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Meir J, Huang L, Mahmood S, Whiteson H, Cohen S, Aronow WS. The vascular complications of diabetes: a review of their management, pathogenesis, and prevention. Expert Rev Endocrinol Metab 2024; 19:11-20. [PMID: 37947481 DOI: 10.1080/17446651.2023.2279533] [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: 08/08/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION This review highlights the pathogenesis of both microvascular and macrovascular complications of diabetes and how these mechanisms influence both the management and preventative strategies of these complications. The cumulative data shown in this review suggest hyperglycemic and blood pressure control remain central to this intricate process. AREAS COVERED We reviewed the literature including retrospective, prospective trials as well as meta-analysis, and post hoc analysis of randomized trials on microvascular andmacrovascular complications. EXPERT OPINION Further research is needed to explore the ideal intervention targets and preventative strategies needed to prevent macrovascular complications. Furthermore, as the data for trials looking at microvascular complications lengthen more long-term data will further elucidate the role that the duration of diabetes has on these complications. Additionally, trials looking to maximize hyperglycemic control with multiple agents in diabetes, such as metformin, SGL2isand GLP-1 receptor agonists are currently in process, which will have implications for rates of microvascular as well as macrovascular complications.
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Affiliation(s)
- Juliet Meir
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Lillian Huang
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Sumaita Mahmood
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Harris Whiteson
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Scott Cohen
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Wilbert S Aronow
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
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Meir J, Michaud L, Frishman WH, Aronow WS. The Past, Present, and The Future of Carcinoid Heart Disease. Cardiol Rev 2023; 31:193-198. [PMID: 36515580 DOI: 10.1097/crd.0000000000000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Carcinoid heart disease is a frequent manifestation of carcinoid syndrome. It results from the release of a large amount of serotonin and subsequently fibrosis of right sided heart valves, that is, tricuspid and pulmonic valve. This article reviews the pathogenesis, clinical symptoms, diagnosis, treatment and prognosis of carcinoid heart disease. Recent developments in treating carcinoid heart disease have improved the poor prognosis associated with the disease.
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Affiliation(s)
- Juliet Meir
- From the Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Vaslhalla, NY
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Ahlawat Y, Meir J, Benjamin C, Steinberg A. Mediastinal Mass as an Initial Presentation of Acute Myeloid Leukemia in a Young Man. Cureus 2023; 15:e41006. [PMID: 37383304 PMCID: PMC10299849 DOI: 10.7759/cureus.41006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 06/30/2023] Open
Abstract
A 29-year-old male, hemodynamically stable, presented with chest pain radiating to the interscapular region, with no fever, cough, dyspnea, or other constitutional symptoms. He had right cervical lymphadenopathy on physical examination. Investigations revealed a 3.1 cm anterior mediastinal nodular mass, peripheral immature blood cells, and thrombocytopenia. Bone marrow core biopsy findings were consistent with acute myeloid leukemia (AML). The mediastinal mass was resected via robotic-assisted thoracoscopic surgery. Histopathology revealed involvement of the mediastinal adipose tissue with myeloid sarcoma. Molecular testing showed TP53 mutation, signifying a poor prognosis. The patient failed several lines of therapy and expired. This case demonstrates an atypical presentation of AML and emphasizes the criticality of early detection in individuals who do not exhibit the usual symptoms associated with the disease. The presence of immature cell lines in peripheral blood should prompt an investigation to determine bone marrow involvement in an otherwise healthy young adult.
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Affiliation(s)
- Yagya Ahlawat
- Internal Medicine, Westchester Medical Center, New York, USA
| | - Juliet Meir
- Internal Medicine, Westchester Medical Center, New York, USA
| | - Cory Benjamin
- Internal Medicine, Westchester Medical Center, New York, USA
| | - Amir Steinberg
- Hematology and Oncology, Westchester Medical Center, New York, USA
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Michaud L, Seplowe M, Meir J, Aronow WS. Safety and cardiometabolic efficacy of novel antidiabetic drugs. Expert Opin Drug Saf 2023; 22:119-124. [PMID: 36877138 DOI: 10.1080/14740338.2023.2188190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
INTRODUCTION There are three major drug classes discussed in this review: dipeptidyl dipeptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAS), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. A literature review of the landmark cardiovascular outcome trials from 2008 to 2021 was conducted. AREAS COVERED The cumulative data shown in this review suggest that in patients with Type 2 Diabetes (T2D), SGLT2 inhibitors and GLP-1 RAS may reduce cardiovascular (CV) risk. Specifically, in the heart failure (HF) population, SGLT2 inhibitors have shown a reduction in hospitalizations in some randomized controlled trials (RCTs). DPP4 inhibitors have not shown a similar reduction in CV risk and even exhibited an increase in hospitalizations for HF in one RCT. It is important to note that the DPP4 inhibitors did not demonstrate an increase in major CV events, with the exception of the increase in HF hospitalizations in the SAVOR TIMI 53 trial. EXPERT OPINION Future avenues of research to explore include the use of novel antidiabetic agents to reduce post-myocardial infarction (MI) CV risk and arrhythmias independent of their use as diabetic agents.
