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Liu D, Wang M, Murthy V, McNamara DM, Nguyen TTL, Philips TJ, Vyas H, Gao H, Sahni J, Starling RC, Cooper LT, Skime MK, Batzler A, Jenkins GD, Barlera S, Pileggi S, Mestroni L, Merlo M, Sinagra G, Pinet F, Krejčí J, Chaloupka A, Miller JD, de Groote P, Tschumperlin DJ, Weinshilboum RM, Pereira NL. Myocardial Recovery in Recent Onset Dilated Cardiomyopathy: Role of CDCP1 and Cardiac Fibrosis. Circ Res 2023; 133:810-825. [PMID: 37800334 PMCID: PMC10746262 DOI: 10.1161/circresaha.123.323200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is a major cause of heart failure and carries a high mortality rate. Myocardial recovery in DCM-related heart failure patients is highly variable, with some patients having little or no response to standard drug therapy. A genome-wide association study may agnostically identify biomarkers and provide novel insight into the biology of myocardial recovery in DCM. METHODS A genome-wide association study for change in left ventricular ejection fraction was performed in 686 White subjects with recent-onset DCM who received standard pharmacotherapy. Genome-wide association study signals were subsequently functionally validated and studied in relevant cellular models to understand molecular mechanisms that may have contributed to the change in left ventricular ejection fraction. RESULTS The genome-wide association study identified a highly suggestive locus that mapped to the 5'-flanking region of the CDCP1 (CUB [complement C1r/C1s, Uegf, and Bmp1] domain containing protein 1) gene (rs6773435; P=7.12×10-7). The variant allele was associated with improved cardiac function and decreased CDCP1 transcription. CDCP1 expression was significantly upregulated in human cardiac fibroblasts (HCFs) in response to the PDGF (platelet-derived growth factor) signaling, and knockdown of CDCP1 significantly repressed HCF proliferation and decreased AKT (protein kinase B) phosphorylation. Transcriptomic profiling after CDCP1 knockdown in HCFs supported the conclusion that CDCP1 regulates HCF proliferation and mitosis. In addition, CDCP1 knockdown in HCFs resulted in significantly decreased expression of soluble ST2 (suppression of tumorigenicity-2), a prognostic biomarker for heart failure and inductor of cardiac fibrosis. CONCLUSIONS CDCP1 may play an important role in myocardial recovery in recent-onset DCM and mediates its effect primarily by attenuating cardiac fibrosis.
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Affiliation(s)
- Duan Liu
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Min Wang
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Vishakantha Murthy
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine. Mayo Clinic, Rochester, MN, USA
| | | | | | - Thanh Thanh L. Nguyen
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Trudy J. Philips
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Hridyanshu Vyas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Huanyao Gao
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Jyotan Sahni
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Leslie T. Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Michelle K. Skime
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Anthony Batzler
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Simona Barlera
- Department of Cardiovascular Research, Istituto di Ricovero e Cura a Carattere Scientifico–Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Silvana Pileggi
- Department of Cardiovascular Research, Istituto di Ricovero e Cura a Carattere Scientifico–Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Luisa Mestroni
- Cardiovascular Institute, University of Colorado School of Medicine, Aurora, CO, USA
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Italy
| | - Florence Pinet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167, Lille, France
| | - Jan Krejčí
- St. Anne’s University Hospital and Masaryk University, Brno, Czech Republic
| | - Anna Chaloupka
- St. Anne’s University Hospital and Masaryk University, Brno, Czech Republic
| | - Jordan D. Miller
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Pascal de Groote
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167, Lille, France
- CHU Lille, Service de Cardiologie, Lille, France
| | | | - Richard M. Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Naveen L. Pereira
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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Castrichini M, Agboola KM, Vyas H, Abou Ezzeddine OF, Siontis KC, Giudicessi JR, Rosenbaum AN, Pereira NL. Cardiac Sarcoidosis Mimickers: Genetic Testing in Undifferentiated Inflammatory Cardiomyopathies. Circ Genom Precis Med 2023; 16:478-479. [PMID: 37401491 DOI: 10.1161/circgen.123.004099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Affiliation(s)
