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Chung GE, Jeong S, Yu SJ, Yoo J, Cho Y, Lee K, Shin DW, Kim YJ, Yoon J, Han K, Cho EJ. Gamma-glutamyl transferase and the risk of all-cause and disease-specific mortality in patients with diabetes: A nationwide cohort study. J Diabetes 2024; 16:e13551. [PMID: 38664890 PMCID: PMC11045922 DOI: 10.1111/1753-0407.13551] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND There exists a paucity of data regarding whether gamma-glutamyl transferase is associated with disease-specific mortality in patients with type 2 diabetes mellitus. This study aimed to investigate the association of serum gamma-glutamyl transferase levels with all-cause and disease-specific mortality in patients with diabetes mellitus using a Korean nationwide health-screening database. METHODS A total of 9 687 066 patients without viral hepatitis or liver cirrhosis who underwent health examination in 2009 were included. These patients were divided into four groups according to sex-specific quartiles of serum gamma-glutamyl transferase levels. RESULTS During a median follow-up period of 8.1 years, 222 242 deaths were identified. The all-cause mortality rate increased as the serum gamma-glutamyl transferase levels became higher (highest quartile vs lowest quartile: hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.55-1.59; p for trend <.001). Similar trends were observed for cardiovascular disease (HR, 1.57; 95% CI, 1.53-1.62), ischemic heart disease (HR, 1.40; 95% CI, 1.33-1.48), and stroke (HR, 1.72; 95% CI, 1.60-1.85) in the highest quartile, as compared with the lowest quartile (p for trend <.001). As the gamma-glutamyl transferase quartiles became higher, mortality rates related to cancer (HR, 1.56; 95% CI, 1.52-1.60), liver disease (HR, 9.42; 95% CI, 8.81-10.07), respiratory disease (HR, 1.55; 95% CI, 1.49-1.62), and infectious disease (HR, 1.73; 95% CI, 1.59-1.87) also increased in the highest quartile, compared with the lowest quartile (p for trend <.001). CONCLUSIONS Serum gamma-glutamyl transferase levels may be useful for the risk assessment of all-cause and disease-specific mortality among patients with type 2 diabetes mellitus.
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Affiliation(s)
- Goh Eun Chung
- Department of Internal Medicine and Healthcare Research InstituteSeoul National University Hospital Healthcare System Gangnam CenterSeoulRepublic of Korea
| | - Su‐Min Jeong
- Department of MedicineSeoul National University College of MedicineSeoulRepublic of Korea
| | - Su Jong Yu
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
| | - Jeong‐Ju Yoo
- Department of Internal Medicine, Division of Gastroenterology and HepatologySoonchunhyang University Bucheon HospitalGyeonggi‐doRepublic of Korea
| | - Yuri Cho
- Center for Liver and Pancreatobiliary CancerNational Cancer CenterGoyangRepublic of Korea
| | - Kyu‐na Lee
- Department of Biomedicine & Health ScienceThe Catholic University of KoreaSeoulKorea
| | - Dong Wook Shin
- Department of MedicineSeoul National University College of MedicineSeoulRepublic of Korea
- Department of Clinical Research Design and Evaluation/Department of Digital HealthSamsung Advanced Institute for Health ScienceSeoulRepublic of Korea
| | - Yoon Jun Kim
- Department of Internal Medicine and Healthcare Research InstituteSeoul National University Hospital Healthcare System Gangnam CenterSeoulRepublic of Korea
| | - Jung‐Hwan Yoon
- Department of Internal Medicine and Healthcare Research InstituteSeoul National University Hospital Healthcare System Gangnam CenterSeoulRepublic of Korea
| | - Kyungdo Han
- Department of BiostatisticsCollege of Medicine, Soongsil UniversitySeoulRepublic of Korea
| | - Eun Ju Cho
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
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Ruddy S, Bapna M, Karnik K, Yung L, Rodriguez G, Urban C, Yoon J, Prasad N, Segal-Maurer S, Turett G. Novel case of combination antibiotic therapy for treatment of a complicated polymicrobial urinary tract infection with one organism harboring a metallo-β-lactamase (MBL) in a pregnant patient. IDCases 2024; 36:e01946. [PMID: 38646598 PMCID: PMC11031789 DOI: 10.1016/j.idcr.2024.e01946] [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: 10/04/2023] [Revised: 02/23/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024] Open
Abstract
Carbapenem resistance due to metallo-beta-lactamases (MBLs) is a global phenomenon and an important challenge for antibiotic therapy (Boyd et al., 2020 [1]). While previous reports have demonstrated both in vitro and in vivo synergy using the combination of ceftazidime-avibactam and aztreonam against Stenotrophomonas maltophilia, an MBL-harboring organism, this treatment strategy has not been reported during pregnancy (Mojic et al., 2017 [2], [3], Mojica et al., 2016 [4], Alexander et al., 2020 [5]). We describe a 33-year-old pregnant female with polymicrobial, bilateral pyelonephritis caused by Stenotrophomonas maltophilia and other gram-negative bacteria. The organisms were eradicated with the combination of ceftazidime-avibactam and aztreonam followed by successful delivery with no observed adverse effects in either mother or child post-partum.
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Affiliation(s)
- S. Ruddy
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - M. Bapna
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - K. Karnik
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - L. Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Rodriguez
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Columbia University School of Nursing, New York, NY, 10032, United States of America
| | - C. Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - J. Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - N. Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - S. Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
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Chung GE, Yu SJ, Yoo J, Cho Y, Lee K, Shin DW, Kim YJ, Yoon J, Han K, Cho EJ. Differential risk of 23 site-specific incident cancers and cancer-related mortality among patients with metabolic dysfunction-associated fatty liver disease: a population-based cohort study with 9.7 million Korean subjects. Cancer Commun (Lond) 2023; 43:863-876. [PMID: 37337385 PMCID: PMC10397567 DOI: 10.1002/cac2.12454] [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] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/30/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION Although an association between metabolic dysfunction-associated fatty liver disease (MAFLD) and cardiovascular disease or overall mortality has been reported, it is unclear whether there is an association between MAFLD and cancer incidence or mortality. We aimed to investigate the differential risk of all- and site-specific cancer incidence and mortality according to MAFLD subgroups categorized by additional etiologies of liver disease. METHODS Using the Korean National Health Insurance Service database, we stratified the participants into three groups: (1) single-etiology MAFLD (S-MAFLD) or MAFLD of pure metabolic origin; (2) mixed-etiology MAFLD (M-MAFLD) or MAFLD with additional etiological factor(s) (i.e., concomitant liver diseases and/or heavy alcohol consumption); and (3) non-MAFLD. Hepatic steatosis and fibrosis were defined using the fatty liver index and the BARD score, respectively. Cox proportional hazards regression was performed to estimate the risk of cancer events. RESULTS Among the 9,718,182 participants, the prevalence of S-MAFLD and M-MAFLD was 29.2% and 6.7%, respectively. During the median 8.3 years of follow-up, 510,330 (5.3%) individuals were newly diagnosed with cancer, and 122,774 (1.3%) cancer-related deaths occurred among the entire cohort. Compared with the non-MAFLD group, the risk of all-cancer incidence and mortality was slightly higher among patients in the S-MAFLD group (incidence, adjusted hazard ratio [aHR] = 1.03; 95% confidence interval [CI]: 1.02-1.04; mortality, aHR = 1.06; 95% CI: 1.04-1.08) and highest among patients with M-MAFLD group (incidence, aHR = 1.31; 95% CI: 1.29-1.32; mortality, aHR = 1.45; 95% CI: 1.42-1.48, respectively). The M-MAFLD with fibrosis group (BARD score ≥ 2) showed the highest relative risk of all-cancer incidence (aHR = 1.38, 95% CI = 1.36-1.39), followed by the M-MAFLD without fibrosis group (aHR = 1.09, 95% CI = 1.06-1.11). Similar trends were observed for cancer-related mortality. CONCLUSIONS MAFLD classification, by applying additional etiologies other than pure metabolic origin, can be used to identify a subgroup of patients with poor cancer-related outcomes.
