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Norrish G, Kolt G, Cervi E, Field E, Dady K, Ziółkowska L, Olivotto I, Favilli S, Passantino S, Limongelli G, Caiazza M, Rubino M, Baban A, Drago F, Mcleod K, Ilina M, McGowan R, Stuart G, Bhole V, Uzun O, Wong A, Lazarou L, Brown E, Daubeney PE, Lota A, Delle Donne G, Linter K, Mathur S, Bharucha T, Adwani S, Searle J, Popoiu A, Jones CB, Reinhardt Z, Kaski JP. Clinical presentation and long-term outcomes of infantile hypertrophic cardiomyopathy: a European multicentre study. ESC Heart Fail 2021; 8:5057-5067. [PMID: 34486247 PMCID: PMC8712843 DOI: 10.1002/ehf2.13573] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/22/2021] [Accepted: 08/04/2021] [Indexed: 11/11/2022] Open
Abstract
AIMS Children presenting with hypertrophic cardiomyopathy (HCM) in infancy are reported to have a poor prognosis, but this heterogeneous group has not been systematically characterized. This study aimed to describe the aetiology, phenotype, and outcomes of infantile HCM in a well-characterized multicentre European cohort. METHODS AND RESULTS Of 301 children diagnosed with infantile HCM between 1987 and 2019 presenting to 17 European centres [male n = 187 (62.1%)], underlying aetiology was non-syndromic (n = 138, 45.6%), RASopathy (n = 101, 33.6%), or inborn error of metabolism (IEM) (n = 49, 16.3%). The most common reasons for presentation were symptoms (n = 77, 29.3%), which were more prevalent in those with syndromic disease (n = 62, 61.4%, P < 0.001), and an isolated murmur (n = 75, 28.5%). One hundred and sixty-one (53.5%) had one or more co-morbidities. Genetic testing was performed in 163 (54.2%) patients, with a disease-causing variant identified in 115 (70.6%). Over median follow-up of 4.1 years, 50 (16.6%) underwent one or more surgical interventions; 15 (5.0%) had an arrhythmic event (6 in the first year of life); and 48 (15.9%) died, with an overall 5 year survival of 85%. Predictors of all-cause mortality were an underlying diagnosis of IEM [hazard ratio (HR) 4.4, P = 0.070], cardiac symptoms (HR 3.2, P = 0.005), and impaired left ventricular systolic function (HR 3.0, P = 0.028). CONCLUSIONS This large, multicentre study of infantile HCM describes a complex cohort of patients with a diverse phenotypic spectrum and clinical course. Although overall outcomes were poor, this was largely related to underlying aetiology emphasizing the importance of comprehensive aetiological investigations, including genetic testing, in infantile HCM.
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Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
- Institute of Cardiovascular Sciences University College LondonLondonUK
| | - Gali Kolt
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
| | - Elena Cervi
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
| | - Ella Field
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
- Institute of Cardiovascular Sciences University College LondonLondonUK
| | - Kathleen Dady
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
| | - Lidia Ziółkowska
- Department of CardiologyThe Children's Memorial Health InstituteWarsawPoland
| | | | | | - Silvia Passantino
- Careggi University HospitalFlorenceItaly
- Meyer Children's HospitalFlorenceItaly
| | | | | | | | | | | | | | | | - Ruth McGowan
- West of Scotland Centre for Genomic MedicineQueen Elizabeth University HospitalGlasgowUK
| | - Graham Stuart
- University Hospitals Bristol NHS Foundation TrustBristolUK
| | - Vinay Bhole
- Birmingham Women and Children's NHS Foundation TrustBirminghamUK
| | | | - Amos Wong
- University Hospital of WalesCardiffUK
| | | | | | - Piers E.F. Daubeney
- Royal Brompton and Harefield Hospital, National Heart and Lung InstituteImperial College LondonLondonUK
| | - Amrit Lota
- Royal Brompton and Harefield Hospital, National Heart and Lung InstituteImperial College LondonLondonUK
| | - Grazia Delle Donne
- Royal Brompton and Harefield Hospital, National Heart and Lung InstituteImperial College LondonLondonUK
| | | | - Sujeev Mathur
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation TrustLondonUK
| | - Tara Bharucha
- University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Satish Adwani
- Oxford University Hospitals NHS Foundation TrustOxfordUK
| | - Jon Searle
- Oxford University Hospitals NHS Foundation TrustOxfordUK
| | - Anca Popoiu
- Department of PediatricsChildren's Hospital ‘Louis Turcanu’, University of Medicine and Pharmacy “Victor Babes” TimisoaraTimisoaraRomania
| | | | | | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular DiseasesGreat Ormond Street HospitalLondonWC1N 3JHUK
- Institute of Cardiovascular Sciences University College LondonLondonUK
