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Moore N, Maher M, Murphy G, O'Callaghan Maher M, O'Connor OJ, McEntee MF. CT in the detection of latent tuberculosis: a systematic review. Clin Radiol 2023; 78:568-575. [PMID: 37270335 DOI: 10.1016/j.crad.2023.04.014] [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: 11/29/2022] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 06/05/2023]
Abstract
AIM To evaluate the use of computed tomography (CT) and low-dose CT in the detection of latent tuberculosis (TB). MATERIALS AND METHODS A systematic search of literature in adherence with the PRISMA guidelines was carried out. Quality assessment of the included studies was conducted. RESULTS The search strategy identified a total of 4,621 studies. Sixteen studies were considered eligible and included in the review. There was high heterogeneity among all studies. CT was identified as much more sensitive for the detection of latent TB in all studies despite chest radiography often being recommended in guidelines to assess patients for latent TB. Low-dose CT showed promising results in four of the studies; however, these results were limited due to small sample sizes. CONCLUSION CT is much superior to chest radiography consistently identifying additional cases of latent TB. There are limited high-quality publications available using low-dose CT but findings thus far suggest low-dose CT could be used as an alternative to standard-dose CT for the detection of latent TB. It is recommended that a randomised controlled trial investigating low-dose CT should be carried out.
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Affiliation(s)
- N Moore
- Medical Imaging and Radiation Therapy, University College Cork, Ireland.
| | - M Maher
- Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland
| | - G Murphy
- Department of Rheumatology, Cork University Hospital, Cork, Ireland
| | | | - O J O'Connor
- Department of Radiology, University College Cork, Cork, Ireland; Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland
| | - M F McEntee
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
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Gilley R, David LR, Leamy B, Moloney D, Moore N, England A, Waldron M, Maher M, McEntee MF. Establishing weight-based diagnostic reference levels for neonatal chest X-rays. Radiography (Lond) 2023; 29:812-817. [PMID: 37276688 DOI: 10.1016/j.radi.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION As weights among neonates can vary from <900 g to >2.5 kg, weight-based Diagnostic Reference Levels (DRLs) specific to the neonatal intensive care unit (NICU) are essential. Repeated radiation exposure to this sensitive patient group raises concerns regarding high cumulative radiation doses and the potential for long-term health detriment. This study aimed to establish weight-based DRLs for neonates undergoing mobile chest radiography (CXR) in the NICU. METHODS Neonates were classified into three discrete groups; <1000, 1000-2500 and >2500 g. Data were collected prospectively over three months; 95 DAP values were collected, and five were excluded due to poor technique, leaving 90 patients that met the inclusion criteria for mobile CXR in the NICU. Dose-area-product (DAP) in mGycm2, the peak kilovoltage (kVp) and the product of tube current and exposure time (mAs) were retrieved from the Picture Archiving and Communication System (PACS). Images and radiological reports were also analysed to confirm diagnostic image quality (IQ). Local DRLs (LDRLs) were derived using the median DAP, and national DRLs were suggested using the 3rd quartile value. RESULTS The proposed LDRLs for neonates weighing <1000 g was 2.7 mGycm2, for neonates weighing between 1000 g and 2500 g, it was 3.7 mGycm2, and for neonates weighing >2500 g it was 6.6 mGycm2. The radiation dose received by the 90 (100%) neonates included in the study fell below 11.4 mGycm2; of these, 82% of the DAP values fell below the study institution's existing LDRL of 7.25 mGycm2. CONCLUSION Weight-based DRLs provide crucial information on doses to this specific radiation-sensitive group. This work recommends using weight-based categories for DRLs and serves as a benchmark for neonatal CXR standardisation and optimisation. IMPLICATIONS FOR PRACTICE The proposed weight-based DRLs can be adopted for neonates' locally, nationally and internationally.
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Affiliation(s)
- R Gilley
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
| | - L R David
- Department of Medical Diagnostic Imaging, College of Health of Sciences, University of Sharjah, United Arab Emirates
| | - B Leamy
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - D Moloney
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - N Moore
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
| | - A England
- Medical Imaging and Radiation Therapy, University College Cork, Ireland.
| | - M Waldron
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - M Maher
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
| | - M F McEntee
- Medical Imaging and Radiation Therapy, University College Cork, Ireland
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Kajawo S, Linn M, Maher M, Rath S, Fitzmaurice K, Brolly A, Buckley M. 222 TOWARDS A DELIRIUM FRIENDLY EMERGENCY DEPARTMENT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.192] [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: 11/15/2022] Open
Abstract
Abstract
Background
Delirium affects approx. 10-30 % of patients over the age of 65. Up to 70% of cases are missed in the Emergency Department (ED). Delirium results in increased morbidity, mortality, increased length of stay and decreased functional status with increased discharges to residential care centres. Delirium in the ED is an independent predictor of death within 6 months.
Methods
We completed an audit which showed 40% of those > 65 years of age in the ED were delirious and 60% of those had dementia. None of these had been identified as delirious prior to review. We have approx. 5,000 patients >75 years of age attending our ED annually (1/7th of presentations). This audit was used as a catalyst for our quality improvement project. We established a steering group with a small quality improvement sub-committee. We combed the literature, identified areas for improvement and costed our project. We also looked at reliance on 1:1 carers for those with delirium and potential benefits to patient, staff and management.
Results
We used the SPARK ignite programme as a means to gain momentum and also educate ourselves on business management and change management. We competed in the finals with our “delirium package” – focussing on orientation, stimulation, safety and education. These 4 pillars of delirium care have been shown to prevent delirium, reduce hospital stay for those with delirium and also augment their delirium cycle. Competing and winning a prize highlighted the importance of delirium care and brought our project to a bigger stage.
Conclusion
Due to our multi-disciplinary team composed of non-consultant hospital doctors, advanced nurse practitioners and occupational therapists, we have been able to introduce the national dementia programme for early identification of delirium in the emergency department. We now have a space for managing those with delirium and have received funding to put our package in place. This can be replicated in hospitals around the country highlighting the non-pharmacological treatments for delirium.
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Affiliation(s)
- S Kajawo
- University Hospital Kerry , Tralee, Ireland
| | - M Linn
- University Hospital Kerry , Tralee, Ireland
| | - M Maher
- University Hospital Kerry , Tralee, Ireland
| | - S Rath
- University Hospital Kerry , Tralee, Ireland
| | | | - A Brolly
- University Hospital Kerry , Tralee, Ireland
| | - M Buckley
- University Hospital Kerry , Tralee, Ireland
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Coakley S, Young R, Moore N, England A, O'Mahony A, O'Connor OJ, Maher M, McEntee MF. Radiographers' knowledge, attitudes and expectations of artificial intelligence in medical imaging. Radiography (Lond) 2022; 28:943-948. [PMID: 35839662 DOI: 10.1016/j.radi.2022.06.020] [Citation(s) in RCA: 6] [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: 05/04/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Artificial intelligence (AI) is increasingly utilised in medical imaging systems and processes, and radiographers must embrace this advancement. This study aimed to investigate perceptions, knowledge, and expectations towards integrating AI into medical imaging amongst a sample of radiographers and determine the current state of AI education within the community. METHODS A cross-sectional online quantitative study targeting radiographers based in Europe was conducted over ten weeks. Captured data included demographical information, participants' perceptions and understanding of AI, expectations of AI and AI-related educational backgrounds. Both descriptive and inferential statistical techniques were used to analyse the obtained data. RESULTS A total of 96 valid responses were collected. Of these, 64% correctly identified the true definition of AI from a range of options, but fewer (37%) fully understood the difference between AI, machine learning and deep learning. The majority of participants (83%) agreed they were excited about the advancement of AI, though a level of apprehensiveness remained amongst 29%. A severe lack of education on AI was noted, with only 8% of participants having received AI teachings in their pre-registration qualification. CONCLUSION Overall positive attitudes towards AI implementation were observed. The slight apprehension may stem from the lack of technical understanding of AI technologies and AI training within the community. Greater educational programs focusing on AI principles are required to help increase European radiography workforce engagement and involvement in AI technologies. IMPLICATIONS FOR PRACTICE This study offers insight into the current perspectives of European based radiographers on AI in radiography to help facilitate the embracement of AI technology and convey the need for AI-focused education within the profession.
