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D'Oria M, Lima GBB, Dias N, Parlani G, Farber M, Tsilimparis N, DeMartino R, Timaran C, Kolbel T, Gargiulo M, Milner R, Melissano G, Maldonado T, Mani K, Tenorio ER, Oderich GS. Outcomes of "Anterior Versus Posterior Divisional Branches of the Hypogastric Artery as Distal Landing Zone for Iliac Branch Devices": The International Multicentric R3OYAL Registry. J Endovasc Ther 2024; 31:282-294. [PMID: 36113081 DOI: 10.1177/15266028221120513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
OBJECTIVE The aim of this multicentric registry was to assess the outcomes of "anteRior versus posteRior divisional bRanches Of the hYpogastric artery as distAl landing zone for iLiac branch devices (R3OYAL)." METHODS The main exposure of interest for the purpose of this study was the internal iliac artery (IIA) divisional branch (anterior vs posterior) that was used as distal landing zone. Early endpoints included technical success and adverse events. Late endpoints included survival, primary/secondary IIA patency, and IIA branch instability. RESULTS A total of 171 patients were included in the study, of which 50 received bilateral implantation of iliac branch devices (IBDs). This resulted in a total of 221 incorporated IIAs included in the final analysis, of which 40 were anterior divisional branches and 181 were posterior divisional branches. Technical success was high in both groups (anterior division: 98% vs posterior division: 100%, P = .18). Occurrence of any adverse event was noted in 14% of patients in both groups (P = 1.0). The overall rate of freedom from the composite IBD branch instability did not show significant differences between patients receiving distal landing in the anterior or posterior division of the IIA at 3 years (79% vs 87%, log-rank test = .215). The 3-year estimates of IBD patency were significantly lower in patients who received distal landing in the anterior divisional branch than those who received distal landing in the posterior divisional branch (primary patency: 81% vs 96%, log-rank test = .009; secondary patency: 81% vs 97%, log-rank test < .001). CONCLUSIONS The use of the anterior or posterior divisional branches of the IIA as distal landing zone for IBD implantation shows comparable profiles in terms of immediate technical success, perioperative safety, and side-branch instability up to 3 years. However, IBD patency at 3 years was higher when the distal landing zone was achieved within the posterior divisional branch of the IIA. CLINICAL IMPACT The results from this large multicentric registry confirm that use of the anterior or posterior divisional branches of the internal iliac artery (IIA) as distal landing zone for implantation of iliac branch devices (IBD) shows comparable profiles of safety and feasibility, thereby allowing to extend the indications for endovascular repair of aorto-iliac aneurysms to cases with unsuitable anatomy within the IIA main trunk. Although mid-term rates of device durability and branch instability seem to be similar, the rates of primary and secondary IBD patency at three years was favored when the distal landing zone was achieved in the posterior divisional branch of the IIA.
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Affiliation(s)
- Mario D'Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, ASUGI, Trieste, Italy
| | - Guilherme B B Lima
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, The University of Texas Health Science Centre at Houston, Houston, TX, USA
| | - Nuno Dias
- Department of Thoracic Surgery and Vascular Diseases, Vascular Centre, Skåne University Hospital, Malmö, Sweden
| | - Giambattista Parlani
- Vascular and Endovascular Surgery Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Mark Farber
- Division of Vascular Surgery, Department of Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nikolaos Tsilimparis
- Department of Vascular Surgery, Ludwig Maximilians University Hospital, Munich, Germany
| | - Randall DeMartino
- Division of Vascular and Endovascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA
| | - Carlos Timaran
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tilo Kolbel
- Department of Vascular Medicine, German Aortic Centre, University Heart and Vascular Centre, Hamburg, Germany
| | - Mauro Gargiulo
- Vascular Surgery, IRCCS University Hospital, Policlinico S. Orsola and University of Bologna, Bologna, Italy
| | - Ross Milner
- Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Germano Melissano
- Division of Vascular Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Thomas Maldonado
- Division of Vascular and Endovascular Surgery, NYU Langone Health, New York, NY, USA
| | - Kevin Mani
- Division of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Emanuel R Tenorio
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, The University of Texas Health Science Centre at Houston, Houston, TX, USA
| | - Gustavo S Oderich
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, The University of Texas Health Science Centre at Houston, Houston, TX, USA
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Modarai B, Haulon S, Ainsbury E, Böckler D, Vano-Carruana E, Dawson J, Farber M, Van Herzeele I, Hertault A, van Herwaarden J, Patel A, Wanhainen A, Weiss S, Esvs Guidelines Committee, Bastos Gonçalves F, Björck M, Chakfé N, de Borst GJ, Coscas R, Dias NV, Dick F, Hinchliffe RJ, Kakkos SK, Koncar IB, Kolh P, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Document Reviewers, Bacher K, Brountzos E, Fanelli F, Fidalgo Domingos LA, Gargiulo M, Mani K, Mastracci TM, Maurel B, Morgan RA, Schneider P. Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety. Eur J Vasc Endovasc Surg 2023; 65:171-222. [PMID: 36130680 DOI: 10.1016/j.ejvs.2022.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023]
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Kindell DG, Marulanda K, Caruso DM, Duchesneau E, Agala C, Farber M, Marston WA, McGinigle KL. Incidence of venous thromboembolism in patients with peripheral arterial disease after endovascular intervention. Eur J Vasc Endovasc Surg 2023. [DOI: 10.1016/j.ejvs.2022.12.020] [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: 01/12/2023]
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Kindell DG, Marulanda K, Caruso DM, Duchesneau E, Agala C, Farber M, Marston WA, McGinigle KL. Incidence of venous thromboembolism in patients with peripheral arterial disease after endovascular intervention. J Vasc Surg Venous Lymphat Disord 2023; 11:61-69. [PMID: 36182086 PMCID: PMC10681019 DOI: 10.1016/j.jvsv.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Venous thromboembolism (VTE) is a well-known postoperative complication; however, the incidence of VTE after peripheral vascular intervention (PVI) has not been well described. Despite the minimally invasive nature of these procedures, the patients undergoing PVI have significant risk factors for the development of VTE. In the present study, our objective was to describe the short-term incidence of VTE after PVI, identify differences between sexes, and examine the periprocedural antiplatelet and anticoagulation regimens. METHODS We identified adults (age >66 years) who had undergone PVI from January 1, 2008 to September 30, 2015 from the inpatient Medicare claims data. The patients were followed for 365 days after the procedure. VTE events during follow-up were identified using the International Classification of Diseases, 9th revision, diagnosis codes. The covariate-standardized 30- and 90-day cumulative incidence of VTE events, overall and stratified by sex, were estimated using Aalen-Johansen estimators, accounting for death as a competing risk. Differences in sex between females and males were identified using Gray's test. Any antiplatelet or anticoagulant prescription fill was defined as any fill from 14 days before the endovascular intervention through the date of the VTE event. Persistence with antiplatelet and anticoagulant therapy was assessed by creating daily logs of antiplatelet and anticoagulant coverage using the dispensing dates and days of supply. Over-the-counter medications (ie, aspirin) were not evaluated. RESULTS We identified 31,593 qualifying patients with a mean age of 76.8 ± 7.4 years. Of the 31,593 patients, 46% were male, and 12% had a history of VTE. After the procedure, deep vein thrombosis (DVT) was a commonly diagnosed complication (3.8% and 4.8% at 30 and 90 days, respectively). The cumulative incidence of pulmonary embolism was 0.9% and 1.2% at 30 and 90 days after the procedure, respectively. Throughout the 90-day postoperative period, females had had a slightly increased risk of DVT compared with males (30-day risk difference, 0.007; P < .01; 90-day risk difference, 0.008; P = .02). We found no sex-based differences in the risk of pulmonary embolism. Of the patients who had developed VTE at 90 days, 970 (55%) had had no prescription fill for an antiplatelet or anticoagulant. Assuming all the patients had been taking aspirin, only 15% of the patients who had developed VTE had been taking prescribed dual antiplatelet medication persistently after PVI. In addition, among the patients who had developed VTE at 90 days, females were less likely to have had a prescription fill for an anticoagulant. CONCLUSIONS The findings from our study have demonstrated that the incidence of VTE after PVI is high, with an increased risk of deep vein thrombosis for females. We also found that females were less likely to have been prescribed an anticoagulant after PVI. Future studies are needed to characterize the variables associated with an increased risk of VTE after PVI and to identify strategies to increase dual antiplatelet therapy or anticoagulant prescription adherence to reduce the risk of VTE.