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Affiliation(s)
- Goh Eun Chung
- Department of Internal Medicine and Healthcare Research InstituteSeoul National University Hospital Healthcare System Gangnam CenterSeoulRepublic of Korea
| | - Su Jong Yu
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
| | - Jeong‐Ju Yoo
- Department of Gastroenterology and HepatologySoonchunhyang University Bucheon HospitalBucheonGyeonggi‐doRepublic of Korea
| | - Yuri Cho
- Center for Liver and Pancreatobiliary CancerNational Cancer CenterGoyangGyeonggi‐doRepublic of Korea
| | - Kyu‐na Lee
- Department of Biomedicine & Health ScienceCatholic University of KoreaSeoulRepublic of Korea
| | - Dong Wook Shin
- Department of Family Medicine/ Supportive care centerSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
- Department of Clinical Research Design and Evaluation/Department of Digital HealthSamsung Advanced Institute for Health ScienceSeoulRepublic of Korea
| | - Yoon Jun Kim
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
| | - Jung‐Hwan Yoon
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulRepublic of Korea
| | - Eun Ju Cho
- Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
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Kasthuri V, Laguna A, Kim N, Yoon J, Ahn S. Abstract No. 289 Modern Search Analytics: What Are Patients Asking ecan Uterine Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.356] [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: 02/27/2023] Open
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Kasthuri V, Kim N, Laguna A, Yoon J, Ahn S. Abstract No. 604 Modern Search Analytics: What Are Patients Asking about Prostate Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.462] [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: 02/27/2023] Open
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Kasthuri V, Shamshad A, Davis M, Yoon J, Kumar S, Ahn S. Abstract No. 605 Modern Search Analytics: What Are Patients Asking about Varicocele Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.463] [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: 02/26/2023] Open
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Kasthuri V, Gillette J, Zhang H, Kumar S, Yoon J, Ahn S. Abstract No. 190 Modern Search Analytics: What Are Patients Asking about Varicose Vein Ablation? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.247] [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: 02/27/2023] Open
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Cenko E, Bergami M, Yoon J, Van Der Schaar M, Manfrini O, Gale C, Vasiljevic Z, Stankovic G, Vavlukis M, Kedev S, Milicic D, Dorobantu M, Badimon L, Bugiardini R. Relation between sex and mortality after myocardial infarction in high-income and middle-income European countries. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The relationship between female sex and cardiovascular mortality in myocardial infarction (MI) is controversial. Most available data are from high-income countries (HIC) where baseline risk is lower and revascularization procedures are more likely, so the generalizability to other populations is unclear.
Purpose
The main goal of this study was to unravel the relation between patient-specific revascularization through percutaneous coronary intervention (PCI) and mortality among women and men.
Methods
Data were drawn from the ISACS-Archives (NCT04008173) which includes a large cohort of patients enrolled in 6 European HIC (Croatia, Italy, Lithuania, Hungary, Romania, and United Kingdom) and 7 middle-income countries (MIC; Bosnia & Herzegovina, Kosovo, Macedonia, Moldova, Montenegro, and Serbia). Participants were stratified by MI subtypes: STEMI and NSTEMI. The primary outcome was 30-day mortality. To yield unbiased sex estimates of the effects of MI on mortality we modeled covariates and outcomes by propensity score-based analytic methods. We calculated the women to men risk ratios (RRs) using weighting with estimates compared by test of interaction on the log scale.
Results
The cohort consisted of 22,087 patients with MI (30.2% women). Patient outcomes varied according to the subtype of MI. Females was associated with a greater excess risk of 30-day mortality in STEMI (RR: 1.94; 95% CI: 1.71–2.21) compared with NSTEMI (RR: 1.12; 95% CI: 0.95–1.50; P interaction <0.001). Coronary revascularization reduced the incidence of death among women and men in the overall population. Despite this, the primary outcome of 30-day mortality remained higher in women than men with STEMI (RR: 2.38; 95% CI: 2.00–2.82) whereas it was comparable across sexes in patients with NSTEMI (RR: 1.21; 95% CI: 0.79–1.83; P interaction=0.002). Sex differences in mortality from STEMI were more significant in MIC compared with HIC (RRs: 2.30; 95% CI: 1.98–2.68 vs. 1.36; 95% CI: 1.05–1.75; P interaction <0.001). The sex gap in mortality was mitigated by the use of revascularization therapy (RRs: 2.05; 95% CI: 1.68–2.50 in MIC vs. 2.17; 95% CI: 1.48–3.18 in HIC; P interaction=0.40)
Conclusion
Women presenting with STEMI have worse early mortality rates than their male counterparts in both HIC and MIC even in patients undergoing revascularization. By contrast, sex differences are attenuated or no longer apparent in NSTEMI. With no information on the type of MI on admission, sex differences in early outcomes are difficult to be fully understood.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Cenko
- University of Bologna , Bologna , Italy
| | - M Bergami
- University of Bologna , Bologna , Italy
| | - J Yoon
- Google Cloud AI , Sunnyvale , United States of America
| | | | | | - C Gale
- University of Leeds , Leeds , United Kingdom
| | | | | | - M Vavlukis
- University Clinic of Cardiology , Skopje , North Macedonia
| | - S Kedev
- University Clinic of Cardiology , Skopje , North Macedonia
| | - D Milicic
- University of Zagreb School of Medicine , Zagreb , Croatia
| | - M Dorobantu
- University of Medicine and Pharmacy Carol Davila , Bucharest , Romania
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC) , Barcelona , Spain
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Yoon J, Armstrong M, Cotton C, Mense M, Allaire N. 592 Ribosome profiling reveals distinct translation termination kinetics and efficiency between Fischer rat thyroid and human bronchial epidermal cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01282-6] [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: 11/07/2022]
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10
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Allaire N, Yoon J, Armstrong M, Valley H, Macadino C, Sivachenko A, Conte J, Tabak B, Bihler H, Cheng Y, Coote K, Cotton C, Mense M. 663 Modulation of cystic fibrosis transmembrane conductance regulator intron 22 alternative polyadenylation use may have therapeutic potential for the treatment of certain 3′ cystic fibrosis transmembrane conductance regulator premature termination codon variants. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01353-4] [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: 11/06/2022]
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Young K, Yoon J, Getachew E, Leung B, Nguyen N, Semenov Y, Theodosakis N. 206 Tetracyclines are associated with development of new hyperpigmentation in acne patients. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Getachew E, Yoon J, Young K, Leung B, Nguyen N, Mostaghimi A, Semenov Y, Theodosakis N. 674 Racial differences in melasma risk factors and treatment patterns. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Avagyan S, Henninger JE, Mannherz WP, Mistry M, Yoon J, Yang S, Weber MC, Moore JL, Zon LI. Resistance to inflammation underlies enhanced fitness in clonal hematopoiesis. Science 2021; 374:768-772. [PMID: 34735227 DOI: 10.1126/science.aba9304] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- S Avagyan
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - J E Henninger
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | | | - M Mistry
- Harvard Chan Bioinformatics Core, Boston, MA, USA
| | - J Yoon
- Harvard Chan Bioinformatics Core, Boston, MA, USA
| | - S Yang
- Boston Children's Hospital, Boston, MA, USA
| | - M C Weber
- Boston Children's Hospital, Boston, MA, USA
| | - J L Moore
- Boston Children's Hospital, Boston, MA, USA
| | - L I Zon
- Boston Children's Hospital, Boston, MA, USA.,Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
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14
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Yoon J, Skach W. 612: Ribosome profiling reveals new complexities in ribosome-mediated mRNA decoding and stalling during CFTR protein synthesis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Cenko E, Yoon J, Van Der Schaar M, Bergami M, Manfrini O, Vasiljevic Z, Zdravkovic M, Stankovic G, Vavlukis M, Kedev S, Milicic D, Badimon L, Bugiardini R. Acute heart failure: a mechanism underscoring sex differences in outcomes following acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It remains uncertain whether female sex is itself a strong risk factor for worse outcomes in acute coronary syndromes (ACS).
