1
|
Giannakakos VP, Syed M, Culican SM, Rosenberg JB. The status of women in academic ophthalmology: Authorship of papers, presentations, and academic promotions. Clin Exp Ophthalmol 2024; 52:137-147. [PMID: 38214049 DOI: 10.1111/ceo.14333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/11/2023] [Accepted: 11/17/2023] [Indexed: 01/13/2024]
Abstract
As the field of ophthalmology has evolved in the last several decades, so has the gender distribution of ophthalmologists. We conducted a narrative review to further characterise the status of women in the realm of publication, presentations, editorial positions, grants, academic promotion, and financial compensation. While the proportion of women publishing, presenting, and filling academic and editorial roles has increased over time, it still does not match that of men. Women are more likely to be first authors instead of senior authors, have lower average h-indices, and are awarded fewer grants. The magnitude of some of these differences is smaller when adjusted for women's shorter career duration on average. Despite increased representation of women in ophthalmology, women continue to receive less compensation for the same work. This review highlights that more can be done to improve gender parity in ophthalmology.
Collapse
Affiliation(s)
- Vasiliki P Giannakakos
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, New York, USA
| | - Misha Syed
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, Texas, USA
| | - Susan M Culican
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jamie B Rosenberg
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center / Albert Einstein College of Medicine, Bronx, New York, USA
| |
Collapse
|
2
|
Aggarwal S, Wisely CE, Syed M, Siatkowski RM, Challa P. Learning From the 2021 Ophthalmology Match: Virtual Residency Matching During the COVID-19 Pandemic. J Grad Med Educ 2022; 14:674-679. [PMID: 36591419 PMCID: PMC9765913 DOI: 10.4300/jgme-d-22-00186.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 02/24/2022] [Revised: 06/20/2022] [Accepted: 10/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The effect of virtual interviews on residency match outcomes during the COVID-19 pandemic is unknown. Examining the ophthalmology match may help inform all specialties undergoing virtual interviews. OBJECTIVE To determine the impact of allopathic applicant match characteristics in the first year of the virtual residency Match process. METHODS Using the Association of University Professors of Ophthalmology match database, a retrospective review was conducted of all allopathic applicants to ophthalmology residency programs in the United States from the 2016 through the 2021 match cycles. Demographic information, interview numbers, and match outcomes were compared between the 2016-2020 (in-person) and 2021 (virtual) cycles. RESULTS A total of 3343 allopathic applicants were analyzed. Applicants in the 2021 Match applied to significantly more programs than 2016-2020 applicants did (78.7±23.6 vs 73.1±22.7, P<.001). Among matched and unmatched applicants, there was no significant difference in the number of interviews granted or completed. There was a significant reduction in the match rate between the 2016-2020 and 2021 Match cycles (81.3% vs 76.6%, P=.0009). A subanalysis of applicants who went to medical schools with ophthalmology residency programs (N=2308) found that the home institution match rate was significantly higher for the 2021 Match compared to the aggregate 2016-2020 Matches (26.1% vs 20.6%, respectively, P=.015). CONCLUSIONS Significantly more applicants to ophthalmology residency programs matched at their home institutions in the 2021 virtual match cycle compared to the previous 5 years without influencing the interview numbers granted and attended.
Collapse
Affiliation(s)
- Sahil Aggarwal
- Sahil Aggarwal, MD, is Chief Resident, PGY-4, Duke Eye Center
| | - C. Ellis Wisely
- C. Ellis Wisely, MD, MBA, is Assistant Professor, Cornea and Refractive Surgery, Duke Eye Center, and Site Director, Ophthalmology Resident Service, Durham VA Medical Center
| | - Misha Syed
- Misha Syed, MD, MEHP, is Assistant Dean for Educational Affairs, Vice Chair for Academic Affairs, and Residency Program Director, Ophthalmology, The University of Texas Medical Branch at Galveston Department of Ophthalmology and Visual Sciences, and Member, Association of University Professors of Ophthalmology
| | - R. Michael Siatkowski
- R. Michael Siatkowski, MD, is CEO, Chair, and Professor, Dean McGee Eye Institute, The University of Oklahoma, and Member, Association of University Professors of Ophthalmology
| | - Pratap Challa
- Pratap Challa, MD, is Professor and Residency Program Director, Duke Eye Center, and Member, Association of University Professors of Ophthalmology
| |
Collapse
|
3
|
Syed M, Shin D, Wan J, Lemeshow A, Gelfand J. 185 Fracture risk in adult and pediatric patients with atopic dermatitis -a population-based cohort study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.192] [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: 10/17/2022]
|
4
|
Syed M, Roehrich M, Giesel F, Liermann J, Choyke P, Kauczor H, Debus J, Haberkorn U, Adeberg S. FAPI-PET/CT Improves Diagnostic Staging and Radiotherapy Planning of Adenoid Cystic Carcinomas ― Imaging Analysis and Histological Validation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1191] [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: 10/20/2022]
|
5
|
Wan J, Shin D, Syed M, Abuabara K, Gelfand J. 266 Risk of opportunistic, viral, and hospitalized infections in atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.288] [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]
|
6
|
Syed M, Shin D, Wan J, Gelfand J. 263 Atopic dermatitis and the risk of developing rheumatoid arthritis - A population-based cohort study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.285] [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]
|
7
|
Babady NE, Aslam A, McMillen T, Syed M, Zehir A, Kamboj M. Genotypic correlation between post discharge Clostridiodes difficle infection (CDI) and previous unit-based contacts. J Hosp Infect 2020; 109:96-100. [PMID: 33171187 DOI: 10.1016/j.jhin.2020.10.028] [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: 01/20/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cases of Clostridiodes difficile infection (CDI) diagnosed after hospital discharge account for a substantial proportion of new infections. It is unclear whether post-discharge infections originate from hospital-based transmission. METHODS This was a Retrospective cohort study at a tertiary-care cancer center (non-outbreak setting). For all laboratory-identified cases of CDI in 2015-2016, patients with post-discharge (PD) CDI within eight weeks of their hospital stay were included in the study. Isolates from PD-CDI cases and their CDI-positive unit-based contacts were first genotyped by multilocus sequence typing (MLST). Common strains were further examined by core genome sequencing (CGS) to evaluate transmission links. RESULTS Of 173 cases examined by MLST, 50% of PD cases matched previous unit contacts. Next, 34 isolates, including 16 PD cases and their 18-unit contacts were examined by CGS. None were ≤3 single-nucleotide variants apart. Seventy percent of PD cases had in-hospital antibiotic exposure before CDI onset in the community. CONCLUSION Our study results suggest that symptomatic CDI cases are not a substantial source of transmission to PD cases. Frequent antibiotic exposure in post-discharge CDI cases is an important target for surveillance and stewardship efforts.