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Affiliation(s)
- Daniel G Kindell
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Kathleen Marulanda
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Deanna M Caruso
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emilie Duchesneau
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Chris Agala
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mark Farber
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - William A Marston
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Zettervall S, Tenorio ER, Schanzer A, Oderich GS, Timaran CH, Schneider DB, Eagleton MJ, Farber M, Gasper W, Beck AW, Sweet MP. Reinterventions After Branched/Fenestrated Aortic Aneurysm Repairs Are Common and Nondetrimental to Long-term Survival. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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El-Domyati M, El-Din WH, Rezk AF, Chervoneva I, Lee JB, Farber M, Uitto J, Igoucheva O, Alexeev V. Systemic CXCL10 is a predictive biomarker of vitiligo lesional skin infiltration, PUVA, NB-UVB and corticosteroid treatment response and outcome. Arch Dermatol Res 2021; 314:275-284. [PMID: 33866437 DOI: 10.1007/s00403-021-02228-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/23/2020] [Revised: 02/24/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
Vitiligo is an acquired pigmentary skin disorder that currently lacks standardized treatment and validated biomarkers to objectively evaluate disease state or therapeutic response. Although prior studies have linked vitiligo autoimmunity with CXCL10/CXCL9-mediated recruitment of leukocytes to the skin, only limited clinical data are available regarding CXCL10 as vitiligo biomarker. To evaluate the utility of systemic CXCL10 as a predictor of disease progression and treatment response on a large cohort of vitiligo patients. CXCL10 levels in lesional, perilesional, and unaffected skin of vitiligo patient (n = 30) and in the serum (n = 51) were measured by quantitative ELISA. CXCL10 expression, recruitment of leukocytes, and inflammatory infiltrates were evaluated by histochemical (n = 32) and immunofluorescence (n = 10) staining. Rigorous cross-sectional and longitudinal biostatistical analysis were employed to correlate CXCL10 levels with disease variables, treatment response, and outcome. We demonstrated that elevated CXCL10 level (2 pg/mm2 and higher) in lesional skin correlates with increased leukocytic infiltrate, disease duration (< 2 year), and its higher level in the serum (50 pg/ml and higher). Changes in CXCL10 serum levels in patients treated with psoralen plus UVA (PUVA) phototherapy, narrowband UVB (NB-UVB) phototherapy, and systemic steroids (SS) correlated with changes in the intralesional CXCL10 levels in repigmented skin. NB-UVB and SS regimens provided most consistent CXCL10 mean change, suggesting that these regimens are most effective in harnessing CXCR3-mediated inflammatory response. Serum CXCL10 is a useful vitiligo biomarker, which predicts lesional skin leukocytic infiltration, and vitiligo treatment response and outcome.
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Affiliation(s)
- M El-Domyati
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.
| | - W H El-Din
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt
| | - A F Rezk
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.,Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - I Chervoneva
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA, 19107, USA
| | - J B Lee
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - M Farber
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - J Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - O Igoucheva
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - Vitali Alexeev
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA.
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Khan SH, Lindroth H, Perkins AJ, Jamil Y, Wang S, Roberts S, Farber M, Rahman O, Gao S, Marcantonio ER, Boustani M, Machado R, Khan BA. Delirium Incidence, Duration, and Severity in Critically Ill Patients With Coronavirus Disease 2019. Crit Care Explor 2020; 2:e0290. [PMID: 33251519 PMCID: PMC7690767 DOI: 10.1097/cce.0000000000000290] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To determine delirium occurrence rate, duration, and severity in patients admitted to the ICU with coronavirus disease 2019. DESIGN Retrospective data extraction study from March 1, 2020, to June 7, 2020. Delirium outcomes were assessed for up to the first 14 days in ICU. SETTING Two large, academic centers serving the state of Indiana. PATIENTS Consecutive patients admitted to the ICU with positive severe acute respiratory syndrome coronavirus 2 nasopharyngeal swab polymerase chain reaction test from March 1, 2020, to June 7, 2020, were included. Individuals younger than 18 years of age, without any delirium assessments, or without discharge disposition were excluded. MEASUREMENTS AND MAIN RESULTS Primary outcomes were delirium rates and duration, and the secondary outcome was delirium severity. Two-hundred sixty-eight consecutive patients were included in the analysis with a mean age of 58.4 years (sd, 15.6 yr), 40.3% were female, 44.4% African American, 20.7% Hispanic, and a median Acute Physiology and Chronic Health Evaluation II score of 18 (interquartile range, 13-25). Delirium without coma occurred in 29.1% of patients, delirium prior to coma in 27.9%, and delirium after coma in 23.1%. The first Confusion Assessment Method for the ICU assessment was positive for delirium in 61.9%. Hypoactive delirium was the most common subtype (87.4%). By day 14, the median number of delirium/coma-free were 5 days (interquartile range, 4-11 d), and median Confusion Assessment Method for the ICU-7 score was 6.5 (interquartile range, 5-7) indicating severe delirium. Benzodiazepines were ordered for 78.4% of patients in the cohort. Mechanical ventilation was associated with greater odds of developing delirium (odds ratio, 5.0; 95% CI, 1.1-22.2; p = 0.033) even after adjusting for sedative medications. There were no between-group differences in mortality. CONCLUSIONS Delirium without coma occurred in 29.1% of patients admitted to the ICU. Delirium persisted for a median of 5 days and was severe. Mechanical ventilation was significantly associated with odds of delirium even after adjustment for sedatives. Clinical attention to manage delirium duration and severity, and deeper understanding of the virus' neurologic effects is needed for patients with coronavirus disease 2019.