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Affiliation(s)
- S Coakley
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - R Young
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Moore
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland.
| | - A O'Mahony
- Department of Radiology, Cork University Hospital, Ireland
| | - O J O'Connor
- Department of Radiology, Cork University Hospital, Ireland
| | - M Maher
- Department of Radiology, Cork University Hospital, Ireland
| | - M F McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
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Dempsey PJ, Power JW, Yates A, Maher M, Murphy BD, McNicholas MMJ. Creation of a protective space between the rectum and prostate prior to prostate radiotherapy using a hydrogel spacer. Clin Radiol 2021; 77:e195-e200. [PMID: 34974913 DOI: 10.1016/j.crad.2021.12.004] [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: 09/22/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
The placement of a polyethylene glycol (PEG) hydrogel spacer is a recently developed technique employed to reduce the radiation dose administered to the rectum during prostate radiotherapy. This procedure has been adopted by urologists and radiation oncologists involved in transperineal prostate biopsy and brachytherapy, and more recently by radiologists with experience in transperineal prostate procedures. Radiologists should be familiar with the product, which may be encountered on computed tomography (CT) or magnetic resonance imaging (MRI). Radiologists may wish to become involved in the delivery of this increasingly utilised procedure. This review familiarises radiologists with the technique and risks and benefits of the use of transperineal delivery of hydrogel spacers with imaging examples.
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Affiliation(s)
- P J Dempsey
- Radiology Department, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
| | - J W Power
- Radiology Department, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
| | - A Yates
- Radiology Department, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
| | - M Maher
- Radiation Oncology Department, Mater Private Hospital, Eccles Street, Dublin, Ireland
| | - B D Murphy
- Radiology Department, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland; Radiation Oncology Department, Mater Private Hospital, Eccles Street, Dublin, Ireland
| | - M M J McNicholas
- Radiology Department, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland; Radiation Oncology Department, Mater Private Hospital, Eccles Street, Dublin, Ireland
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Kermansaravi M, Omar I, Mahawar K, Shahabi S, Bashir A, Haddad A, Abbass A, Abbas SI, Abbas M, Abouzeid T, Akin F, Aghajani E, Aminian A, AlAnsari M, Asghar ST, Balta AZ, Bukhari W, Elfawal MH, Gado W, Gawdat K, Gee T, Ghavami B, Goel R, AlHadad M, AlHadhrami B, AlHaifi M, AlHamdani A, Hassan I, Illan SJ, Inam A, Ismaeil A, Kayyal Y, Mohammad K, Khan AU, Khoursheed M, Khwaja H, Kular KS, Layani LA, Maazulhassan, Mahdy T, Maher M, Mansoor E, Mirza S, Niam MS, Omarov T, Pazouki A, Alqahtani AR, Qassem M, Rezvani M, Sabry K, Salim S, Shabbir A, Skalli M, Taha O, Talebpour M, Taskin HE, Taskin M, Yunus T, Jazi AHD, Kassir R, Nimeri A. Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus. Obes Surg 2021; 31:5303-5311. [PMID: 34617207 DOI: 10.1007/s11695-021-05724-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/11/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. METHODS A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. RESULTS The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. CONCLUSION Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Islam Omar
- Wirral University Teaching Hospital, NHS Foundation Trust, Birkenhead, Wirral, UK
| | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK
| | - Shahab Shahabi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan
| | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan
| | - Alaa Abbass
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | - Mujjahid Abbas
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Tarek Abouzeid
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Faki Akin
- Bariatric and Metabolic Surgery, Istanbul, Turkey
| | - Ebrahim Aghajani
- Department of Surgery, Aleris Hospital, Fredrik Stangs gate 11-13, 0264, Oslo, Norway
| | - Ali Aminian
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mohanad AlAnsari
- Robotic Surgery Academy, International Modern Hospital, Baghdad, Iraq
| | | | - Ahmet Ziya Balta
- Faculty of Health Sciences, Istanbul Rumeli University, Istanbul, Turkey
| | | | | | - Waleed Gado
- Endocrine and Bariatric Surgery Unit, Mansoura University, Mansoura, Egypt
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Tikfu Gee
- Department of Medical Science, School of Healthcare and Medical Sciences, Sunway UniversityJalan UniversitySelangor Darul Ehsan, 47500, Bandar SunwayPetaling Jaya, Malaysia
| | | | | | | | | | | | | | | | - Selim Jalil Illan
- International Center of Excellence in Bariatric and Metabolic Surgery, Hospital BC, Tijuana, Mexico
| | - Atif Inam
- In Charge Metabolic, Thoracic and General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | | | | | | | | | | | - K S Kular
- Founding President MGB-OAGB Club, Kular Research Institute, Bija, India
| | | | - Maazulhassan
- Shalimar Medical and Dental College, Lahore, Pakistan
| | - Tarek Mahdy
- Sharjah University Hospital, Mansoura Faculty of Medicine, Sharjah, UAE
| | | | | | | | - Muhammad S Niam
- Faculty of Medicine, Brawijaya University, Dr Saiful Anwar General Hospital, Malang, Indonesia
| | - Taryel Omarov
- First Surgical Disease Department, Azerbaijan Medical University, Baku, Azerbaijan
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Aayed R Alqahtani
- New You Medical Center, King Saud University, Obesity Chair, Riyadh, Saudi Arabia
| | - Mohamed Qassem
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | - Masoud Rezvani
- Inova Fair Oaks Hospital, COE Bariatric Center, 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, VA, 22191, USA
| | - Karim Sabry
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
| | | | - Asim Shabbir
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | | | - Osama Taha
- Bariatric Unit, Plastic and Obesity Surgery Department, Assiut University Hospital, Assiut, Egypt
| | - Mohammad Talebpour
- Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Halit Eren Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Mustafa Taskin
- Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
| | | | | | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Abdelrahman Nimeri
- Chief, Bariatric and Metabolic Surgery Carolinas Medical Center, Ballantyne and Gastonia Director, Atrium Health University of North Carolina-Charlotte Campus Director, Bariatric Fellowship Program Carolinas Medical Center-Mercy, Atrium Health Weight Management Charlotte, ConcordCharlotte, NC, USA.