| | - Kolade M Agboola
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Hridyanshu Vyas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | | | | | | | - Naveen L Pereira
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Wang M, Nair A, Smith B, Nguyen T, Kehoe N, Vyas H, Liu D, Murthy V, Yip D, Steidley D, Clavell A, Kushwaha S, Park W, Eisen H, Stegall M, Pereira N. Transcriptomic Profiling of Acute Cellular Rejection after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1550] [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: 04/05/2023] Open
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Vyas H, Boucher L, Figueiral M, Pereira NL. PHENOTYPIC FEATURES AND OUTCOMES OF PATIENTS WITH BAG3 CARDIOMYOPATHY: A COMPARISON WITH TTN CARDIOMYOPATHY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00825-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Vyas H, Nebhinani N, Suthar N, Sharma P. Vascular age, cardiovascular disease risk factors, and hematological parameters in patients with Schizophrenia: An exploratory study. J Neurosci Rural Pract 2023; 14:149-153. [PMID: 36891120 PMCID: PMC9945140 DOI: 10.25259/jnrp-2022-7-6] [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: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Patients with schizophrenia have shortened life expectancy due to greater cardiovascular disease (CVD) risk. Due to sparse data, index study was planned to assess the CVD risk factors, vascular age (VA), and hematological parameters in patients with schizophrenia and the concordance between Framingham Risk Score (FRS) for lipids and body mass index (BMI) (FRSLIPIDS and FRSBMI). Materials and Methods Patients with schizophrenia (n = 53) were evaluated for the presence of metabolic syndrome (MS) using the modified NCEP ATP III criteria, along with their functionality, illness severity, physical activity and nutritional score, FRSLIPIDS and FRSBMI, and hematological parameters. Results Prevalence of MS was 39.6%; in addition, 47% of patients were at risk for developing MS as they fulfilled one or two components of MS criteria and 56% of patients were obese. BMI, obesity, and RBC count were found as significant correlates for MS. CVD risk (FRS) median score (3.10) was comparable for BMI and lipid criteria along with significant correlation for FRSLIPIDS and FRSBMI (r = 0.555, P < 0.001). Conclusion VA and 10-year CVD risk (FRS for BMI and lipid criteria) represent easier way to communicate with the patients and caregivers and also to guide for comprehensive treatment plan, appropriate nutrition, physical activity, and cardiometabolic screening.
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Affiliation(s)
- Hridyanshu Vyas
- Department of Cardiovascular Research, Mayo Clinic, Rochester, United States
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Navratan Suthar
- Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Science, Jodhpur, Rajasthan, India
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Coppola J, Gupta D, Lopez-Colon D, DeGroff C, Vyas H. Elevated Aortic Stiffness After Pediatric Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1136] [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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Abu-Rustum RS, Moumne O, Egerman R, Vyas H. Prenatal diagnosis of double-outlet left atrium. Ultrasound Obstet Gynecol 2021; 58:950-953. [PMID: 34096666 DOI: 10.1002/uog.23704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Affiliation(s)
- R S Abu-Rustum
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - O Moumne
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - R Egerman
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
- Department of Internal Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - H Vyas
- Division of Cardiology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