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Affiliation(s)
- Sikandar H Khan
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN
- Indiana University Center of Health Innovation and Implementation Science, Indianapolis, IN
| | - Heidi Lindroth
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN
- Indiana University Center of Health Innovation and Implementation Science, Indianapolis, IN
- Indiana University School of Nursing, Indianapolis, IN
| | - Anthony J Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Sophia Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Scott Roberts
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Mark Farber
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Omar Rahman
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
| | - Edward R Marcantonio
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Malaz Boustani
- IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN
- Indiana University Center of Health Innovation and Implementation Science, Indianapolis, IN
- Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN
- Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN
| | - Roberto Machado
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Babar A Khan
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN
- Indiana University Center of Health Innovation and Implementation Science, Indianapolis, IN
- Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN
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Banga P, Oderich GS, Farber M, Reis de Souza L, Tenorio ER, Timaran C, Schneider DB, Baumgardt Barbosa Lima G, Barreira Marcondes G, Timaran D. Impact of Number of Vessels Targeted on Outcomes of Fenestrated-Branched Endovascular Repair for Complex Abdominal Aortic Aneurysms. Ann Vasc Surg 2020; 72:98-105. [PMID: 33227467 DOI: 10.1016/j.avsg.2020.09.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this study was to investigate the impact of number of vessels targeted by fenestrations or branches on early outcomes of fenestrated-branched endovascular aortic repair (F-BEVAR) for complex abdominal aortic aneurysms (cAAAs). METHODS The clinical data of 260 patients (209 men; mean, 74 ± 7 years) treated for cAAAs in four academic centers using fenestrated-branched stent grafts with one to five fenestrations or branches were entered into prospectively maintained databases (2010-2015). Data were analyzed in patients treated with ≤2-vessel (group 1, n = 124), 3-vessel (group 2, n = 80), or ≥4 fenestrations or directional branches (group 3, n = 56). For group definition, only vessels incorporated by fenestrations or directional branches were accounted. End points were technical success, procedural variables, 30-day mortality, and major adverse events (MAEs). RESULTS A total of 830 vessels (mean, 3.19 ± 0.8 vessels/patient) were targeted by fenestrations (n = 672), scallops (n = 136), or branches (n = 22). Two-vessel designs were used more often in the early experience (64%), whereas ≥3-vessel design (groups 2 and 3) was preferred in the late experience (68%, P < 0.05). Patients with ≥4-vessel designs had longer operating and fluoroscopy time (+78 min, P < 0.0001 and + 27 min, P < 0.001), higher volume of contrast use (+31 mL, P = 0.03), and longer hospital stay (+3 days, P = 0.007) of those who had ≤2-vessel designs. Technical success, estimated blood loss, mortality, MAEs, and rate of spinal cord injury were similar in all three groups (P > 0.05). CONCLUSIONS F-BEVAR for complex abdominal aortic aneurysms was associated with high technical success and low 30-day mortality and morbidity. Increasing complexity was associated with longer operating and fluoroscopy time, more contrast use, and longer hospital stay but did not affect technical success and MAEs of the procedure.
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Affiliation(s)
- Peter Banga
- Division of Vascular and Endovascular Surgery, The Advanced Endovascular Aortic Research Program, Mayo Clinic, Rochester, MN
| | - Gustavo S Oderich
- Department of Cardiothoracic and Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
| | - Mark Farber
- The Division of Vascular Surgery, University of North Carolina Chapel Hill, NC
| | - Leonardo Reis de Souza
- Division of Vascular and Endovascular Surgery, The Advanced Endovascular Aortic Research Program, Mayo Clinic, Rochester, MN
| | - Emanuel R Tenorio
- Department of Cardiothoracic and Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX
| | - Carlos Timaran
- The Division of Vascular Surgery University of Texas South-Western Medical Center, Dallas, TX
| | - Darren B Schneider
- The Division of Vascular Surgery, Weill Cornell Medical Center, New York, NY
| | - Guilherme Baumgardt Barbosa Lima
- Department of Cardiothoracic and Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX
| | - Giulianna Barreira Marcondes
- Department of Cardiothoracic and Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX
| | - David Timaran
- The Division of Vascular Surgery University of Texas South-Western Medical Center, Dallas, TX
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Edman N, Sweet MP, Schanzer A, Oderich GS, Farber M, Schneider DB, Timaran C, Beck AW. Sex-related Outcomes After Fenestrated-Branched Endovascular Aneurysm Repair for Thoracoabdominal Aortic Aneurysms in the US Fenestrated and Branched Aortic Research Consortium. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.325] [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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Tenorio ER, Oderich GS, Kolbel T, Dias N, Farber M, Timaran C, Tsilimparis N, Haulon S. Multicenter Global Early Feasibility Study to Evaluate Total Endovascular Arch Repair Using Three-vessel Inner Branch Stent-grafts for Aneurysms and Dissections. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Merlo A, Farber M, Ohana E, Pascarella L, Crowner J, Long J. Aberrant Right Subclavian Artery to Esophageal Fistula: A Rare Case and Its Management. Ann Thorac Surg 2020; 110:e85-e86. [PMID: 32035051 DOI: 10.1016/j.athoracsur.2019.12.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/13/2019] [Revised: 12/08/2019] [Accepted: 12/16/2019] [Indexed: 11/17/2022]
Abstract
A 29-year-old woman underwent esophageal stent placement after developing esophageal stenosis in the setting of tracheoesophageal fistula repair in childhood. The patient developed hemoptysis from an esophageal to aberrant right subclavian artery fistula; this was managed with several staged procedures involving arterial stent placement, carotid-to-subclavian bypass, and aberrant subclavian artery ligation. The patient then underwent pericardial patch repair of her perforated esophagus. This case illustrates the importance of understanding congenital anatomy and frequent associations, such as tracheoesophageal fistula and aberrant right subclavian artery; furthermore, it demonstrates the importance of multidisciplinary care for complex cases.
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Affiliation(s)
- Aurelie Merlo
- Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina.
| | - Mark Farber
- Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Elad Ohana
- Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Luigi Pascarella
- Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Jason Crowner
- Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Jason Long
- Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina, Chapel Hill, North Carolina
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Crowner J, Kalbaugh C, Motta F, Knowles M, Farber M. Female Sex is not A Factor In Early and Midterm Outcomes Following Fenestrated-branched Endovascular Aortic Repair (F-BEVAR) of Complex Aortic Aneurysms (CAA). Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.09.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Timaran C, Oderich G, Schneider D, Beck A, Farber M, Sweet M. Expanded Use of Preloaded Branched and Fenestrated Endografts for Endovascular Repair of Complex Aortic Aneurysms in the US IDE Experience. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.06.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Motta F, Oderich G, Schanzer A, Timaran C, Schneider D, Sweet M, Beck A, Eagleton M, Farber M. Fenestrated-branched Endovascular Aortic Repair (F-BEVAR) is a Safe and Effective Option for Octogenarians in Treating Complex Aortic Aneurysm (CAA) Compared to Non-octogenarians. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.09.183] [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]
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15
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Westerhausen D, Perkins AJ, Conley J, Khan BA, Farber M. Burden of Substance Abuse-Related Admissions to the Medical ICU. Chest 2019; 157:61-66. [PMID: 31494083 DOI: 10.1016/j.chest.2019.08.2180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/03/2019] [Accepted: 08/24/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Admissions to the ICU related to alcohol, prescription drugs, and illicit drugs are shown to be widespread and costly. In 1993, a study revealed 28% of ICU admissions at Johns Hopkins Hospital were related to substance abuse and accrued 39% of costs. Since then, health-care expenditures have increased, and substance abuse treatment admissions have risen. We conducted a study to provide updated data on ICU utilization and costs related to licit and illicit abuse at a large county hospital in Indianapolis, Indiana. METHODS All admissions to the medical ICU at Eskenazi Hospital from March to October 2017 were reviewed. Demographics, reason for admission, relation to substance abuse and specific substance, ICU and hospital length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, mortality, insurance status, and hospital charges were collected based on chart review. RESULTS A total of 611 admissions generated $74,587,280.35 in charges. A total of 25.7% of admissions related to substance abuse accounted for 23.1% of total charges. Illicit drugs were 13% of total admissions, generating 11% of charges. Alcohol-related admissions were 9.5% of total admissions, generating 7.6% of charges. Prescription drugs were 2.9% of admissions, generating 4.2% of charges. Of the substance abuse admissions, patients were generally men and 40 to 64 years of age, with longer ICU stay, higher APACHE II scores, and higher mortality. CONCLUSIONS Substance abuse admissions make up almost a one-quarter of resources used by our ICU. Patients tend to be younger and sicker with a higher risk of death. Identifying and accurately describing the landscape of this current health crisis will help us take appropriate action in the future.
