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Chen L, Thapaliya G, Papantoni A, Benson L, Carnell S. Neural correlates of appetite in adolescents. Appetite 2023; 191:107076. [PMID: 37806450 PMCID: PMC10997743 DOI: 10.1016/j.appet.2023.107076] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
Appetitive characteristics are associated with child adiposity, but their biological underpinnings are unclear. We sought to investigate the neural correlates of psychometric and behavioral measures of appetitive characteristics in youth. Adolescents (14-18y; 39F, 37M) varying in familial obesity risk and body weight (20% with overweight, 24% with obesity) viewed pictures of high energy-density (ED) foods, low-ED foods and non-foods during fMRI scanning on two separate days. On one day participants consumed a 474 ml preload of water (0 kcal, fasted) and on another (counter-balanced) 474 ml milkshake (480 kcal, fed), before scanning. A multi-item ad libitum meal (ALM) followed scanning. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing food approach and food self-regulation. Caloric compensation was calculated as the percentage of preload intake compensated for by down-regulation of ALM intake in the fed vs. fasted condition. Analyses correcting for multiple comparisons demonstrated that, for the fasted condition, higher CEBQ Food Responsiveness scores were associated with greater activation to high-ED (vs. low-ED) foods in regions implicated in food reward (insula, rolandic operculum, putamen). In addition, higher caloric compensation was associated with greater fed vs. fasted activations in response to foods (vs. non-foods) in thalamus and supramarginal gyrus. Uncorrected analyses provided further support for associations of different measures of appetitive characteristics with brain responses to food cues in each condition. Measures of appetitive characteristics demonstrated overlapping and distinct associations with patterns of brain activation elicited by food cues in fasted and fed states. Understanding the neural basis of appetitive characteristics could aid development of biobehaviorally-informed obesity interventions.
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Affiliation(s)
- L Chen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - G Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - A Papantoni
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - L Benson
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - S Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
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2
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Dencer-Brown AM, Shilland R, Friess D, Herr D, Benson L, Berry NJ, Cifuentes-Jara M, Colas P, Damayanti E, García EL, Gavaldão M, Grimsditch G, Hejnowicz AP, Howard J, Islam ST, Kennedy H, Kivugo RR, Lang'at JKS, Lovelock C, Malleson R, Macreadie PI, Andrade-Medina R, Mohamed A, Pidgeon E, Ramos J, Rosette M, Salim MM, Schoof E, Talukder B, Thomas T, Vanderklift MA, Huxham M. Integrating blue: How do we make nationally determined contributions work for both blue carbon and local coastal communities? Ambio 2022; 51:1978-1993. [PMID: 35503201 PMCID: PMC9063623 DOI: 10.1007/s13280-022-01723-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Blue Carbon Ecosystems (BCEs) help mitigate and adapt to climate change but their integration into policy, such as Nationally Determined Contributions (NDCs), remains underdeveloped. Most BCE conservation requires community engagement, hence community-scale projects must be nested within the implementation of NDCs without compromising livelihoods or social justice. Thirty-three experts, drawn from academia, project development and policy, each developed ten key questions for consideration on how to achieve this. These questions were distilled into ten themes, ranked in order of importance, giving three broad categories of people, policy & finance, and science & technology. Critical considerations for success include the need for genuine participation by communities, inclusive project governance, integration of local work into national policies and practices, sustaining livelihoods and income (for example through the voluntary carbon market and/or national Payment for Ecosystem Services and other types of financial compensation schemes) and simplification of carbon accounting and verification methodologies to lower barriers to entry.
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Affiliation(s)
| | - Robyn Shilland
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland
| | - Daniel Friess
- Department of Geography, National University of Singapore, Singapore, Singapore
- NUS Centre for Nature-Based Climate Solutions, National University of Singapore, Singapore, Singapore
| | - Dorothée Herr
- Global Marine and Polar Program, IUCN, Gland, Switzerland
| | - Lisa Benson
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas), Pakefield Road, Lowestoft, NR33 0HT, Suffolk, UK
| | | | - Miguel Cifuentes-Jara
- CATIE - Centro Agronómico Tropical de Investigación y Enseñanza, Turrialba, 30501, Costa Rica
| | - Patrick Colas
- Conservation Finance Africa Field Division - Conservation International, Ndege Road, Nairobi, Kenya
| | - Ellyn Damayanti
- Faculty of Forestry and Environment, IPB University, Bogor, 16680, Indonesia
| | - Elisa López García
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Marina Gavaldão
- Ubá Sustainability Institute - Blue Carbon Hub, Marseille, France
| | - Gabriel Grimsditch
- United Nations Environment Programme, UN Avenue, PO Box 67578, Nairobi, Kenya
| | - Adam P Hejnowicz
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
- Department of Biology, University of York, York, UK
| | - Jennifer Howard
- Blue Carbon Program, Conservation International, 2011 Crystal Drive, Suite 600, Arlington, VA, 22202, USA
| | - Sheikh Tawhidul Islam
- Institute of Remote Sensing and GIS, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Hilary Kennedy
- School of Ocean Sciences, Bangor University, Wales, LL59 5AB, UK
| | - Rahma Rashid Kivugo
- Mikoko Pamoja Community Base Organization, P.O. BOX 178-80404, Msambweni, Kenya
| | - Joseph K S Lang'at
- Kenya Marine and Fisheries Research Institute, P. O. Box 81651-80100, Mombasa, Kenya
| | - Catherine Lovelock
- School of Biological Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Ruth Malleson
- University College London, 14 Taviton Street, London, WC1H 0BW, UK
| | - Peter I Macreadie
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Burwood Campus, Burwood, VIC, 3125, Australia
| | - Rosalía Andrade-Medina
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Ahmed Mohamed
- United Nations Environment Programme, UN Avenue, PO Box 67578, Nairobi, Kenya
| | - Emily Pidgeon
- Center for Oceans, Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA, 22202, USA
| | - Jorge Ramos
- Institute for Land, Water and Society, Charles Sturt University, PO Box 6087, South Bunbury, WA, 6230, Australia
| | - Minerva Rosette
- CINVESTAV - Laboratorio de Producción Primaria, Recursos del Mar, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional - Unidad Mérida, Carretera Antigua a Progreso Km 6, CP 97310, Mérida, Yucatán, México
- Resiliencia Azul (NPO), Mogi das Cruzes, Mexico
| | - Mwanarusi Mwafrica Salim
- Vanga Blue Forest Community Based Organization, P.O Box 115-80402, Lungalunga, Kwale County, Kenya
| | - Eva Schoof
- Plan Vivo Foundation, Thorn House, 5 Rose Street, Edinburgh, EH2 2PR, UK
| | - Byomkesh Talukder
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Tamara Thomas
- International Ocean Policy, Global Policy and Government Relations, Conservation International, 2011 Crystal Drive, Suite 600, Arlington, VA, 22202, USA
| | - Mathew A Vanderklift
- CSIRO Oceans & Atmosphere, Indian Ocean Marine Research Centre, Crawley, WA, 6009, Australia
| | - Mark Huxham
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland
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3
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Jittla P, Graham DM, Zhou C, Halliwell J, O'Reilly S, Aruketty S, Azizi A, Germetaki T, Lowe J, Little M, Punnett G, McMahon P, Benson L, Carter L, Krebs MG, Thistlethwaite FC, Darlington E, Yorke J, Cook N. EPIC: an evaluation of the psychological impact of early-phase clinical trials in cancer patients. ESMO Open 2022; 7:100550. [PMID: 35994790 PMCID: PMC9420347 DOI: 10.1016/j.esmoop.2022.100550] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Anxiety and depression in patients with cancer is associated with decreased quality of life and increased morbidity and mortality. However, these are often overlooked and untreated. Early-phase clinical trials (EPCTs) recruit patients with advanced cancers who frequently lack future treatment options, which may lead to increased anxiety and depression. Despite this, EPCTs do not routinely consider psychological screening for patients. Patients and methods This prospective observational study explored levels of anxiety and depression alongside impact of trial participation in the context of EPCTs. The Hospital Anxiety and Depression Scale and the Brief Illness Perceptions Questionnaire were completed at the point of EPCT consent, the end of screening and at pre-specified time points thereafter. Results Sixty-four patients (median age 56 years; median Eastern Cooperative Oncology Group performance status 1) were recruited. At consent, 57 patients returned questionnaires; 39% reported clinically relevant levels of anxiety whilst 18% reported clinically relevant levels of depression. Sixty-three percent of patients experiencing psychological distress had never previously reported this. Males were more likely to be depressed (P = 0.037) and females were more likely to be anxious (P = 0.011). Changes in anxiety or depression were observed after trial enrolment on an individual level, but not significant on a population level. Conclusions Patients on EPCTs are at an increased risk of anxiety and depression but may not seek relevant support. Sites offering EPCTs should consider including psychological screening to encourage a more holistic approach to cancer care and consider the sex of individuals when tailoring psychological support to meet specific needs. Early-phase cancer trial patients have an increased risk of anxiety and depression. Patients at risk were not seeking support for anxiety and depression. Male patients were more likely to be depressed; female patients were more likely to be anxious. This work highlights the need to screen for psychological symptoms in patients entering early-phase trials.
