as itch and sleeplessness, which we used.For 'Participant- or parent-reported global assessment of disease severity at the end of treatment', one trial (20 participants) found improvement in 7/9 participants (78%) treated with the SIT compared with 3/11 (27%) treated with the placebo (risk ratio (RR) 2.85, 95% confidence interval (CI) 1.02 to 7.96; P = 0.04). Another study (24 participants) found no difference: global disease severity improved in 8/13 participants (62%) treated with the SIT compared with 9/11 (81%) treated with the placebo (RR 0.75, 95% CI 0.45 to 1.26; P = 0.38). We did not perform meta-analysis because of high heterogeneity between these two studies. The quality of the evidence was low.For 'Participant- or parent-reported specific symptoms of eczema, by subjective measures', two trials (184 participants) did not find that the SIT improved SCORAD part C (mean difference (MD) -0.74, 95% CI -1.98 to 0.50) or sleep disturbance (MD -0.49, 95% CI -1.03 to 0.06) more than placebo. For SCORAD part C itch severity, these two trials (184 participants) did not find that the SIT improved itch (MD -0.24, 95% CI -1.00 to 0.52). One other non-blinded study (60 participants) found that the SIT reduced itch compared with no treatment (MD -4.20, 95% CI -3.69 to -4.71) and reduced the participants' overall symptoms (P < 0.01), but we could not pool these three studies due to high heterogeneity. The quality of the evidence was very low.Seven trials reported systemic adverse reactions: 18/282 participants (6.4%) treated with the SIT had a systemic reaction compared with 15/210 (7.1%) with no treatment (RR 0.78, 95% CI 0.41 to 1.49; the quality of the evidence was moderate). The same seven trials reported local adverse reactions: 90/280 participants (32.1%) treated with the SIT had a local reaction compared with 44/204 (21.6%) in the no treatment group (RR 1.27, 95% CI 0.89 to 1.81). As these had the same study limitations, we deemed the quality of the evidence to also be moderate.Of our secondary outcomes, there was a significant improvement in 'Investigator- or physician-rated global assessment of disease severity at the end of treatment' (six trials, 262 participants; RR 1.48, 95% CI 1.16 to 1.88). None of the studies reported our secondary outcome 'Parent- or participant-rated eczema severity assessed using a published scale', but two studies (n = 184), which have been mentioned above, used SCORAD part C, which we included as our primary outcome 'Participant- or parent-reported specific symptoms of eczema, by subjective measures'.Our findings were generally inconclusive because of the small number of studies. We were unable to determine by subgroup analyses a particular type of allergen or a particular age or level of disease severity where allergen immunotherapy was more successful. We were also unable to determine whether sublingual immunotherapy was associated with more local adverse reactions compared with subcutaneous immunotherapy. AUTHORS' CONCLUSIONS Overall, the quality of the evidence was low. The low quality was mainly due to the differing results between studies, lack of blinding in some studies, and relatively few studies reporting participant-centred outcome measures. We found limited evidence that SIT may be an effective treatment for people with AE. The treatments used in these trials were not associated with an increased risk of local or systemic reactions. Future studies should use high quality allergen formulations with a proven track record in other allergic conditions and should include participant-reported outcome measures.