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Shankar V, Haritha C, Shreya VS, Parekh S, Kumar R, Karthikayan A, Bhavya P, Vyas H, Bhange A. Post SRS Target Diffusion Metrics for Response Prognostication in Idiopathic Trigeminal Neuralgia. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.440] [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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Shreya V, Shankar V, Parekh S, Haritha C, Kumar R, Karthikayan A, Adhityan R, Bhavya P, Vyas H, Bhange A. Post SRS Reversal of Masticator Muscles Atrophy in Idiopathic Trigeminal Neuralgia. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shreya VS, Shankar V, Raja T, Haritha C, Kumar R, Karthikayan A, Bhavya P, Bhange A, Vyas H. Frameless Multisession Radiosurgery for Symptomatic Circumscribed Choroidal Hemangioma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.432] [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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Shankar V, Sai Shreya V, Vyas H, Bhavya P, Haritha C, Bushra S, Lohith G, Basu T, Saxena U. Frameless Radiosurgery for Intractable Idiopathic Glossopharyngeal Neuralgia. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shankar V, Sai Shreya V, Bhavya P, Vyas H, Haritha C, Ibrahim K. Outcomes of Fractionated Radiosurgery in Cystic Vestibular Schwannoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Vyas H, Vangipuram S, Bhange A, Patel D, Patneedi B, Ar K. PO-1822: PET-CT based metabolic regression velocity following SBRT for spinal oligometstases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Shankar V, Sai Shreya V, Haritha C, Bhavya P, Vyas H, Sebastin S, Basu T, Saxena U. Post SRS Normotensive Hydrocephalus In Acoustic Schwannoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Shankar V, Shreya VS, Deshpande R, Raut N, Kendre P, Chauhan B, Haritha C, Vyas H, Bhavya P. Long Term Clinical Outcomes Of Multi-Level Spinal SBRT For Vertebral Metastases. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Shankar V, Deshpande R, Raut N, Haritha C, Kendre P, Shreya VS, Bhavya P, Vyas H, Chauhan B, Saxena U, Basu T. Inter-Breath Hold Displacements of Daily GTV Positions With ABC for Lung SBRT. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bhavya P, Shreya VS, Shankar V, Turel K, Deopujari C, Vyas H, Haritha C. Radiosurgical Ablation Of Intramedullary Spinal Cord AVM. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Haritha C, Shreya VS, Shankar V, Bhavya P, Vyas H, Bushra S. White Matter Plasticity in Trigeminal Neuralgia - FCD Mapping Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shankar V, Shreya VS, Bhavya P, Vyas H, Haritha C, Deopujari C, Velho V, Turel K, Andar U, Saxena U, Basu T. Intradural Spine Tumors Radiosurgery Delivery Accuracy using CBCT Image Guidance. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vyas H, Shankar V, Purohit R, Deepanjali P, Chigurupalli K. Acute Toxicity Patterns in Adaptive High Precision Radiotherapy for Head and Neck Cancer - a Randomised Controlled Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.442] [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: 10/26/2022]
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Karuppusamy A, Shankar V, Haritha C, Bhange A, Bhaskar V, Maurya S, Ganeshan P, Ajai Kumar B, Mutha S, Purohit R, Chigurupalli K, Vyas H, Deepanjali P. Anatomically Corrected DVH Metrics Accounting for Intrafraction Motion of Esophagus in Dorsal Spine SBRT. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Bhange A, Shankar V, Haritha C, Bhaskar V, Karuppusamy A, Mutha S, ajai Kumar B, Purohit R, Vyas H, Deepanjali P, Chigurupalli K. Dosimetric Influence of Oscillatory Spinal Cord Motion on the Cord Doses for Cervico-Thoracic Spine SBRT. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bhaskar V, Shankar V, Haritha C, Karuppusamy A, Bhange A, Maurya S, Kumar BA, Sen D, Mutha S, Purohit R, Chigurupalli K, Vyas H, Deepanjali P. Dosimetric Analysis of Flat versus Unflat Beams for Frameless Image guided Trigeminal Radiosurgery. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fahey R, Gilmore W, Papageorge M, Chang D, Azzouni L, Chaudhary S, Balint A, Ashrafi A, Darwish G, Oreadi D, Viswanath A, English R, Mehtani A, Alharthi K, Vyas H, Decoteau C, Stark P. Evaluation of postoperative oedema and pain following third molar extraction with application of pulsed electromagnetic field therapy. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Pleuropulmonary manifestations of rheumatological diseases are rare in children but pose a significant risk to overall morbidity and mortality. We have reviewed the literature to provide an overview of the respiratory complications of the commonest rheumatological diseases to occur in children (juvenile systemic lupus erythematosus, scleroderma, juvenile dermatomyositis, mixed connective tissue disease, granulomatosis with polyangitis and juvenile idiopathic arthritis). Pulmonary function testing in these patients can be used to refine the differential diagnosis and establish disease severity, but also has a role in ongoing monitoring for respiratory complications. Early detection of pulmonary involvement allows for prompt and targeted therapies to achieve the best outcome for the child. This is best achieved with joint specialist paediatric rheumatology and respiratory reviews in a multidisciplinary setting.