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Affiliation(s)
| | | | | | - Babar A Khan
- Indiana University School of Medicine, Indianapolis, IN; Indiana University Center for Aging Research, Indianapolis, IN; Regenstrief Institute, Inc, Indianapolis, IN; Indiana University Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, Indianapolis, IN
| | - Mark Farber
- Indiana University School of Medicine, Indianapolis, IN
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16
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Enriquez GF, Macchiaverna NP, Argibay HD, López Arias L, Farber M, Gürtler RE, Cardinal MV, Garbossa G. Polyparasitism and zoonotic parasites in dogs from a rural area of the Argentine Chaco. Vet Parasitol Reg Stud Reports 2019; 16:100287. [PMID: 31027600 DOI: 10.1016/j.vprsr.2019.100287] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 03/13/2019] [Accepted: 04/07/2019] [Indexed: 12/30/2022]
Abstract
Dogs play an important role as reservoirs and hosts of multiple pathogens shared with humans and wildlife, which contribute significantly to the global burden of disease. Here, we assessed the occurrence of a broad range of zoonotic and non-zoonotic parasites in dogs from a rural area in the humid Chaco; determined the occurrence of polyparasitism; and explored its association with selected risk factors. In total, 212 dogs were examined serologically to determine Trypanosoma cruzi infection and 152 of them also were examined for Ehrlichia canis, Borrelia bugderfori, Anaplasma phagocitophylum, Dirofilaria immitis and Toxoplasma gondii. Fecal samples from 85 dogs were examined for intestinal parasites. Seventeen parasite species were seen, 77% of which are zoonotic. The most prevalent parasites were Ancylostoma caninum (68.2%), T. gondii (55.3%, first report for dogs in Argentina), Giardia sp. (25.9%), Cryptosporidium sp. (20.0%), T. cruzi (16.5%), trematodes (15.3%) and Toxocara canis (14.1%). Polyparasitism was found in 96% of the dogs, with up to six parasite species in a single dog, and was significantly associated with age of dog but not with host body condition or sex. The most frequent pair of parasites found together were T. gondii-A. caninum (46%), A. caninum-T. cruzi (34%) and T. gondii-T. cruzi (27%). The prevalence of anemia and leukocytosis was significantly higher in dogs showing the worst body condition. Our findings likely reflect structural poverty, poor sanitation and lack of a safe water supply. Importantly, many of the prevalent parasites seen are threats to human health. 243 words.
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Affiliation(s)
- G F Enriquez
- Laboratory of Eco-Epidemiology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina; Institute of Ecology, Genetics and Evolution of Buenos Aires (UBA-CONICET), Argentina.
| | - N P Macchiaverna
- Laboratory of Eco-Epidemiology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina; Institute of Ecology, Genetics and Evolution of Buenos Aires (UBA-CONICET), Argentina
| | - H D Argibay
- Laboratory of Eco-Epidemiology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina; Institute of Ecology, Genetics and Evolution of Buenos Aires (UBA-CONICET), Argentina
| | - L López Arias
- Laboratory of Molecular Parasitology, Institute of Biotechnology, Center for Research in Veterinary and Agronomic Sciences, INTA, Los Reseros S/N, Castelar, Province of Buenos Aires, Argentina
| | - M Farber
- Laboratory of Molecular Parasitology, Institute of Biotechnology, Center for Research in Veterinary and Agronomic Sciences, INTA, Los Reseros S/N, Castelar, Province of Buenos Aires, Argentina
| | - R E Gürtler
- Laboratory of Eco-Epidemiology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina; Institute of Ecology, Genetics and Evolution of Buenos Aires (UBA-CONICET), Argentina
| | - M V Cardinal
- Laboratory of Eco-Epidemiology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina; Institute of Ecology, Genetics and Evolution of Buenos Aires (UBA-CONICET), Argentina
| | - G Garbossa
- Laboratory of Clinical and Environmental Parasitology, Faculty of Exact and Natural Sciences, University of Buenos Aires, Intendente Güiraldes 2160, Piso 4, Ciudad Universitaria, Buenos Aires, Argentina; Public Health Research Institute, University of Buenos Aires, Presidente José Evaristo Uriburu 950, Piso 1, Buenos Aires, Argentina
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17
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Ruiz C, Kalbaugh C, Browder S, McGinigle K, Kibbe M, Farber M, Crowner J, Marston W, Pascarella L. Operative Strategies for Inferior Vena Cava Reconstruction in Oncologic Surgery. J Vasc Surg Venous Lymphat Disord 2019. [DOI: 10.1016/j.jvsv.2019.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Dake MD, Murphy TP, Krämer AH, Darcy MD, Sewall LE, Curi MA, Johnson MS, Arena F, Swischuk JL, Ansel GM, Silver MJ, Saddekni S, Brower JS, Mendes R, Dake MD, Feezor R, Kalva S, Kies D, Bosiers M, Ziegler W, Farber M, Paolini D, Spillane R, Jones S, Peeters P. One-Year Analysis of the Prospective Multicenter SENTRY Clinical Trial: Safety and Effectiveness of the Novate Sentry Bioconvertible Inferior Vena Cava Filter. J Vasc Interv Radiol 2018; 29:1350-1361.e4. [DOI: 10.1016/j.jvir.2018.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
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19
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Nievas J, Farber M, Aballay D, Smayevsky J. Intestinal Carriage of Carbapenemase-Producing Organisms:Development sensitiveand rapid molecular assay to detect blaKPC and blaOXA gene from fecal swabs. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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Brown MB, Kempf A, Collins CM, Long GM, Owens M, Gupta S, Hellman Y, Wong V, Farber M, Lahm T. A prescribed walking regimen plus arginine supplementation improves function and quality of life for patients with pulmonary arterial hypertension: a pilot study. Pulm Circ 2017; 8:2045893217743966. [PMID: 29199900 PMCID: PMC5731727 DOI: 10.1177/2045893217743966] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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] [Indexed: 12/19/2022] Open
Abstract
Current evidence suggests that exercise training is beneficial in pulmonary arterial hypertension (PAH). Unfortunately, the standard supervised, hospital-based programs limit patient accessibility to this important intervention. Our proof-of-concept study aimed to provide insight into the usefulness of a prescribed walking regimen along with arginine supplementation to improve outcomes for patients with PAH. Twelve PAH patients (all women) in New York Heart Association (NYHA) functional class (FC) II (n = 7) or III (n = 5) and in stable condition for ≥ 3 months were enrolled. Patients performed home- and fitness-center- based walking at 65-75% heart rate (HR) reserve for 45 min, six sessions/week for 12 weeks. Concomitant L-arginine supplementation (6000 mg/day) was provided to maximize beneficial endothelial training adaptations. Cardiopulmonary exercise testing, 6-min walk testing (6MWT), echocardiography, laboratory studies, and quality of life (QoL) survey (SF-36) were performed at baseline and 12 weeks. Eleven patients completed the study (72 session adherence rate = 96 ± 3%). Objective improvement was demonstrated by the 6MWT distance (increased by 40 ± 13 m, P = 0.01), VO2max (increased by 2 ± 0.7 mL/kg/min, P = 0.02), time-to-VO2max (increased by 2.5 ± 0.6 min, P = 0.001), VO2 at anaerobic threshold (increased by 1.3 ± 0.5 mL/kg/min, P = 0.04), HR recovery (reduced by 68 ± 23% in slope, P = 0.01), and SF-36 subscales of Physical Functioning and Energy/Fatigue (increased by 70 ± 34% and 74 ± 34%, respectively, P < 0.05). No adverse events occurred, and right ventricular function and brain natriuretic peptide levels remained stable, suggesting safety of the intervention. This proof-of-concept study indicates that a simple walking regimen with arginine supplementation is a safe and efficacious intervention for clinically stable PAH patients, with gains in objective function and QoL measures. Further investigation in a randomized controlled trial is warranted.