Collapse
Affiliation(s)
- N E Babady
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Aslam
- Infection Control and Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - T McMillen
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Syed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Zehir
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Kamboj
- Infection Control and Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
8
|
Syed M, Fletcher A, Dweck M, Forsythe R, Tambyraja A, Van Beek E, Newby D. 18F-sodium fluoride positron emission tomography-computed tomography in acute aortic syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2344] [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: 11/14/2022] Open
Abstract
Abstract
Background
Acute aortic syndrome is characterised by diseases that disrupt the intima and weaken the aorta. This damaged aorta is prone to aneurysmal dilation and ultimately rupture – a catastrophic event. 18F-sodium fluoride positron emission tomography and computed tomography (PET-CT) is a promising multimodality imaging technique that informs on the pathological state of the aorta. In abdominal aortic aneurysms (a chronic aortic disease), 18F-sodium fluoride PET uptake is associated with aortic expansion and requirement for aortic repair.
Purpose
The aim of this study was to describe aortic 18F-sodium fluoride uptake in patients with acute aortic syndrome for the first time.
Methods
Patients with intramural haematomas, aortic dissections or penetrating aortic ulcers, along with healthy control subjects, underwent contrast-enhanced 18F-sodium fluoride PET-CT. 18F-Sodium fluoride uptake was assessed using standardised uptake values and corrected for background blood pool activity to obtain tissue-to-background ratios (TBR).
Results
Forty-six patients and twenty healthy control subjects were matched for age, gender, body mass index, ischaemic heart disease and diabetes mellitus. Participants with acute aortic syndrome had widespread aortic 18F-sodium fluoride uptake. Radiotracer binding in patients with acute aortic syndrome was substantially greater than healthy subjects (TBR 2.00±0.45 vs 1.36±0.39, p<0.001). Subgroup analysis in patients with untreated type B acute aortic dissection revealed peak radiotracer binding at the site of intimal disruption compared to the proximal reference aorta (TBR [inter-quartile range] 1.61 [1.38–1.88] vs 1.18 [1.08–1.39] respectively; p<0.001).
Radiotracer uptake was highest in patients with penetrating aortic ulcers, followed by aortic dissection and intramural haematomas (TBR (±SD) 2.19±0.55 vs 1.99±0.43 vs 1.71±0.27 respectively; p=0.046). No difference in radiotracer uptake was observed between patients with sub-acute and chronic disease (TBR (±SD) 1.94±0.37 vs 2.04±0.51, p=0.497). 18F-sodium fluoride uptake was similar between Stanford Type A and Type B dissections (TBR (±SD) 1.98±0.49, 2.00±0.44, p=0.851). 18F-Sodium fluoride binding was independent of maximum aortic diameter (R2 = 0.036, p=0.21).
Conclusion
Our preliminary findings suggest that aortic 18F-sodium fluoride uptake is increased in patients with acute aortic syndrome, especially around the site of intimal disruption or penetrating aortic ulcers. This technique appears to identify disease activity that may have clinical applications for assessing prognosis and guiding therapeutic interventions.
18F-NaF PET/CT in Acute Aortic Syndrome
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation
Collapse
Affiliation(s)
- M Syed
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - A.J Fletcher
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - M Dweck
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - R.O Forsythe
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - A.L Tambyraja
- NHS National Services Scotland, Department of Vascular and Endovascular Surgery, Edinburgh, United Kingdom
| | - E Van Beek
- University of Edinburgh, Queens Medical Research Institute, Edinburgh, United Kingdom
| | - D.E Newby
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| |
Collapse
|
9
|
Hoegen P, Lang C, Akbaba S, Häring P, Splinter M, Miltner A, Bachmann M, Stahl-Arnsberger C, Brechter T, Bernhardt D, Klüter S, Syed M, Weykamp F, König L, Debus J, Hörner-Rieber J. PO-1652: In silico trial of cone-beam-CT guided adaptive planning for radiotherapy of locally advanced NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01670-4] [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: 11/16/2022]
|
10
|
Liermann J, Syed M, Neuberger U, Reuss D, El Shafie R, Julia W, Debus J, Hassel J, Rieken S. PO-1228: Stereotactic radiosurgery with concurrent immunotherapy in malignant melanoma brain metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01246-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Syed M, Liermann J, Kratochwil C, Debus J, Adeberg S, Haberkorn U, Giesel F. Visualization of Cancer Associated Fibroblasts Using the Novel FAPI PET/CT for Diagnosing and Delineating Lung Cancers for Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2189] [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]
|
12
|
Munir M, Khan M, Agrawal P, Benjamin M, Syed M, Farjo P, Patel K, Ghaffar Y, Khan M, Khan S, Balla S. Catheter ablation for atrial fibrillation in patients with reduced systolic function: a national perspective. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0558] [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: 11/12/2022] Open
Abstract
Abstract
Background
Randomized trials have shown improvement in hard clinical end points when catheter ablation (CA) was employed as a management strategy for certain atrial fibrillation (AF) patients with heart failure and reduced ejection fraction (HFrEF). We sought to determine real world data on mortality and complications after utilization of CA in such patients.