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Affiliation(s)
- Anne E Richardson
- Department of Paediatrics, Nottingham University Hospitals, Nottingham, UK
| | - Kishore Warrier
- Department of Paediatrics, Nottingham University Hospitals, Nottingham, UK
| | - H Vyas
- Department of Child Health, Nottingham University Hospital, Nottingham, UK
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Abstract
Capillary refill time (CRT) is a simple means of cardiovascular assessment which is widely used in clinical care. Currently, CRT is measured through manual assessment of the time taken for skin tone to return to normal colour following blanching of the skin surface. There is evidence to suggest that manually assessed CRT is subject to bias from ambient light conditions, a lack of standardisation of both blanching time and manually applied pressure, subjectiveness of return to normal colour, and variability in the manual assessment of time. We present a novel automated system for CRT measurement, incorporating three components: a non-invasive adhesive sensor incorporating a pneumatic actuator, a diffuse multi-wavelength reflectance measurement device, and a temperature sensor; a battery operated datalogger unit containing a self contained pneumatic supply; and PC based data analysis software for the extraction of refill time, patient skin surface temperature, and sensor signal quality. Through standardisation of the test, it is hoped that some of the shortcomings of manual CRT can be overcome. In addition, an automated system will facilitate easier integration of CRT into electronic record keeping and clinical monitoring or scoring systems, as well as reducing demands on clinicians. Summary analysis of volunteer (n = 30) automated CRT datasets are presented, from 15 healthy adults and 15 healthy children (aged from 5 to 15 years), as their arms were cooled from ambient temperature to 5°C. A more detailed analysis of two typical datasets is also presented, demonstrating that the response of automated CRT to cooling matches that of previously published studies.
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Affiliation(s)
- L L Blaxter
- Electrical Systems & Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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Howard S, Patel M, Lang AR, Youle C, Vyas H, Shaw D, Sharples S. P157 Individual patterns of inhaler use and health outcomes in adolescents with asthma: Abstract P157 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Viswanath A, Vyas H, Klein G, Cyr G, Papageorge M. Efficacy of preemptive analgesia for third molar surgery. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.857] [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]
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Viswanath A, Vyas H, Klein G, Cyr G, Papageorge M. Assessment of preemptive analgesic effect of Caldolor® vs Ofirmev® on third molar surgery: a prospective, randomized, double-blinded pilot study. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.856] [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: 10/22/2022]
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30
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Vyas H, Oreadi D, Balint A, Viswanath A, Papageorge M, Rosenberg M. Surgery Safety Checklist for Ambulatory Oral Surgical Procedures. J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.joms.2015.06.058] [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]
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31
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Prayle A, Parslow R, Erikson S, Alexander J, Vyas H, Fogarty A, Smyth A. 313 An international study of survival of children with cystic fibrosis after the first episode of invasive mechanical ventilation. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30487-2] [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: 10/23/2022]
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Abstract
Respiratory disease is a common cause of morbidity and mortality in children with Down's syndrome (DS). Causes range from those problems common to many children with DS, such as a narrow airway or impaired immunity, to rare structural lesions, such as tracheal bronchus. Additionally, other organ systems or extrinsic factors may play a role. A thorough understanding of the range of potential problems will aid in the evaluation and management of children with DS and respiratory symptoms.