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Affiliation(s)
- P Jittla
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - D M Graham
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - C Zhou
- CRUK Manchester Institute Cancer Biomarker Centre, University of Manchester, Manchester, UK
| | - J Halliwell
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S O'Reilly
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - S Aruketty
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - A Azizi
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - T Germetaki
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Lowe
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - M Little
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - G Punnett
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - P McMahon
- Medical Oncology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - L Benson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - L Carter
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - M G Krebs
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F C Thistlethwaite
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - E Darlington
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK
| | - J Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - N Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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Von Olshausen G, Benson L, Dahlstrom U, Lund L, Savarese G, Braunschweig F. Catheter ablation for patients with atrial fibrillation and heart failure: insights from the swedish heart failure registry. Europace 2022. [DOI: 10.1093/europace/euac053.241] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): DFG (Deutsche Forschungsgemeinschaft) to G.O.
Aims
To investigate the association between catheter ablation and mortality as well as hospitalization for heart failure (HF) in patients with atrial fibrillation (AF) and HF across the ejection fraction (EF) spectrum in a contemporary cohort.
Methods
Between 2005 and 2019, patients with first-time catheter ablation for AF (ablation group) compared to only medical treated AF patients (medical therapy group) were identified from the Swedish Heart Failure Registry. The primary outcome (all-cause mortality/first HF hospitalization) was assessed by cox regression models in a 1:2 propensity score (PS) matched cohort and pre-specified EF subgroups (preserved EF [HFpEF] [EF≥50%], mildly reduced EF [HFmrEF] [EF 40% to 49%], reduced EF [HFrEF] [EF<40%]) of this cohort.
Results
452 patients in the ablation and 43766 patients in the medical therapy group were identified. After PS matching, 437 patients in the ablation group were compared to 874 patients in the medical therapy group. Over the entire follow-up, catheter ablation was associated with a lower risk of the primary outcome (Hazard ratio [HR] 0.71 [95%CI, 0.59-0.85]) and first cardiovascular (CV) hospitalization (HR 0.85 [95%CI, 0.72-0.99]) in PS matched analysis. Results were consistent across all EF subgroups. In HFpEF patients, catheter ablation was associated with a significantly lower risk of recurrent HF hospitalization (Incidence rate ratio (IRR) 0.17 [95%CI, 0.07-0.42]).
Conclusion
In this nationwide study, catheter ablation was associated with a significant lower risk of the primary outcome (all-cause mortality/first HF hospitalization) in HF patients with AF. This study advocates catheter ablation as a potent treatment option for AF in HF patients across all EF subgroups, including HFpEF.
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Affiliation(s)
- G Von Olshausen
- Karolinska University Hospital, Heart and Vascular Theme, Stockholm, Sweden
| | - L Benson
- Karolinska Institutet, Department of Medicine, Stockholm, Sweden
| | - U Dahlstrom
- Linköping University, Department of Cardiology and Department of Health, Linköping, Sweden
| | - L Lund
- Karolinska Institutet, Department of Medicine, Stockholm, Sweden
| | - G Savarese
- Karolinska Institutet, Department of Medicine, Stockholm, Sweden
| | - F Braunschweig
- Karolinska University Hospital, Heart and Vascular Theme, Stockholm, Sweden
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5
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Jittla P, Graham D, Zhou C, Halliwell J, O'Reilly S, Aruketty S, Azizi A, Germetaki T, Lowe J, Little M, Punnett G, McMahon P, Benson L, Carter L, Krebs M, Thistlethwaite F, Yorke J, Cook N. 1493P An evaluation of the psychological impact of early phase clinical trials in cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.821] [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: 12/01/2022] Open
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6
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Gomes J, Saeed Y, Kawada S, Benson L, Downar E, Nair K. Outcome of catheter ablation of arrhythmias in adult congenital heart disease with high density multi-electrode mapping with automatic annotation algorithm. Europace 2021. [DOI: 10.1093/europace/euab116.499] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Arrhythmias are frequently encountered in adult congenital heart disease (ACHD) and respond poorly to pharmacological therapies. Catheter ablation is challenging due to anatomical variation and complexity of the arrhythmia substrate. High density multi electrode mapping (MEM) with automatic annotation of activation time may aid mapping of arrhythmia, decrease procedure time and improve the accuracy of targeting of ablation therapy.
Purpose
To compare the acute and long term outcomes and procedural characteristics of catheter ablation in ACHD patients with and without automatic annotation of activation with MEM.
Methods
Retrospective analysis of the acute and long term outcomes of ACHD patients in a single centre undergoing ablation procedures from 1 Jan 2014 to 18 August 2017 was undertaken. 2 groups were identified.
Group 1 included patients who had arrhythmia mapping performed with the CARTO 3D electroanatomic mapping system without the use of automatic signal annotation. Most patients in this group had sequential mapping performed with the ablation catheter (78%), the rest had multi-electrode mapping with the PentaRay 20 pole catheter.
Group 2 included patients who had arrhythmia mapping performed with the CARTO 3D electroanatomic mapping system using the automated CONFIDENSE mapping algorithm.
Results
Group 1: n = 27, mean age 44.6 +/-3 years. Male 46.6%. Group 2: n = 38, mean age 44.0 +/- 1.9 years. Male 56.7%. All patients had CHD of at least moderate complexity. 25% of patients in group 1 and 45% in group 2 were repeat ablations. 45 arrhythmias were induced in group 1 of which 29 were targeted and 74 arrhythmias were induced in group 2 of which 46 were targeted. Acute success rates (after attempts at reinduction) were 96.3% in group 1 and 94.7% in group 2. Recurrences of arrhythmia occurred significantly less in patients in group 2 compared to group 1 (44.7% and 70.4% respectively, p < 0.05) after a follow up duration of 17.3+/-0.43 months in group 2 and 45.3 +/-1.19 months in group 1. Fluoroscopy time, procedure time and ablation time were not significantly different between groups.
Conclusions
The use of multi-electrode mapping with an automatic annotation algorithm was associated with a significantly lower risk of recurrence during the follow up period of this study.
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Affiliation(s)
- J Gomes
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - Y Saeed
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - S Kawada
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - L Benson
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - E Downar
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - K Nair
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
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Savarese G, Hage C, Benson L, Schrage B, Thorvaldsen T, Lundberg A, Fudim M, Linde C, Dahlström U, Rosano GMC, Lund LH. Eligibility for sacubitril/valsartan in heart failure across the ejection fraction spectrum: real-world data from the Swedish Heart Failure Registry. J Intern Med 2021; 289:369-384. [PMID: 32776357 PMCID: PMC7984286 DOI: 10.1111/joim.13165] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/09/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Randomized controlled trials (RCT) generalizability may be limited due to strict patient selection. OBJECTIVE In a real-world heart failure (HF) population, we assessed eligibility for sacubitril/valsartan based on PARADIGM-HF (sacubitril/valsartan effective)/PARAGON-HF [sacubitril/valsartan effective in mildly reduced ejection fraction (EF)]. METHODS Outpatients from the Swedish HF Registry (SwedeHF) were analysed. In SwedeHF, EF is recorded as <30, 30-39, 40-49 and ≥50%. In PARAGON-HF, sacubitril/valsartan was effective with EF ≤ 57% (i.e. median). We defined reduced EF/PARADIGM-HF as EF < 40%, mildly reduced EF/PARAGON-HF ≤ median as EF 40-49%, and normal EF/PARAGON-HF > median as EF ≥ 50%. We assessed 2 scenarios: (i) criteria likely to influence treatment decisions (pragmatic scenario); (ii) all criteria (literal scenario). RESULTS Of 37 790 outpatients, 57% had EF < 40%, 24% EF 40-49% and 19% EF ≥ 50%. In the pragmatic scenario, 63% were eligible in EF < 50% (67% for EF < 40% and 52% for 40-49%) and 52% in EF ≥ 40% (52% for EF ≥ 50%). For the literal scenario, 32% were eligible in EF < 50% (38% of EF < 40%, 20% of EF 40-49%) and 22% in EF ≥ 40% (25% for EF ≥ 50%). Eligible vs. noneligible patients had more severe HF, more comorbidities and overall worse outcomes. CONCLUSION In a real-world HF outpatient cohort, 81% of patients had EF < 50%, with 63% eligible for sacubitril/valsartan based on pragmatic criteria and 32% eligible based on literal trial criteria. Similar eligibility was observed for EF 40-49% and ≥50%, suggesting that our estimates for EF < 50% may be reproduced whether or not a higher cut-off for EF is considered.
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Affiliation(s)
- G Savarese
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C Hage
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - L Benson
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B Schrage
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - T Thorvaldsen
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - M Fudim
- Duke University Medical Center, Durham, NC, USA
| | - C Linde
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Dahlström
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - G M C Rosano
- Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy.,Cardiology Clinical Academic Group, St George's Hospitals NHS Trust University of London, London, UK
| | - L H Lund
- From the, Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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8
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Lincoln S, Vannoni M, Benson L, Engelhard GH, Tracey D, Shaw C, Molisa V. Assessing intertidal seagrass beds relative to water quality in Vanuatu, South Pacific. Mar Pollut Bull 2021; 163:111936. [PMID: 33360525 DOI: 10.1016/j.marpolbul.2020.111936] [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] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 11/27/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
Seagrasses are globally important, but their extent is decreasing due to the impact of human activities and changing climatic conditions. Seagrass meadows provide vital services, but their condition and distribution are not yet well known, particularly in many small tropical Pacific islands. In 2018, observations and samples were collected from intertidal seagrasses of Efate Island, Vanuatu (South Pacific). Observations included canopy height, percentage cover, growth rate and species variety. Water quality samples were also collected in some locations. Our seagrass metrics suggested more challenging conditions for the seagrasses near Port Vila, the main urban area in the island, where water quality analyses indicated higher levels of dissolved inorganic nitrogen and suspended solids.