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Rapalino O, Pourvaziri A, Maher M, Jaramillo-Cardoso A, Edlow BL, Conklin J, Huang S, Westover B, Romero JM, Halpern E, Gupta R, Pomerantz S, Schaefer P, Gonzalez RG, Mukerji SS, Lev MH. Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy. AJNR Am J Neuroradiol 2021; 42:632-638. [PMID: 33414226 DOI: 10.3174/ajnr.a6966] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Patients infected with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) can develop a spectrum of neurological disorders, including a leukoencephalopathy of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology. MATERIALS AND METHODS Twenty-seven consecutive patients positive for SARS-CoV-2 who had brain MR imaging following intensive care unit admission were included. Seven (7/27, 26%) developed an unusual pattern of "leukoencephalopathy with reduced diffusivity" on diffusion-weighted MR imaging. The remaining patients did not exhibit this pattern. Clinical and laboratory indices, as well as neuroimaging findings, were compared between groups. RESULTS The reduced-diffusivity group had a significantly higher body mass index (36 versus 28 kg/m2, P < .01). Patients with reduced diffusivity trended toward more frequent acute renal failure (7/7, 100% versus 9/20, 45%; P = .06) and lower estimated glomerular filtration rate values (49 versus 85 mL/min; P = .06) at the time of MRI. Patients with reduced diffusivity also showed lesser mean values of the lowest hemoglobin levels (8.1 versus 10.2 g/dL, P < .05) and higher serum sodium levels (147 versus 139 mmol/L, P = .04) within 24 hours before MR imaging. The reduced-diffusivity group showed a striking and highly reproducible distribution of confluent, predominantly symmetric, supratentorial, and middle cerebellar peduncular white matter lesions (P < .001). CONCLUSIONS Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy with reduced diffusivity and obesity, acute renal failure, mild hypernatremia, anemia, and an unusual brain MR imaging white matter lesion distribution pattern. Together, these observations may shed light on possible SARS-CoV-2 pathophysiologic mechanisms associated with leukoencephalopathy, including borderzone ischemic changes, electrolyte transport disturbances, and silent hypoxia in the setting of the known cytokine storm syndrome that accompanies severe COVID-19.
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Affiliation(s)
- O Rapalino
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - A Pourvaziri
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - M Maher
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - A Jaramillo-Cardoso
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | | | - J Conklin
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - S Huang
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | | | - J M Romero
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - E Halpern
- Institute for Technology Assessment (E.H.), Massachusetts General Hospital, Boston, Massachusetts
| | - R Gupta
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - S Pomerantz
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - P Schaefer
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | - R G Gonzalez
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
| | | | - M H Lev
- From the Department of Radiology (O.R., A.P., M.M., A.J.-C., J.C., S.H., J.M.R., R.G., S.P., P.S., R.G.G., M.H.L.)
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McCarthy S, Foley CC, Dvorakova V, Quinlan C, Murphy M, Maher M. PASH syndrome with bony destruction. Clin Exp Dermatol 2019; 44:918-920. [PMID: 30666706 DOI: 10.1111/ced.13909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S McCarthy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C C Foley
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - V Dvorakova
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Quinlan
- Department of Dermatology, Beaumont Hospital, Dublin, Ireland
| | - M Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - M Maher
- Department of Radiology, University College Cork and Cork University Hospital, Cork, Ireland
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Abstract
The Koebner phenomenon is the development of lesions in traumatized skin, often with spontaneously occurring lesions elsewhere. We report a case of a woman in her 20 s presenting with discoid lesions superimposed on tattoos that she obtained many years ago. Although a few case reports have been published describing development of lesions on red tattoos attributed to photosensitivity, or koebnerization occurring less than a month following tattoo placement, our patient demonstrates a unique delayed development of discoid lesions years after obtaining her tattoos in non-sun exposed skin. Patients with conditions associated with the Koebner phenomenon must be counseled regarding forms of preventable trauma such as tattoos, and should be made aware that the Koebner phenomenon may not only manifest immediately, but can also present many years later.
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Affiliation(s)
- R F Wang
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - M Maher
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C Chung
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Vassallo T, Mizzi A, Depasquale R, Maher M, Rainford L. The development of patient information leaflets incorporating patient diversity considerations: Varicocele embolisation and fluoroscopy guided joint injection examinations. Radiography (Lond) 2018; 24 Suppl 1:S20-S27. [PMID: 30166004 DOI: 10.1016/j.radi.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 06/10/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The production of patient information leaflets (PILs) for diverse patient cohorts is challenging. This study developed varicocele and fluoroscopy guided joint injection (FLGJI) procedural PILs. METHODOLOGY Evidence-based PILs were developed, providing radiological procedural information - preparation, explanation of interventional procedures and aftercare. PIL readability was tested via validated readability programs: Flesch Kincaid and Flesch ease reading score methods. Radiology approval of PIL(s) content was confirmed. PILs were distributed with appointment information. Patient interviews were conducted just prior to examination and by telephone, 7 days post procedure. RESULTS Participants were purposely sampled (6 months): varicocele embolisation (n = 17) and FLGJI (n = 47). Overall 78.1% of all participants preferred Maltese leaflets. Varicocele embolisation patients were generally younger and a greater percentage educated to tertiary level compared to FLGJI patients. Education and age were found to be recurrent significant variables in the patient demographics and responses for both patient cohorts. Age versus education for the FLGJI cohort proved to be significant for several responses. Readability statistics identified the FLGJI leaflet as a plain English rating, the varicocele embolisation leaflet was more difficult. Patient feedback identified 'what is a varicocele?' as important to varicocele embolisation patients whereas FLGJI patients chose, 'advice about aftercare' and 'advice about pain management', highlighting differences in patients' priorities between procedures. CONCLUSION PILs provided tangible, accurate information pre and post examination. Patient involvement in achieving appropriate information informed the PILs development, which were adopted clinically. The development of tailored PILs to meet the diversity of other interventional radiology procedures is recommended.
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Affiliation(s)
- T Vassallo
- Medical Imaging Department, Mater Dei University Hospital, Radiology Department, Malta; Medical Imaging Department, Mater Dei Hospital, Msida, MSD 2090, Malta.
| | - A Mizzi
- Medical Imaging Department, Mater Dei University Hospital, Radiology Department, Malta; Medical Imaging Department, Mater Dei Hospital, Msida, MSD 2090, Malta.
| | - R Depasquale
- Medical Imaging Department, Mater Dei University Hospital, Radiology Department, Malta; Medical Imaging Department, Mater Dei Hospital, Msida, MSD 2090, Malta.
| | - M Maher
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
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Van Mil A, Castilho M, Maher M, Metz CH, Maas RGC, Hochleitner G, Groll J, Ito K, Malda J, Sluijter JPG. P463Engineering myocardial tissue in vitro using stretchable microfiber scaffolds and human iPSC-derived cardiomyocytes. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Van Mil
- University Medical Center Utrecht, Department of Cardiology, Utrecht, Netherlands
| | - M Castilho
- University Medical Center Utrecht, Department of Orthopaedics, Utrecht, Netherlands
| | - M Maher
- University Medical Center Utrecht, Department of Orthopaedics, Utrecht, Netherlands
| | - C H Metz
- University Medical Center Utrecht, Department of Cardiology, Utrecht, Netherlands
| | - RGC Maas
- University Medical Center Utrecht, Department of Cardiology, Utrecht, Netherlands
| | - G Hochleitner
- University Hospital of Wurzburg, Department for Functional Materials in Medicine and Dentistry, Wurzburg, Germany
| | - J Groll
- University Hospital of Wurzburg, Department for Functional Materials in Medicine and Dentistry, Wurzburg, Germany
| | - K Ito
- Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven, Netherlands
| | - J Malda
- University Medical Center Utrecht, Department of Orthopaedics, Utrecht, Netherlands
| | - JPG Sluijter
- University Medical Center Utrecht, Department of Cardiology, Utrecht, Netherlands
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El-Khayat H, Fouad Y, Mohamed HI, El-Amin H, Kamal EM, Maher M, Risk A. Sofosbuvir plus daclatasvir with or without ribavirin in 551 patients with hepatitis C-related cirrhosis, genotype 4. Aliment Pharmacol Ther 2018; 47:674-679. [PMID: 29314146 DOI: 10.1111/apt.14482] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Received: 07/21/2017] [Revised: 08/14/2017] [Accepted: 11/30/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Daclatasvir and Sofosbuvir combination therapy (SOF/DCV) has shown efficacy in patients with chronic hepatitis C in clinical trials. AIM To investigate the efficacy and safety of SOF/DCV for treatment of patients with hepatitis C-related liver cirrhosis genotype 4. METHODS Multicentre study involving 551 patients with liver cirrhosis genotype 4; 432 naïve patients and 119 treatment-experienced patients. All patients received SOF (400 mg) and DCV (60 mg) daily in addition to weight-based ribavirin (RBV) for 12 weeks and when RBV is contraindicated the treatment duration was extended to 24 weeks. RESULTS Sustained virological response at 12 weeks after end of treatment (SVR12) rate was 92% in naïve cirrhotic patients and 87% in previous treated patients (by ITT analysis). Virological failure was infrequent, occurring in 42 patients (8%) overall. Thirty-two (6%) were non responders; and 10 (2%) cases were relapsers, 31 patients (7%) were CTP-A and 11 (13.3%) patients were CTP-B (by ITT analysis). The most common adverse events were anaemia, fatigue, headache, pruritus. Serious side effects were recorded mainly in CTP-B cirrhotic patients including HCC and hepatic encephalopathy. CONCLUSIONS The SOF/DCV combination therapy has proven efficacy and safety in treating patients with hepatitis C-related liver cirrhosis genotype 4 in a large cohort of patients in the real world.