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Affiliation(s)
- Mary Beth Brown
- 1 Department of Physical Therapy, Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN, USA.,2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Attie Kempf
- 1 Department of Physical Therapy, Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN, USA
| | - Catherine M Collins
- 1 Department of Physical Therapy, Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN, USA
| | - Gary M Long
- 1 Department of Physical Therapy, Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN, USA
| | - Matthew Owens
- 1 Department of Physical Therapy, Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN, USA
| | - Shikha Gupta
- 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yaron Hellman
- 3 12250 Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, IN, USA
| | - Vincent Wong
- 3 12250 Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, IN, USA
| | - Mark Farber
- 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tim Lahm
- 2 Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,4 Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
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21
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López MG, Pallarés HM, Alfonso V, Carmona SJ, Farber M, Taboga O, Wilkowsky SE. Novel biotechnological platform based on baculovirus occlusion bodies carrying Babesia bovis small antigenic peptides for the design of a diagnostic enzyme-linked immunosorbent assay (ELISA). Appl Microbiol Biotechnol 2017; 102:885-896. [PMID: 29177536 DOI: 10.1007/s00253-017-8662-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 08/09/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 11/28/2022]
Abstract
Baculoviruses are large DNA virus of insects principally employed in recombinant protein expression. Its ability to form occlusion bodies (OBs), which are composed mainly of polyhedrin protein (POLH), makes them biotechnologically attractive, as these crystals (polyhedra) can incorporate foreign peptides and can be easily isolated. On the other hand, peptide microarrays allow rapid and inexpensive high-throughput serological screening of new candidates to be incorporated to OBs. To integrate these 2 biotechnological approaches, we worked on Babesia bovis, one of the causative agents of bovine babesiosis. Current molecular diagnosis of infection with B. bovis includes enzyme-linked immunosorbent assay (ELISA) techniques, which use merozoite lysate obtained from infected bovine erythrocytes. However, it is important to produce recombinant antigens that replace the use of crude antigens. Here, we describe a new biotechnological platform for the design of indirect ELISAs based on 5 antigenic peptides of 15 amino acid residues of B. bovis (ApBb), selected from a peptide microarray and expressed as a fusion to POLH. An Sf9POLHE44G packaging cell line infected with recombinant baculoviruses carrying POLH-ApBb fusions yielded higher levels of chimeric polyhedra, highlighting the advantage of a trans-contribution of a mutant copy of polyhedrin. Finally, the use of dissolved recombinant polyhedra as antigens was successful in an ELISA assay, as B. bovis-positive sera recognized the fusion POLH-ApBb. Thus, the use of this platform resulted in a promising alternative for molecular diagnosis of relevant infectious diseases.
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Affiliation(s)
- M G López
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina. .,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - H M Pallarés
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina
| | - V Alfonso
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - S J Carmona
- Ludwig Cancer Research Center, Department of Fundamental Oncology, University of Lausanne, Epalinges, Switzerland.,Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - M Farber
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - O Taboga
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - S E Wilkowsky
- Instituto de Biotecnología, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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22
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Alberta H, Takayama T, Phelan P, Panthofer A, Cambria R, Farber M, Jordan W, Matsumura J. Thoracic Endovascular Aortic Repair Migration and Aortic Elongation Differentiated Using Dual Reference Point Analysis. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.07.018] [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]
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23
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Banga P, Oderich G, Farber M, Timaran C, Schneider D, Vallabhaneni R, Timaran D, de Souza L, Harmsen S. Impact of Number of Vessels Targeted by Fenestrations or Branches on Outcomes of Patients Undergoing Endovascular Repair of Complex Abdominal Aortic Aneurysms. Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.034] [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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24
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Jordan WD, Ouriel K, Mehta M, Varnagy D, Moore WM, Arko FR, Joye J, de Vries JPP, Jordan WD, de Vries JP, Joye J, Eckstein H, van Herwaarden J, Arko FR, Bove P, Bohannon W, Fioole B, Setacci C, Resch T, Riambau V, Scheinert D, Schmidt A, Clair D, Moursi M, Farber M, Tessarek J, Torsello G, Fillinger M, Glickman M, Henretta J, Hodgson K, Jim J, Katzen B, Lipsitz E, Cox M, Naslund T, Ramaiah V, Schermerhorn M, Schneider P, Starnes BW, Donayre C, Mehta M, Zipfel B, Malhotra N, Varnagy D, Moore W, Cheshire N, Bicknell C, Back M, Muhs B, Malas MB, Hussain S, Gupta N, Bockler D, Verhoeven E, Reijnen M. Outcome-based anatomic criteria for defining the hostile aortic neck. J Vasc Surg 2015; 61:1383-90.e1. [DOI: 10.1016/j.jvs.2014.12.063] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/21/2014] [Indexed: 12/22/2022]
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25
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Parnia S, Spearpoint K, de Vos G, Fenwick P, Goldberg D, Yang J, Zhu J, Baker K, Killingback H, McLean P, Wood M, Zafari AM, Dickert N, Beisteiner R, Sterz F, Berger M, Warlow C, Bullock S, Lovett S, McPara RMS, Marti-Navarette S, Cushing P, Wills P, Harris K, Sutton J, Walmsley A, Deakin CD, Little P, Farber M, Greyson B, Schoenfeld ER. AWARE—AWAreness during REsuscitation—A prospective study. Resuscitation 2014; 85:1799-805. [DOI: 10.1016/j.resuscitation.2014.09.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 09/02/2014] [Accepted: 09/07/2014] [Indexed: 11/25/2022]
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Oderich GS, Greenberg RK, Farber M, Lyden S, Sanchez L, Fairman R, Jia F, Bharadwaj P. Results of the United States multicenter prospective study evaluating the Zenith fenestrated endovascular graft for treatment of juxtarenal abdominal aortic aneurysms. J Vasc Surg 2014; 60:1420-8.e1-5. [DOI: 10.1016/j.jvs.2014.08.061] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/06/2014] [Indexed: 11/30/2022]
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de Vries JPP, Ouriel K, Mehta M, Varnagy D, Moore WM, Arko FR, Joye J, Jordan WD, Jordan WD, Paul de Vries J, Joye J, Eckstein H, van Herwaarden J, Arko FR, Bove P, Bohannon W, Fioole B, Setacci C, Resch T, Riambau V, Scheinert D, Clair D, Moursi M, Farber M, Tessarek J, Torsello G, Fillinger M, Glickman M, Henretta J, Hodgson K, Jim J, Katzen B, Lipsitz E, Cox M, Naslund T, Ramaiah V, Schermerhorn M, Schneider P, Starnes BW, Donayre C, Mehta M, Zipfel B, Malhotra N, Varnagy D, Moore W, Cheshire N, Bicknell C, Back M, Muhs B, Malas MB, Hussain S, Gupta N, Bockler D, Verhoeven E, Reijnen M. Analysis of EndoAnchors for endovascular aneurysm repair by indications for use. J Vasc Surg 2014; 60:1460-7.e1. [DOI: 10.1016/j.jvs.2014.08.089] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
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28
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McInerney M, Nobari M, Farber M. A Retrospective Analysis of Accuracy of Pulmonary Function Test Interpretation at an Academic Medical Center. Chest 2014. [DOI: 10.1378/chest.1994927] [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: 11/01/2022] Open
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Thompson C, Baravalle ME, Valentini B, Mangold A, Torioni de Echaide S, Ruybal P, Farber M, Echaide I. Typification of virulent and low virulence Babesia bigemina clones by 18S rRNA and rap-1c. Exp Parasitol 2014; 141:98-105. [PMID: 24681200 DOI: 10.1016/j.exppara.2014.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 02/24/2014] [Accepted: 03/04/2014] [Indexed: 11/29/2022]
Abstract
The population structure of original Babesia bigemina isolates and reference strains with a defined phenotypic profile was assessed using 18S rRNA and rap-1c genes. Two reference strains, BbiS2P-c (virulent) and BbiS1A-c (low virulence), were biologically cloned in vitro. The virulence profile of the strains and clones was assessed in vivo. One fully virulent and one low-virulence clone were mixed in identical proportions to evaluate their growth efficiency in vitro. Each clone was differentiated by two microsatellites and the gene gp45. The 18S rRNA and rap-1c genes sequences from B. bigemina biological clones and their parental strains, multiplied exclusively in vivo or in vitro, were compared with strain JG-29. The virulence of clones derived from the BbiS2P-c strain was variable. Virulent clone Bbi9P1 grew more efficiently in vitro than did the low-virulence clone Bbi2A1. The haplotypes generated by the nucleotide polymorphism, localized in the V4 region of the 18S rRNA, allowed the identification of three genotypes. The rap-1c haplotypes allowed defining four genotypes. Parental and original strains were defined by multiple haplotypes identified in both genes. The rap-1c gene, analyzed by high-resolution melting (HRM), allowed discrimination between two genotypes according to their phenotype, and both were different from JG-29. B. bigemina biological clones made it possible to define the population structure of isolates and strains. The polymorphic regions of the 18S rRNA and rap-1c genes allowed the identification of different subpopulations within original B. bigemina isolates by the definition of several haplotypes and the differentiation of fully virulent from low virulence clones.