Purpose
We hypothesized that sex differences in vulnerability to heart failure after ACS may modify the association between sex and outcomes.
Methods
Data were drawn from the ISACS-Archives network of registries. The study population consisted of 87,812 patients with known time from symptom onset to hospital presentation. Participants were stratified by ACS subtypes: STEMI and NSTE-ACS Data on presenting heart failure symptoms were collected from medical record abstraction. Heart failure was categorized as Killip class >2. Time from symptom onset to hospital presentation was categorized as early (≤120 minutes) or late (>120 minutes). Primary outcome measure was 30-day mortality. Estimates were performed using a parametric balancing strategy by weighting and compared by test of interaction on the log scale.
Results
Among the study sample, 30922 (35.2%) patients were women. Patient outcomes varied according to subtype of ACS. The mortality rates at 30-days were significantly higher among women vs men in STEMI (RR:1.65; 95% CI: 1.56–1.73) compared with NSTE-ACS (RR:1.18; 95% CI: 1.09–1.28; P interaction <0.0001). Similarly, the women vs men RR of heart failure was higher in STEMI (RR: 1.24; 95% CI: 1.20–1.29) compared with NSTE-ACS (RR:1.02; 95% CI: 0.97–1.08; P interaction <0.0001). Sex difference in heart failure rates with STEMI presentation were independent (P<0.0001) of early (34.3% in women vs 24.2% in men) or late (35.5% in women vs 30.7% in men) hospital presentation. The same finding was not seen in NSTE-ACS patients. Overall, women presenting with heart failure was had higher 30-day mortality than did their male counterparts with heart failure (29.8% vs 25.5%; RR: 1.24; 95% CI: 1.17–1.31).
Conclusions
Women exhibit substantially more vulnerability to heart failure in STEMI than men: a greater percentage of women have heart failure, and women with heart failure have higher 30-day mortality than men with heart failure. This finding was not seen in NSTE-ACS. heart failure on initial assessment is a key feature to explain the sex gap in mortality after ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Cenko
- University of Bologna, Department of Internal Medicine, Section of Cardiology, Bologna, Italy
| | - J Yoon
- Google Cloud AI, Sunnyvale, United States of America
| | - M Van Der Schaar
- University of Cambridge, Cambridge Centre for Artificial Intelligence in Medicine, Department of Applied Mathematics and Th, Cambridge, United Kingdom
| | - M Bergami
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
| | - O Manfrini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
| | - Z Vasiljevic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | - M Zdravkovic
- University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - G Stankovic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | - M Vavlukis
- University Clinic of Cardiology, Skopje, North Macedonia
| | - S Kedev
- University Clinic of Cardiology, Skopje, North Macedonia
| | - D Milicic
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain
| | - R Bugiardini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
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Bergami M, Cenko E, Yoon J, Mendieta G, Kedev S, Zdravkovic M, Vasiljevic Z, Milicic D, Manfrini O, Van Der Schaar M, Gale CP, Badimon L, Bugiardini R. Statins for primary prevention among elderly men and women. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The debate about statins in primary prevention of cardiovascular (CV) disease is still alive, especially in old and very old adults.
Purpose
We undertook a propensity match-weighted cohort study to investigate whether statin treatment recommendations translate into improved cardiovascular (CV) outcomes in the current routine clinical care of the elderly.
Methods
We included in our analysis 5,619 people aged 65 years or older from the ISACS (International Survey of Acute Coronary Syndrome) Archives (NCT04008173) who presented to hospital with a first manifestation of CV disease. Participants were stratified as statin users versus nonusers and as old (65 to 75 years) versus very old (76 years or over) adults. We estimated the effects of statins on the most severe clinical manifestation of CV disease, namely ST segment elevation myocardial infarction (STEMI), using inverse probability of treatment weighting models. Estimates were compared by test of interaction on the log scale.
Results
The risk of STEMI was much lower in statin users than in nonusers in both patients aged 65 to 75 years (14.7% absolute risk reduction; relative risk [RR] ratio: 0.55, 95% CI 0.45 to 0.66) and those aged 76 years and older (13.3% absolute risk reduction; RR ratio: 0.58, 95% CI 0.46 to 0.72). Estimates were similar in patients with and without history of hypercholesterolemia (interaction test; p value= 0.2408). Proportional reductions in STEMI diminished with female sex in the old (p for interaction=0.002), but not in the very old age (p for interaction=0.26). We also observed a remarkable reduction in the risk of 30- day mortality from STEMI with statin therapy in both age groups (10.2% absolute risk reduction; RR ratio: 0.39; 95% CI 0.23 – 0.68 for patients aged 76 or over and 3.8% absolute risk reduction; RR ratio 0.37; 95% CI 0.17 – 0.82 for patients aged 65 to 75 years old; interaction test, p value=0.4570).