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Affiliation(s)
- H El-Khayat
- Gastroenterology and Endemic Medicine Department, Theodore Research Institute, Cairo, Egypt
| | - Y Fouad
- Gastroenterology and Endemic Medicine Department, Minia University, Minia, Egypt
| | - H I Mohamed
- Gastroenterology and Endemic Medicine Department, Minia University, Minia, Egypt
| | - H El-Amin
- Internal Medicine Department, Assuit University, Assuit, Egypt
| | - E M Kamal
- Gastroenterology and Endemic Medicine Department, Minia University, Minia, Egypt
| | - M Maher
- Gastroenterology and Endemic Medicine Department, Ain Shams University, Cairo, Egypt
| | - A Risk
- Rheumatology Department, Cairo University, Cairo, Egypt
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El-Khayat HR, Kamal EM, El-Sayed MH, El-Shabrawi M, Ayoub H, RizK A, Maher M, El Sheemy RY, Fouad YM, Attia D. The effectiveness and safety of ledipasvir plus sofosbuvir in adolescents with chronic hepatitis C virus genotype 4 infection: a real-world experience. Aliment Pharmacol Ther 2018; 47:838-844. [PMID: 29349793 DOI: 10.1111/apt.14502] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 07/20/2017] [Revised: 08/10/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The combination of ledipasvir plus sofosbuvir was recently approved for treatment of adolescent (12-17 years) HCV genotype 1, 4, 5 & 6 patients. However, few clinical trials have been performed in genotype 1 patients. AIM To investigate the effectiveness and safety of ledipasvir plus sofosbuvir in chronic HCV adolescent patients with genotype 4 in the real world. METHODS This prospective multicentre (six centres) open-label study included 144 adolescent chronic HCV patients with genotype 4 (mean age 14 ± 2, 69% males). All patients received a combination tablet containing 400 mg sofosbuvir and 90 mg ledipasvir once daily for 12 weeks. Laboratory and virological markers were evaluated at baseline, week 4, week 8 and week 12 (EOT), and 12 weeks after end of treatment (SVR12). RESULTS SVR12 was observed in 142/144 patients (99%). The relapsers occurred in previous naïve patients (n = 2/128, 2%), while the experienced patients showed 100% SVR12. SVR12 was 98% in F0/F1 patients in comparison to 100% in F2 patients (P = 0.552). No serious side effects were observed, nor was treatment discontinuation or death. Headache was the most common side effect in all patients (20%). In experienced patients, pruritus (31%, P = 0.007), diarrhoea (44%, P < 0.001) and skin rash (19%, P = 0.002) were higher than in naïve patients. CONCLUSIONS A ledipasvir plus sofosbuvir regimen is well tolerated and effective, and can be used safely in treating adolescent patients with chronic hepatitis C genotype 4.
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Affiliation(s)
- H R El-Khayat
- Department of Gastroenterology, Hepatology and Endemic Medicine, Theodore Bilharz Research Institute, Cairo, Egypt
| | - E M Kamal
- Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University Hospitals, Minia, Egypt
| | - M H El-Sayed
- Rheumatology Department, Cairo University Hospitals, Cairo, Egypt
| | - M El-Shabrawi
- Rheumatology Department, Cairo University Hospitals, Cairo, Egypt
| | - H Ayoub
- Department of Gastroenterology, Hepatology and Endemic Medicine, Ain Shams University Hospitals, Cairo, Egypt
| | - A RizK
- Rheumatology Department, Cairo University Hospitals, Cairo, Egypt
| | - M Maher
- Department of Gastroenterology, Hepatology and Endemic Medicine, Egyptian Military Academy, Cairo, Egypt
| | - R Y El Sheemy
- Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University Hospitals, Minia, Egypt
| | - Y M Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Minia University Hospitals, Minia, Egypt
| | - D Attia
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Beni-suef University, Beni-suef, Egypt
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Caplice N, Devoe M, Choi J, Dahly D, Spitzer E, Van Guens R, Maher M, Tuite D, Kerins D, Kelly P, Kearney P, Curtin R, Vaughan C, Eustace J, McFadden E. P2125Randomised placebo controlled trial evaluating the safety and efficacy of intracoronary insulin like growth factor 1 post percutaneous intervention for acute myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2125] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Jolly K, Hammond D, Maher M, Evriviades D. New technique for bloodless surgery to the scalp. Br J Oral Maxillofac Surg 2016; 54:e55-6. [PMID: 26948705 DOI: 10.1016/j.bjoms.2016.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 02/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- K Jolly
- Queen Elizabeth Hospital Birmingham.
| | | | - M Maher
- Queen Elizabeth Hospital Birmingham
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El Khiyat I, Alouan A, Mahdi Y, Kharmoum J, Cherkaoui O, Tachfouti S, Amazouzi A, Daoudi R, Maher M, Cherradi N. Hyperplasie lymphoïde réactionnelle de l’orbite avec extension intracrânienne. J Fr Ophtalmol 2015; 38:e211-3. [DOI: 10.1016/j.jfo.2015.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/06/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
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Doyle MBM, Vachharajani N, Wellen JR, Lowell JA, Shenoy S, Ridolfi G, Jendrisak MD, Coleman J, Maher M, Brockmeier D, Kappel D, Chapman WC. A novel organ donor facility: a decade of experience with liver donors. Am J Transplant 2014; 14:615-20. [PMID: 24612713 DOI: 10.1111/ajt.12607] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 10/28/2013] [Accepted: 11/20/2013] [Indexed: 01/25/2023]
Abstract
Transplant surgeons have historically traveled to donor hospitals, performing complex, time-sensitive procedures with unfamiliar personnel. This often involves air travel, significant delays, and frequently occurs overnight.In 2001, we established the nation's first organ recovery center. The goal was to increase efficiency,reduce costs and reduce surgeon travel. Liver donors and recipients, donor costs, surgeon hours and travel time, from April 1,2001 through December 31,2011 were analyzed. Nine hundred and fifteen liver transplants performed at our center were analyzed based on procurement location (living donors and donation after cardiac death donors were excluded). In year 1, 36% (9/25) of donor procurements occurred at the organ procurement organization (OPO) facility, rising to 93%(56/60) in the last year of analysis. Travel time was reduced from 8 to 2.7 h (p<0.0001), with a reduction of surgeon fly outs by 93% (14/15) in 2011. Liver organ donor charges generated by the donor were reduced by37% overall for donors recovered at the OPO facility versus acute care hospital. Organs recovered in this novel facility resulted in significantly reduced surgeon hours, air travel and cost. This practice has major implications for cost containment and OPO national policy and could become the standard of care.