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Affiliation(s)
- C Thompson
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina.
| | - M E Baravalle
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina
| | - B Valentini
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina
| | - A Mangold
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina
| | - S Torioni de Echaide
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina
| | - P Ruybal
- Instituto Nacional de Tecnología Agropecuaria, Centro Nacional de Investigaciones Agropecuarias Castelar, Los Reseros y Las Cabañas, CP 1712 Castelar, Buenos Aires, Argentina
| | - M Farber
- Instituto Nacional de Tecnología Agropecuaria, Centro Nacional de Investigaciones Agropecuarias Castelar, Los Reseros y Las Cabañas, CP 1712 Castelar, Buenos Aires, Argentina
| | - I Echaide
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 km 227, CC 22, CP 2300 Rafaela, Santa Fe, Argentina
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Conrad MF, Fairman RM, Cambria RP, Farber M, Matsumoto A, Williams D, Criado FJ, Kwolek CJ. One-Year Safety and Efficacy of Thoracic Aortic Stent Grafting (TEVAR) in Patients Who Are Poor Open Surgical Candidates: Results of the High-Risk Arm of the Valor Trial. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2012.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Oderich GS, Timaran C, Farber M, Quinones-Baldrich W, Escobar G, Gloviczki P, Greenberg RK, Black J, Ellozy S, Woo E, Singh M, Fillinger M, Lee J, Dosluoglu HH. RR14. Spinal Cord Injury after Hybrid Endovascular Repair of Thoracoabdominal Aortic Aneurysms in the North American Complex Abdominal Aortic Debranching (NACAAD) Registry. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.03.223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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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Campbell NL, Khan BA, Farber M, Campbell T, Perkins AJ, Hui SL, Abernathy G, Buckley J, Sing R, Tricker J, Zawahiri M, Boustani MA. Improving delirium care in the intensive care unit: the design of a pragmatic study. Trials 2011; 12:139. [PMID: 21645330 PMCID: PMC3123563 DOI: 10.1186/1745-6215-12-139] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 06/06/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Delirium prevalence in the intensive care unit (ICU) is high. Numerous psychotropic agents are used to manage delirium in the ICU with limited data regarding their efficacy or harms. METHODS/DESIGN This is a randomized controlled trial of 428 patients aged 18 and older suffering from delirium and admitted to the ICU of Wishard Memorial Hospital in Indianapolis. Subjects assigned to the intervention group will receive a multicomponent pharmacological management protocol for delirium (PMD) and those assigned to the control group will receive no change in their usual ICU care. The primary outcomes of the trial are (1) delirium severity as measured by the Delirium Rating Scale revised-98 (DRS-R-98) and (2) delirium duration as determined by the Confusion Assessment Method for the ICU (CAM-ICU). The PMD protocol targets the three neurotransmitter systems thought to be compromised in delirious patients: dopamine, acetylcholine, and gamma-aminobutyric acid. The PMD protocol will target the reduction of anticholinergic medications and benzodiazepines, and introduce a low-dose of haloperidol at 0.5-1 mg for 7 days. The protocol will be delivered by a combination of computer (artificial intelligence) and pharmacist (human intelligence) decision support system to increase adherence to the PMD protocol. DISCUSSION The proposed study will evaluate the content and the delivery process of a multicomponent pharmacological management program for delirium in the ICU. TRIAL REGISTRATION ClinicalTrials.gov: NCT00842608.
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Affiliation(s)
- Noll L Campbell
- Department of Pharmacy Practice, Purdue University School of Pharmacy, West Lafayette, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Wishard Health Services, Indianapolis, IN, USA
- Indiana University Health, Indianapolis, IN, USA
| | - Babar A Khan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mark Farber
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA
| | | | | | - Siu L Hui
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Greg Abernathy
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John Buckley
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Regg Sing
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Malaz A Boustani
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Tomassone L, Nuñez P, Ceballos LA, Gürtler RE, Kitron U, Farber M. Detection of "Candidatus Rickettsia sp. strain Argentina"and Rickettsia bellii in Amblyomma ticks (Acari: Ixodidae) from Northern Argentina. Exp Appl Acarol 2010; 52:93-100. [PMID: 20186466 PMCID: PMC3072707 DOI: 10.1007/s10493-010-9339-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 01/30/2010] [Indexed: 05/28/2023]
Abstract
Ixodid ticks were collected from vegetation and from humans, wild and domestic mammals in a rural area in the semi-arid Argentine Chaco in late spring 2006 to evaluate their potential role as vectors of Spotted Fever Group (SFG) rickettsiae. A total of 233 adult ticks, identified as Amblyomma parvum, Amblyomma tigrinum and Amblyomma pseudoconcolor, was examined for Rickettsia spp. We identified an SFG rickettsia of unknown pathogenicity, "Candidatus Rickettsia sp. strain Argentina", in A. parvum and A. pseudoconcolor by PCR assays targeting gltA, ompA, ompB and 17-kDa outer membrane antigen rickettsial genes. Rickettsia bellii was detected in a host-seeking male of A. tigrinum. Amblyomma parvum is widespread in the study area and is a potential threat to human health.
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Affiliation(s)
- L Tomassone
- Department of Animal Production Epidemiology and Ecology, University of Torino, via L. Da Vinci 44, Grugliasco, Turin, Italy
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Boustani M, Campbell N, Munger S, Farber M, Weiner M, Castelluccio P. P2‐107: Enhancing care for hospitalized older adults with memory problems: The e‐CHAMP trial. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Malaz Boustani
- Regenstrief InstituteIndianapolis IN USA
- Indiana University School of MedicineIndianapolis IN USA
| | | | - Stephanie Munger
- Regenstrief InstituteIndianapolis IN USA
- Indiana University Center for Aging ResearchIndianapolis IN USA
| | - Mark Farber
- Indiana University School of MedicineIndianapolis IN USA
- Wishard Health ServicesIndianapolis IN USA
| | - Michael Weiner
- Regenstrief InstituteIndianapolis IN USA
- Indiana University School of MedicineIndianapolis IN USA
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Boustani M, Baker MS, Campbell N, Munger S, Hui SL, Castelluccio P, Farber M, Guzman O, Ademuyiwa A, Miller D, Callahan C. Impact and recognition of cognitive impairment among hospitalized elders. J Hosp Med 2010; 5:69-75. [PMID: 20104623 PMCID: PMC2814975 DOI: 10.1002/jhm.589] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Older adults are predisposed to developing cognitive deficits. This increases their vulnerability for adverse health outcomes when hospitalized. OBJECTIVE To determine the prevalence and impact of cognitive impairment (CI) among hospitalized elders based on recognition by lCD-coding versus screening done on admission. DESIGN Observational cohort study. SETTING Urban public hospital in Indianapolis. PATIENTS 997 patients age 65 and older admitted to medical services between July 2006 and March 2008. MEASUREMENTS Impact of CI in terms of length of stay, survival, quality of care and prescribing practices. Cognition was assessed by the Short Portable Mental Status Questionnaire (SPMSQ). RESULTS 424 patients (43%) were cognitively impaired. Of those 424 patients with CI, 61% had not been recognized by ICD-9 coding. Those unrecognized were younger (mean age 76.1 vs. 79.1, P <0.001); had more comorbidity (mean Charlson index of 2.3 vs.1.9, P = 0.03), had less cognitive deficit (mean SPMSQ 6.3 vs. 3.4, P < 0.001). Among elders with CI, 163 (38%) had at least one day of delirium during their hospital course. Patients with delirium stayed longer in the hospital (9.2 days vs. 5.9, P < 0.001); were more likely to be discharged into institutional settings (75% vs. 31%, P < 0.001) and more likely to receive tethers during their care (89% vs. 69%, P < 0.001), and had higher mortality (9% vs. 4%, P = 0.09). CONCLUSION Cognitive impairment, while common in hospitalized elders, is under-recognized, impacts care, and increases risk for adverse health outcomes.