Methods and results
Data were derived from National Inpatient Sample from January 2008 to August 2015. Patients were identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Baseline characteristics and outcomes were compared among AF and HFrEF patients undergoing CA or not. Propensity matching was done to mitigate selection bias and balance confounding variables. Various CA related complications were assessed. Logistic regression was done to determine predictors of mortality in our study cohort. A total of 2,569,919 patients were enrolled and out of these approximately 7773 patients underwent CA. Mortality was significantly better in CA group in both unmatched (1.2% vs. 4.9%, p<0.01) and propensity matched cohorts (1.2% vs. 3.6%, p<0.01). Overall complication rate was 10.2% in CA cohort and were primarily cardiac and neurological in origin. In regression analysis, CA remains a strong predictor of reduced mortality (OR 0.301, 95% CI 0.184–0.494).
Conclusion
CA is associated with improved mortality in admitted AF patients with concomitant HFrEF. Overall complication rate after CA was modest at 10.2%.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M Munir
- University of California, San Diego, San Diego, United States of America
| | - M.Z Khan
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - P Agrawal
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - M.M Benjamin
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - M Syed
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - P Farjo
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - K Patel
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - Y.A Ghaffar
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - M.U Khan
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - S Khan
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - S Balla
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| |
Collapse
|
13
|
Wan J, Shin D, Syed M, Abuabara K, Gelfand J. 390 Atopic dermatitis and risk of major neuropsychiatric disorders: A population-based cohort study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.398] [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: 10/24/2022]
|
14
|
Al Shamsi H, Syed M, Al Shamsi I, Al Suwaidi K, ANWAR S, More Y, Maciver C, Devine J, Khan A, Ahmed W, Chandrasekar T, Al Madani A, Basha S. SUN-208 Cost Analysis of Parathyroidectomy for Patients with Severe Uncontrolled Secondary Hyperparathyroidism at a Large Integrated Health Care Service in United Arab Emirates. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.742] [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: 10/24/2022] Open
|
15
|
Syed M, Flechsig P, Liermann J, Windisch P, Haberkorn U, Debus J, Adeberg S. Fibroblast Activation Protein (FAPI) Specific PET for Advanced Target Volume Delineation in Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1645] [Citation(s) in RCA: 5] [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: 11/25/2022]
|
16
|
Salata K, Syed M, Hussain M, de Mestral C, Greco E, Mamdani M. Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systemic Review and Meta-Analysis. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2018.12.004] [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: 10/27/2022]
|
17
|
Dziedzic A, Nakrani M, Ezra B, Syed M, Popinet S, Afkhami S. Breakup of finite-size liquid filaments: Transition from no-breakup to breakup including substrate effects ⋆. Eur Phys J E Soft Matter 2019; 42:18. [PMID: 30788688 DOI: 10.1140/epje/i2019-11785-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 01/23/2019] [Indexed: 06/09/2023]
Abstract
This work studies the breakup of finite-size liquid filaments, when also including substrate effects, using direct numerical simulations. The study focuses on the effects of three parameters: Ohnesorge number, the ratio of the viscous forces to inertial and surface tension forces, the liquid filament aspect ratio, and where there is a substrate, a measure of the fluid slip on the substrate, i.e. slip length. Through these parameters, it is determined whether a liquid filament breaks up during the evolution toward its final equilibrium state. Three scenarios are identified: a collapse into a single droplet, the breakup into one or multiple droplets, and recoalescence into a single droplet after the breakup (or even possibly another breakup after recoalescence). The results are compared with the ones available in the literature for free-standing liquid filaments. The findings show that the presence of the substrate promotes the breakup of the filament. The effect of the degree of slip on the breakup is also discussed. The parameter domain regions are comprehensively explored when including the slip effects. An experimental case is also carried out to illustrate the collapse and breakup of a finite-size silicon oil filament supported on a substrate, showcasing a critical length of the breakup in a physical configuration. Finally, direct numerical simulations reveal striking new details into the breakup pattern for low Ohnesorge numbers, where the dynamics are fast and the experimental imaging is not available; our results therefore significantly extend the range of Ohnesorge number over which filament breakup has been considered.
Collapse
Affiliation(s)
- A Dziedzic
- Department of Mathematical Sciences, New Jersey Institute of Technology, 07102, Newark, NJ, USA
| | - M Nakrani
- Department of Mathematical Sciences, New Jersey Institute of Technology, 07102, Newark, NJ, USA
| | - B Ezra
- Department of Mathematical Sciences, New Jersey Institute of Technology, 07102, Newark, NJ, USA
| | - M Syed
- Department of Mathematical Sciences, New Jersey Institute of Technology, 07102, Newark, NJ, USA
| | - S Popinet
- Sorbonne Université, Centre National de la Recherche Scientifique, Institut Jean le Rond ∂'Alembert, F-75005, Paris, France
| | - S Afkhami
- Department of Mathematical Sciences, New Jersey Institute of Technology, 07102, Newark, NJ, USA.