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Khan K, Susan P, Bourke L, Maher M, Crush L, Kennedy M, Henry M. 133 Radiological histological features and clinical outcome of lung cancer with coexistent idiopathic pulmonary fibrosis. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70134-5] [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: 11/24/2022]
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Sedano-Balbas S, Lyons M, Cleary B, Murray M, Gaffney G, Maher M. Placental prothrombin mRNA levels in APC resistance (APCR) women with increased placental fibrin deposition. Ir J Med Sci 2013; 183:477-80. [PMID: 24362889 DOI: 10.1007/s11845-013-1056-1] [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] [Received: 10/13/2013] [Accepted: 12/03/2013] [Indexed: 11/29/2022]
Abstract
We investigated the link between the mRNA of the procoagulant prothrombin in the placental tissue with the increased placental fibrin deposition associated with activated protein C resistance (APCR). Women with APCR were not found to produce higher levels of prothrombin transcript compared to women with a normal APC ratio. This indicates that accumulated fibrin in the placenta is not the consequence of too much production of the procoagulant prothrombin transcript, but may be associated with altered function of other haemostatic factors interacting with APC in the placenta.
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Affiliation(s)
- S Sedano-Balbas
- Molecular Diagnostics Research Group, National Centre for Biomedical Engineering Science, National Diagnostics Centre, National University of Ireland, Galway, Ireland,
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Casey R, Slattery D, Prendeville S, Moore M, Maher M, O'Halloran D. SDHB gene positive metastatic paraganglioma associated with lesions which demonstrate both positive and negative uptake of 18FDG PET and 131MIBG. QJM 2013; 106:1035-7. [PMID: 23708795 DOI: 10.1093/qjmed/hct118] [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: 11/14/2022] Open
Affiliation(s)
- R Casey
- Department of Endocrinology, Cork University Hospital, Cork, Ireland.
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Edgeworth D, Brohan J, O'Neill S, Maher M, Breen D, Murphy D. Pulmonary sequelae of severe H1N1 infection treated with high frequency oscillatory ventilation. Ir Med J 2013; 106:249-252. [PMID: 24282900] [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: 06/02/2023]
Abstract
During the recent influenza A (H1N1) pandemic, due to severe respiratory failure many patients required treatment with alternative ventilator modalities including High Frequency Oscillatory Ventilation (HFOV). We present four such patients treated with HFOV at an academic, tertiary referral hospital in Ireland. We detail outcomes of clinical examination, pulmonary function testing, quality of life assessment and radiographic appearance on CT Thorax at follow-up at 6 months. Further clinical assessment and pulmonary function testing were performed at median 19 months (range 18-21 months) post-discharge. At initial review all patients were found to have reduced gas transfer (median predicted DLCO 74%) with preservation of lung volumes and normal spirometrical values at 6 months (median FVC 5.42L [101% predicted] and FEV14.5L [101.2% predicted] respectively), with improvements in gas transfer (median predicted DLCO 83%)at subsequent testing. Post-inflammatory changes on CT thorax at 6 months were seen in all 4 cases. To our knowledge this is the first report to document the long-term effects of severe H1N1 infection requiring high frequency oscillation on respiratory function. We conclude that the effects on respiratory function and pulmonary radiological appearance are similar to those observed following conventional treatment of Acute Respiratory Distress Syndrome [ARDS].
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Soufi G, Hajji Z, Imdary I, Slassi N, Essakalli Housseini L, Maher M, Benchekroun N, Boulanouar A, Berraho A. [Retrobulbar optic neuropathy secondary to an undifferentiated carcinoma of the sphenoid sinus]. J Fr Ophtalmol 2012; 35:792-7. [PMID: 23141167 DOI: 10.1016/j.jfo.2012.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 06/29/2012] [Accepted: 06/29/2012] [Indexed: 12/23/2022]
Abstract
Undifferentiated carcinoma of the paranasal sinuses is a rare malignant tumor, characterized by rapid growth, local/regional invasion, metastatic potential and poor prognosis despite aggressive treatment. Clinically, this tumor may manifest as episodes of epistaxis, headache or ophthalmic signs, particularly oculomotor nerve palsies, optic atrophy or even proptosis in the case of orbital extension. We report the case of a patient admitted with a left retrobulbar optic neuropathy, which led to a diagnosis of undifferentiated carcinoma of the sphenoid sinus.
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Affiliation(s)
- G Soufi
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Maroc.
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O'Mahony A, O'Sullivan T, Walsh Y, Vaughan A, Maher M, Fitzgerald GF, van Sinderen D. Characterisation of Antimicrobial Producing Lactic Acid Bacteria from Malted Barley. Journal of the Institute of Brewing 2012. [DOI: 10.1002/j.2050-0416.2000.tb00531.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Harmouch A, Chefchaouni MC, Maher M, Sefiani S. [Role of the pathologist in the diagnosis of palpebral keratoacanthoma: case report and literature review]. J Fr Ophtalmol 2012; 35:816.e1-3. [PMID: 23021084 DOI: 10.1016/j.jfo.2012.05.001] [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: 03/12/2012] [Revised: 04/29/2012] [Accepted: 05/03/2012] [Indexed: 11/19/2022]
Abstract
We report the case of a keratoacanthoma of the lower lid in a 14-year-old girl posing diagnostic difficulty with differentiating the lesion from a verrucous squamous cell carcinoma on histologic examination of an incisional biopsy. It was only upon complete excision of the tumor that the diagnosis of keratoacanthoma could be made and that of malignancy ruled out. We discuss the clinical and histologic diagnostic criteria for keratoacanthoma and assert that wide biopsy is essential for adequate morphologic study to enable better therapeutic management.
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Affiliation(s)
- A Harmouch
- Service d'anatomie pathologique, faculté de médecine et de pharmacie, hôpital oto-neuro-ophtalmologique, Rabat, Maroc.
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O'Regan K, Filan P, Pandit N, Maher M, Fanning N. Image quality associated with the use of an MR-compatible incubator in neonatal neuroimaging. Br J Radiol 2012; 85:363-7. [PMID: 22457402 DOI: 10.1259/bjr/66148265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES MRI in the neonate poses significant challenges associated with patient transport and monitoring, and the potential for diminished image quality owing to patient motion. The objective of this study was to evaluate the usefulness of a dedicated MR-compatible incubator with integrated radiofrequency coils in improving image quality of MRI studies of the brain acquired in term and preterm neonates using standard MRI equipment. METHODS Subjective and objective analyses of image quality of neonatal brain MR examinations were performed before and after the introduction of an MR-compatible incubator. For all studies, the signal-to-noise ratio (SNR) was calculated, image quality was graded (1-3) and each was assessed for image artefact (e.g. motion). Student's t-test and the Mann-Whitney U-test were used to compare mean SNR values. RESULTS 39 patients were included [mean gestational age 39 weeks (range 30-42 weeks); mean postnatal age 13 days (range 1-56 days); mean weight 3.5 kg (range 1.4-4.5 kg)]. Following the introduction of the MR-compatible incubator, diagnostic quality scans increased from 50 to 89% and motion artefact decreased from 73 to 44% of studies. SNR did not increase initially, but, when using MR sequences and parameters specifically tailored for neonatal brain imaging, SNR increased from 70 to 213 (p=0.001). CONCLUSION Use of an MR-compatible incubator in neonatal neuroimaging provides a safe environment for MRI of the neonate and also facilitates patient monitoring and transport. When specifically tailored MR protocols are used, this results in improved image quality.
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Affiliation(s)
- K O'Regan
- Department of Radiology, Cork University Hospital, Cork, Ireland.