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Affiliation(s)
- Susana Lincoln
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas). Pakefield Road, Lowestoft, Suffolk NR33 0HT, UK.
| | - Marta Vannoni
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas). Pakefield Road, Lowestoft, Suffolk NR33 0HT, UK
| | - Lisa Benson
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas). Pakefield Road, Lowestoft, Suffolk NR33 0HT, UK
| | - Georg H Engelhard
- The Centre for Environment, Fisheries and Aquaculture Science (Cefas). Pakefield Road, Lowestoft, Suffolk NR33 0HT, UK
| | - Dieter Tracey
- Science Graphics, 28 Dalziel Street, Stratford, QLD 4870, Australia
| | - Christina Shaw
- Vanuatu Environmental Science Society (VESS), PO Box 1630, Anchor House, Kumal Highway, Port Vila, Shefa Province, Vanuatu
| | - Vatumaraga Molisa
- Department of Environmental Protection and Conservation, PMB 9063, Port Vila, Shefa Province, Vanuatu
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9
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Von Olshausen G, Bourke T, Schwieler J, Drca N, Bastani H, Tapanainen J, Saluveer O, Benson L, Goedel A, Kenneback G, Insulander P, Jensen-Urstad M, Braunschweig F. Long-term outcome of patients with invasive electrophysiology procedure related cardiac tamponade. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0411] [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
Aims
Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analyzed the risk of death or serious cardiovascular events in patients suffering from EP related cardiac tamponade requiring pericardiocentesis during long-term follow-up.
Methods and results
Out of 19997 invasive EPs at our university hospital between January 1998 and September 2018, all patients with EP related periprocedural cardiac tamponade were identified (n=60) and matched (1:3 ratio) to a control group (n=180). After a follow-up of 5 years, the composite primary end point - death from any cause, acute myocardial infarction, TIA/stroke and hospitalization for heart failure – occurred in significantly more patients in the tamponade than in the control group (12 patients (20.0%) vs 19 patients (10.6%); Hazard ratio (HR) 2.53 (95% CI, 1.15–5.58); p=0.021). This was mainly driven by a higher incidence of TIA/stroke in the tamponade than in the control group (HR 3.75 (95% CI, 1.01–13.97); p=0.049). Death from any cause, acute myocardial infarction and hospitalization for heart failure did not show a significant difference between the groups. Hospitalization for pericarditis occurred in significantly more patients in the tamponade than in the control group (HR 36.0 (95% CI, 4.68–276.86); p=0.001).
Conclusion
Patients with EP related cardiac tamponade are at higher risk for cerebrovascular events during the first two weeks and hospitalization for pericarditis during the first months after index procedure. Despite the increased risk for early complications tamponade patients have a good long-term prognosis without increased risk for mortality or other serious cardiovascular events.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): German Research Foundation
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Affiliation(s)
| | - T Bourke
- Karolinska University Hospital, Stockholm, Sweden
| | - J Schwieler
- Karolinska University Hospital, Stockholm, Sweden
| | - N Drca
- Karolinska University Hospital, Stockholm, Sweden
| | - H Bastani
- Karolinska University Hospital, Stockholm, Sweden
| | - J Tapanainen
- Karolinska University Hospital, Stockholm, Sweden
| | - O Saluveer
- Karolinska University Hospital, Stockholm, Sweden
| | - L Benson
- Karolinska Institutet, Stockholm, Sweden
| | - A Goedel
- Karolinska Institutet, Stockholm, Sweden
| | - G Kenneback
- Karolinska University Hospital, Stockholm, Sweden
| | - P Insulander
- Karolinska University Hospital, Stockholm, Sweden
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Axiotis N, Benson L. The future for dental events. Br Dent J 2020; 228:811. [PMID: 32541702 PMCID: PMC7294202 DOI: 10.1038/s41415-020-1749-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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11
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Arias-Ortiz A, Masqué P, Glass L, Benson L, Kennedy H, Duarte CM, Garcia-Orellana J, Benitez-Nelson CR, Humphries MS, Ratefinjanahary I, Ravelonjatovo J, Lovelock CE. Losses of Soil Organic Carbon with Deforestation in Mangroves of Madagascar. Ecosystems 2020. [DOI: 10.1007/s10021-020-00500-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Frankfurter C, Muthuppalaniappan A, Gorocica-Romero R, Abrahamyan L, Olesovsky C, Osten M, Benson L, Horlick E. Coronary artery disease in adults undergoing transcatheter patent foramen ovale closure following cryptogenic stroke. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.483] [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: 10/25/2022] Open
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13
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Axiotis N, Benson L. An apparent dissociation. Br Dent J 2019; 227:175. [DOI: 10.1038/s41415-019-0629-4] [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: 11/09/2022]
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14
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Pakpoor J, Seminatore B, Graves J, Schreiner T, Waldman A, Lotze T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema J, McDonald J, Hart J, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Mar S, Kahn I, Rose J, Carmichael S, Roalstad S, Waltz M, Casper T, Waubant E. Dietary factors and pediatric multiple sclerosis: A case-control study. Mult Scler 2018; 24:1067-1076. [PMID: 28608728 PMCID: PMC5711616 DOI: 10.1177/1352458517713343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease. OBJECTIVE To determine the association between dietary factors and MS in children. METHODS Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011-2016. Chi-squared test compared categorical variables, Kruskal-Wallis test compared continuous variables, and multivariable logistic regression analysis was performed. RESULTS In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01). CONCLUSION Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.
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Affiliation(s)
- J. Pakpoor
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - B. Seminatore
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Graves
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - T. Schreiner
- University of Colorado School of Medicine, Neurology
| | - A. Waldman
- Children’s Hospital of Philadelphia, Neurology
| | - T. Lotze
- Texas Children’s Hospital, Child Neurology
| | - A. Belman
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | | | | | - G. Aaen
- Loma Linda University, Neurology
| | | | - J. McDonald
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Hart
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
| | - J. Ness
- University of Alabama at Birmingham, Pediatrics
| | - Y. Harris
- University of Alabama at Birmingham, Pediatrics
| | - J. Rubin
- Ann & Robert Lurie Children's Hospital of Chicago, Neurology
| | | | - L. Krupp
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | - M. Gorman
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | - L. Benson
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | | | | | - S. Mar
- Washington University St. Louis, Neurology
| | - I. Kahn
- Children’s National Medical Center, Washington, D.C
| | - J. Rose
- University of Utah, Neurology
| | - S.L. Carmichael
- Department of Pediatrics Division of Neonatal and Developmental Medicine, Stanford University, California, USA
| | | | | | | | - E. Waubant
- Multiple Sclerosis Center, University of California, San Francisco, CA
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
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15
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Mathew J, Zahavich L, Lafreniere-Roula M, Wilson J, George K, Benson L, Bowdin S, Mital S. Utility of genetics for risk stratification in pediatric hypertrophic cardiomyopathy. Clin Genet 2017; 93:310-319. [DOI: 10.1111/cge.13157] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/17/2017] [Accepted: 09/27/2017] [Indexed: 12/29/2022]
Affiliation(s)
- J. Mathew
- Cardiology Department; The Royal Children’s Hospital; Melbourne Victoria Australia
| | - L. Zahavich
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - M. Lafreniere-Roula
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - J. Wilson
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - K. George
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - L. Benson
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - S. Bowdin
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
| | - S. Mital
- Division of Cardiology, Department of Pediatrics; Hospital for Sick Children, University of Toronto; Toronto Ontario Canada
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16
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Godfrey EM, Gilmore KC, Benson L. A novel anticipatory counseling video for new levonorgestrel intrauterine system (LNG-IUS) users: a multicenter randomized–controlled pilot study. Contraception 2017. [DOI: 10.1016/j.contraception.2017.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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Ouellette A, Mathew J, Manickaraj A, Manase G, Zahavich L, Wilson J, George K, Benson L, Bowdin S, Mital S. Clinical genetic testing in pediatric cardiomyopathy: Is bigger better? Clin Genet 2017; 93:33-40. [DOI: 10.1111/cge.13024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 03/06/2017] [Accepted: 03/14/2017] [Indexed: 12/20/2022]
Affiliation(s)
- A.C. Ouellette
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - J. Mathew
- Cardiology Department; The Royal Children's Hospital, Melbourne; Victoria Australia
| | - A.K. Manickaraj
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - G. Manase
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - L. Zahavich
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - J. Wilson
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - K. George
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - L. Benson
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - S. Bowdin
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - S. Mital
- Division of Cardiology, Department of Pediatrics, Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
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18
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Carnell S, Benson L, Gibson EL, Mais LA, Warkentin S. Caloric compensation in preschool children: Relationships with body mass and differences by food category. Appetite 2017; 116:82-89. [PMID: 28432007 DOI: 10.1016/j.appet.2017.04.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 02/26/2017] [Accepted: 04/17/2017] [Indexed: 11/27/2022]
Abstract
Maintaining a healthy weight may involve compensating for previously consumed calories at subsequent meals. To test whether heavier children demonstrated poorer caloric compensation across a range of conditions, and to explore whether compensation failure was the result of inadequate adjustment of overall intake or specific over-consumption of highly palatable, high energy-density 'junk' foods, we administered two compensation tests to a sample of 4-5 y olds. For Test A, preloads varied only in carbohydrate content and were organoleptically indistinguishable (200 ml orange-flavored beverage [0 kcal vs. 200 kcal]). For Test B, the preloads varied substantially in both macronutrient composition and learned gustatory cues to caloric content (200 ml water [0 kcal] vs. 200 ml strawberry milkshake [200 kcal]). Each preload was followed 30 min later by a multi-item ad-libitum meal containing junk foods (chocolate cookies, cheese-flavored crackers) and core foods (fruits and vegetables, bread rolls, protein foods). Testing took place at the children's own school under normal lunch-time conditions. Children were weighed and measured. Caloric compensation occurred in both tests, in terms of total, junk and core food intake (RMANOVA, all p < 0.01). Higher BMI z scores were associated with greater average caloric compensation (r = -0.26; p < 0.05), such that overweight/obese children showed least compensation (41%), children over the 50th centile the next least (59%), and children under the 50th centile (80%) the most. For Test A only, obese/overweight children compensated less well than normal-weight children in terms of junk food intake (RMANOVA preload-by-weight group interaction p < 0.05), with no significant effect for core foods. Our results suggest that caloric compensation is consistently poorer in heavier children, and that overweight/obese children's preferences for junk foods may overwhelm intake regulation mechanisms within meals containing those foods.