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Affiliation(s)
- Herman Tam
- Imperial College LondonSection of Paediatrics, Division of Infectious Diseases, Department of MedicineWright Fleming BuildingNorfolk PlaceLondonUKW2 1PG
| | - Moises A Calderon
- National Heart and Lung Institute, Imperial College LondonAllergy and Clinical Immunology, Section of Inflammation, Repair and DevelopmentLondonUKSW3 6LY
| | - Logan Manikam
- Imperial College LondonSection of Paediatrics, Division of Infectious Diseases, Department of MedicineWright Fleming BuildingNorfolk PlaceLondonUKW2 1PG
| | - Helen Nankervis
- The University of Nottinghamc/o Cochrane Skin GroupA103, King's Meadow CampusLenton LaneNottinghamUKNG7 2NR
| | - Ignacio García Núñez
- Hospital Universitario Carlos HayaServicio de AlergologíaPlaza Del Hospital Civil S/NMálagaSpain29009
| | - Hywel C Williams
- The University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
| | - Stephen Durham
- National Heart and Lung Institute, Imperial College LondonAllergy and Clinical Immunology, Section of Inflammation, Repair and DevelopmentLondonUKSW3 6LY
| | - Robert J Boyle
- Imperial College LondonSection of Paediatrics, Division of Infectious Diseases, Department of MedicineWright Fleming BuildingNorfolk PlaceLondonUKW2 1PG
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Islam S, Yin R, Riddell A, Tam H, Jhaveri K, Koh DM. Increase in lesion enhancement on gadoxetic acid enhanced MRI is associated with complete response to neoadjuvant chemotherapy in colorectal liver metastases. Cancer Imaging 2015. [PMCID: PMC4601739 DOI: 10.1186/1470-7330-15-s1-p3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sadarangani M, Tam H, McDonald S, Fidler S, Foster C. Response to Hepatitis B virus vaccine in young adults with perinatally acquired HIV infection. J Infect 2015; 71:495-7. [PMID: 26072139 DOI: 10.1016/j.jinf.2015.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 02/08/2023]
Affiliation(s)
- Manish Sadarangani
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and NIHR Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
| | - Herman Tam
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Sarah Fidler
- Imperial College Healthcare NHS Trust, London, UK
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van West H, Hodgson B, Parent E, Samuel S, Hodgson B, Ferland C, Soroceanu A, Soroceanu A, Protopsaltis T, Protopsaltis T, Radovanovic I, Amritanand R, Shamji M, Haugo K, Malham G, Jarzem P, Rampersaud Y, Tomkins-Lane C, Manson N, Malham G, Rampersaud Y, Malham G, Malham G, King V, Goldstein C, Fisher C, Fehlings M, Fisher C, Wong E, Sardar Z, Christie S, Patel A, Pinkoski C, Ahn H, Drew B, Dvorak M, Pezeshki P, Altaf F, Wilde P, Rampersaud Y, Sparrey C, Tetreault L, Fehlings M, Tetreault L, Rampersaud R, Jack A, Johnstone R, Fernandes A, Urquhart J, Morokoff A, Manson N, Tomkins-Lane C, Phan P, Evaniew N, Shamji M, Manson J, Rampersaud Y, Nault ML, St-Pierre GH, Larouche J, Lewis S, Wilgenbusch C, Lewis S, Rampersaud Y, Johnson R, Cushnie D, Sridharan S, Street J, Gregg C, Missiuna P, Abraham E, Abraham E, Manson N, Huang E, Passmore S, Mac-Thiong JM, Labelle H, Moulin D, Turgeon I, Roy-Beaudry M, Bourassa N, Petit Y, Parent. S, Chabot S, Westover L, Hill D, Moreau M, Hedden D, Lou E, Adeeb. S, Smith M, Bridge C, Hsu B, Gray. R, Group PORSCHES, Saran N, Mac-Thiong JM, Stone L, Ouellet. J, Protopsaltis T, Terran J, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Schwab F, Lafage V, Protopsaltis T, Ames C, Bess S, Smith J, Errico. T, Schwab F, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage. V, Terran J, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Kim HJ, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Urquhart J, Gananapathy V, Siddiqi F, Gurr K, Bailey C, Ravi B, David K, Rampersaud. R, Tu Y, Salter. M, Nichol H, Fourney D, Kelly. M, Parker R, Ellis N, Blecher C, Chow F, Claydon. M, Sardar Z, Alexander D, Oxner W, Plessis SD, Yee A, Wai. E, Lewis S, Davey J, Gandhi R, Mahomed. N, Hu R, Thomas K, Hepler C, Choi K, Rowed K, Haig. A, Lam. K, Parker R, Blecher C, Seex. K, Perruccio A, Gandhi R, Program. UHNA, Ellis N, Parker R, Goss B, Blecher C, Ballok. Z, Parker R, Ellis N, Chan P, Varma. D, Swart A, Winder M, Varga PP, Gokaslan Z, Boriani S, Luzzati A, Rhines L, Fisher C, Chou D, Williams R, Dekutoski M, Quraishi N, Bettegowda C, Kawahara N, Fehlings. M, Versteeg A, Boriani S, Varga PP, Dekutoski M, Luzzati