Conclusion
Preventive statin therapy in the elderly reduces the risk of STEMI with benefits in mortality from STEMI, irrespective of the presence of a history of hypercholesterolemia. This effect persists after the age of 76 years. Benefits are less pronounced in women.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Bergami
- University of Bologna, DIMES, Bologna, Italy
| | - E Cenko
- University of Bologna, DIMES, Bologna, Italy
| | - J Yoon
- University of California Los Angeles, Department of Electrical and Computer Engineering, Los Angeles, United States of America
| | - G Mendieta
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - S Kedev
- University Clinic of Cardiology, Skopje, North Macedonia
| | - M Zdravkovic
- University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | | | - D Milicic
- University Hospital Centre Zagreb, Department for Cardiovascular Diseases, Zagreb, Croatia
| | - O Manfrini
- University of Bologna, DIMES, Bologna, Italy
| | - M Van Der Schaar
- University of California Los Angeles, Department of Electrical and Computer Engineering, Los Angeles, United States of America
| | - C P Gale
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom
| | - L Badimon
- Hospital de la Santa Creu i Sant Pau, Cardiovascular Research Program ICCC, IR-IIB Sant Pau, Barcelona, Spain
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17
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Hur SJ, Choi Y, Yoon J, Jang J, Shin NY, Ahn KJ, Kim BS. Intraindividual Comparison between the Contrast-Enhanced Golden-Angle Radial Sparse Parallel Sequence and the Conventional Fat-Suppressed Contrast-Enhanced T1-Weighted Spin-Echo Sequence for Head and Neck MRI. AJNR Am J Neuroradiol 2021; 42:2009-2015. [PMID: 34593379 DOI: 10.3174/ajnr.a7285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/25/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The golden-angle radial sparse parallel-volumetric interpolated breath-hold (GRASP-VIBE) sequence is a recently introduced imaging technique with high resolution. This study compared the image quality between conventional fat-suppressed T1-weighted TSE and GRASP-VIBE after gadolinium enhancement in the head and neck region. MATERIALS AND METHODS Data from 65 patients with clinical indications for head and neck MR imaging between September 2020 and January 2021 were retrospectively reviewed. Two radiologists assessed the overall image quality, overall artifacts, and image conspicuities in the oropharynx, hypopharynx, and cervical lymph nodes according to 5-point scores (best score: 5). Interobserver agreement was assessed using weighted κ statistics. The SNR and contrast-to-noise ratio were calculated and compared between the 2 sequences using a paired Wilcoxon signed rank test. RESULTS The analysis included 52 patients (mean age, 60 [SD, 14 ] years; male, 71.2% [37/52]) who were mostly diagnosed with head and neck malignancies (94.3% [50/52]). κ statistics ranged from slight agreement in cervical lymph node conspicuity (κ = 0.18) to substantial agreement in oropharyngeal mucosal conspicuity (κ = 0.80) (κ range, 0.18-0.80). Moreover, GRASP-VIBE demonstrated significantly higher mean scores in overall image quality (4.68 [SD, 0.41] versus 3.66 [SD, 0.73]), artifacts (4.47 [SD, 0.48] versus 3.58 [SD, 0.71]), oropharyngeal mucosal conspicuity (4.85 [SD, 0.41] versus 4.11 [SD, 0.79]), hypopharyngeal mucosal conspicuity (4.84 [SD, 0.34] versus 3.58 [SD, 0.81]), and cervical lymph node conspicuity (4.79 [SD, 0.32] versus 4.08 [SD, 0.64]) than fat-suppressed T1-weighted TSE (all, P < .001). Furthermore, GRASP-VIBE demonstrated a higher SNR (22.8 [SD, 11.5] versus 11.3 [SD, 5.6], P < .001) and contrast-to-noise ratio (4.7 [SD, 5.4] versus 2.3 [SD, 2.7], P = .059) than fat-suppressed T1-weighted TSE. CONCLUSIONS GRASP-VIBE provided better image quality with fewer artifacts than conventional fat-suppressed T1-weighted TSE for the head and neck regions.
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Affiliation(s)
- S-J Hur
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y Choi
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Yoon
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Jang
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - N-Y Shin
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-J Ahn
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - B-S Kim
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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18
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Kim J, Kim DH, Jee H, Hwang J, Yoon J. Type B valvular and supravalvular pulmonic stenosis with aberrant pre-pulmonic right coronary artery diagnosed by non-electrocardiography-gated, multislice computed tomography in a Boston terrier. J Vet Cardiol 2021; 38:12-17. [PMID: 34689048 DOI: 10.1016/j.jvc.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
Pulmonic stenosis (PS) is a common congenital heart disease in dogs. It may be associated with an aberrant coronary artery (CA) in brachycephalic breeds. If present, a CA anomaly must be identified before pulmonic valvuloplasty. A 1.7-year-old Boston terrier was referred for a grade V/VI systolic heart murmur and exercise intolerance. Echocardiography revealed combined type B valvular and supravalvular PS; an aberrant CA was also suspected. Non-electrocardiography (ECG)-gated, 160-multislice computed tomographic angiography (CTA) confirmed severe right ventricular wall hypertrophy, a hypoplastic pulmonic valve annulus, and severe supravalvular PS with a marked main pulmonary artery bulge; a single left coronary ostium with an anomalous pre-pulmonic right CA was also identified. Surgical correction with pulmonic valvuloplasty and pulmonary artery patch angioplasty under cardiopulmonary bypass was planned. The patient died intraoperatively due to profound hypotension after weaning from extracorporeal circulation. However, this is the first case report in which type B valvular and supravalvular PS with an aberrant pre-pulmonic right CA was diagnosed by non-ECG-gated, 160-multislice CTA in a Boston terrier, showing a similar level of image quality to ECG-gated CTA. Thus, in PS cases, high-slice CTA may be helpful to determine if CA anomalies are present and to establish a therapeutic plan.
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Affiliation(s)
- J Kim
- Helix Animal Medical Center, Seoul, 06546, South Korea; College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, South Korea
| | - D-H Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, 34134, South Korea
| | - H Jee
- Helix Animal Medical Center, Seoul, 06546, South Korea
| | - J Hwang
- Helix Animal Medical Center, Seoul, 06546, South Korea
| | - J Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, South Korea.
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19
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Pham K, Wu Y, Turett G, Prasad N, Yung L, Rodriguez GD, Segal-Maurer S, Urban C, Yoon J. Edwardsiella tarda, a rare human pathogen isolated from a perihepatic abscess: Implications of transient versus long term colonization of the gastrointestinal tract. IDCases 2021; 26:e01283. [PMID: 34527514 PMCID: PMC8433271 DOI: 10.1016/j.idcr.2021.e01283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/05/2021] [Accepted: 09/05/2021] [Indexed: 11/25/2022] Open
Abstract
Although gastroenteritis is the most commonly described manifestation of Edwardsiella tarda infection, the pathogenesis and transient or long-term colonization of the gastrointestinal tract of this organism in human disease is not clear. We describe a rare manifestation of E. tarda infection in a perihepatic abscess in the setting of a patient with perforated cholecystitis and its successful eradication following antibiotic treatment.