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Affiliation(s)
- S Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - L Benson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E L Gibson
- Department of Psychology, University of Roehampton, London, UK
| | - L A Mais
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - S Warkentin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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19
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Kinzel A, Ambrogi M, Varshaver M, Benson L, Kirson E. P09.23 Tumor Treating Fields delivery using second generation Optune® system for glioblastoma treatment: patient experience and compliance. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Bourne T, Waltz M, Casper TC, Kavak K, Aaen G, Belman A, Benson L, Candee M, Chitnis T, Graves J, Greenberg B, Gorman M, Harris Y, Krupp L, Lotze T, Mar S, Ness J, Olsen C, Roalstad S, Rodriguez M, Rose J, Rubin J, Schreiner T, Tillema JM, Kahn I, Waldman A, Barcellos L, Waubant E, Weinstock-Guttman B. Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population. J Neurol Sci 2017; 375:371-375. [PMID: 28320170 DOI: 10.1016/j.jns.2017.02.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results. OBJECTIVE To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort. METHODS The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT). RESULTS We included 271 cases (mean age at disease onset of 15.7years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (0.14 vs 0.48, p=0.01). CONCLUSIONS While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.
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Affiliation(s)
| | | | - T C Casper
- University of Utah, Pediatrics, United States
| | - K Kavak
- State University of New York, Neurology, United States
| | - G Aaen
- Loma Linda University, Neurology, United States
| | - A Belman
- SUNY Stony Brook, Neurology, United States
| | - L Benson
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center, United States
| | - M Candee
- University of Utah, Pediatrics, United States
| | - T Chitnis
- Brigham and Women's Hospital, Neurology, United States
| | - J Graves
- Multiple Sclerosis Center, University of California, San Francisco, CA, United States
| | - B Greenberg
- University of Texas Southwestern, Neurology, United States
| | - M Gorman
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center, United States
| | - Y Harris
- University of Alabama at Birmingham, Pediatrics, United States
| | - L Krupp
- SUNY Stony Brook, Neurology, United States
| | - T Lotze
- Texas Children's Hospital, Child Neurology, United States
| | - S Mar
- Washington University St. Louis, Neurology, United States
| | - J Ness
- University of Alabama at Birmingham, Pediatrics, United States
| | - C Olsen
- University of Utah, Pediatrics, United States
| | - S Roalstad
- University of Utah, Pediatrics, United States
| | | | - J Rose
- University of Utah, Neurology, United States
| | - J Rubin
- Ann & Robert Lurie Children's Hospital of Chicago, Neurology, United States
| | - T Schreiner
- University of Colorado School of Medicine, Neurology, United States
| | | | - I Kahn
- Children's National Medical Center, Washington, United States
| | - A Waldman
- Children's Hospital of Philadelphia, Neurology, United States
| | - L Barcellos
- University of California Berkeley, United States
| | - E Waubant
- Multiple Sclerosis Center, University of California, San Francisco, CA, United States
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21
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Abstract
Twelve patients with primary amyloidosis (AL) were investigated with magnetic resonance imaging (MRI). In 9 patients an abnormal thickening of the heart walls was present and in 2 macroglossia was found at MRI. T1 was significantly increased in liver (p<0.05) and subcutaneous fat (p<0.01) while it was decreased in the spleen (p<0.05). T2 was significantly decreased (p<0.01) in the spleen in patients with amyloidosis, while it was not significantly altered in the liver or subcutaneous fat. After therapy T1 of the liver was reduced towards normal values in 4 patients. It is concluded that MRI might be a method to quantitate the amount of amyloid deposits in the tissue, and that the effect of therapy may be monitored with this technique.
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22
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Carnell S, Pryor K, Mais LA, Warkentin S, Benson L, Cheng R. Lunch-time food choices in preschoolers: Relationships between absolute and relative intakes of different food categories, and appetitive characteristics and weight. Physiol Behav 2016; 162:151-60. [PMID: 27039281 DOI: 10.1016/j.physbeh.2016.03.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 02/02/2016] [Revised: 03/25/2016] [Accepted: 03/25/2016] [Indexed: 02/08/2023]
Abstract
Children's appetitive characteristics measured by parent-report questionnaires are reliably associated with body weight, as well as behavioral tests of appetite, but relatively little is known about relationships with food choice. As part of a larger preloading study, we served 4-5year olds from primary school classes five school lunches at which they were presented with the same standardized multi-item meal. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing satiety responsiveness (CEBQ-SR), food responsiveness (CEBQ-FR) and enjoyment of food (CEBQ-EF), and children were weighed and measured. Despite differing preload conditions, children showed remarkable consistency of intake patterns across all five meals with day-to-day intra-class correlations in absolute and percentage intake of each food category ranging from 0.78 to 0.91. Higher CEBQ-SR was associated with lower mean intake of all food categories across all five meals, with the weakest association apparent for snack foods. Higher CEBQ-FR was associated with higher intake of white bread and fruits and vegetables, and higher CEBQ-EF was associated with greater intake of all categories, with the strongest association apparent for white bread. Analyses of intake of each food group as a percentage of total intake, treated here as an index of the child's choice to consume relatively more or relatively less of each different food category when composing their total lunch-time meal, further suggested that children who were higher in CEBQ-SR ate relatively more snack foods and relatively less fruits and vegetables, while children with higher CEBQ-EF ate relatively less snack foods and relatively more white bread. Higher absolute intakes of white bread and snack foods were associated with higher BMI z score. CEBQ sub-scale associations with food intake variables were largely unchanged by controlling for daily metabolic needs. However, descriptive comparisons of lunch intakes with expected amounts based on metabolic needs suggested that overweight/obese boys were at particularly high risk of overeating. Parents' reports of children's appetitive characteristics on the CEBQ are associated with differential patterns of food choice as indexed by absolute and relative intake of various food categories assessed on multiple occasions in a naturalistic, school-based setting, without parents present.