A, Gokaslan Z, Williams R, Reynolds J, Fehlings M, Bettegowda C, Rhines. L, Zamorano J, Nater A, Tetrault L, Varga P, Gokaslan Z, Boriani S, Fisher C, Rhines L, Bettegowda C, Kawahara N, Chou. D, Fehlings M, Kopjar B, Vaccaro A, Arnold P, Schuster J, Finkelstein J, Rhines L, Dekutoski M, Gokaslan Z, France. J, Whyne C, Singh D, Ford. M, Aldebeyan W, Ouellet J, Steffen T, Beckman L, Weber M, Jarzem. P, Kwon B, Ahn H, Bailey C, Fehlings M, Fourney D, Gagnon D, Tsai E, Tsui D, Parent S, Chen J, Dvorak M, Noonan V, Rivers C, Network RHSCIR, Batke J, Lenehan B, Fisher C, Dvorak M, Street. J, Fox R, Nataraj A, Bailey C, Christie S, Duggal N, Fehlings M, Finkelstein J, Fourney D, Hurlbert R, Kwon B, Townson A, Tsai E, Attabib N, Chen J, Dvorak M, Noonan V, Rivers C, Network. RHSCIR, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Kwon B, Parent S, Tsai E, Dvorak M, Noonan V, Rivers C, Shen T, Network. RHSCIR, Fisher C, Kwon B, Drew B, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Mac-Thiong JM, Parent S, Tsai E, Fallah N, Noonan V, Rivers C, Network RHSCIR, Davidson S, McCann C, Akens M, Murphy K, Whyne C, Sherar M, Yee. A, Belanger L, Ronco J, Dea N, Paquette S, Boyd M, Street J, Fisher C, Dvorak M, Kwon B, Gonzalvo A, Fitt G, Liew S, de la Harpe D, Turner P, Rogers M, Bidos A, Fanti C, Young B, Drew B, Puskas. D, Tam H, Manansala S, Nosov V, Delva M, Alshafai N, Kopjar B, Tan G, Arnold P, Fehlings. M, Kopjar B, Arnold P, Ibrahim A, Tetrault. L, Kopjar B, Arnold P, Fehlings. M, Sundararajan K, Eng. S, St-Pierre G, Nataraj A, Urquhart J, Rosas-Arellano P, Tallon C, Gurr K, Siddiqi F, Bailey S, Bailey C, Sundararajan K, Rampersaud. R, Rosa-Arellano P, Tallon C, Bailey S, Gurr K, Bailey. C, Parker R, Milili L, Goss B, Malham. G, Green A, McKeon M, Abraham. E, Lafave L, Parnell J, Rempel J, Moriartey S, Andreas Y, Wilson P, Hepler C, Ray H, Hu. R, Ploumis A, Hess K, Wood. K, Yarascavitch B, Madden K, Ghert M, Drew B, Bhandari M, Kwok D, Tu YS, Salter. M, Hadlow. A, Tso P, Walker K, Lewis S, Davey J, Mahomed N, Coyte. P, Mac-Thiong JM, Roy-Beaudry M, Turgeon I, Labelle H, deGuise J, Parent. S, Jack A, Fox R, Nataraj A, Paquette S, Leroux T, Yee A, Ahn H, Broad R, Fisher C, Hall H, Nataraj A, Hedden D, Christie S, Carey T, Mehta V, Fehlings M, Wadey. V, Dear T, Hashem. M, Fourney D, Goldstein S, Bodrogi A, Lipkus M, Dear T, Keshen S, Veillette C, Gandhi R, Adams D, Briggs N, Davey J, Fehlings M, Lau J, Lewis S, Magtoto R, Marshall K, Massicotte E, Ogilvie-Harris D, Sarro A, Syed K, Mohamed. N, Perera S, Taha A, Urquhart J, Gurr K, Siddiqi F, Bailey C, Thomas K, Cho R, Swamy G, Power C, Henari S, Lenehan. B, McIntosh G, Hall H, Hoffman. C, Karachi A, Pazionis T, AlShaya O, Green A, McKeon M, Manson. N, Green A, McKeon M, Manson. N, Green A, McKeon M, Murray J, Abraham. E, Thomas K, Suttor S, Goyal T, Littlewood J, Bains I, Bouchard J, Hu R, Jacobs B, Cho R, Swamy G, Johnson M, Pelleck V, Amad Y, Ramos E, Glazebrook C. Combined Spine Conference of the Canadian Spine Society New Zealand Orthopaedic Spine Society, Spine Society of Australia: Fairmont Château Lake Louise, Lake, Louise, Alberta, Tuesday, Feb. 25 to Saturday, Mar. 1, 20141.1.01 The use of suspension radiographs to predict LIV tilt.1.1.02 Surgical correction of adolescent idiopathic scoliosis without fusion: an animal model.1.1.03 Are full torso surface topography postural measurements more sensitive to change than back only parameters in adolescents with idiopathic scoliosis and a main thoracic curve?1.2.04 Restoration of thoracic kyphosis in adolescent idiopathic kyphosis: comparative radiographic analysis of round versus rail rods.1.2.05 Scoliosis surgery in spastic quadriplegic cerebral palsy: Is fusion to the pelvis always necessary? A 4–18-year follow-up study.1.2.06 Identification and validation of pain-related biomarkers surrounding spinal surgery in adolescents.1.3.07 Cervical sagittal deformity develops after PJK in adult throacolumbar deformity correction: radiographic analysis using a novel global sagittal angular parameter, the CTPA.1.3.08 Impact of obesity on complications and patient-reported outcomes in adult spinal deformity surgery.1.3.09 The T1 pelvic angle, a novel radiographic measure of sagittal deformity, accounts for both pelvic retroversion and truncal inclination and correlates strongly with HRQOL.1.4.10 Determining cervical sagittal deformity when it is concurrent with thoracolumbar deformity.1.4.11 The influence