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Affiliation(s)
- Malaz Boustani
- Indiana University Center for Aging Research, Indiana University, Indianapolis, Indiana, USA.
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Affiliation(s)
- Khalil Diab
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
| | - Riley J Snook
- Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, and the Department of Neurology, Indiana University School of Medicine, Indianapolis, IN
| | - Mark Farber
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
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Cambria RP, Crawford RS, Cho JS, Bavaria J, Farber M, Lee WA, Ramaiah V, Kwolek CJ. A multicenter clinical trial of endovascular stent graft repair of acute catastrophes of the descending thoracic aorta. J Vasc Surg 2009; 50:1255-64.e1-4. [PMID: 19958982 DOI: 10.1016/j.jvs.2009.07.104] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 07/03/2009] [Accepted: 07/25/2009] [Indexed: 11/19/2022]
Affiliation(s)
- Richard P Cambria
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass, USA.
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Khan BA, Baker L, Farber M, Hage C. CORTICOSTEROIDS IN ACUTE RESPIRATORY DISTRESS SYNDROME SECONDARY TO OVERWHELMING PULMONARY BLASTOMYCOSIS. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.29s-d] [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: 11/01/2022] Open
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Campbell N, Boustani MA, Ayub A, Fox GC, Munger SL, Ott C, Guzman O, Farber M, Ademuyiwa A, Singh R. Pharmacological management of delirium in hospitalized adults--a systematic evidence review. J Gen Intern Med 2009; 24:848-53. [PMID: 19424763 PMCID: PMC2695535 DOI: 10.1007/s11606-009-0996-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [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] [Received: 07/24/2008] [Revised: 01/29/2009] [Accepted: 04/07/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite the significant burden of delirium among hospitalized adults, there is no approved pharmacologic intervention for delirium. This systematic review evaluates the efficacy and safety of pharmacologic interventions targeting either prevention or management of delirium. DATA SOURCES We searched Medline, PubMed, the Cochrane Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) information systems from January 1966 to October 2008. We included randomized, controlled trials comparing pharmacologic compounds either to each other or placebo. We excluded non-comparison trials, studies with patients aged < 18 years, a history of an Axis I psychiatric disorder, and patients with alcohol-related delirium. REVIEW METHODS Three reviewers independently extracted the data for participants, interventions and outcome measures, and critically appraised each study using the JADAD scale. RESULTS We identified 13 studies that met our inclusion criteria and evaluated 15 compounds: second-generation antipsychotics, first-generation antipsychotics, cholinergic enhancers, an antiepileptic agent, an inhaled anesthetic, injectable sedatives, and a benzodiazepine. Four trials evaluated delirium treatment and suggested no differences in efficacy or safety among the evaluated treatment methods (first and second generation antipsychotics). Neither cholinesterase inhibitors nor procholinergic drugs were effective in preventing delirium. Multiple studies, however, suggest either shorter severity and duration, or prevention of delirium with the use of haloperidol, risperidone, gabapentin, or a mixture of sedatives in patients undergoing elective or emergent surgical procedures. CONCLUSION The existing limited data indicates no superiority for second-generation antipsychotics over haloperidol in managing delirium. Although preliminary results suggest delirium prevention may be accomplished through various mechanisms, further studies are necessary to prove effectiveness.
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Affiliation(s)
- Noll Campbell
- Department of Pharmacy, Wishard Health Services, Indianapolis, IN, USA
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Deaton DH, Mehta M, Kasirajan K, Chaikof E, Farber M, Glickman MH, Neville RF, Fairman RM. The phase I multicenter trial (STAPLE-1) of the Aptus Endovascular Repair System: Results at 6 months and 1 year. J Vasc Surg 2009; 49:851-7; discussion 857-8. [DOI: 10.1016/j.jvs.2008.10.064] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 10/30/2008] [Accepted: 10/31/2008] [Indexed: 11/26/2022]
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Wilkowsky S, Farber M, Gil G, Echaide I, Mosqueda J, Alcaraz E, Suarez CE, Florin-Christensen M. Molecular characterization of babesia bovis strains using PCR restriction fragment length polymorphism analysis of the msa2-a/b genes. Ann N Y Acad Sci 2009; 1149:141-4. [PMID: 19120193 DOI: 10.1196/annals.1428.074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The merozoite surface antigen-2 (msa-2) family of Babesia bovis is a group of variable genes that share conserved 5' and 3' ends and encode for membrane-anchored glycoproteins that have been postulated as vaccine candidates. In this work, we analyzed the sequences of three of these genes (msa-2a1, a2, and 2b) from two geographically distant strains and detected a certain degree of genotypic diversity that could be exploited to work out new molecular tools for the discrimination of B. bovis field samples. Here we describe a PCR restriction assay that was developed based on this observation and tested on several B. bovis strains and isolates. The results show a strain-specific band pattern in geographically distant isolates, indicating the presence of differentially located BspMI restriction sites. This approach provides a simple method for the differentiation of American B. bovis strains.
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Affiliation(s)
- Silvina Wilkowsky
- Centro de Investigaciones en Ciencias Veterinarias y Agronómicas, Instituto Nacional de Tecnología Agropecuaria (INTA), Castelar, Buenos Aires, Argentina
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Rieger JW, Kim A, Argyelan M, Farber M, Glazman S, Liebeskind M, Meyer T, Bodis-Wollner I. Cortical functional anatomy of voluntary saccades in Parkinson disease. Clin EEG Neurosci 2008; 39:169-74. [PMID: 19044213 DOI: 10.1177/155005940803900404] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [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: 11/17/2022]
Abstract
In Parkinson Disease (PD) several aspects of saccades are affected. The saccade-generating brainstem neurons are spared, however, the signals they receive may be flawed. In particular voluntary saccades suffer, but the functional anatomy of the impairment of saccade-related cortical control is unknown. We measured blood-oxygenation-level-dependent (BOLD) activation with functional Magnetic Resonance Imaging (fMRI) while healthy participants and patients with PD performed horizontal voluntary saccades between peripheral visual targets or fixated centrally. We compared saccade-related BOLD-activity vs. fixation in patients with PD and in healthy controls and correlated perisaccadic BOLD-activity in PD patients with saccade kinetics (multistep saccades). Saccade related BOLD-activation was found in both PD and healthy participants in the superior parietal cortex (PEF) and the occipital cortex. Our results suggest remarkable hypoactivity of the frontal and supplementary eye fields (FEF and SEF) in PD patients. On the other hand, PD patients showed a statistically more reliable BOLD modulation than healthy participants in the posterior cingulate gyrus, the parahippocampal gyrus, inferior parietal lobule, precuneus and in the middle temporal gyrus. Given abnormal frontal and normal PEF responses, our results suggest that in PD a frontal cortical circuitry, known to be associated with saccade planning, selection, and predicting a metric error of the saccade, is deficient.