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Affiliation(s)
- S Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - K Pryor
- Duke University School of Medicine, 201 Trent Drive, Durham, NC 27710, USA
| | - L A Mais
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - S Warkentin
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - L Benson
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Cheng
- St. George's University School of Medicine, 3500 Sunrise Highway, Building 300, Great River, NY 11739, USA
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23
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Andersson IM, Benson L, Christensson K, Gemzell-Danielsson K. Paracervical block as pain treatment during second-trimester medical termination of pregnancy: an RCT with bupivacaine versus sodium chloride. Hum Reprod 2015; 31:67-74. [PMID: 26573530 DOI: 10.1093/humrep/dev286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 08/10/2015] [Accepted: 10/23/2015] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Can paracervical block (PCB) administered before the onset of pain decrease women's pain experience during second-trimester medical termination of pregnancy (MToP)? SUMMARY ANSWER There were no clinically significant differences between groups receiving PCB with bupivacaine or saline with regard to the highest and lowest pain intensity, morphine consumption or induction-to abortion interval. WHAT IS KNOWN ALREADY The most common side effect of misoprostol is pain; nevertheless, there are sparse studies in pain and pain treatment during MToP, especially in second-trimester abortion. Pain reported in second-trimester medical abortion is often intense, and peaks when the fetal expulsion occurs. STUDY DESIGN, SIZE, DURATION A double-blinded RCT was carried out from May 2012 until April 2015. A power calculation was based on a previous pilot study showing that the proportion of women with severe pain [visual analogue scale (VAS) ≥7] was 63%. A clinically significant reduction was considered to yield 35% with severe pain, and with a power of 80% and significance level of 5% (two-sided) 112 women were needed. Accounting for a 20% drop-out rate, a total of 140 women were needed. The primary outcome, pain intensity measured as any VAS ≥7, was analysed using a generalized estimating equations model. The level of significance was set to P < 0.05 two-sided. A computer generated randomization list with block size of 10 was used. The treatment allocation was placed in a sealed, opaque, envelope and picked consecutively. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 589 women attending a gynaecological clinic had a second-trimester abortion during the study period and 276 were invited to participate. A total of 113 women undergoing abortion from 13 weeks of gestation and above were recruited, of which 55 were randomly allocated to receive a PCB with bupivacaine and 58 a PCB with sodium chloride 1 h after the first dose of misoprostol. The full analysis set (FAS) population was defined as all randomized women that had at least one value for any of the outcomes (n = 102). The per-protocol (PP) population was defined as a subset of the FAS excluding patients with major protocol deviations or without a value for the primary outcome (n = 99). Pain was measured by VAS at misoprostol initiation (baseline) and repeated every 30 min until fetal expulsion. The primary outcome was the highest VAS pain intensity at any time point. MAIN RESULTS AND THE ROLE OF CHANCE The highest pain intensity, did not show any differences at a cut-off of VAS ≥7 [risk ratio (RR): 1.1; 95% confidence interval (CI): 0.9-1.5; P = 0.0.292]. In the PP analyses, there were 75% women in the bupivacaine group and 64% in the sodium chloride group with VAS ≥7 (RR: 1.2; 95% CI: 0.9-1.5; P = 0.235). Most women did not experience pain at the misoprostol start, 19 women scored a VAS of >0, ranging from 1 to 4 with a mean of 1.8 and median of 2 (P = 1.000). Immediately prior to PCB, 61 women scored a VAS of >0, from 1 to 10 with a mean of 2.0 and median of 1 (P = 0.771). There was a 48% loss of VAS scores at the time of expulsion and the remaining scores did not differ between groups (RR: 1.5; 95% CI: 0.9-2.5). A subgroup analysis of primipara did not show any difference in highest pain intensity VAS ≥7 (RR: 1.2; 95% CI: 0.9-1.6; P = 0.283). No statistically significant differences were observed between groups with regard to the highest and lowest (P = 553 and 0.182) pain intensity and morphine consumption (P = 0.772). Side effects were reported by 28 women (14 women in each group), with no differences between groups. Most common was nausea and vomiting in connection to morphine injection. LIMITATIONS, REASONS FOR CAUTION Nearly 60% of the invited women did not want to participate in the study (fear of needles and fear of receiving the placebo) therefore women who tolerate pain may have been overrepresented in the study population. Data collection was stopped, in error, when 113 participants had been recruited. The loss to follow-up was, however, only 11 women (10%), which was lower than expected but intrinsically the study did not fully reach the intended number of women, which may have influenced the results. In addition, the obstetrical and gynaecological background of participating women differs. The participants were informed that they had a 50% chance of receiving a PCB with active substance, which could theoretically have affected their expectations and pain experience (placebo effect). The frequent attention at VAS scoring and the overall care provided may also have affected the participants in a positive way, and helped women to feel supported and more relaxed during the abortion. WIDER IMPLICATIONS OF THE FINDINGS The highest pain intensity was severe (VAS: 7-10) among 65-75% of the participants, as reported for first-trimester medical abortion; however, the maximal pain scores remain high despite the PCB. There is, therefore, a clear need for more optimal pain treatment but only limited data exist on pain treatment during MToP over all gestational lengths. As PCB was well tolerated, did not cause any serious side effects and had no negative impact on the abortion process and efficacy, another approach may be worth exploring, namely PCB given on demand at the onset of painful contractions. STUDY FUNDING/COMPETING INTERESTS The study was supported by grants from the Swedish Research Council (grant no: 2012-2844), ALF (Karolinska Institutet - Stockholm County Council, Agreement on Medical Research and Training) funding, the Karolinska Institutet, Stockholm South General Hospital, and Swedish Nurses in the Area of Pain - SSOS together with GlaxoSmithKline. None of the authors have any conflicts of interest. TRIAL REGISTRATION NUMBER The trial was registered with ClinicalTrials.gov (identifier: NCT01617564) and The EudraCT (number: 2010-020780-21) and was approved by The Regional Ethical Review Board at Karolinska Institutet (dnr: 2007/1277-31/2 and 2010/410-31/1). TRIAL REGISTRATION DATE Clinical trial registration was done in May 2012 before initiation of patient recruitment. DATE OF FIRST PATIENT'S ENROLMENT 29 May 2012.
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Affiliation(s)
- I-M Andersson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm South General Hospital, 118 83 Stockholm, Sweden
| | - L Benson
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm South General Hospital, 118 83 Stockholm, Sweden
| | - K Christensson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - K Gemzell-Danielsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, WHO Centre, Karolinska University Hospital, Stockholm, Sweden
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Chaudhry A, Benson L, Varshaver M, Farber O, Weinberg U, Kirson E, Palti Y. NovoTTFTM-100A System (Tumor Treating Fields) Transducer Array Layout Planning for Recurrent Glioblastoma: Results of a NovoTALTM System User Study. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Stevens J, Benson L, Prager S. Leukocytosis and fever during cervical preparation for dilation and evacuation with laminaria versus synthetic Dilapan. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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26
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Wilson W, Horlick E, Benson L. Successful transcatheter occlusion of an anomalous pulmonary vein with dual drainage to the left atrium. Catheter Cardiovasc Interv 2015; 85:1212-6. [PMID: 25384927 DOI: 10.1002/ccd.25734] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 11/03/2014] [Indexed: 11/07/2022]
Abstract
We describe a case of a scimitar syndrome "variant" where dual drainage existed from the right upper and middle pulmonary veins to the inferior vena cava and left atrium. Device closure of the anomalous vein at the level of the connection to the IVC was successful in achieving diversion of pulmonary venous flow to the left atrium. Vigilance during work-up of anomalous pulmonary venous drainage (whether isolated or associated with other cardiac defects that may be amenable to device closure) is important to define the presence of dual connections to the left atrium, in which case a less-invasive transcatheter approach may be feasible.
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Affiliation(s)
- W Wilson
- Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada
| | - E Horlick
- Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada
| | - L Benson
- Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada
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Wilson W, Shah A, Benson L, Osten M, Horlick E. Late clinical outcomes post transcatheter intervention for coarctation. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.744] [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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28
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Linde C, Stahlberg M, Benson L, Braunschweig F, Edner M, Dahlstrom U, Alehagen U, Lund LH. Gender, underutilization of cardiac resynchronization therapy, and prognostic impact of QRS prolongation and left bundle branch block in heart failure. Europace 2014; 17:424-31. [DOI: 10.1093/europace/euu205] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Bartczak A, Plaskota K, Trojnarska O, Szczepaniak-Chichel L, Popiel M, Grajek S, Eindhoven JA, Van Den Bosch A, Ruys T, Opic P, Cuypers J, Mc Ghie - Vletter J, Witsenburg M, Boersma H, Roos-Hesselink J, Carro A, Sanz M, Galuppo V, Maldonado G, Santos A, Miranda B, Huguet F, Gonzalez N, Abad C, Evangelista A, Eindhoven JA, Van Den Bosch A, Menting M, Cuypers J, Witsenburg M, Vletter- Mcghie J, Ruys P, Boermsa H, Roos-Hesselink J, Dragulescu A, Mroczek D, Chaturvedi R, Benson L, Friedberg M, Mertens L, Nastase O, Enache R, Popescu B, Botezatu D, Aschie D, State S, Rosca M, Calin A, Beladan C, Ginghina C, Huang F, Zhong L, Tan J, Le T, Tan R, Pietrzak R, Werner B, Scognamiglio G, Karonis T, Gatzoulis M, Babu-Narayan S, Li W, Gonzalez-Gonzalez A, Alonso-Gonzalez R, West C, Senior R, Li W. Moderated Posters session * Congenital heart disease: 12/12/2013, 14:00-18:00 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jay AR, Krotscheck U, Parsley E, Benson L, Kravitz A, Mulligan A, Silva J, Mohammed H, Schwark WS. Pharmacokinetics, bioavailability, and hemodynamic effects of trazodone after intravenous and oral administration of a single dose to dogs. Am J Vet Res 2013; 74:1450-6. [DOI: 10.2460/ajvr.74.11.1450] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Grosse-Wortmann L, Windram J, Andreea D, Yoo S, Mertens L, Wong D, Benson L. Prevalence and Significance of Late Gadolinium Enhancement in Children and Adolescents With Hypertrophic Cardiomyopathy. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.118] [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] Open
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32
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Benson L, Martins S, Whitaker A. Correlates of heterosexual anal intercourse among women in the 2006–2010 National Survey of Family Growth. Contraception 2013. [DOI: 10.1016/j.contraception.2013.05.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mazurov AA, Kombo DC, Hauser TA, Miao L, Dull G, Genus JF, Fedorov NB, Benson L, Sidach S, Xiao Y, Hammond PS, James JW, Miller CH, Yohannes D. Discovery of (2S,3R)-N-[2-(Pyridin-3-ylmethyl)-1-azabicyclo[2.2.2]oct-3-yl]benzo[b]furan-2-carboxamide (TC-5619), a Selective α7 Nicotinic Acetylcholine Receptor Agonist, for the Treatment of Cognitive Disorders. J Med Chem 2012; 55:9793-809. [DOI: 10.1021/jm301048a] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [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]
Affiliation(s)
- Anatoly A. Mazurov
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - David C. Kombo
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Terry A. Hauser
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Lan Miao
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Gary Dull
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - John F. Genus
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Nikolai B. Fedorov
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Lisa Benson
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Serguei Sidach
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Yunde Xiao
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Philip S. Hammond
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - John W. James
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Craig H. Miller
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
| | - Daniel Yohannes
- Targacept, Inc., Winston-Salem, North
Carolina 27101-4165,
United States
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Schantz D, Benson L, Windram J, Wong D, Dragulescu A, Yoo S, Mertens L, Friedberg M, Al Nafisi B, Grosse-Wortmann L. 808 Mitral Valve Dimensions in Children With Hypertrophic Cardiomyopathy. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.727] [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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Abstract
Neuroimaging is becoming increasingly common in obesity research as investigators try to understand the neurological underpinnings of appetite and body weight in humans. Positron emission tomography (PET), functional magnetic resonance imaging (fMRI) and magnetic resonance imaging (MRI) studies examining responses to food intake and food cues, dopamine function and brain volume in lean vs. obese individuals are now beginning to coalesce in identifying irregularities in a range of regions implicated in reward (e.g. striatum, orbitofrontal cortex, insula), emotion and memory (e.g. amygdala, hippocampus), homeostatic regulation of intake (e.g. hypothalamus), sensory and motor processing (e.g. insula, precentral gyrus), and cognitive control and attention (e.g. prefrontal cortex, cingulate). Studies of weight change in children and adolescents, and those at high genetic risk for obesity, promise to illuminate causal processes. Studies examining specific eating behaviours (e.g. external eating, emotional eating, dietary restraint) are teaching us about the distinct neural networks that drive components of appetite, and contribute to the phenotype of body weight. Finally, innovative investigations of appetite-related hormones, including studies of abnormalities (e.g. leptin deficiency) and interventions (e.g. leptin replacement, bariatric surgery), are shedding light on the interactive relationship between gut and brain. The dynamic distributed vulnerability model of eating behaviour in obesity that we propose has scientific and practical implications.