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Harmouch A, Bellarbi S, Derkaoui Hassani F, Maher M, Elkhamlichi A, Sefiani S. [Cerebral atypical rhabdoid/teratoid tumor: report of two cases]. Neurochirurgie 2012; 58:254-7. [PMID: 22464603 DOI: 10.1016/j.neuchi.2012.02.003] [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: 02/12/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
Abstract
The cerebral atypical rhabdoid/teratoid tumor constitutes one of the most aggressive tumors of children. Such tumors are equally characterized by a critically and speedly mortal development. The optimal management of such tumors remains unknown. The authors report two cases of cerebral atypical rhabdoid teratoid tumor in 8- and 10-year girls and discuss the histological features, immunochemistry study, prognosis and treatment of these rare tumors.
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Affiliation(s)
- A Harmouch
- Service d'anatomie pathologique, faculté de médecine, université Mohammed V, hôpital des spécialités, Souissi, Rabat, Maroc.
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Harmouch A, Taleb M, Lasseini A, Maher M, Sefiani S. Epidemiology of pediatric primary tumors of the nervous system: A retrospective study of 633 cases from a single Moroccan institution. Neurochirurgie 2012; 58:14-8. [DOI: 10.1016/j.neuchi.2012.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
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Arshed MS, Qureshi S, Channa A, Maher M. Audit of splenectomy at Jinnah Postgraduate Medical Centre, Karachi. J Ayub Med Coll Abbottabad 2011; 23:79-81. [PMID: 23272441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Splenectomy is often performed in patients with heamatalogical diseases or trauma who are at high risk of complications. Our aim is to perform an audit on splenectomy in order to determine the reasons for the operation, its complication and compliance with the recent recommendations for post-splenectomy patients at Jinnah Postgraduate Medical Centre. DESIGN It is a Descriptive study conducted in surgical ward 2 at Jinnah Postgraduate Medical Centre from June 2003 to June 2008. METHODS A retrospective review of hospital records of surgical ward 2 of consecutive splenectomy patients with a mean follow up of 12 months. RESULTS Fifty-five patients underwent splenectomy in 6 years duration. The mean age was 26.7 years. The indication for splenectomy was mainly heamatological diseases and trauma. Vaccination was done in 83.6% patients. Twelve patients had postsplenectomy complications, although there were no cases of OPSI. Mean hospital stay was 6.4 days. CONCLUSION We still lack compliance with the standard guidelines for post-splenectomy patients. There is space for an improvement of the vaccination rate and prophylactic antibiotic. Patients should be counselled for the risk of OPSI and should have a splenectomised card for prompt treatment. There is need for careful documentation of this important health risk and counselling of patients in the discharge summaries.
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El Khannoussi B, Harmouch A, Boumezaoued M, Maher M, Sefiani S. Les chordomes: à propos de sept cas. ONCOLOGIE 2010. [DOI: 10.1007/s10269-010-1966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Harmouch A, Cherif Chefchaouni M, Maher M, Sefiani S. Tumeur fibreuse solitaire de l’orbite: à propos de deux cas avec revue de la littérature. ONCOLOGIE 2010. [DOI: 10.1007/s10269-010-1967-7] [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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Shamil N, Quraishi S, Riaz S, Channa A, Maher M. Is nasogastric decompression necessary in elective enteric anastomosis? J Ayub Med Coll Abbottabad 2010; 22:23-26. [PMID: 22455254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Placement of nasogastric tube is common surgical practice after bowel anastomosis. What is to be achieved by this prophylaxis is gastric decompression, a decreased likelihood of nausea and vomiting, decreased distension, less chance of pulmonary aspiration and pneumonia, less risk of wound separation and infection, less chance of fascial dehiscence and hernia, earlier return of bowel function and earlier discharge from hospital. We conducted a prospective observational study in Surgical Ward 2, Jinnah Postgraduate Medical Centre, Karachi from January 2008 to December 2009 to assess whether routine use of nasogastric decompression in elective enteric anastomosis can be safely omitted. METHOD Patients who underwent elective enteric anastomosis were included in this study. These patients were managed prospectively without nasogastric decompression. Outcome were measured in terms of time of passing flatus, nausea, vomiting, abdominal distension, pulmonary complications, wound infection, wound dehiscence, anastomotic leak, length of hospital stay and mortality. RESULTS Except for incidence of minor symptoms like nausea or vomiting, omission of NG tube did not lead to any serious complication like anastomotic leak, pulmonary complications wound dehiscence or death. CONCLUSION Nasogastric decompression can safely be omitted from a routine part of postoperative care after elective enteric anastomosis.
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Affiliation(s)
- Nadia Shamil
- Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
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Qureshi MS, Ali S, Parkash D, Maher M. Short term clinical outcome of stapled haemorrhoidectomy. J PAK MED ASSOC 2010; 60:335-337. [PMID: 20527600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To evaluate short term clinical outcome after stapled haemorrhoidectomy. METHODS From May 2005 to Oct 2007, 55 patients with symptomatic late 2nd and 3rd degree haemorrhoids were admitted to Surgical Ward 2, Jinnah Postgraduate Medical Centre. All of them underwent stapled haemorrhoidectomy after routine preoperative preparation. Postoperatively, pain scores, complications, hospital stay, return to routine activities, and patient satisfaction was recorded on a structured proforma. Follow-up was done weekly for 4weeks then at 2nd, 3rd and 6th month. RESULTS In 55 consecutive patients stapled haemorrhoidectomy was done with an operative time range of 21-30 minutes, average hospital stay was 2 days and return to daily routine activities was within one week in majority of the patients. All patients were followed at the outpatient clinic for six months postoperatively. No deterioration of symptoms occurred during the follow up. Recurrence or procedure related adverse affects, in particular impaired continence or persistent anal pain were absent. CONCLUSION Despite the cost and difficult access, stapled haemorrhoidectomy results in less postoperative pain, fast recovery and patient satisfaction.
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Soomro SA, Memon SA, Mohammad N, Maher M. Swiss roll operation for giant fibroadenoma. J Ayub Med Coll Abbottabad 2009; 21:76-78. [PMID: 20364747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Fibroadenoma 5 cm or more is called giant fibroadenoma. Giant fibroadenoma can distort the shape of breast and causes asymmetry, so it should be excised. There are several techniques for excision of giant fibroadenoma. In our technique we remove them through cosmetically acceptable circumareolar incision to maintain the shape and symmetry of breast. The objectives were to assess the cosmetic results of Swiss roll operation for giant fibroadenoma. The study was conducted for six years from January, 2002 to December, 2007. METHODS Seventy patients of giant fibroadenoma were included in this study. They were diagnosed on history and clinical examination supported by ultrasound and postoperative histopathological examination. Data were collected from outpatient department and operation theatre. Swiss roll operation was performed under general anaesthesia. RESULTS Mean tumor size was 6.38 cm. Three cm and 4 cm incisions were used for tumour < or = 6 cm and > 6 cm in size respectively. Skin closed with Vicryl 3/0 subcuticular stitches. Sixteen out of 70 patients had no scar while others hadminimal scar. All patients had normal shape and symmetry of breast. On histopathology fibroadenoma was confirmed. CONCLUSION Giant fibroadenoma should be removed through cosmetically acceptable cicumareolar incision especially in unmarried young females who have small breast. Swiss-roll operation is superior in maintaining the shape and symmetry of breast. No major complication was found in our series except seroma formation in 10 patients.
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Affiliation(s)
- Saleem A Soomro
- Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi.