| |
Collapse
|
18
|
Syed M, Salata K, Hussain M, de Mestral C, Verma S, Wheatcroft M, Harlock J, Verma A, Razak F, Al-Omran M. MS02.8 Economic and Clinical Burden of Diabetic Foot Ulcers: A Multicentre Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.011] [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
|
19
|
Burnes D, Syed M. UNDERSTANDING HOW RESIDENT-TO-RESIDENT AGGRESSION IN LONG-TERM CARE DEMENTIA UNITS UNFOLDS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2685] [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: 11/14/2022] Open
|
20
|
Syed M, Kinzy TG, Mehra R, Moul DE, Vanek R, Campean T, Foldvary-Schaefer N, Walia HK. 0600 Impact of Group-Based Sleep Apnea Management Intervention on Patient Reported Outcomes in Patients on Positive Airway Pressure for Obstructive Sleep Apnea. Sleep 2018. [DOI: 10.1093/sleep/zsy061.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Syed
- Cleveland Clinic, Cleveland, OH
| | | | - R Mehra
- Cleveland Clinic, Cleveland, OH
| | | | - R Vanek
- Cleveland Clinic, Cleveland, OH
| | | | | | | |
Collapse
|
21
|
Syed M, Wang L, Kaw S, Mehra R, Moul DE, Vanek R, Campean T, Foldvary-Schaefer N, Walia HK. 0599 Positive Airway Pressure Barriers Reduction in Response to Group Sleep Apnea Management Clinic. Sleep 2018. [DOI: 10.1093/sleep/zsy061.598] [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: 11/14/2022] Open
Affiliation(s)
- M Syed
- Cleveland Clinic, Cleveland, OH
| | - L Wang
- Cleveland Clinic, Cleveland, OH
| | - S Kaw
- Cleveland Clinic, Cleveland, OH
| | - R Mehra
- Cleveland Clinic, Cleveland, OH
| | | | - R Vanek
- Cleveland Clinic, Cleveland, OH
| | | | | | | |
Collapse
|
22
|
Shukla P, Cristescu M, Syed M, Bishay V, Ranade M, Kim E, Nowakowski F, Patel R, Lookstein R, Fischman A. 3:00 PM Abstract No. 101 Utility of cone-beam computed tomography in lower gastrointestinal bleeding: safety and technical feasibility of prophylactic embolization. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.116] [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: 10/17/2022] Open
|
23
|
Nazarali S, Liu H, Syed M, Ter-Zakarian A, Karanjia R, Sadun A. Cabin pressure aboard commercial aircraft and non-arteritic ischemic optic neuropathy. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t038] [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: 11/29/2022]
Affiliation(s)
- S. Nazarali
- Faculty of Medicine; University of Ottawa; Ottawa ON Canada
| | - H. Liu
- Faculty of Medicine; University of Ottawa; Ottawa ON Canada
| | - M. Syed
- Faculty of Medicine; University of Ottawa; Ottawa ON Canada
| | | | - R. Karanjia
- Faculty of Medicine; University of Ottawa; Ottawa ON Canada
- Ottawa Eye Institute; University of Ottawa; Ottawa ON Canada
- Ophthalmology; Doheny Eye Institute; Los Angeles CA USA
- The Ottawa Hospital Research Institute; The Ottawa Hospital; Ottawa ON Canada
- UCLA; Doheny Eye Center UCLA; Los Angeles CA USA
| | - A.A. Sadun
- Ophthalmology; Doheny Eye Institute; Los Angeles CA USA
- UCLA; Doheny Eye Center UCLA; Los Angeles CA USA
| |
Collapse
|
24
|
Liu H, La Morgia C, Di Vito L, Nazarali S, Gauthier I, Syed M, Chahal J, Ammar M, Carbonelli M, De Negri A, Sadun A, Carelli V, Karanjia R. Differences in onset between eyes in patients with Leber's hereditary optic neuropathy (LHON). Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H. Liu
- Medicine; University of Ottawa; Ottawa Canada
| | - C. La Morgia
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Department of Biomedical and NeuroMotor Sciences, Ophthalmology; Bologna Italy
| | - L. Di Vito
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
| | - S. Nazarali
- Medicine; University of Ottawa; Ottawa Canada
| | - I. Gauthier
- Medicine; University of Ottawa; Ottawa Canada
| | - M. Syed
- Medicine; University of Ottawa; Ottawa Canada
| | - J. Chahal
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
| | - M. Ammar
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
| | - M. Carbonelli
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Ophthalmology; Studio Oculistico D'Azeglio; Bologna Italy
| | - A.M. De Negri
- Ophthalmology; S.Camillo-Forlanini Hospital; Rome Italy
| | - A. Sadun
- Ophthalmology; Doheny Eye Institute; Los Angeles United States
- Ophthalmology; David Geffen School of Medicine at UCLA; Los Angeles United States
| | - V. Carelli
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
| | - R. Karanjia
- Medicine; University of Ottawa; Ottawa Canada
- Ophthalmology; IRCCS-Institute of Neurological Sciences of Bologna; Bologna Italy
- Ophthalmology; David Geffen School of Medicine at UCLA; Los Angeles United States
- Ophthalmology; Ottawa Hospital Research Institute; Ottawa Canada
| |
Collapse
|
25
|
Syed M, Zech J, Fischman A, Tabori N, Nowakowski F, Kim E, Lookstein R, Patel R. Effect of transjugular intrahepatic portosystemic shunt creation on spleen volume. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
26
|
Syed M, Tabori N, Patel R, Nowakowski F, Kim E, Lookstein R, Fischman A. Feasibility of tablet-based ultrasound for arterial access in interventional procedures. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1085] [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] Open
|
27
|
Syed M, Co D, North P, Steinberg J. P172 Eosinophilic granulomatous polyangiitis presenting with acute hypotension. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.183] [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: 10/20/2022]
|
28
|
Syed M, Sachdev V, Chopra R. Intercomparison of salivary nitric oxide as a biomarker of dental caries risk between caries-active and caries-free children. Eur Arch Paediatr Dent 2016; 17:239-43. [DOI: 10.1007/s40368-016-0234-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/11/2016] [Indexed: 01/19/2023]
|
29
|
Syed M, Bahl S, Perez L, Dreifuss R. Hepatocellular carcinoma tumor board 101. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
30
|
Reddy SM, Sinha A, Syed M, Barcenas C, Valero V. Abstract P4-10-09: Relapse-free survival of triple negative breast cancer long term survivors and characterization of late events in MD Anderson experience. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-10-09] [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: 11/16/2022]
Abstract
Abstract
Background:
Stage I-III TNBC patients have a high risk of disease relapse during the first 5 years after diagnosis. However, there is limited data on the risk of late relapse in TNBC survivors who are disease free at 5 years or more from diagnosis. We sought to characterize this risk in a cohort of TNBC long-term survivors from a large institutional database.