of sagittal balance and pelvic parameters on the outcome of surgically treated patients with degenerative spondylolisthesis.1.4.12 Predictors of degenerative spondylolisthesis and loading translation in surgical lumbar spinal stenosis patients.2.1.13 Mechanical allodynia following disc herniation requires intraneural macrophage infiltration and can be blocked by systemic selenium delivery or attenuation of BDNF activity.2.1.14 The effect of alanyl-glutamine on epidural fibrosis in a rat laminectomy model.2.1.15 Anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2: a prospective study of complications.2.2.16 2-year results of a Canadian, multicentre, blinded, pilot study of a novel peptide in promoting lumbar spine fusion.2.2.17 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: long-term change in health-related quality of life.2.2.18 Changes in objectively measured walking performance, function, and pain following surgery for spondylolisthesis and lumbar spinal stenosis.2.3.19 A prospective multicentre observational data-monitored study of minimally invasive fusion to treat degenerative lumbar disorders: complications and outcomes at 1-year follow-up.2.3.20 Assessment and classification of subsidence in lateral interbody fusion using serial computed tomography.2.3.21 Predictors of willingness to undergo spinal and orthopaedic surgery after surgical consultation.2.4.22 Indirect foraminal decompression is independent of facet arthropathy in extreme lateral interbody fusion.2.4.23 Cervical artificial disc replacement with ProDisc-C: clinical and radiographic outcomes with long-term follow-up.2.4.24 Tantalum trabecular metal implants in anterior cervical corpectomy and fusion.3.1.25 Hemangiomas of the spine: results of surgical management and prognostic variables for local recurrence and mortality in a multicentre study.3.1.26 Chondrosarcomas of the spine: prognostic variables for local recurrence and mortality in a multicentre study.3.1.27 Risk factors for recurrence of surgically treated spine schwannomas: analysis of 169 patients from a multicentre international database.3.2.28 Survival pattern and the effect of surgery on health related quality of life and functional outcome in patients with metastatic epidural spinal cord compression from lung cancer — the AOSpine North America prospective multicentre study.3.2.29 A biomechanical assessment of kyphoplasty as a stand-alone treatment in a human cadaveric burst fracture model.3.2.30 What is safer in incompetent vertebrae with posterior wall defects, kyphoplasty or vertebroplasty: a study in vertebral analogs.3.3.31 Feasibility of recruiting subjects for acute spinal cord injury (SCI) clinical trials in Canada.3.3.32 Prospective analysis of adverse events in elderly patients with traumatic spinal cord injury.3.3.33 Does traction before surgery influence time to neural decompression in patients with spinal cord injury?3.4.34 Current treatment of individuals with traumatic spinal cord injury: Do we need age-specific guidelines?3.4.35 Current surgical practice for traumatic spinal cord injury in Canada.3.4.36 The importance of “time to surgery” for traumatic spinal cord injured patients: results from an ambispective Canadian cohort of 949 patients.3.5.37 Assessment of a novel coil-shaped radiofrequency probe in the porcine spine.3.5.38 The effect of norepinephrine and dopamine on cerebrospinal fluid pressure after acute spinal cord injury.3.5.39 The learning curve of pedicle screw placement: How many screws are enough?4.1.40 Preliminary report from the Ontario Inter-professional Spine Assessment and Education Clinics (ISAEC).4.1.41 A surrogate model of the spinal cord complex for simulating bony impingement.4.1.42 Clinical and surgical predictors of specific complications following surgery for the treatment of degenerative cervical myelopathy: results from the multicentre, prospective AOSpine international study on 479 patients.4.2.43 Outcomes of surgical management of cervical spondylotic myelopathy: results of the prospective, multicentre, AOSpine international study in 479 patients.4.2.44 A clinical prediction rule for clinical outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international AOSpine prospective multicentre data set of 757 subjects.4.2.45 The prevalence and impact of low back and leg pain among aging Canadians: a cross-sectional survey.4.3.46 Adjacent segment pathology: Progressive disease course or a product of iatrogenic