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Tzelves L, Glykas I, Lazarou L, Zabaftis C, Fragkoulis C, Leventi A, Moulavasilis N, Tzavellas D, Tsirkas K, Ntoumas K, Mourmouris P, Dellis A, Varkarakis I, Skolarikos A, Liatsikos E, Gkialas I. Urology residency training in Greece. Results from the first national resident survey. Actas Urol Esp 2021; 45:S0210-4806(21)00092-9. [PMID: 34120774 DOI: 10.1016/j.acuro.2020.11.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/22/2020] [Accepted: 11/29/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement. MATERIAL AND METHODS A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Fisher's exact test, chi-squared test and Kruskal-Wallis test were used with statistical significance set at p=.05. RESULTS The median overall satisfaction regarding surgical training was 6/10 regardless of working schedule, working in a University Department, PGY or number of residents in clinic. Most residents have not performed any scrotal ultrasound or pressure-flow-studies; however, they are more familiar with KUB ultrasound. Double-J stent insertion and cystoscopy were common procedures for residents. Bureaucracy was reported as a major issue by 70.4% of residents. ESWL has not been performed by 80.2% of residents, 58.2% residents performed less than 10 ureteroscopies, and only the last year trainees performed more than 10 TURBT and TURP. Most residents mentioned to rarely perform basic steps in many open or laparoscopic urological procedures. Surprisingly, 59.3% of residents have not published any study in peer-reviewed journals. Regarding satisfaction, 44% rarely feel satisfied at work and 59.3% sometimes suffer from burnout. Response rate reached 87.5%. CONCLUSIONS Considering the results from this survey, regulatory authorities should join forces to establish a structured curriculum of clinical, surgical and research training in Urology across Europe.
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Affiliation(s)
- L Tzelves
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - I Glykas
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia.
| | - L Lazarou
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - C Zabaftis
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - C Fragkoulis
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - A Leventi
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - N Moulavasilis
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - D Tzavellas
- First Department of Urology, National and Kapodistrian University of Athens, Laiko Hospital, Atenas, Grecia
| | - K Tsirkas
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - K Ntoumas
- Department of Urology, General Hospital of Athens"G. Gennimatas", Atenas, Grecia
| | - P Mourmouris
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - A Dellis
- 2.(nd) Department of Surgery, National and Kapodistrian University of Athens, School of Medicine, Aretaieion Hospital, Atenas, Grecia, 1.(st) Department of Urology, National and Kapodistrian University of Athens, School of Medicine, Laiko Hospital, Atenas, Grecia
| | - I Varkarakis
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - A Skolarikos
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Atenas, Grecia
| | - E Liatsikos
- Department of Urology, University of Patras, School of Medicine, Patras, Grecia
| | - I Gkialas
- Department of Urology «Agios Savvas», Anti-Cancer Oncologic Hospital of Athens, Atenas, Grecia
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Mantica G, Carrion D, Pang K, Ucar T, Parodi S, Tappero S, Lazarou L, Glykas I, Zambaftis C, Lourenco M, Gonzalez Padilla D, Ortega Polledo L, Gomez Rivas J, Esperto F. Defining the ideal urology training programme from the trainee’s and professor’s perspective: Is there a concordance in their idea of good training? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The laboratory mouse, Mus musculus domesticus, has been the workhorse of the very successful laboratory study of mammalian immunology. These studies--discovering how the mammalian immune system can work--have allowed the development of the field of wild immunology that is seeking to understand how the immune responses of wild animals contributes to animals' fitness. Remarkably, there have hardly been any studies of the immunology of wild M. musculus domesticus (or of rats, another common laboratory model), but the general finding is that these wild animals are more immunologically responsive, compared with their laboratory domesticated comparators. This difference probably reflects the comparatively greater previous exposure to antigens of these wild-caught animals. There are now excellent prospects for laboratory mouse immunology to make major advances in the field of wild immunology.