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Affiliation(s)
- S Carnell
- New York Obesity Nutrition Research Center, Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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Pham QH, Von Lueder TG, Namtvedt SK, Rosjo H, Omland T, Steine K, Timoteo AT, Mota Carmo M, Simoes M, Branco LM, Ferreira RC, Kato R, Ito J, Tahara T, Yokoyama Y, Ashikaga T, Satoh Y, Na JO, Hong HE, Kim MN, Shin SY, Choi CU, Kim EJ, Rha SW, Park CG, Seo HS, Oh DJ, Ticulescu R, Brigido S, Vriz O, Sparacino L, Popescu BA, Ginghina C, Carerj S, Nicolosi GL, Antonini-Canterin F, Onaindia Gandarias JJ, Romero A, Laraudogoitia E, Velasco S, Quintana O, Cacicedo A, Rodriguez I, Alarcon JA, Gonzalez J, Lekuona I, Onaindia Gandarias JJ, Laraudogoitia E, Romero A, Velasco S, Cacicedo A, Quintana O, Subinas A, Gonzalez J, Alarcon JA, Lekuona I, Abdula G, Lund LH, Winter R, Brodin L, Sahlen A, Masaki M, Cha YM, Yuasa T, Dong K, Dong YX, Mankad SV, Oh JK, Vallet F, Lequeux B, Diakov C, Sosner P, Christiaens L, Coisne D, Kihara C, Murata K, Wada Y, Uchida K, Ueyama T, Okuda S, Susa T, Matsuzaki M, Cho EJ, Choi KY, Kwon BJ, Kim DB, Jang SW, Cho JS, Jung HO, Jeon HK, Youn HJ, Kim JH, Cikes M, Bijnens B, Velagic V, Kopjar T, Milicic D, Biocina B, Gasparovic H, Almuntaser I, Brown A, Foley B, Mulvihill N, Crean P, King G, Murphy R, Takata Y, Taniguchi M, Nobusada S, Sugawara M, Toh N, Kusano K, Itoh H, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Poulsen MK, Henriksen JE, Dahl J, Johansen A, Haghfelt T, Hoilund-Carlsen PF, Beck-Nielsen H, Moller JE, Dankowski R, Wierzchowiecki M, Michalski M, Nowicka A, Szymanowska K, Pajak A, Poprawski K, Szyszka A, Kasner M, Westermann D, Schultheiss HP, Tschoepe C, Watanabe T, Iwai-Takano M, Kobayashi A, Machii H, Takeishi Y, Paelinck BP, Van Herck PL, Bosmans JM, Vrints CJ, Lamb HJ, Doltra A, Vidal B, Silva E, Poyatos S, Mont L, Berruezo A, Castel A, Tolosana JM, Brugada J, Sitges M, Dencker M, Bjorgell O, Hlebowicz J, Szelenyi ZS, Szenasi G, Kiss M, Prohaszka Z, Patocs A, Karadi I, Vereckei A, Saha SK, Anderson PL, Govind S, Govindan M, Moggridge JC, Kiotsekoglou A, Gopal AS, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Graefe M, Huang FQ, Zhang RS, Le TT, Tan RS, Sattarzadeh Badkoubeh R, Tavoosi A, Elahian AR, Drapkina O, Ivashkin VI, Vereckei A, Szelenyi ZS, Fazakas A, Pepo L, Janosi O, Karadi I, Kopitovic I, Goncalves A, Marcos-Alberca P, Almeria C, Feltes G, Rodriguez E, Garcia E, Hernandez-Antolin R, Macaya C, Silva Cardoso J, Zamorano JL, Navarro MS, Valentin M, Banes CM, Rigo F, Grolla E, Tona F, Cuaia V, Moreo A, Badano L, Raviele A, Iliceto S, Tarzia P, Sestito A, Nerla R, Di Monaco A, Infusino F, Matera D, Greco F, Tacchino RM, Lanza GA, Crea F, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Holte E, Vegsundvag J, Hole T, Hegbom K, Wiseth R, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Zagatina A, Zhuravskaya N, Tyurina TV, Tagliamonte E, Cirillo T, Coppola A, Marinelli U, Romano C, Riccio G, Citro R, Astarita C, Capuano N, Tagliamonte E, Cirillo T, Marinelli U, Quaranta G, Desiderio A, Riccio G, Romano C, Capuano N, Frattini S, Faggiano P, Zilioli V, Locantore E, Longhi S, Bellandi F, Faden G, Triggiani M, Dei Cas L, Dalsgaard M, Kjaergaard J, Iversen K, Hassager C, Dinh W, Nickl WN, Smettan JS, Koehler TK, Scheffold TD, Coll Barroso MCB, Guelker JG, Fueth RF, Kamperidis V, Hadjimiltiades S, Sianos G, Efthimiadis G, Karvounis H, Parcharidis G, Styliadis IH, Velasco Del Castillo MS, Cacicedo A, Onaindia JJ, Quintana O, Alarcon JA, Rodriguez I, Telleria M, Subinas A, Lekuona I, Laraudogoitia E, Carstensen HG, Nordenberg C, Sogaard P, Fritz-Hansen T, Bech J, Galatius S, Jensen JS, Mogelvang R, Bartko PE, Graf S, Rosenhek R, Burwash IG, Bergler-Klein J, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kirilmaz B, Eser I, Tuzun N, Komur B, Dogan H, Taskiran Comez A, Ercan E, Cusma-Piccione M, Zito C, Oreto G, Piluso S, Tripepi S, Oreto L, Longordo C, Ciraci L, Di Bella G, Carerj S, Piatkowski R, Kochanowski J, Scislo P, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Sknouril L, Dorda M, Holek B, Gajdusek L, Chovancik J, Branny M, Fiala M, Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P, Jander N, Minners J, Martin G, Zeh W, Allgeier M, Gohlke-Baewolf C, Gohlke H, Nistri S, Porciani MC, Attanasio M, Abbate R, Gensini GF, Pepe G, Duncan RF, Piantadosi C, Nelson AJ, Wittert G, Dundon B, Worthley MI, Worthley SG, Jung P, Berlinger K, Rieber J, Sohn HZ, Schneider P, Leibig M, Koenig A, Klauss V, Tomkiewicz-Pajak L, Kolcz J, Olszowska M, Pieculewicz M, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Suchon E, Sobien B, Podolec P, Pieculewicz M, Przewlocki T, Wilkolek P, Tomkiewicz-Pajak L, Ziembicka A, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Hlawaty M, Wilkolek P, Sobien B, Suchon E, Podolec P, Van De Bruaene A, Hermans H, Buys R, Vanhees L, Delcroix M, Voigt JU, Budts W, De Cillis E, Acquaviva T, Basile D, Bortone AS, Kalimanovska-Ostric D, Nastasovic T, Vujisic-Tesic B, Jovanovic I, Milakovic B, Dostanic M, Stosic M, Frogoudaki A, Andreou K, Parisis J, Triantafyllidi E, Gaitani S, Paraskevaidis J, Anastasiou-Nana M, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Sobien B, Hlawaty M, Podolec P, De Pasquale G, Kuehn A, Petzuch K, Mueller J, Meierhofer C, Fratz S, Hager A, Hess J, Vogt M, Attenhofer Jost CH, Dearani JA, Scott CG, Burkhart HM, Connolly HM, Vitarelli A, Battaglia D, Caranci F, Padella V, Continanza G, Dettori O, Capotosto L, Vitarelli M, De Cicco V, Cortez Morichetti M, Mohanan Nair KK, Sasidaharan B, Thajudeen A, Tharakan JM, Mertens L, Ahmad N, Kantor PK, Grosse-Wortmann L, Friedberg MK, Bernard YF, Morel MA, Descotes-Genon V, Jehl J, Meneveau N, Schiele F, Kaldararova M, Simkova I, Tittel P, Masura J, Trojnarska O, Szczepaniak L, Mizia -Stec K, Cieplucha A, Bartczak A, Grajek S, Tykarski A, Gasior Z, Attenhofer Jost CH, Babovicvuksanovic D, Scott CG, Bonnichsen CR, Burkhart HM, Connolly HM, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee KJ, Chaturvedi R, Benson L, Mertens L, Bradley T, Iancu ME, Ghiorghiu I, Serban M, Craciunescu I, Hodo A, Popescu BA, Ginghina C, Morgan J, Morgan GJ, Slorach C, Hui W, Roche L, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Morgan J, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Milanesi O, Favero V, Padalino M, Biffanti R, Cerutti A, Maschietto N, Reffo E, Vida V, Stellin G, Irtyuga O, Gamazin D, Voronkina I, Tsoyi N, Gudkova E, Moiseeva O, Aggeli C, Kazazaki C, Felekos I, Lagoudakou S, Roussakis G, Skoumas J, Pitsavos C, Stefanadis C, Cueff C, Keenan N, Steg PG, Cimadevilla C, Ducrocq G, Vahanian A, Messika-Zeitoun D, Petrella L, Mazzola AM, Villani CV, Giancola RG, Ciocca MC, Di Eusanio DEM, Nolan S, Ionescu A, Skaug TR, Amundsen BH, Hergum T, Torp H, Haugen BO, Lopez Aguilera J, Mesa Rubio D, Ruiz Ortiz M, Delgado Ortega M, Villanueva Fernandez E, Cejudo Diaz Del Campo L, Toledano Delgado F, Leon Del Pino M, Romo Pena E, Suarez De Lezo Cruz-Conde J, De Marco E, Colucci A, Comerci G, Gabrielli FA, Natali R, Garramone B, Savino M, Lotrionte M, Sonaglioni A, Loperfido F, Zdravkovic M, Perunicic J, Krotin M, Ristic M, Vukomanovic V, Zaja M, Radovanovic S, Saric J, Zdravkovic D, Cotrim C, Almeida AR, Miranda R, Almeida AG, Picano E, Carrageta M, D'andrea A, Cocchia R, Riegler L, Golia E, Scarafile R, Citro R, Caso P, Russo MG, Bossone E, Calabro' R, Noman H, Adel A, Elfaramawy AMR, Abdelraouf M, Elnaggar WAEL, Baligh E, Sargento L, Silva D, Goncalves S, Ribeiro S, Vinhas Sousa G, Almeida A, Lopes M, Rodriguez-Manero M, Aguado Gil L, Azcarate P, Lloret Luna P, Macias Gallego A, Castano SARA, Garcia M, Pujol Salvador C, Barba J, Redondo P, Tomasoni L, Sitia S, Atzeni F, Gianturco L, Ricci C, Sarzi-Puttini P, Turiel M, Sitia S, Tomasoni L, Atzeni F, De Gennaro Colonna V, Sarzi-Puttini P, Turiel M, Uejima T, Jaroch J, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evanvelista A, Leftheriotis G, Fraser AG, Lewczuk A, Sobkowicz B, Tomaszuk-Kazberuk A, Sawicki R, Hirnle T, Michalski BW, Filipiak D, Kasprzak JD, Lipiec P, Dalen H, Haugen BO, Mjolstad OC, Klykken BE, Graven T, Martensson M, Olsson M, Brodin LA, Antonini-Canterin F, Ticulescu R, Vriz O, Enache R, Leiballi E, Popescu BA, Ginghina C, Nicolosi GL, Penhall A, Perry R, Altman M, Sinhal A, Bennetts J, Chew DP, Joseph MX, Larsen LH, Kjaergaard J, Kristensen T, Kober LV, Kofoed KF, Hassager C, Moscoso Costa F, Ribeiras R, Brito J, Boshoff S, Neves J, Teles R, Canada M, Andrade MJ, Gouveia R, Silva A, Miskovic A, Poerner TP, Stiller CS, Goebel BG, Moritz AM, Stefani L, Galanti GG, Moraldo M, Bergamini C, Pabari PA, Dhutia NM, Malaweera ASN, Willson K, Davies J, Hughes AD, Xu XY, Francis DP, Jasaityte R, Amundsen B, Barbosa D, Loeckx D, Kiss G, Orderud F, Robesyn V, Claus P, Torp H, D'hooge J, Kihara C, Murata K, Wada Y, Uchida K, Nao T, Okuda S, Susa T, Miura T, Matsuzaki M, Shams K, Samir S, Samir R, El-Sayed M, Anwar AM, Nosir Y, Galal A, Chamsi-Pasha H, Ciobanu A, Dulgheru R, Bennett S, Vinereanu D, De Luca A, Toncelli L, Cappelli F, Stefani L, Cappelli B, Vono MCR, Galanti G, Zorman Y, Yilmazer MS, Akyildiz M, Gurol T, Aydin A, Dagdeviren B, Kalangos A. Poster session V * Saturday 11 December 2010, 08:30-12:30. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pinzon-Rondon AM, Botero JC, Benson L, Briceno-Ayala L, Kanamori M. Workplace Abuse and Economic Exploitation of Children Working in the Streets of Latin American Cities. International Journal of Occupational and Environmental Health 2010. [DOI: 10.1179/oeh.2010.16.2.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Pinzon-Rondon AM, Botero JC, Benson L, Briceno-Ayala L, Kanamori M. Workplace abuse and economic exploitation of children working in the streets of Latin American cities. Int J Occup Environ Health 2010; 16:162-169. [PMID: 20465061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study presents the prevalence of, and factors associated with workplace abuse and economic exploitation among 584 children ages 5 to 17 working in the streets of the Latin American cities of Bogotá, Lima, Quito, and São Paulo. Each additional 10 hours/week of children's work in the streets increased workplace abuse prevalence by 8% (odds ratio [OR], 1.08; 95% confidence interval [95% CI], 1.01-1.19). Suffering an occupational injury was associated with abuse (OR, 1.70; 95% CI, 1.13-2.57). Participation in begging was associated with an almost five-fold increase in economic exploitation (OR, 4.94; 95% CI, 1.96-12.48). Children residing with their mothers were 2.6 times more likely to experience economic exploitation (OR, 2.61; 95% CI, 1.58-4.33), reflecting our definition of economic exploitation in which a child's income is confiscated by parents, even if used for basic family needs. Increased health care coverage and conditional cash transfer programs are recommended to improve the situation.
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Diedrich J, Benson L, Drey E, Harper C, Steinauer J. The postabortion progestin contraception study: which demographic factors predict choice of long-acting, reversible contraception? Contraception 2009. [DOI: 10.1016/j.contraception.2009.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ljunhgall S, Akerström G, Benson L, Hetta J, Rudberg C, Wide L. Effects of Epinephrine and Norepinephrine on Serum Parathyroid Hormone and Calcium in Normal Subjects. Exp Clin Endocrinol Diabetes 2009; 84:313-8. [PMID: 6543193 DOI: 10.1055/s-0029-1210404] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Infusions with stepwise increasing concentrations of epinephrine (from 2.5 to 10 micrograms/min) and norepinephrine (0.5-2.0 micrograms/min) were given to normal subjects. During infusion of epinephrine there was a clear rise of the serum parathyroid hormone (PTH) levels already at the lowest concentration. Concomitantly there was a fall in the serum concentrations of calcium. The PTH levels returned to baseline promptly after termination of infusion whereas hypocalcaemia persisted up to 30 minutes, indicating a primary response of PTH to epinephrine. When propranolol was given prior to and during the epinephrine infusion no significant changes occurred for either PTH or calcium. During infusion of norepinephrine no consistent significant changes were noted for either PTH or serum calcium. Thus, our data do not support any concept of a basal adrenergic tone which normally modulates the secretion of PTH. However, during conditions of stress the beta-adrenergic stimulation night be of importance.
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Benson L, Lundqvist G, Wide L, Akerström G, Oberg K, Ljunghall S. Effects of secretin on parathyroid hormone and calcium in normal subjects, patients with hyperparathyroidism and patients with gastrinoma. Acta Med Scand 2009; 217:205-11. [PMID: 3993434 DOI: 10.1111/j.0954-6820.1985.tb01657.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In vitro studies have demonstrated that secretin can stimulate the release of parathyroid hormone (PTH), but reports concerning its effects on PTH and calcium in vivo are contradictory. To examine this question further, a bolus injection of secretin (75 IU) was given to 12 normal subjects and 10 patients with primary hyperparathyroidism (HPT). Six of the patients had multiple endocrine neoplasia and five had endocrine pancreatic tumours (EPT). Three normocalcaemic patients with EPT were also included in the study. The mean serum gastrin level rose significantly (from 19 to 40 pmol/l, p less than 0.01) within 15 min of secretin injection in the normal subjects. HPT patients without EPT had a somewhat higher mean basal level of gastrin (39 pmol/l, p less than 0.05 compared with controls), but it did not increase significantly after the secretin bolus. In six EPT patients the gastrin concentrations rose by more than 300 pmol/l. Although secretin had a biological capacity to release gastrin, it had no discernible effects on either serum PTH or serum calcium in any of the groups studied. Nor were any changes in PTH or calcium observed when secretin was given as a continuous infusion (3 IU/kg/h) over 90 min. Thus, our data do not support the concept that secretin, in vivo, is a secretagogue of PTH.
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Rastad J, Benson L, Johansson H, Knuutila M, Pettersson B, Wallfelt C, Akerström G, Ljunghall S. Clodronate treatment in patients with malignancy-associated hypercalcemia. Acta Med Scand 2009; 221:489-94. [PMID: 2955674 DOI: 10.1111/j.0954-6820.1987.tb01285.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The possibility of reducing symptomatic hypercalcemia and of maintaining total serum calcium concentrations less than 2.8 mmol/l with clodronate (dichloromethylene bisphosphonate) was evaluated in 28 patients with various types of malignant tumors. Four episodes of hypercalcemic crisis with mean serum calcium concentrations of 4.43 mmol/l were controlled within 4-6 days of intravenous clodronate (4 mg/kg BW/day). This was accompanied by a moderate increase in serum creatinine values which, however, returned to pretreatment levels after therapy withdrawal in all but one case. Oral clodronate successfully reduced a mean serum calcium concentration of 3.16 mmol/l in 22 out of 25 patients after 3-12 days (800-3,200 mg/day). After reversal of the hypercalcemias oral clodronate controlled the serum calcium concentration for up to 42 weeks in six out of 15 patients After discontinuation of initial therapy five of seven recurrent hypercalcemias were successfully treated with oral or intravenous clodronate. Hypocalcemia and subjective side-effects were uncommon. It is concluded that clodronate is a valuable clinical tool in the management of patients with malignancy-associated hypercalcemia.