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Affiliation(s)
- Rachel Watts
- PICU and Respiratory Medicine, Nottingham University Hospital, , Nottingham, UK
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Johnson G, Payne J, Hooks MA, Johnson S, Vyas H, Saunders D, Kadis GN, Fredericks CA, Sehgal R, McHayleh WM. Gamma knife surgery for non-small cell lung cancer patients with brain metastasis: A community cancer center experience. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vyas H, Jackson K, Chenzbraun A. Switching to volumetric left atrial measurements: impact on routine echocardiographic practice. European Journal of Echocardiography 2010; 12:107-11. [DOI: 10.1093/ejechocard/jeq119] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Hurley M, Dineen R, Padfield CJH, Wilson S, Stephenson T, Vyas H, McConachie N, Jaspan T. Is there a causal relationship between the hypoxia-ischaemia associated with cardiorespiratory arrest and subdural haematomas? An observational study. Br J Radiol 2010; 83:736-43. [PMID: 20647510 DOI: 10.1259/bjr/36871113] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to determine the frequency of subdural haematomas (SDHs) occurring in infants presenting following atraumatic cardiorespiratory collapse. This study was a review of retrospective case notes, brain imaging and post-mortem examinations carried out in the paediatric intensive care unit (PICU) and emergency department (ED) in a tertiary paediatric centre in the UK. The study included infants and children less than 4 years old dying in the ED or admitted to the PICU after atraumatic cardiorespiratory arrest. We identified macroscopic SDHs on brain imaging or post-mortem examination. Of those children who experienced a cardiorespiratory arrest from a non-traumatic cause and met inclusion criteria, 33 presented and died in the ED and 17 were admitted to the PICU. These children had a post-mortem examination, brain imaging or both. None of these infants had a significant SDH. One child had a small clot adherent to the dura found on post-mortem and two had microscopic intradural haemorrhage, but it is unclear in each case whether this was artefact, as each had otherwise normal brains. Subdural haematoma arising in infants or young children in the context of catastrophic cardiorespiratory compromise from a non-traumatic cause was not observed.
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Affiliation(s)
- M Hurley
- University of Nottingham, Nottingham, UK
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Abstract
A study was undertaken to identify the work stressors among male and female weavers (N=516) in powerloom and handloom and examine the association of work stressors with the prevalence of work related musculo-skeletal disorders (MSDs). Physical and psychosocial stresses of work, job diagnostics, hazards of workplace, working environment and MSDs prevalence were assessed. There is high prevalence of MSDs among weavers. Female weavers in powerloom and handloom were more prone to developing MSDs in upper back (OR 1.8; p<0.05 and OR 2.1; p<0.01) and lower back (OR 1.9; p<0.05 and OR 1.8; p<0.05). Male weavers were more prone to developing pain in the knee (OR 2.9; p<0.001), and hand (OR 2.2; p<0.05). Multivariate analysis indicated that job duration >10 yr (OR 3.7, p<0.05), manual material handling (OR 3, p<0.05), and poor machinery safety (OR 11, p<0.05), contributed to occurrence of MSDs amongst powerloom weavers. Among the handloom weavers, age >25 yr (OR 3.2, p<0.05), poor machinery design (OR 2.2, p<0.01), mental overload (OR 5.7, p<0.001), skill requirement to perform jobs (OR 20.7, p<0.05) had significant influence in the occurrence of pain. Gender differences exist in the prevalence of MSDs and the perception of work and psycho-social stresses among the weavers.
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Affiliation(s)
- Anjali Nag
- National Institute of Occupational Health, Meghani Nagar, Ahmedabad 380016, India.