Methods:
The MD Anderson Breast Cancer Management System database was queried for TNBC survivors who were disease free 5 years or more from diagnosis. Demographic, tumor, and treatment data was extracted. Electronic medical records were searched to confirm pathology reports for invasive breast cancer diagnosis, triple negative receptor status, and hormone receptor percentage (%). The primary and secondary outcomes of interest were relapse free survival (RFS) and distant relapse free survival (DRFS). Patients were censored at time of developing a second primary breast cancer or at last follow-up time for those who were alive during the study. We used ACP-ASCO definition of ER and PR <1% and HER2/neu negative (IHC 0-1 or ratio <2 and average copy number <4) but also included patients with low ER/PR(1-9%) and HER2 normal. Kaplan-Meier analysis was performed to compare RFS and DRFS for the overall population and categorized by ER/PR <1%, and ER/PR 1-9%.
Results:
We identified 1038 patients who had a median follow-up of 8.0 years. Receptor % information was available on 69% of patients, with 78% of them meeting current TNBC definition. From the total cohort of 130, 12.5% suffered event(s) that occurred after 5 years from diagnosis, with 86.2% of them occurring within 5-10 years of diagnosis. The event rate was 16.4% among patients with ER/PR 1-9% versus 11.3% among patients with ER/PR <1%. Table 1 shows RFS and DRFS by year from diagnosis for the entire cohort and categorized by % receptor. 18 patients developed second primary breast cancer as first event and were censored. Of total events recorded, 53(40.8%) were deaths and 77(59.2%) were recurrences, of which 51(66%) were distant and 26(34%) local, of whom 12(46.2%) subsequently developed distant metastases. Among patients who initially presented with distant recurrence, frequencies of initial sites of metastases are shown in Table 2.
Conclusions:
TNBC long term survivors are still at risk for relapse events after 5 years from diagnosis, and it is important to quantity this risk when counseling our patients. Frequency of late events was higher among patients with low hormone receptor positivity. Multivariate modeling of predictors of late recurrence is ongoing.
Table 1: RFS and DRFS by Year from Diagnosis All PatientsER/PR <1%ER/PR 1-9%Year From DiagnosisRFSDRFSRFSDRFSRFSDRFS4-51.01.01.01.01.01.05-60.950.960.940.950.940.956-70.930.940.930.940.910.927-80.900.920.900.920.870.898-90.860.880.870.890.810.849-100.840.870.840.860.800.8310-120.810.840.810.830.800.8312-150.730.780.730.750.670.74
Table 2: Site of Initial Distant RecurrenceSiteN (%)Lung/Pleura28 (54.9)Bone19 (37.3)Distant Lymph Nodes19 (37.3)Liver11 (21.6)Brain/Spinal Cord8 (15.7)Colorectal/Pancreas/Kidney/Adrenal6 (11.7)Other2 (3.9)*Patients presenting with multiple sites of distant recurrence are counted in each category.
Citation Format: Reddy SM, Sinha A, Syed M, Barcenas C, Valero V. Relapse-free survival of triple negative breast cancer long term survivors and characterization of late events in MD Anderson experience. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-09.