fusion?4.3.47 Natural history of degenerative lumbar spondylolisthesis in patients with spinal stenosis.4.3.48 Changes in self-reported clinical status and health care utilization during wait time for surgical spine consultation: a prospective observational study.4.3.49 The Canadian surgical wait list for lumbar degenerative spinal stenosis has a detrimental effect on patient outcomes.4.3.50 Segmental lordosis is independent of interbody cage position in XLIF.4.3.51 Elevated patient BMI does not negatively affect self-reported outcomes of thoracolumbar surgery.1.5.52 The Spinal Stenosis Pedometer and Nutrition Lifestyle Intervention (SSPANLI): development and pilot.1.5.53 Study evaluating the variability of surgical strategy planning for patients with adult spinal deformity.1.5.54 Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality.1.5.55 Peripheral hypersensitivity to subthreshold stimuli persists after resolution of acute experimental disc-herniation neuropathy.1.5.56 Radiation induced lumbar spinal osteonecrosis: case report and literature review.1.5.57 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: Part 2 — estimated lifetime incremental cost-utility ratios.1.5.58 A predictive model of progression for adolescent idiopathic scoliosis based on 3D spine parameters at first visit.1.5.59 Development of a clinical prediction model for surgical decision making in patients with degenerative lumbar spine disease.2.5.60 Canadian spine surgery fellowship education: evaluating opportunity in developing a nationally based training curriculum.2.5.61 Pedicle subtraction osteotomy for severe proximal thoracic junctional kyphosis.2.5.62 A comparison of spine surgery referrals triaged through a multidisciplinary care pathway versus conventional referrals.2.5.63 Results and complications of posterior-based 3 column osteotomies in patients with previously fused spinal deformities.2.5.64 Orthopaedic Surgical AdVerse Event Severity (Ortho-SAVES) system: identifying opportunities for improved patient safety and resource utilization.2.5.65 Spontaneous spinal extra-axial haematomas — surgical experience in Otago and Southland 2011–2013.2.5.66 Obesity and spinal epidural lipomatosis in cauda equina syndrome.2.5.67 Factors affecting restoration of lumbar lordosis in adult degenerative scoliosis patients treated with lateral trans-psoas interbody fusion.3.6.68 Systematic review of complications in spinal surgery: a comparison of retrospective and prospective study design.3.6.69 Postsurgical rehabilitation patients have similar fear avoidance behaviour levels as those in nonoperative care.3.6.70 Outcomes of surgical treatment of adolescent spondyloptosis: a case series.3.6.71 Surgical success in primary versus revision thoracolumbar spine surgery.3.6.72 The effect of smoking on subjective patient outcomes in thoracolumbar surgery.3.6.73 Modelling patient recovery to predict outcomes following elective thoracolumbar surgery for degenerative pathologies.3.6.74 Outcomes from trans-psoas versus open approaches in the treatment of adult degenerative scoliosis.3.6.75 Lumbar spinal stenosis and presurgical assessment: the impact of walking induced strain on a performance-based outcome measure. Can J Surg 2014. [DOI: 10.1503/cjs.005614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tam H, Calderon MA, Boyle RJ. Efficacy of allergen-specific immunotherapy for patients with atopic dermatitis. J Allergy Clin Immunol 2013; 132:1012-3. [DOI: 10.1016/j.jaci.2013.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 07/12/2013] [Indexed: 11/24/2022]
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Erken O, Sikivie P, Tam H, Yang Q. Axion dark matter and cosmological parameters. Phys Rev Lett 2012; 108:061304. [PMID: 22401054 DOI: 10.1103/physrevlett.108.061304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 09/09/2011] [Indexed: 05/31/2023]
Abstract
We observe that photon cooling after big bang nucleosynthesis but before recombination can remove the conflict between the observed and theoretically predicted value of the primordial abundance of ^{7}Li. Such cooling is ordinarily difficult to achieve. However, the recent realization that dark matter axions form a Bose-Einstein condensate provides a possible mechanism because the much colder axions may reach thermal contact with the photons. This proposal predicts a high effective number of neutrinos as measured by the cosmic microwave anisotropy spectrum.