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Affiliation(s)
- Liana Michaud
- Department of Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Matthew Seplowe
- Department of Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Juliet Meir
- Department of Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Wilbert S Aronow
- Department of Cardiology, Westchester Medical Center, Valhalla, NY, USA
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Izumchenko E, Meir J, Bedi A, Wysocki PT, Hoque MO, Sidransky D. Patient-derived xenografts as tools in pharmaceutical development. Clin Pharmacol Ther 2016; 99:612-21. [PMID: 26874468 DOI: 10.1002/cpt.354] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/20/2016] [Accepted: 02/11/2016] [Indexed: 12/16/2022]
Abstract
Successful drug development in oncology is grossly suboptimal, manifested by the very low percentage of new agents being developed that ultimately succeed in clinical approval. This poor success is in part due to the inability of standard cell-line xenograft models to accurately predict clinical success and to tailor chemotherapy specifically to a group of patients more likely to benefit from the therapy. Patient-derived xenografts (PDXs) maintain the histopathological architecture and molecular features of human tumors, and offer a potential solution to maximize drug development success and ultimately generate better outcomes for patients. Although imperfect in mimicking all aspects of human cancer, PDXs are a more predictable platform for preclinical evaluation of treatment effect and in selected cases can guide therapeutic decision making in the clinic. This article summarizes the current status of PDX models, challenges associated with modeling human cancer, and various approaches that have been applied to overcome these challenges and improve the clinical relevance of PDX cancer models.
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Affiliation(s)
- E Izumchenko
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - J Meir
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Bedi
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - P T Wysocki
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M O Hoque
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - D Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
UNLABELLED We report on a 9-year-old boy who suffered from hyperthyroidism and a new appearance of enuresis. Bedwetting ceased and prepulse inhibition (PPI) - measured as a parameter of central control - increased during the course of therapy. CONCLUSION The increase in PPI is an indication that enuresis in hyperthyroidism could be as a result of a temporary loss of central control on brainstem reflexes. The case conveys new insights into the correlation between thyroid hormones and micturition patterns and the aetiology of enuresis.
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Affiliation(s)
- J Meir
- Hospital for Children and Adolescents, University Leipzig, Leipzig, Germany
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Keidar S, Freud M, Rothfeld H, Meir J. Pneumoperitoneum after mechanical ventilation without pneumothorax or pneumomediastinum. Int Surg 1982; 67:275-6. [PMID: 6761295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Lewin A, Kraiem Z, Kahana L, Sheinfeld M, Abramovici H, Lurie M, Lurie A, Eisenkraft S, Meir J, Kaufman H. Congenital adrenal hyperplasia diagnosed in a middle-aged woman. Isr J Med Sci 1980; 16:607-9. [PMID: 6968308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Short stature, severe hirsutism, an enlarged clitoris and lack of vaginal introitus were manifest in a 55-year-old female karyotype, male phenotype patient brough up as a female. The hormone profile suggested congenital adrenal hyperplasia due to 21-hydroxylase adrenal enzyme deficiency. Follicle-stimulating hormone and luteinizing hormone levels were 122.5 and 100.3 mIU/ml, respectively, within the normal range for a postmenopausal woman. Computerized axial tomography revealed a large cystic tumor connected to the right adrenal gland. Both the right adrenal gland and the cyst were removed. The adrenal cortex showed diffuse hyperplasia and contained a well-defined nodule. The case was interesting because we had the opportunity of examining a patient of advanced age with untreated congenital adrenal hyperplasia and because of the very rare combination of adrenogenital syndrome with nodular hyperplasia and a cystic tumor, which was most probably a degenerated adenoma.
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Heifetz M, De-Myttenaere SA, Meir J, Kedar S. Unusual complications of subclavian catheterization. Anaesthesist 1980; 29:46-8. [PMID: 6772051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Infraclavicular subclavian vein catheterization is still a well accepted technique both in operating rooms and intensive care units. Two unusual complications are described: delayed intrathoracic haematoma and severe mediastinal emphysema needing prolonged treatment. The case reports are presented and the complications discussed. The necessity for routine chest x-ray post-operative catheterization and the danger of multiple attempts are stressed.
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Keidar S, Freud M, Rosenschein S, Meir J, Rothfeld H. Intestinal obstruction due to a wandering spleen. Am J Gastroenterol 1978; 69:701-4. [PMID: 707467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Rejovitzky R, Rothfeld H, Meir J, Freud M. [Gastric duplication in an adult (author's transl)]. Harefuah 1977; 93:146-7. [PMID: 924240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Meir J, Keidar S, Freud M. [Intraluminal duodenal diverticulum]. Harefuah 1977; 92:120-1. [PMID: 403108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Meir J. [Gastroenterostomy and vagotomy in duodenal ulcer]. Dapim Refuiim 1965; 24:121-5. [PMID: 5829082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Meir J, Adler O. [Amplatz' intravenous pyelography in renal hypertension]. Dapim Refuiim 1965; 24:126-9. [PMID: 5829083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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