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Affiliation(s)
- M Viney
- School of Biological Sciences, University of Bristol, Bristol, UK
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Adams M, Jenney M, Lazarou L, White R, Birdsall S, Staab T, Schindler D, Meyer S. Acute myeloid leukaemia after treatment for acute lymphoblastic leukaemia in girl with Bloom syndrome. ACTA ACUST UNITED AC 2013; 4. [PMID: 24932421 DOI: 10.4172/2157-7412.1000177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bloom syndrome (BS) is an inherited genomic instability disorder caused by disruption of the BLM helicase and confers an extreme cancer predisposition. Here we report on a girl with BS who developed acute lymphoblastic leukaemia (ALL) at age nine, and treatment-related acute myeloid leukaemia (t-AML) aged 12. She was compound heterozygous for the novel BLM frameshift deletion c.1624delG and the previously described c.3415C>T nonsense mutation. Two haematological malignancies in a child with BS imply a fundamental role for BLM for normal haematopoiesis, in particular in the presence of genotoxic stress.
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Affiliation(s)
- Madeleine Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Laz Lazarou
- Department of Medical Genetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Rhian White
- Department of Medical Genetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Sanda Birdsall
- Tumour Cytogenetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Timo Staab
- Department of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Detlev Schindler
- Department of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Stefan Meyer
- Stem Cell and Leukaemia Proteomics Laboratory; School of Cancer and Imaging Sciences, The University of Manchester, Manchester Academic Health Science Centre ; Department of Paediatric Onclogy, Royal Manchester Children's Hospital ; Paediatric and Adolescent Oncology, The Christie NHS Foundation Trust, Manchester, UK
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Archer HL, Whatley SD, Evans JC, Ravine D, Huppke P, Kerr A, Bunyan D, Kerr B, Sweeney E, Davies SJ, Reardon W, Horn J, MacDermot KD, Smith RA, Magee A, Donaldson A, Crow Y, Hermon G, Miedzybrodzka Z, Cooper DN, Lazarou L, Butler R, Sampson J, Pilz DT, Laccone F, Clarke AJ. Gross rearrangements of the MECP2 gene are found in both classical and atypical Rett syndrome patients. J Med Genet 2005; 43:451-6. [PMID: 16183801 PMCID: PMC2564520 DOI: 10.1136/jmg.2005.033464] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
MECP2 mutations are identifiable in approximately 80% of classic Rett syndrome (RTT), but less frequently in atypical RTT. We recruited 110 patients who fulfilled the diagnostic criteria for Rett syndrome and were referred to Cardiff for molecular analysis, but in whom an MECP2 mutation was not identifiable. Dosage analysis of MECP2 was carried out using multiplex ligation dependent probe amplification or quantitative fluorescent PCR. Large deletions were identified in 37.8% (14/37) of classic and 7.5% (4/53) of atypical RTT patients. Most large deletions contained a breakpoint in the deletion prone region of exon 4. The clinical phenotype was ascertained in all 18 of the deleted cases and in four further cases with large deletions identified in Goettingen. Five patients with large deletions had additional congenital anomalies, which was significantly more than in RTT patients with other MECP2 mutations (2/193; p<0.0001). Quantitative analysis should be included in molecular diagnostic strategies in both classic and atypical RTT.
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Tanner SM, Schneider V, Thomas NS, Clarke A, Lazarou L, Liechti-Gallati S. Characterization of 34 novel and six known MTM1 gene mutations in 47 unrelated X-linked myotubular myopathy patients. Neuromuscul Disord 1999; 9:41-9. [PMID: 10063835 DOI: 10.1016/s0960-8966(98)00090-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
X-linked myotubular myopathy (XLMTM) is a congenital muscle disorder mainly affecting newborn males. Neonatal muscle weakness and hypotonia usually leads to a rapid demise. The responsible gene, MTM1, was isolated in 1996, and mutational data derived from 90 patients have been published. We report on our findings in a further 53 patients, using genomic DNA and mRNA screening protocols. Thirty-four novel mutations were identified in 37 cases, and six known mutations found in 10 other patients. The 34 new mutations include five large deletions, eight nonsense, six frameshift, five missense, and eight splice-site mutations, whereas two intronic variants causing partial exon skipping represent the first report on such a mechanism in MTM1. Two deletions, one involving exon 1, and the second exon 15, are the first defects to be identified in these exons. The heterogeneity of the mutations, their mutational origins, and the varied ethnic backgrounds of the patients, indicate that the majority of XLMTM families are affected by unique MTM1 mutations.