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Affiliation(s)
- O Erken
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
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Pollock KM, Tam H, Grass L, Bowes S, Cooke GS, Pareek M, Montamat-Sicotte D, Kapembwa M, Taylor GP, Lalvani A. Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study. BMJ Open 2012; 2:e000762. [PMID: 22382123 PMCID: PMC3293130 DOI: 10.1136/bmjopen-2011-000762] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND HIV is the most important risk factor for progression of latent tuberculosis infection (LTBI) to active tuberculosis (TB). Detection and treatment of LTBI is necessary to reduce the increasing burden of TB in the UK, but a unified LTBI screening approach has not been adopted. OBJECTIVE To compare the effectiveness of a TB risk-focused approach to LTBI screening in the HIV-positive population against current UK National Institute for Health and Clinical Excellence (NICE) guidance. DESIGN Prospective cohort study. SETTING Two urban HIV treatment centres in London, UK. PARTICIPANTS 114 HIV-infected individuals with defined TB risk factors were enrolled prospectively as part of ongoing studies into HIV and TB co-infection. OUTCOME MEASURES The yield and case detection rate of LTBI cases within the research study were compared with those generated by the NICE criteria. RESULTS 17/114 (14.9%, 95% CI 8.3 to 21.5) had evidence of LTBI. Limiting screening to those meeting NICE criteria for the general population (n=43) would have detected just over half of these, 9/43 (20.9%, 95% CI 8.3 to 33.5) and those meeting criteria for HIV co-infection (n=74) would only have captured 8/74(10.8%, 95% CI 3.6 to 18.1) cases. The case detection rates from the study and NICE approaches were not significantly different. LTBI was associated with the presence of multiple TB risk factors (p=0.002). CONCLUSION Adoption of a TB risk-focused screening algorithm that does not use CD4 count stratification could prevent more cases of TB reactivation, without changing the case detection rate. These findings should be used to inform a large-scale study to create unified guidelines.
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Affiliation(s)
- Katrina M Pollock
- Tuberculosis Research Unit, National Heart and Lung Institute, Imperial College London, London, UK
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Kleindienst A, Schlaffer S, Tam H, Verbalis JG, Buchfelder M. A rat model of cerebral salt wasting. Exp Clin Endocrinol Diabetes 2008. [DOI: 10.1055/s-0028-1096329] [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: 10/20/2022]
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Ao T, Ping Y, Widmann K, Price DF, Lee E, Tam H, Springer PT, Ng A. Optical properties in nonequilibrium phase transitions. Phys Rev Lett 2006; 96:055001. [PMID: 16486941 DOI: 10.1103/physrevlett.96.055001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Revised: 04/04/2005] [Indexed: 05/06/2023]
Abstract
An open question about the dynamical behavior of materials is how phase transition occurs in highly nonequilibrium systems. One important class of study is the excitation of a solid by an ultrafast, intense laser. The preferential heating of electrons by the laser field gives rise to initial states dominated by hot electrons in a cold lattice. Using a femtosecond laser pump-probe approach, we have followed the temporal evolution of the optical properties of such a system. The results show interesting correlation to nonthermal melting and lattice disordering processes. They also reveal a liquid-plasma transition when the lattice energy density reaches a critical value.
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Affiliation(s)
- T Ao
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
We report on the experimental observation of Fermi-Pasta-Ulam (FPU) recurrence in a passively mode-locked fiber ring laser. The spectral sidebands of a CW component generated due to the modulation instability grow up periodically as a result of the reversibility of the effect, demonstrating the existence of FPU recurrence.
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Yu Y, Tam H, Chung W, Demokan MS. Fiber Bragg grating sensor for simultaneous measurement of displacement and temperature. Opt Lett 2000; 25:1141-1143. [PMID: 18066147 DOI: 10.1364/ol.25.001141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A new approach to measuring displacement and temperature simultaneously by use of a specially designed isosceles triangular cantilevered beam as a strain agent is demonstrated. A fiber Bragg grating epoxied onto the beam surface is experimentally demonstrated to have a temperature sensitivity of ~0.113 nm/ degrees C below 60 degrees C and a displacement sensitivity of 9.24x10(-2) nm/mm .
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