Collapse
Affiliation(s)
- SM Reddy
- MD Anderson Cancer Center, Houston, TX
| | - A Sinha
- MD Anderson Cancer Center, Houston, TX
| | - M Syed
- MD Anderson Cancer Center, Houston, TX
| | | | - V Valero
- MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
31
|
Shekhar H, Syed M, Statham P, Sim D. Surgical Management of Cerebrospinal Fluid Leaks Involving the Temporal Bone: “The Edinburgh Experience”. J Neurol Surg B Skull Base 2014. [DOI: 10.1055/s-0034-1384083] [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] Open
|
32
|
Farroha A, Syed M, Dziewulski P. An electrocardiogram for a patient with Biobrane® dressing. Burns 2013; 39:188-9. [DOI: 10.1016/j.burns.2012.03.009] [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] [Received: 03/15/2012] [Accepted: 03/17/2012] [Indexed: 11/16/2022]
|
33
|
Syed M, Shaikh A, Akhter T, Morar K, Cortoss S. Abstract No. 199: Does age of fracture affect the outcome of vertebroplasty? Results from a prospective multi-center FDA-IDE study. J Vasc Interv Radiol 2011. [DOI: 10.1016/j.jvir.2011.01.219] [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] Open
|
34
|
Sagoo R, Bajaj Y, Syed M, Harris A, Martin-Hirsch D. Accuracy of fine needle aspiration cytology in head and neck lumps. Int J Surg 2011. [DOI: 10.1016/j.ijsu.2011.07.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
35
|
Syed M, Persenaire M. Abstract No. 18: Percutaneous vertebroplasty: A comparison of material characteristics and clinical results between Cortoss and PMMA in a multi-center vertebroplasty IDE study. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
36
|
Kulendren D, Syed M, Shah S, Ramakrishnan V. Acute upper limb ischaemia following chest wall reconstruction--a word of caution. J Plast Reconstr Aesthet Surg 2009; 63:e540-2. [PMID: 20018579 DOI: 10.1016/j.bjps.2009.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 11/11/2009] [Accepted: 11/13/2009] [Indexed: 11/30/2022]
Abstract
Irradiation arteriopathy, although rare, is a recognised entity following radiotherapy for the management of advanced cancers. It is known to manifest in varied forms and can be chronic and progressive. We present a case of an acute upper limb ischaemia following deep inferior epigastric artery perforator (DIEP) free flap reconstruction for a chest wall defect in a patient who had previously undergone radiotherapy 25 years back for carcinoma of the breast. It is envisaged that the axillary artery was thrombosed secondary to radiation arteriopathy and the collaterals that had developed were probably damaged during debridement of the irradiated unhealthy tissue prior to free flap reconstruction. A cross-limb vascular graft tunnelled under the flap restored the perfusion to the limb. We propose that the possibility of radiation arteriopathy should be considered and a preoperative arteriogram should be performed prior to planning any major surgical reconstruction in patients having undergone irradiation to major vascular beds.
Collapse
Affiliation(s)
- D Kulendren
- St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, Essex, CM1 7ET, UK.
| | | | | | | |
Collapse
|
37
|
Kulendren D, Syed M, Myers S, Navsaria H. Keloid pathogenesis—Do Human Beta Defensins have a role? Burns 2009. [DOI: 10.1016/j.burns.2009.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
38
|
Abstract
Total serum haemolytic complement (HC) activity has been determined in 130 young bulls of the Norwegian Red Cattle Breed (NRF). A highly significant sire effect (p less than 0.01) on HC with a corresponding heritability of about 0.75 was estimated. Evidence of any simple mode of inheritance is not produced but the distribution patterns of HC indicate influences of relatively few genes.
Collapse
|
39
|
Vestrheim O, Lundin M, Syed M. The Atlantic Salmon MHC class II alpha and beta promoters are active in mammalian cell lines. Anim Biotechnol 2007; 18:297-9. [PMID: 17934904 DOI: 10.1080/10495390701597805] [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: 10/22/2022]
Abstract
The major histocompatibility complex class II (MHCII) genes are only constitutively expressed in certain immune response cells such as B cells, macrophages, dendritic cells and other antigen presenting cells. This cell specific expression pattern and the presence of conserved regions such as the X-, X2-, Y-, and W-boxes make the MHCII promoters especially interesting as vector constructs. We tested whether the Atlantic salmon (Salmo salar L.) MHCII promoters can function in cell lines from other organisms. We found that the salmon MHCII alpha and MHCII beta promoters could drive expression of a LacZ reporter gene in adherent lymphoblast cell lines from dog (DH82) and rabbit (HybL-L). This paper shows that the promoters of Atlantic salmon MHCII alpha and beta genes can function in mammalian cell lines.
Collapse
Affiliation(s)
- O Vestrheim
- Department of Basic Sciences and Aquatic Medicine, Norwegian School of Veterinary Science, Oslo, Norway
| | | | | |
Collapse
|
40
|
Anthony E, Moir G, Shibu M, Nduka C, Vaiude P, Syed M, Navsaria P. A 6-year review of the clinical relevance of steroid therapy. Burns 2007. [DOI: 10.1016/j.burns.2006.10.007] [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]
|
41
|
Chandrashekara S, Syed M, Swapna R. Is three selected parameters adequate to monitor rheumatoid arthritis? Clin Rheumatol 2006; 26:911-4. [PMID: 17028793 DOI: 10.1007/s10067-006-0431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Revised: 08/30/2006] [Accepted: 08/31/2006] [Indexed: 10/24/2022]
Abstract
This pilot study was done to choose which among the five core set criteria will have more discriminating ability and which is easy to administer in a clinical setting. Forty-eight patients recently diagnosed to have rheumatoid arthritis (RA) were recruited for the study. They were assessed by a rheumatologist in each visit (initial and after 2 months of treatment), for five core measures: patient assessment, pain (measured on VAS scale), number of tender joints, health assessment questionnaire (HAQ) score, and erythrocyte sedimentation rate (ESR). All patients were treated with methotrexate 7.5 mg per week and hydroxychloroquin 400 mg per day with adequate dose of NSAIDs. Patients with associated conditions like stroke, ischemic heart disease, and other physical comorbidity were excluded. They were categorized as 20, 50, and 70% improvement, if four of the five criteria occur. The Wilcoxon signed rank test and discriminant function analysis were done to identify the order of importance of measures on influencing the outcome. The ESR followed by patient improvement scale showed the least changes, while HAQ showed the highest changes. Discriminate function analysis has been carried out to see which factors influenced in grouping them for responses with post hoc analyses of finding the order of importance of these factors in classifying the response. Pain scale, ESR, HAQ score, patient improvement scale, and tender score were in the decreasing value of importance. The pain scale, HAQ, and ESR, which are more objective and discriminate measures, are useful as measures in RA.