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Smyth AR, Barbato A, Beydon N, Bisgaard H, de Boeck K, Brand P, Bush A, Fauroux B, de Jongste J, Korppi M, O'Callaghan C, Pijnenburg M, Ratjen F, Southern K, Spencer D, Thomson A, Vyas H, Warris A, Merkus PJ. Respiratory medicines for children: current evidence, unlicensed use and research priorities. Eur Respir J 2009; 35:247-65. [PMID: 19840958 DOI: 10.1183/09031936.00139508] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This European Respiratory Society task force has reviewed the evidence for paediatric medicines in respiratory disease occurring in adults and children. We describe off-licence use, research priorities and ongoing studies. Off-licence and off-label prescribing in children is widespread and potentially harmful. Research areas in asthma include novel formulations and regimens, and individualised prescribing. In cystic fibrosis, future studies will focus on screened infants and robust outcome measures are needed. Other areas include new enzyme and antibiotic formulations and the basic defect. Research into pneumonia should include evaluation of new antibacterials and regimens, rapid diagnostic tests and, in pleural infection, antibiotic penetration, fibrinolytics and surveillance. In uncommon conditions, such as primary ciliary dyskinesia, congenital pulmonary abnormalities or neuromuscular disorders, drugs indicated for other conditions (e.g. dornase alfa) are commonly used and trials are needed. In neuromuscular disorders, the beta-agonists may enhance muscle strength and are in need of evaluation. Studies of antibiotic prophylaxis, immunoglobulin and antifungal drugs are needed in immune deficiency. We hope that this summary of the evidence for respiratory medicines in children, highlighting gaps and research priorities, will be useful for the pharmaceutical industry, the paediatric committee of the European Medicines Agency, academic investigators and the lay public.
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Affiliation(s)
- A R Smyth
- University of Nottingham Division of Child Health, Queens Medical Centre, Nottingham, NG7 2UH, UK.
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Wilson S, Grundy R, Vyas H. Investigation and management of a child who is immunocompromised and neutropoenic with pulmonary infiltrates. Arch Dis Child Educ Pract Ed 2009; 94:129-37. [PMID: 19770492 DOI: 10.1136/adc.2008.148452] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S Wilson
- University Hospital, Queens Medical Centre, Nottingham, UK
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Lorgelly PK, Atkinson M, Lakhanpaul M, Smyth AR, Vyas H, Weston V, Stephenson T. Oral versus i.v. antibiotics for community-acquired pneumonia in children: a cost-minimisation analysis. Eur Respir J 2009; 35:858-64. [DOI: 10.1183/09031936.00087209] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Nag PK, Pal S, Nag A, Vyas H. Influence of arm and wrist support on forearm and back muscle activity in computer keyboard operation. Appl Ergon 2009; 40:286-291. [PMID: 18508029 DOI: 10.1016/j.apergo.2008.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2007] [Revised: 02/16/2008] [Accepted: 04/04/2008] [Indexed: 05/26/2023]
Abstract
The effects of forearm and wrist supports on the upper extremity postures in computer keying tasks and associated EMG activity of arm and back muscles were examined (N = 8). Four positions were forearms unsupported (floating) and supported, wrists supported by bead packed (WR1) and gel-filled (WR2) wrist rest. The right and left elbow extensions were 65 degrees and 68 degrees , respectively, in unsupported forearms. Bilateral elbow extension increased with the forearm/wrist supports and mostly, the elbow was maintained at around 90 degrees or greater. The wrist extension decreased with forearm/wrist supports over the unsupported condition. The forearm support significantly reduced the activity of forearm extensor digitorum, i.e., right (F((1, 47)) = 12.19, p < 0.01) and left (F((1, 47)) = 5.38, p < 0.05) and upper trapezius muscles over the floating posture. Wrist rests, however, increased load on the upper trapezius; the activities of flexor digitorum superficialis and erector spinae were close to the resting EMG activity for both forearm and/or wrist support. The type of wrist rests was a concern and this study indicated that the gel filled wrist rest was advantageous in reducing the forearm muscle load, in comparison to the bead packed cushions.
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Affiliation(s)
- P K Nag
- National Institute of Occupational Health, Indian Council of Medical Research, Ahmedabad 380016, India.
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Abstract
Bronchiolitis is the commonest reason for hospital admission in infancy and the most frequent cause of acute respiratory failure in children admitted to paediatric intensive care units in the UK and North America. The respiratory syncytial virus accounts for most cases of bronchiolitis, however, new virus isolation techniques have led to the discovery of previously unrecognised viruses, including the human metapneumovirus and bocavirus which also play a significant role. The main developments in bronchiolitis management in recent years relate to the use of immunoprophylaxis; a number of other therapies such as the use of heliox are currently being investigated. Supportive therapy remains the mainstay of management with limited or no evidence of benefit for most other pharmacological treatments. This article summarises the current understanding of the different bronchiolitis phenotypes, with a brief description of outcomes and a review of the evidence for the various therapeutic interventions.