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Affiliation(s)
- K Pham
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - Y Wu
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - G Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - N Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - L Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - G D Rodriguez
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Columbia University School of Nursing, Columbia University, NY 10032, USA
| | - S Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Weill Cornell Medicine, Cornell University, NY 10065, USA
| | - C Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Weill Cornell Medicine, Cornell University, NY 10065, USA
| | - J Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
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20
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Lee KW, Park J, Oh DY, Kim S, Sabanathan D, Kim T, Kim M, Yoon J, Lee H, Park S, Paeng K, Ock CY. 977P Interim results of phase I dose escalation study of YBL-006: A novel anti-PD-1 monoclonal antibody in advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1361] [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] Open
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21
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Thompson LL, Yoon J, Chang MS, Polyakov NJ, Pan CX, Chen ST, Wei EX, Charrow AP. Advanced care planning, code status and end-of-life care in patients with bullous pemphigoid. Br J Dermatol 2021; 185:1246-1247. [PMID: 34184254 DOI: 10.1111/bjd.20606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- L L Thompson
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - J Yoon
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - M S Chang
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - N J Polyakov
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - C X Pan
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - S T Chen
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - E X Wei
- Department of Dermatology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - A P Charrow
- Department of Dermatology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
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22
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Thompson L, Li E, Krasnow N, Chang M, Said J, Molina G, Polyakov N, Yoon J, Dee E, Huang K, Blum A, Kuchroo J, Hinton A, Reynolds K, Chen S. Effect of dermatological consultation on survival in patients with checkpoint inhibitor‐associated cutaneous toxicity. Br J Dermatol 2021; 185:627-635. [DOI: 10.1111/bjd.20074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023]
Affiliation(s)
- L.L. Thompson
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - E.B. Li
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - N.A. Krasnow
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - M.S. Chang
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J.T. Said
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - G.E. Molina
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - N.J. Polyakov
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J. Yoon
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - E.C. Dee
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - K. Huang
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - A.E. Blum
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J.R. Kuchroo
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - A.N. Hinton
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - K.L. Reynolds
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - S.T. Chen
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
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23
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Jeon Y, Min G, Park S, Park S, Yoon J, Lee S, Cho B, Eom K, Kim Y, Min C, Lee J, Cho S. Efficacy of ex vivo purging with CD34 positive selection during autologous stem cell transplantation in peripheral T-cell lymphomas. Cytotherapy 2021. [DOI: 10.1016/s1465324921003807] [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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24
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Khan S, Urban C, Singh V, Liu D, Segal-Maurer S, Parmar Y, Yoon J. Novel double beta-lactam therapy for Granulicatella adiacens infective endocarditis. IDCases 2021; 24:e01082. [PMID: 33850724 PMCID: PMC8039821 DOI: 10.1016/j.idcr.2021.e01082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 11/18/2022] Open
Abstract
Granulicatella adiacens, a nutritionally variant streptococci (NVS) is a well described organism associated with endocarditis. Previously communicated cases have documented the use of double beta-lactam therapy with ampicillin and ceftriaxone to treat patients with infective endocarditis due to Enterococcus faecalis and Streptocossus pneumoniae. We describe the first case of Granulicatella adiacens infective endocarditis in a patient successfully treated with the combination of intravenous ampicillin and ceftriaxone and document their synergistic activity.
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Affiliation(s)
- S. Khan
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - C. Urban
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
- Weill Cornell Medical College, Cornell University, NY, 10065, USA
- Corresponding author at: The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA.
| | - V. Singh
- Department of Pathology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - D. Liu
- Department of Pathology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - S. Segal-Maurer
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
- Weill Cornell Medical College, Cornell University, NY, 10065, USA
| | - Y. Parmar
- Department of Cardiology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - J. Yoon
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
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25
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Mall EM, Rotte N, Yoon J, Sandhowe-Klaverkamp R, Röpke A, Wistuba J, Hübner K, Schöler HR, Schlatt S. A novel xeno-organoid approach: exploring the crosstalk between human iPSC-derived PGC-like and rat testicular cells. Mol Hum Reprod 2020; 26:879-893. [PMID: 33049038 DOI: 10.1093/molehr/gaaa067] [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: 04/23/2020] [Revised: 09/11/2020] [Indexed: 02/06/2023] Open
Abstract
Specification of germ cell-like cells from induced pluripotent stem cells has become a clinically relevant tool for research. Research on initial embryonic processes is often limited by the access to foetal tissue, and in humans, the molecular events resulting in primordial germ cell (PGC) specification and sex determination remain to be elucidated. A deeper understanding of the underlying processes is crucial to describe pathomechanisms leading to impaired reproductive function. Several protocols have been established for the specification of human pluripotent stem cell towards early PGC-like cells (PGCLC), currently representing the best model to mimic early human germline developmental processes in vitro. Further sex determination towards the male lineage depends on somatic gonadal cells providing the necessary molecular cues. By establishing a culture system characterized by the re-organization of somatic cells from postnatal rat testes into cord-like structures and optimizing efficient PGCLC specification protocols, we facilitated the co-culture of human germ cell-like cells within a surrogate testicular microenvironment. Specified conditions allowed the survival of rat somatic testicular and human PGCLCs for 14 days. Human cells maintained the characteristic expression of octamer-binding transcription factor 4, SRY-box transcription factor 17, and transcription factor AP-2 gamma and were recovered from the xeno-organoids by cell sorting. This novel xeno-organoid approach will allow the in vitro exploration of early sex determination of human PGCLCs.
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Affiliation(s)
- E M Mall
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - N Rotte
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany.,Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - J Yoon
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - R Sandhowe-Klaverkamp
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - A Röpke
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - J Wistuba
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - K Hübner
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - H R Schöler
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany.,Medical Faculty, University of Münster, Münster, Germany
| | - S Schlatt
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
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26
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Yoon J, Barton MJ, St John JA, Ekberg JAK, Khan A, Redmond M. Anterior skull base olfactory tumours, which is what? A case report and review. J Clin Neurosci 2020; 81:1-5. [PMID: 33222894 DOI: 10.1016/j.jocn.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 07/29/2020] [Accepted: 09/06/2020] [Indexed: 11/17/2022]
Abstract
Intracranial schwannomas not originating from cranial nerves are rare. In this paper, we report a case of a 50-year-old male who presented with worsening headaches, diplopia and nausea over two years. Radiological imaging revealed a large tumour arising from the olfactory groove region with a preoperative diagnosis of olfactory groove meningioma (OGM). Intraoperatively, the tumour originated from the region of the attachment of the falx to the crista galli. The patient recovered without complication and histopathology reported an unexpected diagnosis of WHO Grade 1 schwannoma. However, as olfactory groove schwannomas (OGSs) cannot be distinguished from olfactory ensheathing cell tumours (OECTs), it is possible that the tumour could have been either an OGS or an OECT. Distinguishing between OGSs, OECTs and OGMs preoperatively is difficult. OGMs exhibit distinct histopathological features from OGSs/OECTs, however, OGSs and OECTs currently cannot be distinguished from each other. Here, we review the literature to discuss the differentiating features and cellular origins of these three tumours.