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Ahmed WU, Qureshi H, Maher M, Arif A. Achalasia in a gastroenterology unit of Karachi. J PAK MED ASSOC 2008; 58:661-664. [PMID: 19157316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To study the presentation of Achalasia and compare the response of pneumatic dilatation with surgery. METHODS Retrospective analysis of patient's records (January 2000-December 2005) from outpatients department of Pakistan Medical Research Council), Jinnah Postgraduate Medical Centre, Karachi was done. All patients with Achalasia were analyzed. As a protocol endoscopy, esophageal manometry, esophageal transit time and barium swallow was done to establish the diagnosis. Surgery and endoscopic guided pneumatic dilatation were offered to these patients as treatment options. Patients undergoing surgery or pneumatic dilatation were later followed to assess the efficacy and those not responding to second dilatation were also operated and follow up of all these cases were noted. RESULTS Forty-six patients (24 males, 22 females) with a mean age of 39.8 +/- 15.9 years were analyzed. Dysphagia was the primary symptom in thirty eight patients (83%) followed by vomiting and epigastric pain. Pneumatic dilatation was performed in 32 out of forty-six patients. Out of these cases 22 (69%) had single, and 10 (31%) had two dilatations. Two patients (6%) had perforation, one required emergency surgery, another patient was managed conservatively and recovery was unremarkable. Six patients (19%) later required surgery. Fourteen cases opted for surgery as a primary treatment. Out of 20 patients operated, four (20%) required post operative dilatation and one (5%) developed gastro-esophageal reflux. CONCLUSIONS Achalasia is prevalent in young age, in both sexes almost equally. Pneumatic dilatation is safe and effective, as it can be managed on outpatient basis with little morbidity and 81% success rate. Surgery is still an effective procedure with comparable 80% success rate.
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Affiliation(s)
- Waquar Uddin Ahmed
- Pakistan Medical Research Council, Research Centre, Jinnah Postgraduate Medical Centre, Karachi
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Sedano S, Gaffney G, Mortimer G, Lyons M, Cleary B, Murray M, Maher M. Activated Protein C Resistance (APCR) and Placental Fibrin Deposition. Placenta 2008; 29:833-7. [DOI: 10.1016/j.placenta.2008.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 05/30/2008] [Accepted: 06/25/2008] [Indexed: 11/28/2022]
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Ech-Charif S, Benhammou A, Maher M, Séfiani S. [Solitary myofibroma of the mandible: a case report]. Rev Laryngol Otol Rhinol (Bord) 2008; 129:337-340. [PMID: 19408523] [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: 05/27/2023]
Abstract
OBJECTIVES Infantile myofibromatosis (IMF) are integrated in the group of fibromatosis juvenile-type which are benign mesenchymal lesions, characterized morphologically by a proliferation of fibroblasts and myofibroblastes, with perivascular pattern. Through a case of solitary myofibroma of the mandible, we will emphasize anatomo-clinical features and differential diagnosis. MATERIALS AND METHODS We report a case illustrating solitary myofibroma of the mandible in 18 month old infant. RESULTS The histological diagnosis was done on the identification of two separate components, a fascicular myofibroblastic pattern at the periphery with a hemangiopericytoma like pattern in the centre. Both components positive for alpha-smooth muscle actin and vimentin. DISCUSSION Solitary IMF is characterised by a single lesion arising from cutaneous, bony or soft tissues. Morphological and immunohistochemical examination allow the diagnosis of the typical form. The differential diagnosis includes other benign spindle cells tumours. The prognosis is excellent with possibility to regress spontaneously.
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Affiliation(s)
- S Ech-Charif
- CHU, Hôpital des Spécialités, Service d'Anatomie pathologique, Rabat, Maroc.
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Baloch MN, Aslam T, Maher M. Surgical management of hyperparathyroidism. J Coll Physicians Surg Pak 2007; 17:683-5. [PMID: 18070577 DOI: 11.2007/jcpsp.683685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Accepted: 10/24/2007] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the efficacy of focused parathyroidectomy for adenoma and total parathyroidectomy with forearm autotransplantation for hyperplasia in maintaining serum calcium levels. STUDY DESIGN Observational case series. PLACE AND DURATION OF STUDY Department of General Surgery (Ward-2), Jinnah Postgraduate Medical Centre, Karachi, from January, 2002 to December, 2004. PATIENTS AND METHODS Sixteen patients were admitted in this time period. Eleven of these patients had primary hyperparathyroidism and 4 had secondary hyperparathyroidism due to chronic renal failure. Pre-operative localization was done with Sestamibi scan and ultrasound of neck while methylene blue was used for intra-operative localization. All patients with primary hyperparathyroidism had single gland disease and were treated with focused parathyroidectomy. In 4 patients with parathyroid hyperplasia, total parathyroidectomy with forearm autotransplantation was done. RESULTS In the postoperative period, 3 patients developed hypocalcemia but they were managed on oral calcium and vitamin-D supplements. All of the remaining patients became normocalcaemic and there were no major complications. Mean hospital stay was 7-days. CONCLUSION Focused parathyroidectomy for single gland disease and total parathyroidectomy with forearm auto-transplantation for hyperplasia was a satisfactory treatment for patients in this series.
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Affiliation(s)
- M Naseem Baloch
- Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi
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Lavery R, Glennon M, Houghton J, Nolan A, Egan D, Maher M. Investigation of DAZ and RBMY1 gene expression in human testis by quantitative real-time PCR. ACTA ACUST UNITED AC 2007; 53:71-3. [PMID: 17453684 DOI: 10.1080/01485010600915228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study developed quantitative real-time PCR assays for the DAZ and RBMY1 genes to determine the copy number of RNA extracted from testicular biopsies from a cohort of normospermic controls (n=6) and azoospermic males (n=17) including two males with Y-chromosome microdeletions (AZFc and AZFb + c). All patients underwent testicular sperm extraction (TESE) for intracytoplasmic sperm injection (ICSI). Forty percent of the azoospermic cohort showed a significant reduction in the copies of at least one of the genes (DAZ P=0.003; RBMY1 P=0.009). The histopathology of these patients ranged from Sertoli cell only (SCO) to severe hypospermatogenesis with interstitial fibrosis. The patient with the AZFb + c deletion lacked expression of DAZ and RBMY1 and had a histopathology of SCO. The patient with the AZFc deletion had reduced expression of RBMY1 and no DAZ expression with a histopathology of spermatocyte arrest. The quantitative real-time PCR assays for DAZ and RBMY1 gave positive predictive values of 78% and 70%, respectively for the recovery of sperm from testicular biopsy.
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Affiliation(s)
- R Lavery
- National Diagnostics Centre, National University of Ireland, Galway, Ireland
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Lezrek M, Dahreddine M, Bencherif Z, Karim A, Maher M, Tachfouti S, Karmane A, Mohcine Z. [Bilateral primary pseudotumoral palpebral amyloidosis. A case report]. J Fr Ophtalmol 2007; 30:e17. [PMID: 17646744 DOI: 10.1016/s0181-5512(07)89672-0] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ocular amyloidosis is infrequent, and the palpebral location is uncommon. It usually has a primary localized form, but can occur in systemic or familial amyloidosis. The diagnosis is mainly made by histopathology. Its treatment is surgical and the prognosis depends on clinical presentation and recurrences. We report the case of a 54-year-old woman with no medical history of the disease, who had bilateral isolated palpebral amyloidosis presenting as bilateral upper lid swelling with ptosis and corneal dystrophy. Diagnosis was confirmed by palpebral biopsy and the patient underwent excision of the involved lid tissue with reconstruction of the affected lid with cartilage autograft. Clinical progression showed improvement of the ptosis and the patient's comfort. Although rare, palpebral amyloidosis poses management problems, particularly in advanced cases, because of corneal complications and recurrence.
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Affiliation(s)
- M Lezrek
- Service d'Ophtalmologie A, Hôpital des Spécialités, Rabat, Morocco.