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Affiliation(s)
- S M Tanner
- Human Molecular Genetics, Department of Clinical Research, Children's Hospital, University of Berne, Switzerland.
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Abstract
A search has been conducted for disease-causing mutations in the PKD1 gene in 147 unrelated ADPKD index cases. Using the polymerase chain reaction with primer pairs located in the 3' single copy region of the gene and single-strand conformation polymorphism analysis, we detected novel aberrant bands in five individuals that were absent in 100 control samples. Sequencing revealed three nonsense mutations (Q4010X, E4024X, Q4041X), a frameshift mutation (12262 del 2 bp), and a missense mutation (G4031D). In addition, three polymorphisms were detected [12346 + 19delG, heterozygosity (0.13), I4044V (0.23), 12212-34C > A (0.07)]. The mutational mechanism for the recurrent mutation (Q4041X) is likely to be slipped mispairing of an adjacent direct imperfect repeat sequence.
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Affiliation(s)
- C Daniells
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
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Daniells C, Maheshwar M, Lazarou L, Davies F, Coles G, Ravine D. Human gene mutations. Gene symbol: PKD1. Disease: Polycystic kidney disease. Hum Genet 1998; 102:127. [PMID: 9490292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- C Daniells
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
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Abstract
Between 1987 and 1990 a large series of at-risk individuals has been referred to our Huntington's disease (HD) presymptomatic testing programme. A detailed protocol for assessment and counselling has been followed. Out of 238 serious inquiries, 36% were potentially suitable for the testing programme, but 19% chose not to continue. Reasons for exclusion included the presence of clinical features of HD and being under the age of 18 years. Out of 40 final results given to 38 individuals, 23 indicated a lowered risk, 11 an increased risk, while five results were uninformative, two of these becoming informative on repeat testing. This series contained more women than men, and was disproportionately from the higher socio-economic groups. Motives for requesting a test principally related to child-bearing, informing existing children, and planning for the future. No significant psychiatric symptoms have been reported in the short term, but difficult counselling problems were presented by the high proportion of applicants who already showed clinical signs of HD. It is concluded that a detailed counselling protocol is essential in testing for HD, as many applicants are ill-prepared; this will assume even greater importance when the HD gene is identified and a test for specific mutations is available. The experience of presymptomatic testing for HD provides important general lessons which are likely to be applicable to other inherited neurological and psychiatric disorders.
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Affiliation(s)
- A Tyler
- Institute of Medical Genetics, University of Wales College of Medicine, Heath Park, Cardiff
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12
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Abstract
Experience with nearly 300 applicants for predictive testing for Huntington's disease has shown that apart from the expected problems such as those related to third-party interests and the effects of an adverse test result, there were several less foreseen difficulties. These included the finding that some applicants were already clinically affected, requests for testing of minors, unintentional risk alteration for relatives, and the use of research samples for service purposes. More of the problems involved clinical and counselling aspects rather than laboratory procedures.
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Affiliation(s)
- M J Morris
- Institute of Medical Genetics, University of Wales College of Medicine, Heath Park, Cardiff
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Ramsay M, Reeders ST, Thomson PD, Milner LS, Lazarou L, Barratt TM, Yau A, Lehmann OJ, Jenkins T. Mutations for the autosomal recessive and autosomal dominant forms of polycystic kidney disease are not allelic. Hum Genet 1988; 79:73-5. [PMID: 3163321 DOI: 10.1007/bf00291714] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The autosomal dominant form of polycystic kidney disease (ADPKD) has been linked to the alpha-globin gene locus on 16p. Linkage studies between the autosomal recessive type (ARPKD) and the 3' HVR of the alpha-globin gene cluster showed that the ARPKD and ADPKD are not allelic.
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Affiliation(s)
- M Ramsay
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
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Zotales N, Krekoukias C, Lazarou L, Spengos MN. [Fractures of the maxilla: a report of 62 cases]. Stomatologia (Athenai) 1981; 38:205-19. [PMID: 6947583] [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: 01/22/2023]
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