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Affiliation(s)
- J Yoon
- Neurosurgery Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - M J Barton
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, QLD, Australia
| | - J A St John
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - J A K Ekberg
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - A Khan
- Anatomical Pathology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - M Redmond
- Neurosurgery Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
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27
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Thompson LL, Chang MS, McCormack L, Polyakov N, Yoon J, Song H, Huang JT, Chen ST. Patterns of cutaneous immune-related adverse events in adults and children with advanced sarcoma: a retrospective cohort study. Br J Dermatol 2020; 184:363-365. [PMID: 32894776 DOI: 10.1111/bjd.19540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022]
Affiliation(s)
- L L Thompson
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - M S Chang
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - L McCormack
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,University of Massachusetts Medical School, Worcester, MA, USA
| | - N Polyakov
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - J Yoon
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - H Song
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Harvard Combined Dermatology Residency Program, Harvard Medical School, Boston, MA, USA
| | - J T Huang
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - S T Chen
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
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Shin M, Hwang S, Yoon J, Chung E, Kim T. PAM3 Cost-Effectiveness of Kinesiology Taping for Patients with Mild to Moderate Ankle Sprain. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.004] [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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Shin M, Hwang S, Yoon J, Chung E, Kim T. PAM4 Cost-Effectiveness of Dangguixu-SAN for Patients with Mild to Moderate Ankle Sprain. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.005] [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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Bui L, Yoon J, Harvey M, Luck J, Branscum A. Oregon Experiment with Medicaid Accountable Care and Pediatric Preventive Care Utilization Among Infants. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- L. Bui
- The University of California Berkeley, Berkeley CA United States
| | - J. Yoon
- Oregon State Univeristy Corvallis OR United States
| | - M. Harvey
- Oregon State Univeristy Corvallis OR United States
| | - J. Luck
- Oregon State Univeristy Corvallis OR United States
| | - A. Branscum
- Oregon State Univeristy Corvallis OR United States
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Wong E, Guo R, Yoon J, Chang E. Impact of VHA’s Primary Intensive Care Management Program on Dual System Use. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- E. Wong
- University of Washington Seattle WA United States
- VA Puget Sound Health Care System Seattle WA United States
| | - R. Guo
- VA Greater Los Angeles Health Care System Los Angeles CA United States
- University of California Los Angeles Los Angeles CA United States
| | - J. Yoon
- Department of Veterans Affairs Menlo Park CA United States
| | - E. Chang
- VA Greater Los Angeles Health Care System Los Angeles CA United States
- University of California Los Angeles Los Angeles CA United States
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Yuen M, Schiefke I, Yoon J, Ahn SH, Heo J, Kim JH, Lik Yuen Chan H, Yoon KT, Klinker H, Manns M, Petersen J, Schluep T, Hamilton J, Given BD, Ferrari C, Lai C, Locarnini SA, Gish RG. RNA Interference Therapy With ARC-520 Results in Prolonged Hepatitis B Surface Antigen Response in Patients With Chronic Hepatitis B Infection. Hepatology 2020; 72:19-31. [PMID: 31654573 PMCID: PMC7496196 DOI: 10.1002/hep.31008] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS ARC-520, the first an RNA interference (RNAi) therapeutic, was designed to reduce all RNA transcripts derived from covalently closed circular DNA, leading to a reduction in viral antigens and hepatitis B virus (HBV) DNA. APPROACH AND RESULTS We aimed to evaluate the depth of hepatitis B surface antigen (HBsAg) decline in response to multiple doses of ARC-520 compared to placebo (PBO) in two randomized, multicenter studies in nucleoside/nucleotide analogue reverse-transcriptase inhibitor (NUC)-experienced patients with hepatitis B early antigen (HBeAg)-negative (E-neg) or HBeAg-positive (E-pos) disease. A total of 58 E-neg and 32 E-pos patients were enrolled and received four monthly doses of PBO (n = 20 E-neg, 11 E-pos), 1 mg/kg ARC-520 (n = 17 E-neg, 10 E-pos), or 2 mg/kg ARC-520 (n = 21 E-neg, 11 E-pos) concomitantly with NUC. HBsAg change from baseline to 30 days after the last ARC-520 dose were compared to PBO. Both E-neg and E-pos high-dose groups significantly reduced HBsAg compared to PBO, with mean reductions of 0.38 and 0.54 log IU/mL, respectively. HBsAg reductions persisted for approximately 85 days and >85 days after the last dose in E-neg and E-pos patients, respectively. The low-dose groups did not reach statistical significance in either study. E-pos patients showed a dose-dependent reduction in HBeAg from baseline. Mean maximum reduction was 0.23 and 0.69 log Paul Ehrlich IUs/mL in the low-dose and high dose ARC-520 groups respectively. ARC-520 was well tolerated, with only two serious adverse events of pyrexia possibly related to study drug observed. CONCLUSIONS ARC-520 was active in both E-neg and E-pos, NUC-experienced HBV patients; but absolute HBsAg reductions were moderate, possibly due to expression of HBsAg from integrated HBV DNA, indicating the need for RNAi therapeutics that can target viral transcripts regardless of origin.
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Affiliation(s)
- Man‐Fung Yuen
- Queen Mary HospitalThe University of Hong KongHong KongChina
| | | | - Jung‐Hwan Yoon
- Seoul National University HospitalSeoulRepublic of Korea
| | - Sang Hoon Ahn
- Yonsei University College of MedicineSeoulRepublic of Korea
| | - Jeong Heo
- Pusan National University and Medical Research InstituteBusanRepublic of Korea
| | - Ju Hyun Kim
- Gachon University Gil HospitalIncheonRepublic of Korea
| | | | - Ki Tae Yoon
- Pusan National University Yangsan HospitalYangsan‐siRepublic of Korea
| | | | | | - Joerg Petersen
- IFI Institute at Asklepios Klinik St. GeorgHamburgGermany
| | | | | | | | - Carlo Ferrari
- Unit of Infectious Diseases and HepatologyUniversity of ParmaParmaItaly
| | - Ching‐Lung Lai
- Queen Mary HospitalThe University of Hong KongHong KongChina
| | | | - Robert G. Gish
- Division of Gastroenterology and HepatologyDepartment of MedicineStanford University Medical CenterStanfordCA
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Yoon J, Lee H, Lim JW, Kim H. Inhibitory effect of alpha-lipoic acid on mitochondrial dysfunction and interleukin-8 expression in interleukin-1beta-stimulated ataxia teleangiectasia fibroblasts. J Physiol Pharmacol 2020; 71. [PMID: 32554850 DOI: 10.26402/jpp.2020.1.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/28/2020] [Indexed: 11/03/2022]
Abstract
Ataxia telangiectasia (A-T) is an inherited neurodegenerative disease caused by mutation in the ataxia telangiectasia mutated (ATM) gene, leading to loss of function in the encoded protein ATM. Because ATM functions to reduce oxidative stress by up-regulating antioxidant enzymes, oxidative stress is a prevalent A-T phenotype and a mediator of the inflammation that drives A-T pathology. Reactive oxygen species (ROS) levels and the expression of pro-inflammatory cytokine interleukin-8 (IL-8) were higher in A-T cells than in normal cells. ROS are related to mitochondrial dysfunction and activation of nuclear factor kappa B (NF-κB) to induce IL-8 expression. Alpha-lipoic acid (α-LA), a naturally occurring thiol compound, shows an antioxidant effect in various cells. This study is aimed to determine if α-LA confers protection against NF-κB activation, IL-8 expression, and mitochondrial dysfunction in A-T cells which are exposed to the inflammatory cytokine IL-1β. A-T fibroblasts were treated with or without α-LA. The levels of intracellular and mitochondrial ROS, mRNA and protein levels of IL-8, mitochondrial membrane potential (MMP), ATP levels, and DNA binding activity of NF-κB were determined. As a result, IL-1β increased NF-κB activation, IL-8 expression, intracellular and mitochondrial ROS levels, but decreased MMP and ATP level in A-T cells. Pretreatment of A-T cells with α-LA inhibited IL-1β-induced activation of NF-κB, IL-8 expression, and mitochondrial dysfunction by reducing ROS levels. In conclusion, supplementation with α-LA may be beneficial for reducing the oxidative stress-induced mitochondrial dysfunction and IL-8 production associated with A-T.