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Affiliation(s)
- Jochem W Rieger
- Department of Neurology, II Otto-von-Guericke-University, Magdeburg, Germany
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Fairman RM, Criado F, Farber M, Kwolek C, Mehta M, White R, Lee A, Tuchek JM. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: The VALOR Trial. J Vasc Surg 2008; 48:546-54. [DOI: 10.1016/j.jvs.2008.03.061] [Citation(s) in RCA: 239] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 03/25/2008] [Accepted: 03/29/2008] [Indexed: 11/26/2022]
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Rieger J, Kim A, Argyelan M, Farber M, Glazman S, Liebeskind M, Bodis-Wollner I. Cortical control of voluntary saccades in Parkinson's Disease. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1073011] [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: 10/21/2022]
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Florin-Christensen M, Schnittger L, Dominguez M, Mesplet M, Rodríguez A, Ferreri L, Asenzo G, Wilkowsky S, Farber M, Echaide I, Suarez C. Search for Babesia bovis vaccine candidates. Parassitologia 2007; 49 Suppl 1:9-12. [PMID: 17691600] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Babesia bovis is a tick-borne apicomplexan pathogen that remains an important constrain for the development of cattle industries worldwide. Effective control can be achieved by vaccination with live attenuated forms of the parasite, but they have several drawbacks and thus the development of alternative subunit vaccines, either based in recombinant versions of full size proteins or in recombinant or synthetic peptides containing combinations of protective B-cell and T-cell epitopes is needed. Our current strategies for the identification of vaccine candidate antigens include the identification of functionally relevant antigens, bioinformatics, and comparative genomics using the recently sequenced B. bovis genome. These led us to the functional and immunological characterization of members of the VMSA gene family, a group of well conserved putative cysteine and serine proteases, and to the definition of a surface exposed B-cell epitope present in the Merozoite Surface Antigen-2c. Work in progress is focused in defining additional epitopes, and to determine whether they are neutralization-sensitive. These approaches might unravel useful vaccine candidates for B. bovis, and will increase our understanding of the pathogenicity mechanisms of these and related hemoparasites.
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Wilkowsky S, Farber M, Echaide I, Mosqueda J, Alcaraz E, Suarez C, Florin-Christensen M. Taking advantage of the polymorphism of the MSA-2 family for Babesia bovis strain characterization. Parassitologia 2007; 49 Suppl 1:63-6. [PMID: 17691609] [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: 05/16/2023]
Abstract
The Merozoite Surface Antigen-2 (MSA-2) family of Babesia bovis is a group of variable genes which share conserved 5' and 3' conserved ends. These genes encode membrane anchored glycoproteins, named MSA-2a1, a2, b and c, which are immunodominant antigens located on the surface of sporozoites and merozoites. In this work, we have analyzed the sequences of the msa-2a1, a2 and 2b genes in two geographically distant strains from Mexico and Argentina and detected a certain degree of genotypic diversity that can be exploited for the development of a new molecular tool for the discrimination of B. bovis field samples. Here, we describe a PCR restriction assay based on the msa2-a1, -a2 and -2b genes of B. bovis. When field strains from Argentina, Mexico and USA were analyzed, the results showed a strain-specific band pattern indicating the presence of differentially located BspMI restriction sites. This approach provides a simple method for the genotyping/strain differentiation of B. bovis field samples.
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Affiliation(s)
- S Wilkowsky
- CICVyA, Castelar, INTA, Buenos Aires, Argentina
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Santangelo MP, McIntosh D, Bigi F, Armôa GRG, Campos ASD, Ruybal P, Dellagostin OA, McFadden J, Mendum T, Gicquel B, Winter N, Farber M, Cataldi A. Mycobacterium bovis BCG as a delivery system for the RAP-1 antigen from Babesia bovis. Vaccine 2007; 25:1104-13. [PMID: 17049681 DOI: 10.1016/j.vaccine.2006.09.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Revised: 09/15/2006] [Accepted: 09/15/2006] [Indexed: 11/20/2022]
Abstract
Babesia bovis is the causative agent of babesiosis, a tick-borne disease that is a major cause of loss to livestock production in Latin America. Vaccination against Babesia species represents a major challenge against cattle morbidity and mortality in enzootic areas. The aim of this study was to evaluate the capacity of Bacille Calmette-Guerin (BCG) to deliver the rhoptry associated protein (RAP-1) antigen of B. bovis and to stimulate specific cellular and humoral immune responses in mice. Two of five mycobacterial expression vectors efficiently expressed the antigen. These constructs were subsequently studied in vivo following three immunization protocols. The construct with the greatest in vivo stability proved to be the one that induced the strongest immune responses. Our data support the hypothesis that specific T lymphocyte priming by rBCG can be employed as a component of a combined vaccine strategy to induce long-lasting humoral and cellular immune responsiveness towards B. bovis and encourage further work on the application of rBCG to the development of Babesia vaccines.
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Affiliation(s)
- M P Santangelo
- Institute of Biotechnology, CICVyA-INTA, Los Reseros y Las Cabañas, 1712 Castelar, Argentina
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Farber M. Commentary. Treating aortic dissection and penetrating aortic ulcer with stent graft: thirty cases. Perspect Vasc Surg Endovasc Ther 2006; 18:269-70. [PMID: 17278318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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Aikawa E, Whittaker P, Farber M, Mendelson K, Padera RF, Aikawa M, Schoen FJ. Human semilunar cardiac valve remodeling by activated cells from fetus to adult: implications for postnatal adaptation, pathology, and tissue engineering. Circulation 2006; 113:1344-52. [PMID: 16534030 DOI: 10.1161/circulationaha.105.591768] [Citation(s) in RCA: 315] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The evolution of cell phenotypes and matrix architecture in cardiac valves during fetal maturation and postnatal adaptation through senescence remains unexplored. METHODS AND RESULTS We hypothesized that valvular interstitial (VIC) and endothelial cell (VEC) phenotypes, critical for maintaining valve function, change throughout life in response to environmental stimuli. We performed quantitative histological assessment of 91 human semilunar valves obtained from fetuses at 14 to 19 and 20 to 39 weeks' gestation; neonates minutes to 30 days old; children aged 2 to 16 years; and adults. A trilaminar architecture appeared by 36 weeks of gestation but remained rudimentary compared with that of adult valves. VECs expressed an activated phenotype throughout fetal development. VIC density, proliferation, and apoptosis were significantly higher in fetal than adult valves. Pulmonary and aortic fetal VICs showed an activated myofibroblast-like phenotype (alpha-actin expression), abundant embryonic myosin, and matrix metalloproteinase-collagenases, which indicates an immature/activated phenotype engaged in matrix remodeling versus a quiescent fibroblast-like phenotype in adults. At birth, the abrupt change from fetal to neonatal circulation was associated with a greater number of alpha-actin-positive VICs in neonatal aortic versus pulmonary valves. Collagen content increased from early to late fetal stages but was subsequently unchanged, whereas elastin significantly increased postnatally. Collagen fiber color analysis revealed a progressive temporal decrease in thin fibers and a corresponding increase in thick fibers. Additionally, collagen fibers were more aligned in adult than fetal valves. CONCLUSIONS Fetal valves possess a dynamic/adaptive structure and contain cells with an activated/immature phenotype. During postnatal life, activated cells gradually become quiescent, whereas collagen matures, which suggests a progressive, environmentally mediated adaptation.
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Affiliation(s)
- Elena Aikawa
- Cardiovascular Division, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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