Collapse
Affiliation(s)
- S Chandrashekara
- Immunology and Rheumatology, Chanre Rheumatology and Immunology Center and Research, Bangalore, India.
| | | | | |
Collapse
|
42
|
Abstract
The Ran protein is a highly conserved GTPase factor of the Ras-family of proteins. It is involved in the transport of proteins and RNA through the nuclear pores. cDNA sequences of Ran genes from different organisms are available but no vertebrate genomic sequence as yet. We have isolated a genomic cosmid clone of the Ran1 gene of Atlantic salmon (Salmo salar) and found that the gene is about 2.2 kb and has got 5 introns. Its gene structure was compared to those of Caenorhabditis elegans and Arabidopsis thaliana and one intron was found to be conserved in position. Two different Ran transcripts were identified in salmon, indicating that there are two Ran genes, Ran1 and Ran2. Both transcripts were found in all ten salmon tissues tested, though Ran1 to a higher degree.
Collapse
Affiliation(s)
- M H Lundin
- Department of Morphology, Genetics and Aquatic Biology, The Norwegian School of Veterinary Science, Oslo.
| | | | | | | |
Collapse
|
43
|
Syed M, Khaja F, Rybicki BA, Wulbrecht N, Alam M, Sabbah HN, Goldstein S, Borzak S. Effect of delay on racial differences in thrombolysis for acute myocardial infarction. Am Heart J 2000; 140:643-50. [PMID: 11011340 DOI: 10.1067/mhj.2000.109644] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [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: 11/22/2022]
Abstract
OBJECTIVE To analyze the effect of delay times on racial differences in thrombolysis for acute myocardial infarction. BACKGROUND Lower rates of thrombolytic therapy in blacks with acute myocardial infarction have recently been reported, but the reasons for this disparity are unknown. We hypothesized that lower rates of thrombolysis are caused by delay in presentation after symptom onset. METHODS From November 1992 through November 1996, consecutive patients with a first acute myocardial infarction presenting to a large, urban teaching hospital were prospectively enrolled. Delay times were determined retrospectively from review of medical records. Patients were prospectively followed up for in-hospital cardiac events and death. A multivariable regression model was built to relate presentation times and other variables to thrombolysis administration. RESULTS A total of 395 patients were included in the study, of which 33% were black. Symptom onset to emergency department presentation and door-to-needle times were significantly longer in blacks. Thrombolysis was administered significantly less often in blacks compared with whites (47% vs 68%, P =.001). Black race and age above 60 years were independently associated with delayed presentation and prolonged door-to-needle times. Black race, time to presentation, and non-Q-wave myocardial infarction were independently associated with not receiving thrombolysis. In-hospital mortality rates were similar in both groups. CONCLUSIONS Blacks presented later than whites for first acute myocardial infarction. Late arrival strongly influenced the rate of thrombolysis administration. Lower rates of thrombolysis and prolonged door-to-needle times were apparent in blacks after adjustment for delay times and other clinical factors, a finding that merits further investigation.
Collapse
Affiliation(s)
- M Syed
- Henry Ford Heart and Vascular Institute, Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan, USA.
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Manhapra A, Khaja F, Syed M, Rybicki BA, Wulbrecht N, Alam M, Sabbah H, Goldstein S, Borzak S. Electrocardiographic presentation of blacks with first myocardial infarction does not explain race differences in thrombolysis administration. Am Heart J 2000; 140:200-5. [PMID: 10925330 DOI: 10.1067/mhj.2000.107173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/22/2022]
Abstract
BACKGROUND Previous studies have suggested that thrombolysis is used less often in blacks than in whites. However, whether the greater prevalence of contraindications or less specific electrocardiographic manifestations of myocardial infarction (MI) account for this difference is unclear. METHODS AND RESULTS We studied 498 consecutive patients (32% blacks) with first MI. Initial electrocardiograms were analyzed, blinded to race and outcome, for ST-segment deviation and bundle branch block to determine eligibility for thrombolysis. The relation of electrocardiographic eligibility for thrombolysis and actual use of thrombolysis in both races was explored. Among blacks, 45% received thrombolysis compared with 66% of whites (P <.001). A similar proportion of blacks and whites were eligible for thrombolysis (59% and 66% respectively, P =. 116), but 62% of electrocardiography-eligible blacks were treated with thrombolysis compared with 75% of whites (P =.016). After accounting for eligibility for electrocardiography and other clinical variables likely to affect the decision to administer thrombolysis by means of conditional logistic regression, blacks were still less likely to receive thrombolysis (relative risk 0.73; 95% confidence interval 0.55 to 0.97). CONCLUSIONS We conclude that the differences in thrombolysis administration to blacks and whites are not accounted for by differences in electrocardiographic presentation or other measured variables. Unmeasured differences in clinical presentation of MI may explain racial differences in thrombolysis and merits further study.
Collapse
Affiliation(s)
- A Manhapra
- Henry Ford Heart and Vascular Institute and the Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, MI 48202, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Vasavada RC, Garcia-Ocaña A, Zawalich WS, Sorenson RL, Dann P, Syed M, Ogren L, Talamantes F, Stewart AF. Targeted expression of placental lactogen in the beta cells of transgenic mice results in beta cell proliferation, islet mass augmentation, and hypoglycemia. J Biol Chem 2000; 275:15399-406. [PMID: 10809775 DOI: 10.1074/jbc.275.20.15399] [Citation(s) in RCA: 146] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The factors that regulate pancreatic beta cell proliferation are not well defined. In order to explore the role of murine placental lactogen (PL)-I (mPL-I) in islet mass regulation in vivo, we developed transgenic mice in which mPL-I is targeted to the beta cell using the rat insulin II promoter. Rat insulin II-mPL-I mice displayed both fasting and postprandial hypoglycemia (71 and 105 mg/dl, respectively) as compared with normal mice (92 and 129 mg/dl; p < 0.00005 for both). Plasma insulin concentrations were inappropriately elevated, and insulin content in the pancreas was increased 2-fold. Glucose-stimulated insulin secretion by perifused islets was indistinguishable from controls at 7.5, 15, and 20 mm glucose. Beta cell proliferation rates were twice normal (p = 0. 0005). This hyperplasia, together with a 20% increase in beta cell size, resulted in a 2-fold increase in islet mass (p = 0.0005) and a 1.45-fold increase in islet number (p = 0.0012). In mice, murine PL-I is a potent islet mitogen, is capable of increasing islet mass, and is associated with hypoglycemia over the long term. It can be targeted to the beta cell using standard gene targeting techniques. Potential exists for beta cell engineering using this strategy.