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Affiliation(s)
- M Yanney
- Sherwood Forest Hospitals Foundation Trust, Mansfield Road, Sutton-in-Ashfield, Nottinghamshire NG17 4JL, UK
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Barratt CW, Vyas H, Hayes-Gill BR, Crowe JA, Flatman D. Detection of previously unrecognized daytime desaturation in children with chronic lung disease. J Med Eng Technol 2007; 31:101-8. [PMID: 17365434 DOI: 10.1080/03091900500225888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PRIMARY OBJECTIVE The prime rationale of this research is to investigate the possible occurrence of previously unrecognized episodes of desaturation apparent in preterm infants with chronic lung disease as they freely move around a non-artificial environment. RESEARCH DESIGN The study comprises 58 hours of telemetric recordings of SpO2, heart rate, body movement and temperature, along with full ECG and photoplethysmographic waveforms for eight preterm subjects in their home environment. MAIN OUTCOME/RESULTS: The data is analysed for remarkable events, more particularly periods of spontaneous desaturation. Statistical results for all case studies are collated into a table along with examples of graphical analysis. CONCLUSIONS This study has shown that some patients are prone to episodes of hypoxemia during the course of normal daily activity or daytime sleep that would usually go unrecognized and that more effective management of supplemental oxygen treatment may be possible with continual unobtrusive monitoring.
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Affiliation(s)
- C W Barratt
- School of Electrical & Electronic Engineering, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
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Telford K, Waters L, Vyas H, Manktelow BN, Draper ES, Marlow N. Respiratory outcome in late childhood after neonatal continuous negative pressure ventilation. Arch Dis Child Fetal Neonatal Ed 2007; 92:F19-24. [PMID: 16905573 PMCID: PMC2675290 DOI: 10.1136/adc.2006.096420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2006] [Indexed: 11/04/2022]
Abstract
BACKGROUND The outcome in late childhood for children entered into a randomised trial of continuous negative extrathoracic pressure (CNEP) versus standard respiratory management for the treatment of neonatal respiratory distress was studied. In the original trial, there were advantages in the duration of oxygen and the prevalence of chronic lung disease for those assigned to receive CNEP. AIM To determine whether the above differences had persisted into childhood. METHODS Outpatient evaluation of children by a paediatrician using Spirometry (Vitalograph Spirometer 2120, Ennis, Ireland) and MicroRint (Micro Medical, Rochester, Kent, UK) techniques independently of the original trial. Parents completed questionnaires about their child's respiratory history and social-demographic information. RESULTS 133 (65%) survivors were evaluated at 9.6-14.9 years of age. The group examined were representative of the original cohort and no significant baseline differences were observed between children evaluated who had been allocated to CNEP or standard treatments. We compared Rint (before and after bronchodilator) and forced expiratory flow, volume and vital capacity between the two study groups; none were significant. Children in the standard group had received paediatric intensive care more often (p = 0.19) and were more likely to be receiving inhaled drugs for asthma (p = 0.19; all not significant). CONCLUSIONS No important differences were found at follow-up in late childhood in respiratory outcomes for children treated with neonatal CNEP or standard treatment. Caution should be exercised, as the original trial was not powered to show these differences, but there seems to be no long-term detriment in respiratory outcomes for children treated with CNEP in the neonatal period.