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Affiliation(s)
- J Yoon
- Department of Food and Nutrition, Brain Krea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul, South Korea
| | - H Lee
- Department of Food and Nutrition, Brain Krea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul, South Korea
| | - J W Lim
- Department of Food and Nutrition, Brain Krea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul, South Korea
| | - H Kim
- Department of Food and Nutrition, Brain Krea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul, South Korea.
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Mumtaz S, Li ZY, Yoon J, Yuvienco C. AB1121 IMPLEMENTING HIGH VALUE CARE IN INPATIENT ANTINUCLEAR ANTIBODY TESTING. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Antinuclear Antibody (ANA) testing forms the basis on which many rheumatological diseases are subsequently diagnosed. ANA testing quantifies the dilution of plasma to produce the titer and staining pattern and this can be a part of an ANA order set that reflexively cascades to sub-serology if positive. Studies have shown that a low titer ANA may potentially translate into an erroneous diagnosis: if one estimates a 1 percent prevalence of ANA associated disease in the general population then 30% of those individuals would have a false positive result of ANA detected at 1:40 titer [1]. We theorized that there is no need for several methods to coexist within a single inpatient hospital setting especially since diagnostic value of staining patterns alone is limited.Objectives:To compare the utility and yield of “ANA screening reflex to profile” (ARP) and “ANA reflex to titer” (ART) order sets in the inpatient setting of a community tertiary care hospital. We aim to identify the appropriateness of the ANA testing ordered including cost-effectiveness of ordering ARP over ART in order to implement the identified quality measures towards improving utilization of ANA testing.Methods:We identified all inpatient ANA reflex testing orders performed at Community Regional Medical Center, Fresno, California completed between 11/2018 till 07/2019. This included ART and ARP orders with 6 sub-serologies: SSA, SSB, dsDNA, Smith, Scl-70 and U1RNP. A Health Information Management report was generated which included patient’s age, gender, length of hospital stay, dates of testing ordered, principal diagnosis and type of ANA testing ordered. Descriptive statistics were computed and analyzed.Results:We reviewed a total of 1,012 ANA lab orders performed between 11/01/2018 until 07/30/2019 performed on 700 patients. According to the laboratory standard using Immunofluorescence Assay, an ANA titer starting from 1:40 is reported as positive. Out of the 1,012 tests, 334 tests were positive i.e. 33%. The ART order by itself contributed to 29.9% of the positive testing while ARP formed 70% of the positive testing. 56 of the 910 ARP (6%) performed had one or more sub-serology antibody positive while in 178 ARP orders (20%) only the ANA titer was positive with negative serology. The most common sub-serology antibody noted positive was dsDNA forming 54% of the positive serology results. Multiple testing was noted with 218 orders of ARP and ART being ordered on the same patient within the same week, which shows 21.5% of ANA lab orders were repetitive. Length of stay was noted to be more than 3 days for 89% of the patients who had repetitive testing, majority of those tests (99%) on the same day by the same medical provider. It cost $5.0 for an ART order that resulted negative and $5.0 for an ARP panel that resulted negative. It cost $10.0 for those patients who had both ART and ARP ordered with negative results. A positive ART result added $12.0 additional to the cost of each positive ANA profile ($67.36) when both tests were ordered together.Conclusion:Our study findings reflect the need for using higher yield ANA testing that has been standardized. It demonstrated that physicians ordering the testing were not familiar with the ART vs. ARP, and the laboratory orders needed to be re-structured. We removed the ART from the inpatient Electronic Medical Record i.e. Epic system so that only the ARP order remained. This would prevent repetitive testing and reduce healthcare costs through reduction by at least $12.0 per positive ANA result and may also translate into reduced length of hospital stay. We were able to add Centromere Antibody (Ab) to the ANA profile sub serologies to standardize it further as it is an important part of Scleroderma diagnosis.References:[1]Range of antinuclear antibodies in “healthy” individuals. AU, Tan EM, et al. Arthritis Rheum. 1997; 40(9):1601Disclosure of Interests:None declared
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Lee N, Seo J, Park H, Yoon J. Diagnosis and successful percutaneous ultrasound-guided aspiration treatment of multiple bilomas in a dog. J Small Anim Pract 2020; 61:321-322. [PMID: 32166748 DOI: 10.1111/jsap.13133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- N Lee
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.,Time Animal Medical Center, 57, Dunsan-ro, Seo-gu, Daejeon, 35233, Republic of Korea
| | - J Seo
- Time Animal Medical Center, 57, Dunsan-ro, Seo-gu, Daejeon, 35233, Republic of Korea
| | - H Park
- Time Animal Medical Center, 57, Dunsan-ro, Seo-gu, Daejeon, 35233, Republic of Korea
| | - J Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
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Zhan C, Yoon J, Baghai Kermani A, Gupta A, Moore W. Abstract No. 587 Safety and efficacy of computed tomography–guided percutaneous cryoneurolysis for chronic intercostal pain syndrome. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.648] [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: 11/25/2022] Open
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Cenko E, Van Der Schaar M, Yoon J, Vasiljevic Z, Kedev S, Vavlukis M, Bergami M, Scarpone M, Milicic D, Manfrini O, Badimon L, Bugiardini R. P6419Machine learning in critical care: the role of diabetes and age in acute coronary syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with diabetes and non-ST elevation acute coronary syndrome (NSTE-ACS) have an increased risk of mortality and adverse outcomes following percutaneous coronary intervention (PCI).
Purpose
We aimed to investigate the impact of early, within 24 hours PCI compared with only routine medical treatment on clinical outcomes in a large international cohort of patients with NSTE-ACS and diabetes.