Collapse
Affiliation(s)
- R C Vasavada
- Division of Endocrinology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Lundin M, Mikkelsen B, Gudim M, Syed M. Gene Structure of the U2 snRNP-Specific A' Protein Gene from Salmo salar: Alternative Transcripts Observed. Mar Biotechnol (NY) 2000; 2:204-211. [PMID: 10811961 DOI: 10.1007/s101269900015] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The genomic sequence of the Atlantic salmon (Salmo salar) U2 snRNP-specific A' protein gene (U2A') was identified on a cosmid clone, and the exon/intron organization of a U2A' gene is described for the first time. The cosmid sequence includes 8 exons from which the 227 amino-terminal amino acids, of a total of 339 amino acids, are deduced. The cosmid cloning site was found in the 8th intron, which also contains a BglII minisatellite repeat region of unknown length. The 3' end of the gene was determined from a complementary DNA sequence. In the 234 amino-terminal amino acids the sequence identity is 84% to human and 49% to Arabidopsis thaliana. The phases of introns 1 to 8 are 1, 2, 0, 2, 0, 2, 0, and 1, respectively. The salmon U2A' gene was found by reverse transcription-polymerase chain reaction to be expressed in all 10 tissues tested, and in addition to the expected fragment of 695 bp, a smaller fragment of 615 bp was amplified in all tissues. Nucleotide sequencing of the fragments obtained showed that the smaller transcript lacks exon 6 and this results in frameshift of exon 7 and a truncated deduced polypeptide. This result may be explained by alternative splicing of the salmon U2A' gene. Different U2A' transcripts were found to exist also in human tissue.
Collapse
Affiliation(s)
- M Lundin
- Department of Morphology, Genetics and Aquatic Biology, Norwegian College of Veterinary Medicine, P.O. Box 8146, Dep. N-0033 Oslo, Norway
| | | | | | | |
Collapse
|
47
|
Syed M, Borzak S. Key references: Role of ACE inhibition in acute coronary syndromes. J Thromb Thrombolysis 2000; 9:107-9. [PMID: 10590199 DOI: 10.1023/a:1018637912389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M Syed
- Henry Ford Heart & Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA
| | | |
Collapse
|
48
|
Abstract
Coronary artery aneurysm is defined as coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. This is an uncommon disease which has been diagnosed with increasing frequency since the advent of coronary angiography. The incidence varies from 1.5% to 5% with male dominance and a predilection for the right coronary artery. Atherosclerosis accounts for 50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, rupture and vasospasm. The natural history and prognosis remains obscure. Controversies persist regarding the use of surgical or medical management. The authors recommend surgery based on the severity of associated coronary stenosis rather than the mere presence of aneurysm. Medical therapy is indicated for the majority of patients and consists of antiplatelet and anticoagulant medication.
Collapse
Affiliation(s)
- M Syed
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA
| | | |
Collapse
|
49
|
Syed M, Borzak S, Jafri SM. Angiotensin-converting enzyme inhibition after acute myocardial infarction with special reference to the Fourth International Study of Infarct Survival (ISIS-4). Prog Cardiovasc Dis 1996; 39:201-6. [PMID: 8841011 DOI: 10.1016/s0033-0620(96)80026-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 02/02/2023]
Abstract
Role of ACE inhibitors in the management of asymptomatic or symptomatic left ventricular (LV) dysfunction after acute myocardial infarction (AMI) is well established. More recently, large clinical trials have evaluated the use of angiotensin-converting enzyme (ACE) inhibitors early after AMI, ie, within 24 hours of symptom onset. This concept has emerged with the understanding of pathophysiological changes occurring after AMI. Neurohormonal activation and ventricular remodelling after AMI form the basis of these changes, whereas the extent of LV dysfunction remains strongly predictive of poor outcome. The large clinical trials with mortality end point have shown modest benefit with early use of ACE inhibitors in an unselected population. However, the generalized use of ACE inhibitors remains controversial because of an overall small benefit. We review the pathophysiological changes occurring after AMI, the rationale for early use of ACE inhibitors, and the data available from the large clinical trials. We recommend consideration of early ACE inhibitor in all but the lowest risk patients. Clinical features of such a low-risk population would include small and nonanterior infarctions in patients less than 65 years of age and with LV ejection fractions greater than 50%. Objective assessment of LV function is warranted during hospitalization for AMI to appropriately select patients for ACE inhibitor therapy. Dosing should be started carefully to avoid hypotension and should be titrated to the goal of doses used in the large trials. Duration of therapy in patients at high risk for death or ventricular enlargement should be indefinite. Further large-scale secondary prevention trials with long-term treatment are underway to assess the effect of ACE inhibition on coronary disease progression and reinfarction.
Collapse
Affiliation(s)
- M Syed
- Cardiovascular Division, Henry Ford Hospital, Detroit, MI 48202, USA
| | | | | |
Collapse
|
50
|
|