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Affiliation(s)
- K Telford
- School of Human Development, University of Nottingham, Nottingham, UK
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Richards PG, Bertocci GE, Bonshek RE, Giangrande PL, Gregson RM, Jaspan T, Jenny C, Klein N, Lawler W, Peters M, Rorke-Adams LB, Vyas H, Wade A. Shaken baby syndrome. Arch Dis Child 2006; 91:205-6. [PMID: 16492880 PMCID: PMC2065913 DOI: 10.1136/adc.2005.090761] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Before the Court of Appeal
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Tomerak A, McGlashen J, McKean M, Vyas H. Inhaled beta-2 agonists for treating non-specific chronic cough in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd004232.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abstract
BACKGROUND The pathophysiology of so called 'cough variant asthma' has not received a great deal of research interest and opinion lies divided as to whether it is really asthma or not. The proponents of cough variant asthma suggest a therapeutic trial of medications usually used to treat asthma OBJECTIVES To determine the effectiveness of inhaled ss2 agonists in non-specific chronic cough in children over the age of 2 years. SEARCH STRATEGY The Cochrane Airways Group database (including MEDLINE, EMBASE and CINAHL) and the Cochrane Controlled Trials Register (CCRT) were searched. Additional searching included hand searching of medical journals through the Cochrane Collaboration, references, references of references listed in primary sources and personal communication with authors. In addition "Grey literature" including theses, internal reports, non-peer reviewed journals were sought. SELECTION CRITERIA All randomised (randomised and quasi-randomised) controlled clinical trials in which inhaled ss2 agonists were given for chronic cough in children over 2 years of age were included. Two reviewers independently assessed articles for inclusion and methodological quality. DATA COLLECTION AND ANALYSIS Data for trials of salbutamol versus placebo were extracted by both reviewers and entered into the Cochrane Collaboration software program Review Manager, version 4.2 MAIN RESULTS In children presenting with isolated chronic cough there was no significant difference between salbutamol treated group and placebo group. AUTHORS' CONCLUSIONS Salbutamol was no different from placebo in reducing the frequency of cough measured objectively or scored subjectively.
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Affiliation(s)
- A A T Tomerak
- Department of Child Health, Queen's Medical Centre, Nottingham, UK.
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Abstract
OBJECTIVE To report a case of acetaminophen toxicity diagnosed after a warning note of "interfering substances" on the blood gas report, leading to early and successful treatment. DESIGN Case report. SETTING Tertiary-care pediatric intensive care unit. PATIENT A 14-yr-old boy admitted unconscious with lactic academia and hyperglycemia. INTERVENTIONS Routine investigations. MEASUREMENTS AND MAIN RESULTS His initial investigations revealed hyperglycemia and lactic acidosis. An annotation of "interfering substances" on the blood gas report prompted us to investigate for toxic substances, and an acetaminophen overdose was confirmed. CONCLUSIONS A persistent warning note on the blood gas report of a sick child with elevated lactate and glucose should alert the clinician to the possibility of an acetaminophen overdose.
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Affiliation(s)
- Chetan S Ashtekar
- Pediatric Intensive Care Unit, University Hospital, Queens Medical Centre, Nottingham, UK
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Echeverría JC, Woolfson MS, Crowe JA, Hayes-Gill BR, Croaker GDH, Vyas H. Interpretation of heart rate variability via detrended fluctuation analysis and alphabeta filter. Chaos 2003; 13:467-475. [PMID: 12777109 DOI: 10.1063/1.1562051] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Detrended fluctuation analysis (DFA), suitable for the analysis of nonstationary time series, has confirmed the existence of persistent long-range correlations in healthy heart rate variability data. In this paper, we present the incorporation of the alphabeta filter to DFA to determine patterns in the power-law behavior that can be found in these correlations. Well-known simulated scenarios and real data involving normal and pathological circumstances were used to evaluate this process. The results presented here suggest the existence of evolving patterns, not always following a uniform power-law behavior, that cannot be described by scaling exponents estimated using a linear procedure over two predefined ranges. Instead, the power law is observed to have a continuous variation with segment length. We also show that the study of these patterns, avoiding initial assumptions about the nature of the data, may confer advantages to DFA by revealing more clearly abnormal physiological conditions detected in congestive heart failure patients related to the existence of dominant characteristic scales.
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Affiliation(s)
- J C Echeverría
- School of Electrical and Electronic Engineering, University of Nottingham, Nottingham, United Kingdom.
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Tomerak A, McGlashen J, McKean M, Vyas H. Inhaled beta-2 agonists for treating non-specific chronic cough in children. Hippokratia 2003. [DOI: 10.1002/14651858.cd004232] [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: 11/10/2022]
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