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Abstract
Ileosigmoid knotting or compound volvulus is a very uncommon cause of intestinal obstruction, which is associated with significant morbidity and mortality. A case of compound volvulus is reported in a 24 years old male patient who presented with diagnostic dilemma.
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Affiliation(s)
- Tahira Aslam
- Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi.
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O'Connor L, Ruttledge M, Maher M. P1863 Specific detection of Candida albicans using real-time PCR on the LightCycler™. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71702-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Glynn B, Lacey K, Palta P, Kaplinski L, Remm M, Barry T, Smith T, Maher M. P1408 Demonstration of the application of the tmRNA transcript of the bacterial ssrA gene as a molecular diagnostic target using a combination of NASBA and BiaCore technologies. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71247-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wernecke M, Mullen C, Maher M, Barry T, Smith T. P1422 Development and validation of a real-time PCR assay for the detection of group B Streptococcus in pregnant women. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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O’Grady M, Maher M, Troy D, Moloney A, Kerry J. An assessment of dietary supplementation with tea catechins and rosemary extract on the quality of fresh beef. Meat Sci 2006; 73:132-43. [DOI: 10.1016/j.meatsci.2005.11.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Revised: 11/03/2005] [Accepted: 11/03/2005] [Indexed: 10/25/2022]
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Aslam T, Masood R, Maher M. Early complications following pancreatico-duodenectomy. J Coll Physicians Surg Pak 2006; 15:708-11. [PMID: 16300708 DOI: 11.2005/jcpsp.708711] [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] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Accepted: 08/20/2005] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the mortality and morbidity in patients after Whipple's pancreaticoduodenectomy. DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of General Surgery (Ward-2), Jinnah Postgraduate Medical Centre, Karachi. PATIENTS AND METHODS All the patients who underwent standard Whipple's procedure were followed up during their hospital stay for early postoperative complication. The indicators for the development of complications included daily nasogastric (NG) tube output for delayed gastric emptying, ultrasound abdomen for intra-abdominal collections, presence of blood in drains and NG tubes for haemorrhage and measuring serum amylase for pancreatitis. RESULTS Out of 30 patients, 3 patients died in early postoperative period with 10% mortality while 26.67% had wound infection, 16.67% had chest complications, 13.34% developed intra-abdominal collections, 10% had haemorrhage, 3.34% had delayed gastric emptying, 3.34% had pancreatic fistula and 3.34% had organ failure. CONCLUSION In this series the procedure was associated with decreased mortality due to increased experience and skills but morbidity was still high due to lack of facilities for the detection and management of postoperative complications. It should only be performed in tertiary care centres with expert surgical teams and facilities for adequate management of postoperative complications.
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Affiliation(s)
- Tahira Aslam
- Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi.
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Abstract
The androgen receptor (AR) gene, located on the X chromosome, is an important regulator of human spermatogenesis. In the past decade, the link between the CAG polyglutamine tract, situated on exon one of the AR gene, and reduced spermatogenesis has become a controversial one. Alterations in the length of the CAG polyglutamine tract have been associated with prostate cancer at a reduced intrinsic length and neuromuscular diseases at a CAG repeat length of > or = 40. Minimal intermediate increases have been linked with depressed spermatogenesis in infertile males. Asian and Australian groups have published an association between increased CAG repeat length and reduced spermatogenesis while many European studies have found no such association. The aim of this study was to document the association between increased CAG repeat length and reduced spermatogenesis in a group of Irish infertile males and controls known to have fathered at least one child. The study employed the ABI 377 DNA sequencer to size the CAG repeat region of exon one of the AR gene in each group. Statistical analysis revealed no actual link between the length of the CAG tract and a reduction of spermatogenesis in a cohort of infertile patients (n = 66) of Irish ethnic origin when compared to a fertile control group (n = 77) (p = 0.599).
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Affiliation(s)
- R Lavery
- National Diagnostics Centre, National University of Ireland, Galway.
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Sefiani S, Amarti A, Boulaadas M, Maher M, Saidi A. [Synovial sarcoma of the head and neck: two cases report]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:53-6. [PMID: 16080650] [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: 05/03/2023]
Abstract
UNLABELLED Synovial sarcomas are soft tissue tumors that rarely occur in the head and neck The purpose of this report is to accrue data on this sarcoma at a rare site, and to highlight the histopathological differential diagnosis with other cervical tumors. MATERIALS AND METHODS Two cases of cervico-facial tumors were reported in 26 and 27 year old women. RESULTS Histologically, these tumors were classified into monophasic and biphasic variants. Immunohistochemistry plays a major part in the differential diagnosis, enabling the demonstration of epithelial differentiation. Radical surgery was the mainstay of treatment with post-operative radiotherapy for residual disease in one case. Local recurrence was developed in the patient who had only surgical treatment. DISCUSSION Synovial sarcomas are a rare soft tissue malignancies and the head and neck region location accounts for 3-5% of them. The rarity of this tumor in the head and neck and its multitude of his histopathologic features are responsible for frequent initial misdiagnosis. Histologic, immunohistochemic and characteristic chromosomal translocation findings are necessary for diagnosis. The poor prognosis of this sarcoma justified a radical surgery with post-operative radiotherapy.
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Affiliation(s)
- S Sefiani
- Hôpital Oto-Neuro-Ophtalmologique, Laboratoire d'Anatomie Pathologique, Rabat, Maroc.
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Ellsmere J, Mortele K, Sahani D, Maher M, Cantisani V, Wells W, Brooks D, Rattner D. Does multidetector-row CT eliminate the role of diagnostic laparoscopy in assessing the resectability of pancreatic head adenocarcinoma? Surg Endosc 2004; 19:369-73. [PMID: 15624058 DOI: 10.1007/s00464-004-8712-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [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: 02/02/2004] [Accepted: 09/29/2004] [Indexed: 02/01/2023]
Abstract
BACKGROUND We hypothesized that the high-quality images from multidetector-row computed tomography (MDCT) would lead to improved sensitivity and specificity for predicting resectable pancreatic head adenocarcinoma, thus diminishing the value of staging laparoscopy. METHODS Forty four consecutive patients underwent thin-section dual-phase MDCT to stage their tumor, followed by an attempted pancreaticoduodenectomy. Four radiologists who were blinded to the operative outcome reviewed the scans and graded the presence of distant and nodal metastases, as well as the degree of arterial and portal involvement. The radiologic criteria for resectability were no distant metastasis, a patent portal vein, and < 50% arterial involvement. RESULTS The overall resectability for this cohort was 52% (23/44). The 21 unresectable cases, included five liver metastases, three peritoneal metastases, and 13 locally invasive tumors. The negative margin resection rate was 34% (15/44). There were no portal vein resections. The sensitivity and specificity of MDCT for predicting resectability were 96% (22/23) and 33% (7/21), respectively. In this cohort, the positive and negative predictive values were 61% (22/36) and 87.5% (7/8), respectively. As determined by univariate logistic regression, only the degree of arterial involvement was a significant predictor of resectability (p = 0.02). As determined by multivariate logistic regression using both arterial and portal involvement, arterial involvement was predictive (p = 0.03) but portal vein involvement was not (p = 0.45). CONCLUSIONS Despite the improvements in image quality obtained with multidetector-row technology, CT imaging remains a relatively nonspecific test for predicting resectability in patients with adenocarcinoma of the head of the pancreas. Minimally invasive modalities with higher specificity, particularly laparoscopy, continue to have an important role in staging pancreatic head adenocarcinoma.
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Affiliation(s)
- J Ellsmere
- Department of Surgery, Massachusetts General Hospital, 15 Parkman St, Boston, MA 02114, USA
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