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Harman MK, DesJardins J, Benson L, Banks SA, LaBerge M, Hodge WA. Comparison of polyethylene tibial insert damage from in vivo function and in vitro wear simulation. J Orthop Res 2009; 27:540-8. [PMID: 18932244 DOI: 10.1002/jor.20743] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [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: 02/04/2023]
Abstract
Function and wear of total knee arthroplasties were compared by analysis of damage patterns on polyethylene tibial inserts retrieved from patients (Group R) with inserts obtained after in vitro force-controlled knee joint wear simulation. Two simulator input profiles were evaluated, including standard walking (Group W), and combined walking and stair descent (Group W + S), simulating varied activities and a more severe physiological environment. Damage regions on all inserts were quantitatively assessed. On average, inserts in all groups had internally rotated damage patterns and the greatest articular deformation in the lateral compartment. These patterns were more pronounced in Group W + S compared to Group W. Deformation rates of simulated inserts were analogous to about six years of physiologic function. However, both groups of simulated inserts generally underestimated the magnitude of damage area and extent observed on retrieved inserts, consistent with differences in the simulator's tibiofemoral contact mechanics and those known to occur in patients during functional activities. Modification of simulator inputs, such as the increased anteroposterior excursion and more severe loading conditions in Group W + S, can generate greater wear volume, larger damage areas, and increased surface deformation rates compared to standard inputs.
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Affiliation(s)
- Melinda K Harman
- Orthopaedic Research Laboratory, The BioMotion Foundation, West Palm Beach, Florida 33401, USA.
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Catanzarite J, Alan R, Baig R, Forno P, Benson L. Biomechanical testing of unstable humeral shaft fracture plating. J Surg Orthop Adv 2009; 18:175-181. [PMID: 19995496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study compared the biomechanical performance of 4.5-mm limited-contact dynamic compression plates (DCPs) and 3.5-mm locking compression plates (LCPs) for the fixation of unstable humeral shaft fractures. Composite humeri were divided into two groups: 3.5-mm LCPs and 4.5-mm DCPs. Osteotomy gaps of 5 mm, simulating diaphyseal comminution, were created. Stiffness tests were performed in anterior-posterior (AP) bending, medial-lateral (ML) bending, torsion, and axial compression. Results showed that while construct stiffnesses in ML bending and torsional loading are significantly higher for the 4.5 DCP group (p < .05), no statistically significant differences were observed in AP bending or axial compression. Fatigue characteristics under cyclic AP bending conditions were also evaluated, although no failures occurred. Data from the literature suggest that stiffness results for the LCP constructs perhaps afford sufficient fixation strength capable of supporting the physiologic loads most commonly applied during postoperative rehabilitation. However, results indicate that the DCP construct is mechanically advantageous for stabilizing diaphyseal comminuted fractures.
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Affiliation(s)
- Joshua Catanzarite
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
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Schmidt M, Jaeggi E, Ryan G, Hyldebrandt J, Lilly J, Peirone A, Benson L, Chaturvedi RR. Percutaneous ultrasound-guided stenting of the atrial septum in fetal sheep. Ultrasound Obstet Gynecol 2008; 32:923-928. [PMID: 18839405 DOI: 10.1002/uog.5405] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Hypoplastic left heart syndrome (HLHS) with a restricitive foramen ovale is associated with high mortality related to fetal left atrial hypertension. Fetal atrial balloon septoplasty has largely failed to achieve adequate decompression due to the small size of the holes produced. We attempted to produce larger atrial communications by stenting the atrial septum in fetal sheep using a minimally invasive technique. METHODS We used a percutaneous, ultrasound-guided transpulmonary or transhepatic approach to attempt deployment of coronary stents (2-5 mm in diameter and 13-23 mm in length) in the atrial septum primum of 10 normal fetal sheep. RESULTS Coronary stents were deployed in eight of the 10 fetal sheep (119-139 days' gestation). The transhepatic route was unsuccessful (n = 2). Transpulmonary implantation was only possible in prone fetuses, so three initially supine fetuses underwent external version. Small coronary stents (2.0-2.5 mm in diameter) were deployed rapidly without complication via an 18G needle (n = 4). Larger coronary stents (5 mm in diameter) were delivered through a 4F sheath, but a right pleural effusion occurred in three of the four cases, related to inferior vena cava injury by the balloon. One stent dislodged from a floppy septum. Another was partially occluded within a week by endocardial cells. CONCLUSIONS Percutaneous ultrasound-guided deployment of coronary stents into the septum primum is feasible without laparotomy or uterine exteriorization in fetal sheep. Partial luminal occlusion by rapid proliferation of endocardial cells is a concern.
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Affiliation(s)
- M Schmidt
- Department of Cardiovascular Surgery, Aarhus University Hospital, Aarhus, Denmark
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Benson L, Gustavson KH, Rastad J, Akerström G, Oberg K, Ljunghall S. Cytogenetical investigations in patients with primary hyperparathyroidism and multiple endocrine neoplasia type 1. Hereditas 2008; 108:227-9. [PMID: 2905349 DOI: 10.1111/j.1601-5223.1988.tb00306.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Collins N, Colman J, Benson L, Hansen M, Merchant N, Horlick E. Successful percutaneous treatment of anomalous left coronary artery from pulmonary artery. Int J Cardiol 2007; 122:e29-31. [PMID: 17289183 DOI: 10.1016/j.ijcard.2006.11.075] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Accepted: 11/02/2006] [Indexed: 11/26/2022]
Abstract
Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital condition seen in the adult population, with most patients developing symptoms in infancy. We describe successful closure of an ALCAPA in an adult using a percutaneous transcatheter approach in a patient with evidence of anterior wall ischemia believed to be the consequence of myocardial steal. A 30-year-old female was noted to have continuous flow in the right ventricular septum on transthoracic echocardiography, with subsequent imaging confirming the presence of an ALCAPA. Myocardial perfusion imaging confirmed anterior wall ischemia, and as a strategy to optimize coronary perfusion pressure, the patient underwent percutaneous ALCAPA closure using an Amplatzer vascular plug. The procedure was well tolerated, with no evidence of anterior ischemia or myocardial dysfunction. Follow up perfusion imaging demonstrated no residual anterior wall ischemia. Transcatheter closure of an ALCAPA is a potentially safe and effective alternative treatment strategy in this patient population.
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Swan L, Varma C, Yip J, Warr M, Webb G, Benson L, McLaughlin P. Transcatheter device closure of atrial septal defects in the elderly: Technical considerations and short-term outcomes. Int J Cardiol 2006; 107:207-10. [PMID: 16412798 DOI: 10.1016/j.ijcard.2005.03.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Revised: 02/23/2005] [Accepted: 03/11/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Device closure of an atrial septal defect (ASD) results in symptom-reduction, right heart remodelling and lower pulmonary artery pressures. However it is unclear if there is a chronological limit to these benefits and whether device closure is safe in elderly subjects. The aim of this study was, therefore, to assess the safety and efficacy of device closure in patients >60 years. METHODS Retrospective study of Amplatzer Septal Occluder device closures from a single institution (May 1999-August 2002). RESULTS Fifty subjects aged >60 years (range 60-85 years) had ASD device closure (27% of the total cohort). Defect size and shunt size were similar for both younger and older groups (2.2:1 in both groups, p=0.9) as were procedural duration, fluoroscopy time and device size deployed. Baseline right ventricular (RV) systolic pressure ((younger vs. older) 39 vs. 49 mmHg, p<0.001) and right ventricular size (45 vs. 51 mm, p<0.001) were greater in the older group. Following closure RV systolic pressure (49 vs. 45 mmHg, p<0.01) and RV size (51 vs. 44 mm, p=0.01) decreased in the older group. CONCLUSION Device closure of an ASD can be performed safely in older patients. The right heart shows signs of remodelling even in elderly subjects.
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Affiliation(s)
- L Swan
- Toronto Congenital Cardiac Centre for Adults, Division of Cardiology, Toronto General Hospital, University Health Network, Canada.
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Abstract
Plastic bronchitis is a rare, potentially life-threatening condition in which protein casts form within and occlude the bronchus, resulting in pulmonary failure, and has been identified as a complication after the Fontan procedure. We present a case of a 5-year-old girl who had undergone an extracardiac fenestrated Fontan repair as a component of staged palliation for tricuspid atresia. Six weeks following surgery, the patient presented with airway obstruction, coughing a bronchial cast. Medical therapies to optimize heart function and attempt to control cast formation were implemented, with little clinical impact. Following cardiac catheterization to stent open the fenestration, the symptoms of plastic bronchitis resolved. Cast expectoration recurred following spontaneous closure of the stented fenestration and again resolved with recreation of the baffle defect. Fenestration of the Fontan circuit alters hemodynamics, thereby providing an additional therapeutic option for this devastating disorder.
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Affiliation(s)
- J Wilson
- Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, University of Toronto School of Medicine, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
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