Methods
We identified 1,250 patients with diabetes and NSTE-ACS from a registry-based population between October 2010 and April 2016. The primary endpoint was 30-day all-cause mortality. The secondary endpoint was the composite outcome of 30-day all-cause mortality and left ventricular dysfunction (ejection fraction <40%). We undertook analyses to explore the heterogeneity of treatment effects using meta-classification (MC) algorithms followed by propensity score matching and inverse-probability-of-treatment weighting (IPTW) from a landmark of 24 hours from hospitalization.
Results
Of 1,250 NSTE-ACS first-day survivors with diabetes (median age 67 years; 59%, men), 470 (37.6%) received early PCI and 780 routine medical treatment. The overall 30-day all-cause mortality rates were higher in the routine medical treatment than the early PCI group (6.3% vs. 2.5%). The prediction results of the MC algorithms accounted for only one interaction term that was statistically significant: age ≥65 years. After propensity-matched analysis as well as IPTW, early PCI was associated with reduced 30-day all-cause mortality in the older age (OR: 0.35; 95% CI: 0.14 to 0.92 and 0.43; 95% CI: 0.21 to 0.86, respectively), whereas younger age had no association with the primary endpoint. Similar results were also obtained for the secondary endpoint.
Conclusions
Among patients with diabetes hospitalized for NSTE-ACS, an early, within 24 hours, PCI strategy is associated with reduced odds of 30-day mortality only for patients aged 65 years or over. MC algorithms provide accurate identification of treatment effect modifiers.
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Affiliation(s)
- E Cenko
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Bologna, Italy
| | | | - J Yoon
- University of California Los Angeles, Los Angeles, United States of America
| | | | - S Kedev
- University Clinic of Cardiology, Skopje, North Macedonia
| | - M Vavlukis
- University Clinic of Cardiology, Skopje, North Macedonia
| | - M Bergami
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Bologna, Italy
| | - M Scarpone
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Bologna, Italy
| | - D Milicic
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - O Manfrini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Bologna, Italy
| | - L Badimon
- Autonomous University of Barcelona, Cardiovascular Program (ICCC), IR-Hospital de la Santa Creu i Sant Pau. CiberCV-Institute Carlos, Barcelona, Spain
| | - R Bugiardini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Bologna, Italy
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Choi S, Cho D, Yoon S, Yoon J. EP1.17-22 In Stage I Non-Small Cell Lung Cancer, Abutting Adjacent Structures Is a Possible Prognostic Factor. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kim M, Yoon J, Jang M, Kim H, Park Y, Lee M, Hwang H, Kang C, Lee W, Kang B, Chung H, Choi H. Genomic alterations predict clinical response to systemic chemotherapy and immune checkpoint blockade in biliary tract cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.008] [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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Jussila A, Steele M, DiNuoscio G, Hamburg E, Yoon J, Atit R. 439 Mechanism for loss of intradermal fat accompanying skin fibrosis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.515] [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: 10/27/2022]
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Park S, Choi J, Kim Y, Yoon J, Ahn S, Choi W. EP-1682 Fetal dose from head and neck tomotherapy versus 3D conformal radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32102-4] [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: 11/27/2022]
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Noda C, Yoon J, Raman H, Zhou M, Malone C, Ramaswamy R, Akinwande O. 04:12 PM Abstract No. 110 Comparative outcomes of liver-dominant metastatic neuroendocrine tumors treated with bland embolization, radioembolization, or chemoembolization in a single institution. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.156] [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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Lee I, Lee J, Lee Y, Kim Y, Yoon J, Yin Y, Lee M, Hur S, Kim H, Jae H, Chung J. 03:00 PM Abstract No. 208 Conventional versus Drug-eluting bead transarterial chemoembolization for nodular hepatocellular carcinoma in a superselective fashion using cone-beam CT: analysis of a five-year outcome. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.265] [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: 10/27/2022] Open
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Yoon J, Spies J, Caridi T. 04:21 PM Abstract No. 140 Uterine artery embolization for adenomyosis: a single-center experience. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.189] [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: 10/27/2022] Open
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Exposito MJ, Akce M, Alvarez J, Assenat E, Balart L, Baron A, Decaens T, Heurgue-Berlot A, Martin A, Paik S, Poulart V, Sehbai A, Shimada M, Takemura N, Yoon J. Abstract No. 526 CheckMate-9DX: phase 3, randomized, double-blind study of adjuvant nivolumab vs placebo for patients with hepatocellular carcinoma (HCC) at high risk of recurrence after curative resection or ablation. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Choi M, Kim H, Yoon J, Choi M. CT features of extrahepatic arterioportal fistula in two cats. J Small Anim Pract 2018; 60:697-700. [PMID: 30381839 DOI: 10.1111/jsap.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/12/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022]
Abstract
Two cats presented with large volume ascites and the cause was suspected to be portal hypertension. On contrast CT they both showed enhancement of the main portal vein during the arterial phase and an anomalous connection between the celiac artery and extrahepatic portal vasculature, prompting a diagnosis of extrahepatic arterioportal fistula. An extrahepatic arterioportal fistula is a connection between any artery and the portal vein outside the liver and, to our knowledge, this is the first report in cats.
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Affiliation(s)
- M Choi
- Department of Veterinary Medical Imaging, Haemaru Referral Animal Hospital, Seongnam 463-050, Republic of Korea
| | - H Kim
- Department of Veterinary Medical Imaging, Haemaru Referral Animal Hospital, Seongnam 463-050, Republic of Korea
| | - J Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Republic of Korea
| | - M Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Republic of Korea
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Yoon J, Roque N, Andringa R, Griffis Lewis K, Harrell E, Vitale T, Charness N. INTERVENTION COMPARATIVE EFFECTIVENESS FOR ADULT COGNITIVE TRAINING (ICE-ACT) (CLINICALTRIALS#:NCT03141281). Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kim H, Kim H, Chun Y, Yoon J. NASAL EOSINOPHIL CORRELATION WITH AEROALLERGEN SENSITIZATION IN CHILDREN. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.193] [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: 10/27/2022]
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Lerner N, Trinkoff AM, Storr CL, Han K, Yoon J, Kyum Yang B. FACILITY CHARACTERISTICS ASSOCIATED WITH CARE DEFICIENCIES IN ASSISTED LIVING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Lerner
- University of Maryland, School of Nursing, Baltimore, Maryland, United States
| | - A M Trinkoff
- University of Maryland School of Nursing, Baltimore, Md. U.S.A
| | - C L Storr
- University of Maryland School of Nursing, Baltimore, Md. U.S.A
| | - K Han
- Chung-Ang University Red Cross College of Nursing, Seoul, South Korea, University of Maryland, School of Nursing, Baltimore, Md. USA
| | - J Yoon
- University of Md. School of Nursing, Baltimore, Md. USA
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Lee H, Yoon J, Kim K. NASAL EOSINOPHIL COUNT AND PERCENTAGE IN CHILDREN WITH ALLERGIC RHINITIS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.081] [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: 10/27/2022]
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